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Pulm > Bacterial Infections of the Lung > Flashcards

Bacterial Infections of the Lung Flashcards

1
Q

Causes of pneumonia 0-6 weeks

A

Group B steptococci

E. coli

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2
Q

Causes of pneumonia 6wk-18yrs

A

Viruses (flu, adeno, rhino, RSV)
Mycoplasma pneumonia
Chlamydia pneumonia
Streptococcus pneumonia

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3
Q

Causes of pneumonia 18-40yrs

A

Mycoplasma pneumonia

Streptococcus pneumonia

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4
Q

Causes of pneumonia 40-65yrs

A 
Streptococcus pneumonia
Haemophilus influenza
Anaerobes
Viruses
Mycoplasma pneumonia
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5
Q

Causes of pneumonia >65yrs

A 
Streptococcus pneumonia
Viruses
Anaerobes
Haemophilus influenza
Gram + rods
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6
Q

Causes of pneumonia nosocomial

A

S. aureus

P. aeruginosa

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7
Q

Causes of pneumonia diabetic/alcoholic pateints

A

Klebsiella pneumonia

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8
Q

Legionella-prone patients

A 
Men
>50yrs
smokers
chronic lung disease
immunocompromised
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9
Q

respiratory quinolones

A

levofloxacin
ciprofloxacin
moxifloxacin

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10
Q

1st generation macrolide

A

erythromycin

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11
Q

2nd generation macrolide

A

clarithromycin

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12
Q

3rd generation macrolide

A

azithromycin

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13
Q

Rx for pneumonia caused by Legionella

A

azithromycin/clarithromycin
respiratory quinolones
+/- rifampin

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14
Q

macrolide MOA

A

50s ribosomal inhibitor

blocking translocation

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15
Q

tetracycline MOA

A

30s ribosomal inhibitor

blocking protein synthesis

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16
Q

fluoroquinolones MOA

A

DNA gyrase inhibitor

preventing DNA replication

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17
Q

penicillins MOA

A

blocks cell wall cross-linking

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18
Q

carbopenem MOA

A

blocks cell wall cross-linking

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19
Q

cephalosporins MOA

A

inhibition of cell wall cross-linking

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20
Q

aminoglycosides MOA

A

30s ribosomal inhibitor

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21
Q

tetracyclines used

A

doxycycline

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22
Q

fluoroquinolones used

A

levofloxacin

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23
Q

penicillins used

A

amoxicillin + clavulanic acid

piperacillin + tazobactam

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24
Q

carbopenems used

A

meropenem

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25
cephalosporins used
1st gen: cefazolin 2nd gen: cefuroxime 3rd gen: ceftriaxone 3rd gen w/antipsudomonal activity: ceftazidime & cefepime
26
aminoglycosides used
gentamycin
27
macrolides resistance
ribosomal methylation mutation of 23s rRNA active efflux
28
tetracyclines resistance
decreased entry increased efflux target insensitivity
29
fluoroquinolones resistance
mutation of DNA gyrase | active efflux
30
penicillins resistance
beta-lactamases | altered PBPs
31
cephalosporins resistance
``` altered porins (decreased permeability of gram - outer membrane) active efflux ```
32
aminoglycosides resistance
aminoglycoside modifying enzyme decreased permeability of gram - outer membrane active efflux ribosomal methylation
33
nosocomial pneumonia Rx
imipenem/cilastin (meropenem) aztreonam (piperacillin/tazobactam) ceftazidime (cefepime) vancomycin
34
vancomycin ROA
IV infusion
35
vancomycin indication
MRSA
36
aspiration pneumonia Rx
clindamycin (ampicillin/sulbactam)
37
cindamycin MOA
50s ribosomal inhibitor | blocking translocation
38
clindamycin resistance
methylation of binding site | enzymatic inactivation
39
vancomycin MOA
binds D-ala-D-ala terminus of peptide precursors inhibits peptidoglycan polymerase inhibits transpeptidation
40
vancomycin resistance
replacement of D-ala by D-lactate
41
high oral bioavailability antibiotics
doxycycline | fluoroquinolone
42
concentration-dependent antibiotics (Cmax/MIC)
fluoroquiniolones | aminoglycosides
43
time dependent antibiotics (time>MIC)
beta-lactams cephalosporins carbapenems
44
concentration-dependent antibiotics (AUC/MIC)
``` fluoroquiniolones aminoglycosides tetracyclines vancomycin macrolides clindamycin ```
45
antibiotics that do NOT need dose adjustment for renal impairment
``` azithromycin ceftriaxone clindamycin doxycycline erythromycin linezolid ```
46
doxycycline toxicity
decreased bone growth teeth discoloration photosensitivity GI distress
47
erythromycin toxicity
``` QT prolongation cholestatic jaundice (CYP3A4/Pgp inhibitor) ```
48
gentamicin toxicity
neuromuscular paralysis nephrotoxicity ototoxicity
49
imipenem toxicity
seizures | hypersensitivity w/pen&ceph
50
levofloxacin toxicity
adults: tendon rupture children: cartilage damage
51
linezolid toxicity
bone marrow suppression | MAOI
52
meropenem toxicity
seizures | hypersensitivity w/pen&ceph
53
vancomycin toxicity
Red Man's syndrome nephrotoxicity ototoxicity
54
general antibiotic toxicity
GI distress
55
azithromycin toxicity
QT prolongation | cholestatic jaundice
56
ampicillin toxicity
maculopapular rash | GI distress
57
piperacillin toxicity
decreased coagulation | hypersensitivity w/ceph
58
caution with breastfeeding
clarithromycin | linezolid
59
avoid breastfeeding
metronidazole
60
penicillin use in breastfeeding infants
may cause diarrhea, candidiasis, and skin rash
61
teratogenic antibiotics
``` clarithromycin doxycycline erythromycin gentamicin levofloxacin linezolid metronidazole piperacillin trimethoprim ```
62
bactam MOA
irreversible inhibitor of bacteria beta-lactamases
63
cilastatin MOA
reversible, competitive inhibitor of renal DHP-1
64
what is renal DHP-1 ?
enzyme that breaks down imipenem to inactive but nephrotoxic metabolites
65
daptomycin indication for pulmonary infections
NOT for pulmonary infections inactivated by surfactant (sry trick question)
66
bronchitis Rx
``` amoxicillin+clavulanic acid azithromycin clarithromycin doxycycline (ciprofloxacin) ```
67
causes of bronchitis in younger patients
viral
68
causes of bronchitis in elderly patients
bacterial: - Mycoplasma pneumonia - Streptococcus pneumonia - Haemophilus influenza - Moraxella catarrhalis - Bordetella pertussis
69
causes of bronchitis in smokers
H. influenza
70
lung abscess Rx
clindamycin (superior to penicillin, esp. w/Bacteriodes)
71
nosocomial lung abscess Rx
metronidazole + ceftriaxone

Pulm (4 decks)

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