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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
Q

cephalosporins used

A

1st gen: cefazolin
2nd gen: cefuroxime
3rd gen: ceftriaxone
3rd gen w/antipsudomonal activity: ceftazidime & cefepime

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26
Q

aminoglycosides used

A

gentamycin

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27
Q

macrolides resistance

A

ribosomal methylation
mutation of 23s rRNA
active efflux

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28
Q

tetracyclines resistance

A

decreased entry
increased efflux
target insensitivity

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29
Q

fluoroquinolones resistance

A

mutation of DNA gyrase

active efflux

30
Q

penicillins resistance

A

beta-lactamases

altered PBPs

31
Q

cephalosporins resistance

A 
altered porins (decreased permeability of gram - outer membrane)
active efflux
32
Q

aminoglycosides resistance

A

aminoglycoside modifying enzyme
decreased permeability of gram - outer membrane
active efflux
ribosomal methylation

33
Q

nosocomial pneumonia Rx

A

imipenem/cilastin (meropenem)
aztreonam (piperacillin/tazobactam)
ceftazidime (cefepime)
vancomycin

34
Q

vancomycin ROA

A

IV infusion

35
Q

vancomycin indication

A

MRSA

36
Q

aspiration pneumonia Rx

A

clindamycin (ampicillin/sulbactam)

37
Q

cindamycin MOA

A

50s ribosomal inhibitor

blocking translocation

38
Q

clindamycin resistance

A

methylation of binding site

enzymatic inactivation

39
Q

vancomycin MOA

A

binds D-ala-D-ala terminus of peptide precursors
inhibits peptidoglycan polymerase
inhibits transpeptidation

40
Q

vancomycin resistance

A

replacement of D-ala by D-lactate

41
Q

high oral bioavailability antibiotics

A

doxycycline

fluoroquinolone

42
Q

concentration-dependent antibiotics (Cmax/MIC)

A

fluoroquiniolones

aminoglycosides

43
Q

time dependent antibiotics (time>MIC)

A

beta-lactams
cephalosporins
carbapenems

44
Q

concentration-dependent antibiotics (AUC/MIC)

A 
fluoroquiniolones 
aminoglycosides
tetracyclines
vancomycin
macrolides
clindamycin
45
Q

antibiotics that do NOT need dose adjustment for renal impairment

A 
azithromycin
ceftriaxone
clindamycin
doxycycline
erythromycin
linezolid
46
Q

doxycycline toxicity

A

decreased bone growth
teeth discoloration
photosensitivity
GI distress

47
Q

erythromycin toxicity

A 
QT prolongation
cholestatic jaundice
(CYP3A4/Pgp inhibitor)
48
Q

gentamicin toxicity

A

neuromuscular paralysis
nephrotoxicity
ototoxicity

49
Q

imipenem toxicity

A

seizures

hypersensitivity w/pen&ceph

50
Q

levofloxacin toxicity

A

adults: tendon rupture
children: cartilage damage

51
Q

linezolid toxicity

A

bone marrow suppression

MAOI

52
Q

meropenem toxicity

A

seizures

hypersensitivity w/pen&ceph

53
Q

vancomycin toxicity

A

Red Man’s syndrome
nephrotoxicity
ototoxicity

54
Q

general antibiotic toxicity

A

GI distress

55
Q

azithromycin toxicity

A

QT prolongation

cholestatic jaundice

56
Q

ampicillin toxicity

A

maculopapular rash

GI distress

57
Q

piperacillin toxicity

A

decreased coagulation

hypersensitivity w/ceph

58
Q

caution with breastfeeding

A

clarithromycin

linezolid

59
Q

avoid breastfeeding

A

metronidazole

60
Q

penicillin use in breastfeeding infants

A

may cause diarrhea, candidiasis, and skin rash

61
Q

teratogenic antibiotics

A 
clarithromycin
doxycycline
erythromycin
gentamicin
levofloxacin
linezolid
metronidazole
piperacillin
trimethoprim
62
Q

bactam MOA

A

irreversible inhibitor of bacteria beta-lactamases

63
Q

cilastatin MOA

A

reversible, competitive inhibitor of renal DHP-1

64
Q

what is renal DHP-1 ?

A

enzyme that breaks down imipenem to inactive but nephrotoxic metabolites

65
Q

daptomycin indication for pulmonary infections

A

NOT for pulmonary infections
inactivated by surfactant
(sry trick question)

66
Q

bronchitis Rx

A 
amoxicillin+clavulanic acid
azithromycin
clarithromycin
doxycycline 
(ciprofloxacin)
67
Q

causes of bronchitis in younger patients

A

viral

68
Q

causes of bronchitis in elderly patients

A

bacterial:

  • Mycoplasma pneumonia
  • Streptococcus pneumonia
  • Haemophilus influenza
  • Moraxella catarrhalis
  • Bordetella pertussis
69
Q

causes of bronchitis in smokers

A

H. influenza

70
Q

lung abscess Rx

A

clindamycin (superior to penicillin, esp. w/Bacteriodes)

71
Q

nosocomial lung abscess Rx

A

metronidazole + ceftriaxone

Pulm (4 decks)

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