ANTIBIOTICS OMG

Question 1

why dont we use methacillin anymore?

Answer 1

causes intersitial nephritis

Question 2

how do you treat MSSA(methacillin sensitive staph aureus)? IV? PO?

Answer 2

IV: oxacillin/nafcillin or cefazolin
PO: dicloxacillin or cephalexin

Question 3

how do you treat severe MSRA?

Answer 3

Vancomycin, linezolid, CEFTAROLINE

Question 4

how do you treat minor infections of MSRA? (ex: cellulitis)

Answer 4

TMP/SMX, Clindamycin, Doxycycline

Question 5

Which cephalosporin is the only one that covers MSRA & some gram -‘s?

Answer 5

Ceftaroline (5th gen)

Question 6

girl whos taking phenylzine(or selegaline) comes in with a severe MSRA infection. She gets treatment and develops serotonin syndrome. What was she treated with?

Answer 6

Linezolid = causes thrombocytopenia and interfears with MAOI’s

Question 7

what drug can you use if hte person has a PCN allergy but only gets rashes?

Answer 7

cephalosporins

Question 8

PCN alternate for person who gets anaphylaxis to PCN

Answer 8

clindamycin or Linezolid

Question 9

PCN allergy but has major infection needing PCN. tx?

Answer 9

Vancomycin, linezolid, daptomycin

Question 10

PCN allergy tx with minor infections

Answer 10

macrolides(azithromycin, clarithromycin), clindamycin, TMP/SMX

Question 11

what 3 drugs are SPECIFIC for Streptococcus?

Answer 11

Penicillin, Ampicillin, Amoxicillin

*adding a B-lactamase inhibitor to this will not cover MRSA

Question 12

adding a B-lactam to Ampicillin, Amoxicillin & PCN will add coverage to what….

Answer 12

will now cover staph in addition to strep.

Question 13

what is the only carbepenem that doesnt cover pseudomonas?

Answer 13

ertapenem!

*imipenem, meropenem & doripenem all cover pseudomonas

Question 14

which two strep drugs also cover anaerobes?

Answer 14

piperacillin and ticarcillin

Question 15

which quinolones also cover pseudomonas?

Answer 15

levofloxacin, gemifloxacin, moxifloxacin

Question 16

what are teh only cephalosporins that cover anaerobes?

Answer 16

cefotetan & cefoxitin

Question 17

what drug would you use to treat abdominal anaerobes?

Answer 17

Metronidazole > all carbapenems, piperacillin & ticarcillin
*metro is preferred though but all work

Question 18

drug of choice for respiratory anaerobes?

Answer 18

clindamycin

Question 19

what antibiotics have NO anaerobic covers?

Answer 19

aminoglycosides, aztreonam, FQ, Oxacillin/nafcillin and all cephalosporins EXCEPT Cefoxitin & Cefotetan which do cover anaerobes

Question 20

what is red man syndrome?

Answer 20

rapid infusion of vancomycin releases histamine causing pt to turn red = slow the infusion of vancomycin to avoid this

Question 21

Tx of PID?

Answer 21

Cefotetan or cefoxitin + doxy

*this is bc both cef will cover anaerobes!

Question 22

which cephalosporin is 1st line for pneumococcus(meningitis & CAP, gonorrhea)

Answer 22

ceftriaxone

*also tx lyme of the heart or brain!

Question 23

what drug do we used to tx lyme of the heart or the brain?

Answer 23

ceftriaxone

Question 24

why dnt we give neonates ceftriaxone?

Answer 24

bc they have impaired biliary metabolism = needs time to develop

Question 25

2 cephalosporins with natural pseudomonas coverage?

Answer 25

ceftazidime, cefepime

Question 26

drugs that cover pseudomonas(9)

Answer 26

gentamicin, Pip-tazo, aztreonam, ciprofloxacin, cefepime, ceftazidime, tobramycin, meropenem, doripenem

Question 27

which cephalosporin can be given to neonates & ppl with bacterial peroitonitis? why?

Answer 27

cefotaxime = doesnt mess with the liver!

Question 28

which cephalosporins increase risk of bleeding via depletion of prothrombin?

Answer 28

cefoxitin + cefotetan =2nd gen w/anaerobic coverage used to tx PID

Question 29

which cephalosporin messes will biliary metabolism?

Answer 29

ceftriaxone = dnt use in babies or ppl with liver shit use Cefotaxime instead

Question 30

which monobactam can be used to tx pseudmonas/gram - coverage & has NO CROSS RXN WITH PCN = safe in those will allergy?

Answer 30

AZTREONAM

Question 31

which drugs can be used to tx PCN resistant CAP?

Answer 31

FQs

Question 32

tx of uncomplicated pyelonephritis/cystitis due to ecoli?

Answer 32

CIPROFLOXACIN = great gram - coverage

Question 33

side fx of quinolones?

Answer 33

bone growth abnormalities = dnt use in kids or prego's! & Tendonitis/achiles tendon rupture *likes to go to bone! = great for osteomyelitis

Question 34

aminoglycosides good against anaerobes?

Answer 34

nope!

Question 35

side fx of aminoglycosides?

Answer 35

nephrotoxic + ototoxic

Question 36

Doxycycline is excellent for...

Answer 36

chlamydia, lyme(not cns), 7th CN palsy(not cns), minor MRSA of the skin, rickettsia

Question 37

Tx of stage 1 lyme, stage 2 and stage 3?

Answer 37

stage 1 = amoxicillin or doxy stage 2 = doxy stage 3/cns shit, heart = ceftriaxone

Question 38

doxy side fx?

Answer 38

tooth discoloration(children), photosensitivity, esophagitis

Question 39

1/2 syphilis if allergic to PCN?

Answer 39

doxy!

Question 40

prego women with cystitis tx?

Answer 40

Nitrofurantoin

Question 41

TMP-SMX can be used for...

Answer 41

cystitis, pneumocystis, minor MSRA of the skin

Question 42

side fx of TMP-SMX

Answer 42

rash, hemolysis(G6PD), Bone marrow suppression(folate antagonist)

Question 43

Piperacillin/tazobactam coverage?

Answer 43

gram -, anaerobes and ENTEROCOCCI = gut shit

Question 44

Which drugs cover anaerobes?

Answer 44

PCN(amp, amox), Clindamycin(URI only), metro, pipacillin, carbapenems, cefoxitin, cefotetan

Question 45

GRAM - Gut bacteria(cholecystis, UTI, Pyelo, bowl): Ecoli, Klebsiella, Proteus, Pseudomonas, Enterobacter, Citrobacter infection tx w/....

Answer 45

quinolones, aminoglycosides, carbapenems, piperacillin, ticarcillin, aztreonam, cephalosporins