Antimicrobials - Quiz 7 Flashcards

1
Q

Which Abx are Narrow-Spectrum?

A

PCN

Erythromycin

Clindamycin

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2
Q

What is the Post Antibiotic Effect?

A

The continued supression of Bacterial Growth even when the Abx is no longer detectable d/t Bacteria being weaker to leukocytes

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3
Q

What are some Bacterial Alterations that make them Resistant?

A

Decreased Abx Permeability

Increased Efflux Pumps

Abx Inactivation

Modify Abx

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4
Q

What are the treatments for C. Diff?

A

Oral Vanco

Fidaxomicin

Fecal Transplant

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5
Q

What is a Class I Wound?

A

Clean

Atraumatic

No Sterile Break

No Respiratory, GI, or GU Entry

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6
Q

What is a Class II Wound?

A

Clean-Contaminated

Surgery in Areas known to have Bacteria

No Spillage of Contents

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7
Q

What is a Class III Wound?

A

Contaminated

Major Sterile Break

Traumatic Wound Surgery

GI Spillage

Infected Billiary or GU Entry

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8
Q

What is a Class IV Wound?

A

Dirty-Infected

Pre-Existing Infection before Surgery

Old Wound

Perforated Viscera

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9
Q

What is the most common bacteria for Clean Wounds?

A

Staphylococcal

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10
Q

What is the problem with providing Prophylaxis for Fungal Infection?

A

No proven efficacy of prophylaxis

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11
Q

How should Ancef and Vanco be given as prophylaxis regarding timing?

A

Ancef: Within 60 minutes before incision

Vanco: Within 120 minutes before incision

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12
Q

What was found in the JAMA research about Abx Prophylaxis duration?

A

Longer Abx Duration = MORE C. Diff & AKI, but no additional SSI reduction

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13
Q

How do Beta Lactams work?

A

Binds to PCN Binding Protein and weakens Cell Wall

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14
Q

Which Abx are Beta-Lactamase Inhibitors?

A

Sulbactam

Tazobactam

Clavulanic Acid

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15
Q

Which Abx carries the highest risk for causing C. Diff?

A

Clindamycin

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16
Q

What do Oxacillin, Nafcillin, and Dicloxacillin cover?

A

Staph

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17
Q

How do Cephalosporins compare to PCNs?

A

Same MOA, but less susceptible to Penicillinases

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18
Q

What are Cephalexin & Cefazolin (1st Gen) used for?

A

MSSA

Staph

Strep

E Coli

Klebsiella

Salmonella

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19
Q

What is the advantage of using Cefazolin & Cephalexin?

A

Generally Safe

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20
Q

Cephalexin & Cefazolin have no effect against _______

A

Cephalexin & Cefazolin have no effect against H. Influenzae & Enteroccoi

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21
Q

What are Cefaclor, Cefuroxime, & Cefoxitin (2nd Gen) used for?

A

H. Influenzae

Enterobacter

Nesseria

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22
Q

How do 2nd Gen Cephalosporins compare to 1st Gen?

A

Also safe, but has less Gram Positive coverage than 1st Gen

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23
Q

What are Ceftazidime & Cefoperazone (3rd Gen) used for?

A

Anti-Pseudomonal

CNS Coverage (Ex: Meningitis)

Crosses BBB

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24
Q

Which Cephalosporin has the MOST Gram Negative coverage and destroys everything including Pseudomonas?

A

Ceftazidime (Fortaz) - 3rd Gen

25
Q

Which Cephalosporin has the Good Gram Positive coverage (less than 1st Gen), but does not cover any Gram Negative like Pseudomonas?

A

Ceftriaxone

26
Q

What are some concerns with using Ceftriaxone?

A

Diarrhea

Billiary Sludging

Incompatible w/ Calcium

27
Q

What is Ceftaroline (Teflaro) (5th Gen) used for?

A

Gram Postive; MRSA

Broad Spectrum

28
Q

What is the treatment of choice for ESBLs?

A

Carbapenems

29
Q

Which class of Abx has a high risk for Seizures?

A

Carbapenems - (Primaxin)

30
Q

How does Vanco work?

A

Stop cell wall synthesis via Peptidoglycan Inhibition

31
Q

What are the Adverse Effects of Vanco?

A

Red Man

Nephrotoxicity

Ototoxicity

32
Q

How does Linezolid work?

A

Binds to 50s Ribsome to stop Protein Synthesis

33
Q

What are adverse effects of Linezolid?

A

Serotonin Syndrome

&

Myelosupression

34
Q

How do Macrolides work?

A

Same of Linezolid - Binds 50S Ribosomal Subunit to stop Protein Synthesis

35
Q

What is Azithromycin used for?

A

Gram Positives

Respiratory Infections

H. Pylori

Staph

36
Q

What is the concern when using Azithromycin & Clarithromycin?

A

Prolonged QT & Torsades

Drug Interactions

(Azithromycin is Preferred)

37
Q

What is the main concern with using Erythromycin?

A

Significant GI Toxicity

38
Q

Which drugs are Macrolides?

A

Azithromycin

Clarithromycin

Erythromycin

39
Q

How do Fluoroquinolones work?

A

Stops DNA Synthesis & Supercoiling

40
Q

What are the safety concerns related to Fluoroquinolones?

A

Many Drug Interactions

Achilles Tendonitis & Rupture

QT Prolongation

Hypoglycemia

Neuro Effects

41
Q

What is unique about Delafloxacin as a Fluoroquinolone?

A

Covers MRSA and NOT associated w/ Prolonged QT or Photosensitivty

42
Q

How do Tetracyclines work?

A

Binds to 30s Ribosome to stop Protein Synthesis

43
Q

What are the adverse effects of Tetracyclines?

A

Lots of Photosensitivty

Bone Issues in Preggos & Kids

Tooth Discoloration

Enamel Hypoplasia

Liver Toxicity

44
Q

How do Aminoglycosides work?

A

Binds to 30S Ribosome to disrupt mRNA translations

&

Inteferes w/ Ca & Mg to damage cell wall

45
Q

What are the adverse effects of Aminoglycosides?

A

Nephrotoxic

Ototoxic

Prolonged Neuro Muscular Block

46
Q

How does Trimethoprim/Sulfamethoxazole (Bactrim) work?

A

Stops Folic Acid synthesis to starve Bacteria so they cant make DNA

47
Q

What are the adverse effects of Bactrim?

A

Pancytopenia

Neutropenia

Thrombocytopenia

Steven-Johnsons

48
Q

What is Nitrofurantoin (Macrobid) used for?

A

Urinary Pathogens

49
Q

What are the adverse effects of Nitrofurantoin (Macrobid)?

A

Confusion

Neuropathy

Lung Problems

Blood Problems

Liver Damage

50
Q

What is Clindamycin used for?

A

Gut Anaerobes

MRSA

51
Q

How does Metronidazole (Flagyl) work?

A

Breaks DNA & Unwides Helix to kill the cell

52
Q

What are the adverse effects of Metronidazole (Flagyl)?

A

Pancreatitis

Neuropathy

Ataxia

Confusion

Tremors

53
Q

Which Abx are safe for Preggos?

A

PCN

Cephalosporins

Erythromycin

54
Q

For Preggos, which Abx should only be used if necessary?

A

Aminoglycosides

&

Isoniazid

55
Q

Which Abx should be AVOIDED in Preggos because it can hurt the fetus?

A

Flagyl

Ticarcillin

Rifampin

Trimethroprim

FQs

Tetracyclines

56
Q

What happens when Tetracyline is given to Preggos?

A

Fatty Necrotic Liver

Pancreatitis

Renal Damage

57
Q

What are the adverse effects of Antivirals?

A

Hallucinations

Tremors

Kidney Stones

58
Q

What are the concerns with Antifungals?

A

Renal Failure

Infusion Rxns

HypoK

HypoMag

Drug Interactions for -azoles

Liver Damage