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Clin Therapeutics 1 > Exam 1 - ABX, their bacteria, and indications (high yield) > Flashcards

Exam 1 - ABX, their bacteria, and indications (high yield) Flashcards

1
Q

PCN G IV gram coverage?

A

Gram positive

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2
Q

PCN G IV bacterial coverage?

A

Strep A-G
Enterococci (some)
Anaerobes

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3
Q

PCN G route?

A

IV

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4
Q

PCN G and PCN V good for which infections?

A

Dental, throat

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5
Q

Which bacteria through birth canal? Which abx?

A

Group B Strep. Use PCN G or PCN V.

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6
Q

If PT is noncomplaint or homeless how can PCN be given?

A

IM injection

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7
Q

PCN V and PCN G are in which class?

A

Natural PCNs

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8
Q

Nafacillin, Oxacillin what route? Great coverage for what? Gram?

A

IV. Great at MSSA coverage. Gram positive.

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9
Q

Dicloxacillin route? Great coverage for what? Gram?

A

PO. Great MSSA coverage. Gram positive.

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10
Q

Nafacillin, Oxacillin, and Dicloxacillin in what class?

A

Anti-staph PCN

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11
Q

Anti-staph PCNs good for which infection?

A

Skin infection

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12
Q

Does Anti-Staph PCN class require rental dosing?

A

Nope

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13
Q

Which two abx are in the Amino PCN class?

A

Ampicillin

Amoxicillin

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14
Q

Coverage for Amino PCNs (Amp, Amox)?

A

Gram positives
Gram negative +/-
Enterococcus
Listeria and Shigella

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15
Q

Amino PCNs (Amp, Amox) good for?

A

OM
UTI and URI
Meningitis (use Ampicillin)
Listeria

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16
Q

What is Drug of Choice for Listeria?

A

Ampicillin IV

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17
Q

What is Drug of Choice for Urinary Tract Infections and Upper Resp Infections in pregnancy?

A

Amoxicillin BID

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18
Q

How to overcome gram positive resistance with Amoxicillin? Gram negative resistance?

A

Gram positive=Increase dose

Gram negative=Add Beta-Lactamase Inhibitor

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19
Q

How to overcome gram positive resistance with Amoxicillin?

A

Add Beta-Lactam

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20
Q

Coverage for Beta-Lactamase Inhibitors?

A

Gram Positive
Gram Negative
Beta-Lactamase producing strains

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21
Q

Beta-Lactamase Inhibitors good for what fort of infections?

A

Broad empiric coverage
Hospital acquired infections
Beta Lactamase producing infections
Human/animal bites

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22
Q

What class is used for broad empiric coverage?

A

PCN + Beta-Lactamase Inhibitors

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23
Q

What class is used for hospital acquired infections?

A

Beta-Lactamase Inhibitors

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24
Q

What class used for human/animal bites?

A

Beta-Lactamase Inhibitors

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25
Q

Which abx used for Pseudomonas?

A

Zosyn ( (piperacillin + tazobactam)

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26
Q

Abx for Acinetobacter?

A

Unasyn (Ampicillin + Sulbactam)

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27
Q

1st gen Cephalosporins coverage?

A 
Gram positive (MSSA, Step Pyogenes)
Some Gram negative
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28
Q

1st gen Cephalosporins second line good for?

A

MSSA skin and soft tissue infections

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29
Q

2st gen Cephalosporins coverage?

A 
Gram Positive (Staph, MSSA, Strep Pyogenes)
Enhanced Gram Negative
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30
Q

Which 2nd gen Cephalosporin has anaerrobic B Fragilis coverage?

A

Cefotetan IV

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31
Q

Cefotetan IV covers what special bacteria?

A

Anaerobic B Fragilis

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32
Q

2nd gen Cephalosporins good for what?

A

Abdominal infections
GYN infections
Respiratory tract infections (sinutitis, OM, etc)

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33
Q

1st gen Cephalospirins have increased risk of what?

A

Cross reactivity in PCN allergic patients

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34
Q

3rd gen Cephalospirins have less activity against Gram ____ and broad coverage against Gram ____

A

Gram Positive=less

Gram Negative=broad

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35
Q

Which abx class has less coverage against Gram Positive and broad coverage against gram negative?

A

3rd gen cephalosporins

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36
Q

3rd gen Cephalosporins good for what three things?

A
  1. Community Acquired Pneumonia
  2. Meningitis
  3. Lyme
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37
Q

Which class for Gonorrhea tx?

A

3rd gen Cephalosporins

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38
Q

Which drug used for Hospital Acquired Pneumonia?

A

Ceftazidime, a 3rd gen Cephalosporin

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39
Q

4th gen Cephalosporin coverage? Except?

A

Everything except MRSA, Enterococcus, B. Fragilis

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40
Q

Does 4th gen Cephalosporins cover Pseudomonas?

A

Yes

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41
Q

Does 4th gen Cephalosporins cover Strep Pneumonias?

A

Yes

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42
Q

4th gen Cephalosporins good for what two things?

A
  1. Hospital acquired infections

2. Neutropenic fever

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43
Q

What is the one drug in the 4th gen Cephalosporin class?

A

Cefepime

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44
Q

5th gen Cephalosporins coverage?

A

Gram positive

Gram negative

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45
Q

Does 5th gen Cephalosporins cover Staph including MSSA, MRSA, and VRSA?

A

Yes

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46
Q

5th gen Cephalosporins good for?

A

Skin and skin structure infections

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47
Q

Do 5th gen Cephalosporins cover gram negative anaerobes?

A

Yes, but limited coverage

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48
Q

What is the route for the Carbapenems?

A

IV, except for Etrapenem IM

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49
Q

Gram coverage for Carbapenems?

A

Gram Positive
Gram Negatives, including Pseudomonas
Anaerobes

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50
Q

Do the Carbapenems cover Pseudomonas? Any exceptions?

A

Yes, except for Etrapenem

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51
Q

Carbapenems drug of choice for?

A

Infections caused by resistant organisms

Ceftriaxone-resistant E Coli, Klebsiella, P mirabilis

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52
Q

What is the drug of choice for Extended Spectrum Beta-Lactamases?

A

Carbapenems

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53
Q

Which Carbapenems has highest risk of seizures?

A

Imipenem

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54
Q

If a bacteria is resistant to Ceftriaxone what to use?

A

Carbapenems

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55
Q

Does Ertapenem cover Psueomonas?

A

No.

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56
Q

Monobactam gram coverage?

A

Gram negative aerobic only!

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57
Q

Monobactam good for what two?

A

Pseudomonas

PCN allergic patient

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58
Q

Does Monobactam cover Pseudomonas?

A

Yes!

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59
Q

What is the name of the one Monobactam abx? Route?

A

Aztreonam

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60
Q

Can Monobactam (Aztreonam) be given when PT allergic to Ceftazidme?

A

No!

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61
Q

If PT allergic to PCN can give Monobactam (Aztreonam) as alternative?

A

Yes, but not if also allergic to Ceftazidme

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62
Q

Fluoroquinolones black box warning?

A

Tendonitis, tendon rupture, CNS issues

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63
Q

Fluoroquinolones reserved for what line in therapy? Due to what?

A

Last line therapy due to black box warnings

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64
Q

Fluoroquinolone coverage?

A 
Gram positives
Gram negatives
Excellent atypical coverage
Pseudomonas
M Tuberculosis
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65
Q

Fluoroquinolones don’t cover?

A

No gram negative anaerobes

66
Q

Fluoroquinolone preggers rating?

A

C

67
Q

Use Fluoroquinolones in children?

A

Nope

68
Q

Fluoroquinolones good for what?

A

Systemic infections; soft tissue, bone, and join infx, intraabdominal infx, resp tract infx, UTI

69
Q

Fluoroquinolones interact with which minerals?

A

Fe, Ca, Al, Mg

FeCaAlMag

70
Q

Three examples of atypical bacteria that Fluoroquinolones treat?

A

Chlamydia, Legionella, Mycoplasma

71
Q

Does Cipro cover Gram Positive bacteria?

A

Nope

72
Q

Levoflaxacin superior coverage for what two things?

A

Gram positive and atypicals

73
Q

Coverage of gram negative anaerobes such as B Fragilis?

A

Flagyl + Cipro

74
Q

Fluoroquinolones end in what?

A

“-oxacin”

75
Q

Macrolides end in

A

“-mycin”

76
Q

Macrolides cover?

A

Gram negative

Atypicals

77
Q

Macrolides good for what?

A

Respiratory infection

78
Q

Macrolides not used for infections where?

A

Infections of soft tissue, blood, or urine

79
Q

Macrolides and CAP?

A

Covers most common CAP bugs

80
Q

Tetracyclines coverage?

A

Gram positive, including MSSA and MRSA

Some Gram neg

Some anaerobes and atypicals

81
Q

Tetracyclines good for?

A

Resp tract infx
Skin and soft tissue MRSA infx
Tick-bourne infx (Lyme)

82
Q

Tetracyclines resistance how?

A

Efflux pumps

83
Q

Tetracyclines good for which Gram Negatives?

A

H Influenza

M Cattrahlis

84
Q

Which Tetracycline is anti-inflammatory in low doses? Good for what?

A

Doxycycline. Good for acne.

85
Q

Tetracyclines in preggers?

A

Category D. Don’t.

86
Q

Tetracyclines in kids under 8?

A

Nope. Bones and teeth get messed up.

87
Q

Tetracyclines ADRs?

A

GI upset, photosensitive, tooth discoloration, bone deposits

88
Q

Aminoglycosides end in what?

A

“-mycin”

89
Q

When to use Aminoglycosides?

A

Last resort

90
Q

Are Aminoglycosides used alone?

A

No, except for UTIs

91
Q

When are Aminoglycosides used alone?

A

UTIs

92
Q

Aminoglycosides coverage?

A

Excellent Gram negative, including pseudomonas

93
Q

Do Aminoglycosides cover Gram positives?

A

Only when used synergistically

Ex: Ampacillin + Gentamycin

94
Q

Aminoglycosides anaerobic coverage?

A

None

95
Q

Aminoglycosides used as monotherapy against gram positive?

A

Nope

96
Q

Aminoglycosides cover pseudomonas?

A

Yes! A better than T better than G.

97
Q

Aminoglycosides and Endocarditis?

A

Use Streptomycin in combination with a beta-lactam

98
Q

Aminoglycosides where in line with TB?

A

Second-line

99
Q

Aminoglycosides good for

A

Hospital acquired infection, UTIs

100
Q

Do Aminoglycosides penetrate CSF and lungs?

A

Not yer well

101
Q

Aminoglycosides and preggers?

A

Category D. Nope!

102
Q

Aminoglycoside drug monitoring

A

Monitor peak and trough level.

103
Q

Aminoglycosides and kidneys?

A

Can become nephrotoxic

104
Q

Aminoglycosides and “post antibiotic effect”? How?

A

Residual bactercial effect even after serum MIC. Remains intracellular.

105
Q

Clindamycin gram coverage?

A

Broad gram positive. MRSA and MSSA. NO gram negative coverage.

106
Q

Clindamycin and anaerobes?

A

Covers gram positive anaerobes, including Clostridium

107
Q

Clindamycin good for?

A

Skin, soft tissue, dental, respiratory infections

108
Q

Clindamycin special treatment for what very scary thing?

A

Necrotizing fasciitis

109
Q

Clindamycin recommended for gram positive treatment if PT has what complication?

A

PCN allergy

110
Q

Clindamycin ADR that sucks?

A

C Diff colitis, diarrhea

111
Q

Clindamycin good for what special type of pneumonia?

A

Aspiration pneumonia

112
Q

Clindamycin and B Fragilis coverage?

A

Minimal coverage

113
Q

Trimethoprim/ sulfamethoxazole (Bactrim) gram coverage?

A 
Gram positive (inc MSSA, MRSA)
Gram negative
No anaerobic, atypical, or pseudomonas
114
Q

Does Trimethoprim/ sulfamethoxazole (Bactrim) cover anaerobic, atypical, or pseudomonas

A

Nope

115
Q

Does Trimethoprim/ sulfamethoxazole (Bactrim) cover pneumocystis and toxoplasma gondii?

A

Yes it does

116
Q

Trimethoprim/ sulfamethoxazole (Bactrim) good for?

A

UTIs

MRSA-caused skin soft tissue infx

117
Q

Trimethoprim/ sulfamethoxazole (Bactrim) ADRs?

A

So many. N/V/D, HyperK, photosensitive, hypersentisive, bone marrow suppression, thrombocytopenis, leukopenis, megaloblastic anemia in folate deficiency, hemolytic anemia in G6PD deficiency

118
Q

Trimethoprim/ sulfamethoxazole (Bactrim) drug interctions?

A

Warfarin

Phenytoin

119
Q

Trimethoprim/ sulfamethoxazole (Bactrim) and kidneys?

A

Consider renal dose adjustments

120
Q

Metronidazole (Flagyl) gram coverage?

A

Covers gram positive and gram negative anaerobes

121
Q

What is “gold standard treatment” for anaerobes?

A

Metronidazole (Flagyl)

122
Q

Metronidazole (Flagyl) first line treatment for which bacteria?

A

C. Diff

123
Q

Which agent used to treat parasites?

A

Metronidazole (Flagyl)

124
Q

C Diff first-line tx?

A

Metronidazole (Flagyl)

125
Q

Metronidazole (Flagyl) and EtOH?

A

Don’t mix due to disulfram like reaction

126
Q

Metronidazole (Flagyl) ADR?

A

GI intolerance

127
Q

Anaerobe treatment based off what anatomical part?

A

Diaphragm
Above diaphragm=Clindamyin
Below diaphram=Metronidazole (Flagyl)

128
Q

Nitrofurantoin and UTIs drug of choice when?

A

Preggers

129
Q

What does Nitrofurantoin and Fosfomycin do to UTIs?

A

Suppress UTIs

130
Q

Nitrofurantoin for which bacteria causing UTI?

A

Enterococcus, some E. Coli

131
Q

Nitrofurantoin and Fosfomycin good for?

A

Lower UTIs

Cyctitis

132
Q

Nitrofurantoin concerns?

A

Renal and elderly concerns

133
Q

Fosfomycin dose frequency for UTIs?

A

Single dose for UTI

134
Q

Vancomycin gram coverage

A

Gram positive aerobes and anaerobes

135
Q

Vancomycin good for

A

Hospital acquired pneumonia, skin and soft tissue infx, meningitis, endocarditis caused by MRSA

136
Q

Vancomycin for C. Diff?

A

Yes. PO route only.

137
Q

Vancomycin contraindications

A

If hypersensitive to corn or prior Vancomycin hypersensitivity

138
Q

Vancomycin ADRs?

A

Red man syndrome. Slow down infusion, give H1 blocker.

139
Q

Vancomycin drug monitoring?

A

Check trough levels

140
Q

Vancomycin covers which 3 gram positive anaerobes?

A

Clostridium, peptostreptococcus, Peptococcus

141
Q

Telavancin gram coverage?

A

Gram positive only. MSSA, MRSA, strep, enterococci, some VRE and VISA.

142
Q

What point to give Telavancin?

A

Reserved as later option with gram positive infections

143
Q

Telavancin and preggers

A

Category C. Fetal abnormalities.

144
Q

Telavancin dosing interval?

A

q24-48h

145
Q

Does Telavancin require level monitoring?

A

Nope

146
Q

Does Telavancin require renal adjustment?

A

Yes it does

147
Q

Two major Telavancin ADRs?

A

Fetal abnormalities

QTc prolongation

148
Q

Other Telavancin ADRs

A

Red man syndrome, nephrotoxic, GI intolerance, metallic taste

149
Q

Linezolid last resort when what happens?

A

When Vando doesn’t work

150
Q

Linezolid gram coverage?

A

Gram positive only!

151
Q

Linezolid against which two superbugs?

A

MRSA, VRE

152
Q

Linezolid bacterialcidal against which bug?

A

Steptococcus

153
Q

Linezolid good for

A

Pneumonia, skin and soft tissue, bacteremia, sepsis

154
Q

Linezolid and MAOIs?

A

Be careful with 5HT

155
Q

Linezolid and tyramine foods?

A

Limit them: aged cheeses, chocolate, coffee, bananas, avocados, over-ripe fruit, fave beans, beer, red wine, sherry, soy sauce, fermented meats

156
Q

Linezolid and tyramine food restrictions for how long after d/c?

A

2 weeks

157
Q

Daptomycin gram coverage?

A

Gram positive only

158
Q

Daptomycin against which superbugs?

A

MRSA, VRE

159
Q

Daptomycin and pneumonia?

A

NO! Binds to lung surfactant!

160
Q

Daptomycin and kidneys?

A

If CrCl less than 30 then lower dose

161
Q

Daptomycin and CPK levels?

A

Monitor closely, might increase

162
Q

Fetal abnormalities occur with which abx?

A

Telavancin

Clin Therapeutics 1 (12 decks)

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