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Pharm2 S.Horvath > Antimicrobials > Flashcards

Antimicrobials Flashcards

1
Q

minimum inhibitory concentration is the lowest concentration required to ____

A

prevent growth

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2
Q

minimum bactericidal concentration is the lowest required to ____

A

kill

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3
Q

T/F For most infections, bactericidal is better than bacteriostatic.

A

FALSE.

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4
Q

The more broad the spectrum, the ___ rate of resistance.

A

higher

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5
Q

T/F PAE is decreased in acidic (infected) media

A

TRUE

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6
Q

a beta lactam +aminoglycoside is a common example of

A

syngergism

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7
Q

examples of secondary impaired host defenses:

A

neutropenia, aspleenia, malignancy, HIV, immunosuppressant therapy

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8
Q

pregnant patients have an ___ volume of distribution and GFR, so their risk of complications from an infection are ____

A

increased, increased

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9
Q

which meds are OK for pregnant patients

A

PEC - penicillins, erthromycin, cephalosporins

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10
Q

Which med in a pregnant women is associated with acute fatty necrosis of the liver, pancreatitis, and possible renal injury

A

tetracycline

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11
Q

November 2017 update canadian study showed increased risk of congenital malformations in the first trimester for ____ but no increased risks for ____

A

pcn, ancef

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12
Q

how many people reporting a pcn allergy are truly allergic to cephalosporins?

A

5% or less

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13
Q

T/F according to CDC data, nosocomial infections are on the rise.

A

False. there has been a reduction

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14
Q

rank central line infection rates by site

A

fem>IJ>subclavian

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15
Q

what are the two biggest offenders for C diff?

A

clinda & ancef/keflex.

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16
Q

what is the go to drug to treat c. diff

A

PO vanco

deficit (fidaxomicin)

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17
Q

how do you treat someone with an ongoing original infection who then gets c diff/

A

treat infection with appropriate broad spectrum abx.

continue c. diff therapy also and extend the course for 5-10 days after the completion of the other abx.

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18
Q

T/F Half of SSIs are preventable using evidence based strategies

A

TRUE

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19
Q

what is the recordation for patients at a high or mod risk undergoing procedures involving infected tissues or receiving prosthetic cardiac valves

A

include anti staphylococcal and for cellulite and osteomyelitis

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20
Q

vanco and florquinolones (cipro, levoquin) need to be started within the first ___min of incision

A

120

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21
Q

why is giving someone vanco for SSI prophy not as good as giving ancef?

A

bc it only covers gram+ bacteria. patients with a reported PCN allergy have a 50% increased odds of SSI, attributable to second-line abx.

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22
Q

MOA of beta lactams

A

cell wall synthesis inhibitor. bind to the penicillin binding protein (PBP)

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23
Q

are beta lactams bactericidal or bacteriostatic?

A

bactericidal

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24
Q

which drug class is paired with beta lactam’s to fight resistance

A

beta-lactamase inhibitors. also known as suicide inhibitors.

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25
Q

what are 3 beta-lactamas inhibitors?

A

sulbactam, tazobactam, clavulanic acid.

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26
Q

are aminoglycosides and fluoroquinolone time dependent or concentration dependent?

A

concentration

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27
Q

are bata lactams, mono-bantams, and macrolides time or concentration dependent

A

time

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28
Q

what are the biggest offenders of c-diff

A

1-clinda

2- ancef/keflex

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29
Q

is is estimated that ___ of SSI’s are preventable using evidence based strategies

A

50%

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30
Q

which wound class is atraumatic, no break in sterile technique, resp GI, GU tracts not entered.

A

clean 1

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31
Q

which wound class is surgery in areas known to harbor bacteria with no spillage of contents

A

clean-contaminated 2

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32
Q

which wound class is there a major break in sterile technique, surgery on traumatic wounds, gross GI spillage, entrance into an infected biliary or GU tract

A

contaminated 3

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33
Q

which wound class = infection existed before the surgery, old wound w devitalized tissue, perf viscera

A

dirty infected 4

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34
Q

vancomycin and flurquinolones (cipro, levoquin) need to be started within the first ___min of incision. everything else including ancef and cleomyocin - ___ min

A

120

60

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35
Q

the disadvantage of vancomycin is that it only overs gram ___ bacteria

A

+

does not kill gram - (like e. coli)

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36
Q

what is the MOA of beta lactams

A

cell wall synthesis inhibitor

when the bacteria cell cant repair its cell wall, it bursts open. so beta lactams are bactericidal.

37
Q

_____ breaks a bond in the B-lactam ring of pcn to disable the molecule. Bacteria with this enzyme can resist the effects of pcn and other b-lactam abx.

A

beta-lactamase

38
Q

which agent is associated with jarisch-herxheimer reaction

A

pcn

39
Q

oxacillin, nafcillin, dicloxacillin are ____ specific except MRSA and MRSE

A

staph

40
Q

as you go from 1st gen to 3rd gen, add a lot more ____

A

gram negatives

41
Q

ticarcillin and piperacillin causes ___kalemia

A

hypo

42
Q

what is the MOA of cephalosporins

A

bactericidal, breaking apart the cell wall

43
Q

cefazolin, cephalexin = __ gen cepahlosporins

A

1

44
Q

cefoxitin = __ gen cepahlosporins

A

2

45
Q

ceftazidime , ceftriaxone = __ gen cepahlosporins

A

3

46
Q

cefepime = __ gen cepahlosporins

A

4

47
Q

ceftobiprole, ceftaroline = __ gen cepahlosporins

A

5

48
Q

which 2 drugs are anti-pseudomonal

A

ceftazidime and cefoperazone

49
Q

T/F 3rd gen cephalospines can be used to tx meningitis bc they crosss the CNS. (ceftazidime, cefoperzone)

A

TRUE

50
Q

what is the max does of ceftazidime

A

6g/day

51
Q

which drug causes biliary slugging and precipitates with calcium

A

ceftriaxone

52
Q

which drugs are associated with interstitial nephritis

A

beta lactams at high dose

they are really eliminated, so are cephalosporins

53
Q

which 5th gen cephalosporin covers MRSA, gram pos, broad-spectrum (technically a beta-lactam that covers MRSA)

A

by definition it shouldn’t, but it does

54
Q

carbapenems are the drug of choice for ____

A

ESBL’s

55
Q

imipenem/cilastatin (primaxin) has a high risk of ___

A

seizures

56
Q

meropenem has a higher or lower risk of seizures than primaxin?

A

lower

57
Q

red mans, nephrotoxicity, ototoxitiy, TTP is associated with

A

vanco

58
Q

T/F Red mans is an infusion rate reaction so you can treat it by slowing the rate (1g/hr) and antihistamines

A

TRUE

59
Q

which drug works at ribosomal subunits

A

linezolid (zyvox)

60
Q

which drug has the risk of myelosuppression (anemia, leukopenia, pancytopenia, thrombocytopenia)

A

linezolid

61
Q

linezolid has a drug interaction with ___ which leads to the potential for _____

A

MAO, serotonin syndrome

62
Q

macrolide = ____ = prolonged QT

A

azithromycin

63
Q

macrolide = _____ = significant GI toxicity = ____ of cyp3A4

A

clarithromycin, inhibitor

64
Q

which drug is good for PUD

A

biaxin

65
Q

which drug class is associated with GI, arthopathies, qt prolongations, CNS excitement, altered glucose homeostasis

A

fluoroquinolones

66
Q

use of what drug class increases morbidity and mortality

A

fluoroquinolones

67
Q

what is the drug of choice for bacterial GI infections (travelers)

A

cipro

68
Q

which drug is associated w efflux pump resistance

A

levofloxacin

69
Q

which fluoroquinolone covers MRSA but is not associated with qt prolongation or photosensitivity

A

delafloxacin (baxdela)

70
Q

are tetracyclines bacteriostatic or bacteriocidal?

A

static.

mRNA.. inhibits protein synthesis

71
Q

dont give ___ to kids <12

A

tetracyclines like doxy

72
Q

which drugs “pick up a lot of gram pos and gram neg, wide VOD, risks with children, drug interactions”

A

tetracyclines

73
Q

order the ahminoglycosides and their effects on neuromuscular blockade

A

neo/strep > kana > ami > gent > tobra

ns k a g t

74
Q

which drug is used for people with severe liver disease and portal hypertension because it binds up and breaks down ammonia

A

neomycin

75
Q

gent is mostly gram ___ with some synergistic gram ____

A

negative, positiive

76
Q

trimethoprim/sulfamethoxole (bactrim/septra) are ____ on their own but ____ when they come together

A

bacteriostatic

bactericidal

77
Q

sulfamethoxole (bactrim) is eliminated by ___, carries the risks of…..

A

pancytopenia, neutropenia, TTP, stevens johnson

78
Q

which drug carries the risk of peripheral neuritis, pulm complications, hepatic damage, blood dycrasias

A

nitrofurantoin (macrobid, macrodantin)

79
Q

clinda has the ____ c diff risk

A

highest

80
Q

which drug causes pancreatitis, peripheral neuropathy, ataxia,
confusion, encephalopathy, tremors

A

flagyl

81
Q

rifampin is mostly used for?

A

TB and prosthetics

82
Q

which drug is a potent inducer of the CYP450 system

A

rifampin

83
Q

mono therapy, seem in rifampin leads to

A

rapid resistance

84
Q

which drug class causes hallucinations

A

acyclovir

85
Q

whats important about amphoteracin B? antifungal

A
  • can cause renal failure
  • high rates of infusion reactions
  • loss of K/mg (risk arrhythmias)
  • anemias
86
Q

fluconazole is a potent ___ of CYP3A4

A

inhibitor

87
Q

azole antifungals = ___ drug interactions

A

severe.

esp with voriconazole

88
Q

echinocandin antifungals cause ____ damage

A

liver

Pharm2 S.Horvath (13 decks)

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