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pharm/tox final > Antibiotics part 2 > Flashcards

Antibiotics part 2 Flashcards

1
Q

In what circumstances would you need to monitor antibiotic therapies?

A
  1. narrow therapeutic index
  2. Risk for toxicity
  3. Risk for toxicity and poor outcome
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2
Q

Which antibiotic has risk of toxicity?

A

Aminoglycosides

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3
Q

Which antibiotic has risk of toxicity AND poor outcome?

A

Vancomycin

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4
Q

What is a peak and when should it be drawn?

A

Highest concentration achieved during the dosing interval. Should be measured at least 30 minutes after the end of the infusion.

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5
Q

What is a trough and when should it be drawn?

A

Minimum amount of medication present in the patient before the next dose is given. Ideally, it should be obtained just prior to giving the next dose but can be measured anytime within 30 minutes of a dose.

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6
Q

Level that is drawn at any point during dosing interval.

A

Random level

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7
Q

Levels drawn at least ____ half life/half lives apart can be used to calculate true peak and trough concentrations.

A

1 half life

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8
Q

Inhibits bacterial cell wall synthesis and is slowly bactericidal. Covers C. diff when taken orally but NO gram negatives.

A

Vancomycin

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9
Q

What agent causes red man syndrome?

A

Vancomycin

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10
Q

True or false: Vancomycin uses time-dependent killing.

A

True

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11
Q

True or false: It is recommended to obtain a trough and a peak whenever giving vancomycin.

A

False: Only recommended to obtain a trough (Cmin) because trough monitors efficacy and safety. Only obtain peak (cmax) if performing pt-specific PK.

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12
Q

Which agent targets the 30S subunit?

A

Tetracyclines

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13
Q

Which agent targets the 50S subunit?

A

Linezolid, clindamycin, erythromycin, chloramphenicol

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14
Q

Which agent targets both the 30S and 50S subunits?

A

Aminoglycosides

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15
Q

Which inhibitor of protein synthesis is generally used for empiric double-coverage of gram negative organisms?

A

Aminoglycosides

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16
Q

Aminoglycosides: Concentration-dependent killing or time dependent?

A

Concentration-dependent

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17
Q

True or false: It is recommended to obtain both a peak and a trough with aminoglycosides.

A

True. Peak monitors efficacy; trough monitors safety.

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18
Q

What is the goal amount for aminoglycosides?

A

<2 mcg/mL

19
Q

What type of dosing is used with aminoglycosides?

A

Extended interval dosing (higher than conventional dosing, takes advantage of concentration-dependent killing through optimization of peak:MIC ratios and the post-antibiotic effect.

20
Q

How do you monitor extended interval dosing?

A

Obtain random levels at specific time points after infusion of the first dose.

21
Q

Which agent is effective against ESBL producers?

A

Aminoglycosides

22
Q

Which agent is a broad spectrum antibiotic that binds to the 50S subunit and is used only for life-threatening infections?

A

Chloramphenicol

23
Q

Blood dyscrasias (anemia, thrombocytopenia, granuloctyopenia) are an adverse reaction for what agent?

A

Chloramphenicol

24
Q

What should you monitor in patients receiving chloramphenicol?

A

CBC

25
Q

What binds 50S subunit and includes erythromycin, azithromycin, clarithryomycin, and clindamycin?

A

Macrolides

26
Q

Which agent has a short half life and is commonly used as a prokinetic?

A

Erythromycin

27
Q

Which agent has daily administration and is used for gram negative coverage?

A

Azithromycin (Z pak)

28
Q

Which agent has drug-drug interactions of CYP3A4 inhibitor?

A

Clarithromycin

29
Q

Which agent covers gram positive organisms and mainly oral anaerobes?

A

Clindamycin

30
Q

Which agent covers Staph and enterococcus (including VRE)?

A

Linezolid

31
Q

Which agent is contraindicated with SSRIs?

A

Linezolid

32
Q

Which agent binds to the 30S subunit and is BACTERIOSTATIC?

A

tetracyclines

33
Q

Which agent has the adverse effect of phototoxicity and is contraindicated in children <8 years due to permanent tooth discoloration? (can also cause REVERSIBLE delay of bone growth)

A

Tetracyclines

34
Q

What is the most common cause of health-care associated diarrhea in the adult population?

A

Clostridium difficile

35
Q

What are the first line and second line treatments for C. difficile?

A

first line: metronidazole (oral or IV)

second line: Oral vancomycin

36
Q

Which agent inhibits topoisomerase and DNA-gyrase, thereby inhibiting DNA replication?

A

Fluoroquinolones

37
Q

Which agent causes QTc prolongation and has drug-drug interactions with calcium, magnesium, and iron?

A

Fluoroquinolones

38
Q

Precaution in children 60 years old with what agent?

A

Fluoroquinolones

39
Q

Which agent is rarely used alone, but inhibits RNA polymerase and causes red-orange body fluids and is a CYP450 inducer?

A

Rifampin

40
Q

Which agent combination inhibits steps in bacterial folic acid synthesis? It is effective against MRSA.

A

Trimethoprim and Sulfamethoxazole (TMP-SMZ)

41
Q

Stevens-Johnson Syndrome, TENS, photosensitivty, and bone marrow suppression are adverse effects of what?

A

TMP-SMZ

42
Q

Which agent covers oral and gut anaerobes, including C. diff?

A

Metronidazole (first line of defense for C.diff)

43
Q

Describe the two regimens for H. Pylori treatment.

A 
Triple therapy (PPI plus 2 antibiotics)
Quadruple therapy (PPI, bismuth, 2 antibiotics)
44
Q

Which two antibiotics are used in combination to treat H. pylori?

A

Metronidazole and tetracyclines

pharm/tox final (5 decks)

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