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***pimp questions- rachel > Crozer-antibiotics > Flashcards

Crozer-antibiotics Flashcards

1
Q 
Augmentin
AKA?
Dose?
Clavulonic acid in 500mg Augmentin? 875?
Indication?
Spectrum? 
Psuedomonus?
A

Augmentin
AKA? amoxacillin/clavulonic acid
Dose? 500 mg or 875
Clavulonic acid in 500mg Augmentin? 875? 125 in both
Indication?PO antibiotic for outpatient of polymicrobial infx
Spectrum? Staph (not MRSA), Strep, Enterococci, gram neg, anaerobes
Psuedomonus? No

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2
Q 
Zosyn
AKA?
Dose?
Indication?
Spectrum? 
Psedomonus?
A 
Zosyn
AKA? Piperacillin/tazobactam
Dose?3.375 g IV q6h
Renal-2.25 g IV q6h
Alternative- 4.5 g IV q6h
Indication? tx moderate-severe DFI
Spectrum? Staph (not MRSA) strep enterococci, gram neg, anaerobes 
Psedomonus? Yes
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3
Q 
Unasyn
AKA?
Dose? 
Indication? 
Spectrum?
Pseudomonus?
Alternative if PCN allergy?
A 
Unasyn
AKA?ampicillin/sulbactam
Dose? 3.0 IV q6h
Renal 1.5 g IV q6h
Indication? empiric for poly dfi
Spectrum? staph (not MRSA), Strep, enterococci, gram neg, anerobes,
Pseudomonus? no
Alternative if PCN allergy? clinda/cipro, levaquin
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4
Q 
Timentin
AKA?
Dose? 
Indication? 
Spectrum?
Pseudomonus?
watch for?
A 
Timentin
AKA? ticaracillin/clavulonic acid
Dose? 3.1 g IV q4-6h
Indication? broad spectrum polymicrobial
Spectrum? Staph (not MRSA) strep, gram neg anaerobes 
Pseudomonus?Yes
watch for?Increased Na load
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5
Q 
Penicillins
Which cover psudomonas?
IV alternatives for PCN allergic pts?
how are they excreted?
Concern for combined use of PCN and probenecid?
A

Penicillins
Which cover psudomonas? (4th and 5th generation) piperacillin zosyn ticarcillin, timentin, carbenicillin, mezlocillin, axlocillin
IV alternatives for PCN allergic pts? clindamycin, vancomycin, levaquin, bactrim
how are they excreted?renal execpt- mezlocillin, azlocillin, piperacillin
Concern for PCN and probenecid?probenecid increases duration of serum PCN and cephalosporins

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6
Q 
Cephalosporins
Cross rx of cephalosportins and PCN?
Use? 
1st gen?
2nd gen?
3rd gen? 
4th gen? 
Excreted?
A

Cephalosporins
Cross rx of cephalosportins and PCN?1-10%
Use? Serious gram neg infections with aminoglycosides
1st gen? Cefazolin (ancef), cephalexin (keflex)
2nd gen? cefaclor and cefuroxime
3rd gen? ceftriaxone, ceftazidime and cefdinir
4th gen? cefepime
Excreted?Renal except ceftriaxone (renal and hepatic) and cefoperazone (hepatic)

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7
Q 
Vanco
main indication?
Dose?
levels drawn?
what should peak and trough be?
how do you adjust?
infuse too quick?
Tx red man syn?
side effects?
does duration matter?
A

Vanco
main indication? MRSA
Dose? 1g IV q12h w slow infusion
levels drawn? peak 30 min after 3rd dose. trough 30 min before 4th dose
what should peak and trough be? peak 15-30 mg/mL, trough <10mg/mL
how do you adjust? Peak high decrease dose. trough high increase interval
infuse too quick? Red man syn (erythema and prutitis to the head/neck/torso. anaphylatoid rxn histamine released
Tx red man syn?antihistamines
side effects?ototoxicity and nephrotoxicity
does duration matter? yes longer on it=higher chance of getting oto/nephrotoxicity

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8
Q 
Bactrim 
dose?
single strength tablet=?
double strength tablet=?
How does it work?
Spectrum? 
Psudomonus?
Allergy to be avoided?
Side effect?
Contraindications?
A

Bactrim
dose?1 tab BID
single strength tablet=? TMB 80mg/SMX 400 mg
How does it work?inhibits folate syn in bacteria to prevent DNA replication
Spectrum? broad. gram neg and positive and mursa
Psudomonus?no
Allergy to be avoided?sulfa
Side effect?hemolytic anemia, hypersensitivity
Contraindications? oral hypoglycemia or G6PD def.

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9
Q 
Zithromax
aka?
Dose
Spectrum
PCN allergy?
half life?
A

Zithromax
aka?azithromycin
Dose? 250mg PO, 2 tabs first day than one tab for 4 days
Spectrum? staph strep anaerobes (not bacteroids)
PCN allergy?can give
half life?68 hours

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10
Q 
Primaxin
aka? 
dose?
spectrum?
MRSA?
Psudomonas?
Side effect?
How does it work?
A 
Primaxin
aka? imipenem and cilastatin
dose? 500 mg or 1 gram IV q6-8 h
spectrum?broad
MRSA? no 
Psudomonas?no
Side effect?seizures
How does it work? imipenem=antibiotic
cilastatin-renal dehydropeptidase inhibitor prevents imipenem from being metabolized by the kidneys
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11
Q

antibiotic nicknamed gorillamycin

A

imipenem

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12
Q 
Invanz
aka
dose
indication
spectrum
psudomonas
class?
A 
Invanz
aka= ertapenem
dose? 1 g IV q24 h
indicationz? dfi
spectrum? gram pos, neg and anaerobes
psudomonas? no
class? 1B-methyl-carbapenem related to B lactams
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13
Q 
Zyvox
aka?
Dose?
 indication? 
Spectrum? 
side effect
why isn't it used more
A 
Zyvox
aka? linezolid
Dose? 400-600 PO/IV q12h
indication? outpatient MRSA
Spectrum? gram positives and MRSA,
side effect? thrombocytopenia
why isn't it used more? \$\$$
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14
Q 
quinolones? 
dose of cipro?
Dose of levaquin?
dose of avelox?
spectrum? 
SE?
not be given?
A 
quinolones? 
dose of cipro? 250-750 mg PO q12h. 200-400 mg IV q12 h
Dose of levaquin?250-500mg PO/IV q 24h
dose of avelox? 400 mg PO/IV q24 H
spectrum? gram neg including pseudomonas
SE? tendons
not be given? open growth plates
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15
Q 
Aztreonam
dose? 
spectrum?
SE?
not used more
A 
Aztreonam
dose? 1-2 g IV q8h
spectrum?gram neg aerobes and pseudomonas
SE?none
not used more \$\$$
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16
Q 
Aminoglycosides (gentamycin, tobramycin, amikacin)
spectrum
SE
Dose peaks and troughs
how to dose gentamycin?
A

Aminoglycosides (gentamycin, tobramycin, amikacin)
spectrum? gram neg aerobes
SE? ototoxicity (irreversible), nephrotox (reversible), neuromuscular blockade (prevented by slow infusion)
Dose peaks and troughs? gent and tobra 3-5 mg/kg q8h, peak 6-10, trough=2…
how to dose gentamycin?loading dose 2mg/kg, than creatine clearance

17
Q 
Clindamycin
dose? 
spectrum?
SE?
metabolized?
A 
Clindamycin
dose? 600-900 mg IV q8h or 150-300 mg PO BID
spectrum? gram + and anaerobes
SE? C dif
metabolized? Liver
18
Q

Flagyl
dose?
Spectrum?

A

Flagyl
dose?500 mg PO TID
Spectrum? most gram neg anaerobes

19
Q

MRSA

what antibiotics cover?

A

PO- linezolid, minocycline, cipro/rifampin, bactrim/rifamin
IV-vanco linezolid, minocycline, cipro/rifa, bactrim/rifa, synercid, tigecyclin, telavancin
topical=bactroban

20
Q

Vanco resistant enterococci (VRE)
tx?
only PO med?

A

Vanco resistant enterococci (VRE)
tx? linezolid or dalfopristin-quinupristin
only PO? linezolid

21
Q

drugs that cover pseudomonas?

A

aztreonam, aminoglycosides, cipro, ceftazidine, cefepime, timentin, zosyn

22
Q

Empiric therapy for polymicrobial foot infections?

A

vanco/zosyn, clinda/cipro, vanco/invanz

23
Q

What are only FDA approved drugs for tx diabetic foot infections?

A

Zosyn, Zyvox, Invanz

24
Q

2 main causes of antibiotic diarrhea

A

pseudomembranous colitis-c dif

non specific colitis-staph aureus

25
Q

How to test for C dif

A

check stool for C diff

26
Q

most common cause of C diff

A

clindamycin

27
Q

how do you treat C dif

A

Vanco 125 mg PO q6h

Flagyl 500 mg PO TID

28
Q

antibiotics metabolized by liver

A

clindamycin, cefoperazone, chloramphenicol, erythromycin

29
Q

can antibiotics affect PT/INR?

A

Yes. affect normal flora which alters vit K

30
Q

What can B- lactams cause

A

leukopenia

31
Q

Whats MOA of aminoglycosides

A

bind bacterial 30s ribosomes inhibiting protein syn.

32
Q

MOA of macrolides?

A

bind 50s and inhibit protein syn

33
Q

what antibiotics can be safely used with PMMA beads

A

vacomycin, gentamycin, tobramycin cefazolin,

the curing of PMMA is exothermic and therefore antibiotics must be not heat- labile

34
Q

what open fx should be treated w antibiotics

A

grade 2 and 3

***pimp questions- rachel (12 decks)

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