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Pharm Exam 3 > ch 78 > Flashcards

ch 78 Flashcards

1
Q

Fluoroquinolones can all cause what major adverse effect

A

tendinitis and tendon rupture of achilles tendon

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2
Q

ciprofloxacin is ____ spectrum and ______

A

broad spectrum

bactericidal

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3
Q

drug for preventing anthrax in people who have inhaled

A

Ciprofloxacin

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4
Q

fluoroquinolones in kids

A

no due to tendon rupture

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5
Q

ciprofloxacin adverse effects

A 
tendinitis
rupture of achilles tendon
n/v/d
abd pain
dizziness
headache
restlessness
confusion
candida infections of the pharynx, vagina, 
confusion
somnolence 
psychosis
visual disturbances
phototoxicity (severe sunburn) - characterized by erythema, exudate, vesicles, blistering and edema - which can occur with direct sun, indirect sun and sunlamps even with sunscreen - wear protective clothing on top of sunscreen - d/c cipro at first sign of phototoxic rash
c.diff
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6
Q

cipro should be stopped at the first sign of

A

tendon injury
discontinue at the first sign of tendon pain swelling or inflammation

refrain from exercise until tendon injury is r/o

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7
Q

which fluoroquinolones are approved in children

A

Ciprofloxacin and levofloxacin

however generally avoided in kids

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8
Q

pregnancy fluoroquinolones

A

no

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9
Q

breast feeding fluoroquinolones

A

no

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10
Q

fluoroquinolones older adults

A

well tolerated, creatinine clearance should be calculated

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11
Q

fluoroquinolones - high risk group

A

glucocorticoids
pt 60 and older
history of heart, lung or kidney transplant

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12
Q

education on ciprofloxacin for sun tox

A

characterized by erythema, exudate, vesicles, blistering and edema - which can occur with direct sun, indirect sun and sunlamps even with sunscreen - wear protective clothing on top of sunscreen - d/c cipro at first sign of phototoxic rash

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13
Q

ciprofloxacin and MG

A

can exacerbate weakness. Should not get this drug

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14
Q

cipro and food reaction

A

can be reduced by the following

aluminum or mag containing antacids
iron salts
zinc salts
sucralfate
calcium supplements
milk
dairy products

these cationic agents should be administered at least 6 hours before cipro or 2 hours after

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15
Q

drug interactions ciprofloxacin

A

increase plasma levels of the following drugs

theophylline
warfarin
tinidazole

for pt taking warfarin - prothrombin time should be monitored and dose of warfarin reduced as appropriate

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16
Q

fluoroquinolone used for infections of the resp tract, GI, bones, joint, skin, soft tissue and anthrax

A

Ciprofloxacin (Cipro)

17
Q

used to treat protozoal infections and infections by obligate anaerobic bacteria

A

metronidazole (Flagyl)

18
Q

Bacteroides fragilis and other Bacteroides, c diff and other clostridium species, fusobacterium, gardnerella vaginalis, peptococcus species and peptostroptococcus species

A

Metronidazole (flagyl)

19
Q

flagyl is employed for prophylaxis in surgical procedures associated with a high risk for infection by

A

anaerobes such as colorectal surgery, abd surgery, gynecologic surgury

20
Q

H.Pylori treatment for someone with PUD

A

Metronidazole (flagyl) with a tetracycline and bismuth subsalicylate to eradicate

21
Q

black box for flagyl

A

carcinogenic risk

22
Q

cyclic lipopeptides drug

A

Daptomycin

23
Q

what bad bug can daptomycin target

A

MRSA

24
Q

adverse effect daptomycin

A 
muscle injury - ckmb will be elevated
constipation
n/d
headache
insomnia 
rash
25
Q

can you use daptomycin for community acquired pneumonia

A

no

26
Q

2 approved indications daptomycin

A

1) bloodstream infection to include endocarditis)
2) complicated skin and skin structures by susceptible strains of the following gram pos bacteria:

S aureus (to include MRSA)
strep pyoges
strep agalactiae 
strep dysgalactiae
subspecies equisimilis
E.faecalis (vanc susceptible strains only)
27
Q

Daptomycin and renal

A

renal dosing must be used for GFR less than 30 or risk tox

28
Q

what labs should be done weekly for pt taking daptomycin

A

CPK levels - if levels rise more than 10 times the upper limit, d/c med if also having muscle pain or weakness

29
Q

drug interactions and daptomycin

A

when you combine daptomycin and tobramycin - increased daptomycin levels and moderate decrease in tobramycin levels

statin inhibitor (simvastatin)- both can cause myopathy

30
Q

Treatment in hospital for MRSA

A

Vanc
Daptomycin
Zyvox

31
Q

outpatient treatment for MRSA

A

Bactrim
minocycline
doxycycline
clindamycin

32
Q

what fluoroquinolone will treat MRSA

A

Daptomycin

33
Q

what fluoroquinolone has risk of QT

A

Moxifloxacin (Avelox)

34
Q

which fluoroquinolone is approved for Community acquired pneumonia

A

Gemifloxacin

35
Q

which fluoroquinolones have sun toxicity

A

Levofloxacin
Gemifloxacin
Delafloxacin

Pharm Exam 3 (19 decks)

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