Antibiotics

Question 1

daunorubicin/doxorubicin

Answer 1

• chemotherapeutic abxs
• products of fungi, inhibit DNA synthesis
• rapid clearance from plasma into heart, lungs, kidneys, liver
• don’t cross BBB
• urine becomes red for 2-3 days after administration

Question 2

effect on heart

Answer 2

• cardiomyopathy–dose-related, irreversible
  1) acute form: nonspecific ST changes and dysrhythmia–including PVCs and SVD, Left axis deviation
• decreased QRS
• resolves 1-2 months (except for QRS dec)
  2) insidious form: dry nonproductive cough, with rapid heard failure–irreversible

Question 3

SBE prophylaxis:

Answer 3

• poor po hygiene more likely than surgery to be associated with IE
• GU/GI procedures don’t place patients at high risk

Question 4

SBE prophylaxis high risk cardiac procedures

Answer 4

• prothesthetic valves
• hx IE
• cyanotic CHD (unreparied TOF)
• recently repaired <6 mos CHD
• repaird CHD with residual defects
• cardia transplant with evidence of valvulopathy

Question 5

procedures with highest risk of bacteremia

Answer 5

• dental procedures: gigival, peri-apical, oral mucosa
• infected skin, musculoskeletal tissues
• incision or bx of respiratory tract