Antibiotics

Question 1

Are PCN antibiotics bactericidal or static?

Answer 1

PCN- bactericidal (effective on gram + and some gram -)

Question 2

PCN ADR’s

Answer 2

Diarrhea, Cdiff, vaginitis, steven johnsons

Question 3

In pt with Mono, which Abx do you avoid/ what do you give?

Answer 3

Avoid: Amoxicillin (rash caused)
Give: PCN VK or macrolide if allergic

Question 4

Which abx for mastitis?

Answer 4

Dicloxacillin

Question 5

Anaphylaxis and angioedema are what type of reactions?

Answer 5

Type 1 IgE-mediated reactions

Question 6

Macrolides are what?

Answer 6

Bacteriostatic, cover gram + (staph aureus, strep pyo, mycoplasma and chlamydia)

Question 7

Macrolide ADR’s

Answer 7

GI distress, ototoxicity, cholestatic jaundice, QT prolongation (risk of torsades de pointes)

Question 8

What are tetracyclines?

Answer 8

“Cyclines”

Bacteriostatic.

Question 9

Do not use tetracyclines when?

Answer 9

• Under 8 years
• (13-14 okay for acne tx- topical)
• Pregnancy

Question 10

Tetracycline’s ADR’s

Answer 10

Photo sensitivity, teeth staining, esophageal ulcerations, skeletal defects if pregnant mother takes this.

Question 11

Acne and tetracyclines

Answer 11

• Mild= OTC topicals 1st
• Mild not responding= prescription topicals (benzoyl peroxide, erythromycin, retin-A, azelaic acid)
• Moderate not responding= topical tetracycline can be added. (tetra or mino used)

Question 12

When to take tetracyclines?

Answer 12

Best on empty stomach, 1 hour before meals or 2 hours after meals. (Binds to minerals Ca, Iron, Mg, Zinc)

Question 13

Tetracycline pearl!!

Answer 13

Advise to discard when expired, can cause nephropahty or Fanconi syndrome if used.

Question 14

What are sulfonamides?

Answer 14

Bacteriostatic.

Active against gram - (e.coli, klebsiella, h. influenzae)

Question 15

Examples of sulfa drugs:

Answer 15

Bactrim, erythromycin-sulfisoxazole (pediazole), furosemide, HCTZ, sulfonyureas, celecoxib, celebrex, dapsone, sulfasalazine, nitrofurantoin

Question 16

Contraindications sulfa meds:

Answer 16

G6PD, newborns and infants younger than 2 years, pregnancy (3rd tri), hypersensitivity

Question 17

ADR’s sulfa meds:

Answer 17

Fever and nonblistering morbiliform rash, steven-johnson’s syndrome.

Question 18

Sulfa related steven johnsons syndrome high risk patients are:

Answer 18

HIV patients (25-50%)

Question 19

Fluoroquinolines, what are they?

Answer 19

“quinolones”
- Bactericidal, effective against gram - and som atypicals (chlamydia, mycoplasma, legionella)

-Newer (levo, moxi, gati) also effective against gram + and strep pneumonia

Question 20

Black box warning for quinolones

Answer 20

Increased risk achilles tendon rupture

Question 21

Contraindications Fluoroquinolines

Answer 21

Children under 18yrs
Myasthenia gravis
Pregnancy/ Breastfeeding

Question 22

ADR’s of quinolones:

Answer 22

Hypoglycemia, CNS effects, QT prolongation, peripheral neuropathy, phototoxicity, double vision, tendon rupture

Question 23

How is anthrax inhalation treated?

Answer 23

Bioterrorism related inhalation treated with ciprofloxacin 500mg every 12 hrs for 60 days (treat within 48hrs); 3-dose vaccine recommended.

Cutaneous treated: cipro 500mg BIX x 7-10days

Question 24

Travelers diarrhea tx:

Answer 24

Cipro 500mg BID x 3 days

Question 25

What are cephalosporins?

Answer 25

Beta-lactam family/ bactericidal (5 generations)

Cross sensitivity with PCN’s.

Question 26

Rocephin (ceftriaxone) 1st line for what?

Answer 26

Gonorrheal infections

Question 27

MRSA skin infections (boils/ abscesses) 1st line is:

Answer 27

BACTRIM, doxy, minocycline (do not use cephalosporins)