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Renal/Resp > Antibiotics for Respiratory Tracts > Flashcards

Antibiotics for Respiratory Tracts Flashcards

1
Q

What is ticarcillinused to treat

A

gram + and some anaerobes

gram negative broadened spectrum including psuedomonas

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2
Q

What is piperacillin used to treat?

A

gram negative spectrum like ticarcillin but also
pseudomonas and klebsiella
incl. those that are ticarilis-resistance

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3
Q

What are teh two beta-lactamase inhibitors?

A

clavulanic acid

tazobactam

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4
Q

What are the cephalosporins that reach csf?

A

3rd generation

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5
Q

What is a monoatam that use to treat patients with life-threatening penicillin allergy?

A

aztreonam

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6
Q

What is imipenem used to treat?

A

broad spectrum. gram pos and neg

ressistant to many beta-lactamases

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7
Q

What is vancomycin used to treat?

A

gram positives only but of all type

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8
Q

What re the side effects of vancomycin?

A

red man
nephro toxic
ototoxic
phelebitis

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9
Q

What is the mechanism of action of daptomycin?

A

binds to bacterial cytoplasmic membrane, casing rapid membrane depolarization

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10
Q

What is daptomycin used for?

A

gram pos spectrum
bacteremia
complicated skin infections but
NO PNEUMONIA bc of interaction with surfacant

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11
Q

What is ciprofloxacin used to treat

A

best treatment for psuedomonas and other respiratory gram negative infecitons as well as UTI, diarrhea, bone, skin

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12
Q

What is moxifloxacin used to treat?

A

complex, inpt, Community acquired pneumonia has excellent gram positive spectrum

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13
Q

What are the side effect of quinolones?

A 
dizziness, depression
seizures
rashes
EKG irregularities (prolonged T interval)
perippheral neuropathy
arthotopathy
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14
Q

What is metronidazoles mechanism of action?

A

anaerobes reduce nitro group resulting in damage/disruption of dna

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15
Q

What is metronidazole used to treat?

A

anaerobes
C. diff
Heliobacterpylori

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16
Q

What are aminoglycosides mechanism of action?

A

bind to several ribosomal sites

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17
Q

What are aminoglycosides used to treat?

A

primarily for gram neg aerobics

as well as some gram positive activity

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18
Q

What are the side effects of aminoglycosides?

A

nephrotoxic and ototoxic

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19
Q

What are the three aminoglycosides?

A

gentamicin, tobramicin, amikaci

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20
Q

What are tetracyclines usually used to treat?

A

preferred agents for unusual bugs

and broad spectrum

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21
Q

What is tigecycline used for?

A

skin structure infection
complication intra-abdominal infection
community acquired pneumonia

very wide spectrum including anaerobes

22
Q

What is a macrolides?

A

binds to 50s subunit, blocks translocation along ribosomes

23
Q

What is clarithromycin used to treat?

A

broad spectrum mainly gram pos including penicillin ressitant strep pneumoniae

24
Q

What are the adverse effects of clarithromycin?

A

some CV risk, prolongs QT interval

25
Q

What is azithromycin used to treat?

A

very common for outpatient resp tract infections

+chlamydia and ceftriaxone

26
Q

What is clindamycin used to treat?

A

gram pos cocci

many anaeroes incl. bacterioides fragiles

27
Q

What is linezolid used for?

A

gram positive spectrum broad; inhibits 50 S ribosomal subunit

28
Q

What are the side effects of linezolid

A

bone marrow suppresion

can cause serotonin syndrome; non selective inhibitor of MAO

29
Q

What is empiric antibiotic treatment?

A

broad spectrum and sould be chosen based on the likely pathogen/diagnosis,, pt exposure history, patient alelrgy history

30
Q

What are a variety of ways that antibiotics are misused?

A 
given when not needed
continued when no longer necessary
wrong dose
broad spectrum used to treat susceptible bacteria
wrong antibiotic for infection
31
Q

What is the definition of antibioitic stewardship?

A

a system of informatics, data collection, personnel, and polcy procedures which promote the optimal selection, dosina nd duration of therapy for antimicrobial agents throughout the course of use

32
Q

What are the goals of anitibiotic stewardship?

A

reduce antibiotic consumption and innappropiate use

reduce C. diff

improve pts outcomes

increase adherence of tx guidelines

reduce adverse events

decrease/limit antibioti cresistance

33
Q

What treatment should be used to treat outpt CAP? in previously healthy or with co-morbidiites?

A

healthy-macrolide
-doxycycline

co-morbidities -alpha-pneumococcal Fluoroquinine or
beta lacatm plus macrolide

34
Q

What are the antibiotic choice for inpt Rx of community acquired pneumonia?

A

Beta-lactam plus macrolide
or
alpha-pneumococcal fluoroquinolone

35
Q

What are the ICU treatments for community acquired pneumoniia?

A

beta-lactam plus either macrolide or
alpha-pneumococcal Fluorquinone

or

alpha-pneumococcal Fluoroquinone plus aztreonam

36
Q

What is the inpt treatment for CAP when pseudomonas is considerred?

A

alpha-pseudomonal, pneumococcal beta-lactam plus alpha-psedudomonoal fluroquinolone

37
Q

If MRSA is suspected what should you use to treat Community acquried pneumonia?

A

add vancomycin or linezolid to treatment

38
Q

If aspiratoion is suspected in community acquired pneumonia what should you add to treatment?

A

clindamycin

39
Q

What penicillins are used to treat MSSA?

A

all except PCN, ampicillin

Nafcillin and cefazolin are drugs of choice

40
Q

What beta lactams are used to treat pneumococcus?

A

cefotaxime and ceftriaxone

41
Q

What beta lactams are used to treat pseudomonas aeruginosa?

A

piperaclilin/tazobactam, ceftazadime, cefepine, meropenem/imipenem

axtreonam

42
Q

What is teh antimicrobial spectrum of maccrolides?

A

respiratory gram positive and gram negative bacteria as well as intracellular atypical pathogens

43
Q

What is the anti-pneumococcal fluroquinolones?

A

moxifloxacin and levofloxacin

44
Q

What are the anti-pseudomonal fluroquinolones?

A

ciprofloxacin and levofloxacin

45
Q

What is the antimicrobial spectrum of tetracyclines?

A

wide range of gram positive and gram negative bacteria in respiratory tract as well as most effective atypical organism coverage

46
Q

What are the drugs for resistant gram positive bacteria?

A

vancomycin
linezolid
-but has bone marrow suppression, neuropathy and possible serotonin syndrom
daptomycin but not sued for pneumonia; doesn’t work

47
Q

What isthe duration for treatment of CAP?

A

min 5 days; afebrile for 48-72 hours, breathing wihtout oxxygen, vitals normal

longer duration if culture positive for coag pos staph or psuedomonas

48
Q

What are the risk factors for multi-drug resistant organisms?

A

hospitalization for >5 days
hospitalization for 2 days within last 90 days
resident of nursing home
recipient of IV antibiotic therapy, chemo or wound care in last 30 days
chronic dialysis
fam member with MDRO

49
Q

What treatment do you use to treat HCAP with no risk factors for MDROs?

A

ceftriaxone or amp/sulfbactam or ertapenem or fluoroquinolone

50
Q

What is the treatment for empiric antibiotic therapy for HCAP with risk factors for MDROs?

A

anti-psuedomonal beta-lactam plus anti-psuedomonal fluoroquinolone or aminoglycoside plus
vanco or linezolid if MRSA suspected

51
Q

What increases CURB score?

A

confusion
BUN>19 mg/dL
RR>30
systolic65

52
Q

A curb score greater than what should consider inpt stay?

A

2 or greater with >3 consider ICU

Renal/Resp (22 decks)

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