C Diff and MISC drugs

Question 1

C Diff is becoming more of a problem why

Answer 1

1. NAP1/027 strain lacks tcdC which leads to increased virulence

Question 2

Risk Factors for C. Diff infxn

Answer 2

1. exposure to any antimicrobials, especially w/ multiple (clinda, penicillins, cephalo, fluoro)
2. hospitalizations
3. old age
4. IBD

Question 3

What effect do PPIs have on risk for recurrent C Diff infxn among inpatients

Answer 3

no risk w/ recurrence

Question 4

treament for C diff

Answer 4

1. metronidazole - mild to mod dz
2. vanc - severe dz and pregnant/lactating women
3. vanc and metronidazole for complicated dz

Question 5

ADE and CI of metronidazole

Answer 5

ADE - peripheral neuropathy after high doses or prolonged use
CI - crosses placenta and breast milk

Question 6

MOA Fidaxomicin

Answer 6

macrolide, bactericidal, inhibits bacterial RNA polymerase. No cross resistance, minimal systemization. NO activity against gram negative anaerobes, faultative anaerobes, and enterbacteria

Question 7

ADE of vanc and fidaxomicin

Answer 7

GI problems

Question 8

Fecal microbiota transplant

Answer 8

1. recipient - stops Abx, do prep to reduce stool volume, loperamide after transplant
2. donor - no recent abx use, screen for fecal pathogens, test for viruses, milk of magnesia softener

Question 9

MOA of ampicillin. ADE

Answer 9

beta-lactam. Rash and HSR

Question 10

MOA ciprofloxacin

Answer 10

inhibiting DNA gyrase, a type II topoisomerase, and topoisomerase IV

Question 11

ADE of ciprofloxain

Answer 11

BBW for tendon rupture and Mysathenia gravis

- liver failure, rash, vision problems, GI problems,

Question 12

Chlorpheniramine MOA

Answer 12

H1 antihistamine antagonists + SNRI

Question 13

ADE Chlorpheniramine

Answer 13

drowsiness, dizziness, confusion, constipation, anxiety, nausea, blurred vision, restlessness, decreased coordination, dry mouth, shallow breathing, hallucinations, irritability, problems with memory or concentration, tinnitus and trouble urinating

Question 14

MOA donepezil

Answer 14

centrally acting reversible acetylcholinesterase inhibitor

Question 15

ADE donepezil

Answer 15

hypersecretion of saliva; bradycardia, nausea, diarrhea, anorexia, abdominal pain, and vivid dreams.

Question 16

MOA fosfomycin

Answer 16

bactericidal and inhibits bacterial cell wall biogenesis by inactivating the enzyme UDP-N-acetylglucosamine-3-enolpyruvyltransferase, also known as MurA.

Question 17

MOA Selegilene

Answer 17

selective irreversible MAO-B inhibitor.

Question 18

CI of Selegilene

Answer 18

OCP