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Infectious Diseases > Exam 2- Misc. Agents > Flashcards

Exam 2- Misc. Agents Flashcards

1
Q

GP coverage of tetracyclines

A

PSSP
MSSA
some enterococcus

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2
Q

GN coverage of tetracyclines

A

wimpy GN
most enterobacter are resistant

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3
Q

Misc coverage of tetracyclines

A

Legionella
Chlamydophila pneumonia and psittaci

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4
Q

GP coverage of tetracycline analogues

A

Enterococcus Faecalis (VSE and VRE)
MSSA, MRSA

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5
Q

GN coverage of tetracycline analogues

A

some BLases
NO PROTEUS OR PSEUDOMONAS

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6
Q

clinical uses of tetracyclines

A

mild/moderate community pneumonia causes by PSSA
Chlamydial infections
Nongonococcal urethritis (doxy)

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7
Q

GP coverage for TMP-SMX

A

MRSA
Community Acquired-MRSA

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8
Q

GN coverage for TMP-SMX

A

stenotrophomonas maltophilia
NOT PSEUDMONAS

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9
Q

what is the random bug that TMP-SMX covers

A

pneumocystis carinii/jirovecci
DRUG OF CHOICE

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10
Q

clinical uses of TMP-SMX

A

UTIs
prostatitis
pneumocystis carinii/jirovecci (treatment and prophylaxis)
CA-MRSA
Stenotroph maltophilia

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11
Q

GP coverage for polymyxins

A

NONE

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12
Q

GN coverage for polymyxins

A

Acinetobacter
pseudomonas aeruginosa

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13
Q

what GN do polymyxins NOT cover

A

Burkholderia, Proteus, Providencia, Serratia, Brucella

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14
Q

clinical uses of polymyxins

A

GN bacteria that are resistant

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15
Q

what is polymyxin preferred for

A

systemic infections

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16
Q

what is colistin preferred for

A

UTIs

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17
Q

GP coverage for Clindamycin

A

PSSP
MSSA, CA-MRSA

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18
Q

clinical uses for clindamycin

A

infections due to anaerobes OUTSIDE THE CNS
pulmonary infections
diabetic foot infections
CA-MRSA
alternate for GP aerobes for penicillin allergens

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19
Q

GP coverage of metronidazole

A

Clostridium spp. (including C.diff)

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20
Q

GN coverage of metronidazole

A

Bacteroides Fragilis (DOT organisms)

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21
Q

Clinical uses of metronidazole

A

infections due to anaerobes
(brain abscesses)
Toxic megacolon due to C.diff
Trichomonas Vaginalis
Giardia

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22
Q

tetracycline moa

A

inhibit protein synthesis by binding to the 30S ribosome and block binding of amino-acyl tRNA to the A site

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23
Q

what kind of killers are tetracyclines

A

bacteriostatic

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24
Q

what is the resistance against tetracyclines

A

efflux pumps
ribosomal protection proteins
enzymatic inactivation

25
Q

what should oral tetracyclines not be given with

A

dair or supplements

26
Q

can tetracyclines get in the CSF

A

small amounts/no

27
Q

do you adjust tetracyclines

A

tetracyclines require dosage adjustments in renal insufficiency
analogs do NOT

28
Q

major adverse events of tetracycline

A

Gastrointestinal
Photosensitivity
dental issues in certain populations

29
Q

who cannot use tetracycline

A

pregnancy/peds due to dental issues (discoloration/development)

30
Q

TMP-SMX moa

A

inhibit dihydropteroate synthetase
inhibit activity of bacterial dihydrofolate reductase

31
Q

what kind of killer is TMP-SMX

A

bactericidal

32
Q

what is the resistance against TMP-SMX

A

point mutations in dihydropteroate synthase or alterade bacterial dihydropepteroate reductase

33
Q

what is the ratio of TMP-SMX for steady state concentrations

A

oral or IV combo of 1:5

34
Q

can TMP-SMX access the CNS

A

yes in the presence of inflamed meninges

35
Q

dose adjustment of TMP-SMX

A

adjust in CrCl < 30

36
Q

what are the adverse effects of TMP-SMX

A

hematologic, leukopenia
hypersensitivity reaction
renal insufficiency/crystalluria/hyperkalemia

37
Q

who should avoid TMP-SMX

A

pregnant or lactating women

38
Q

DDI of TMP-SMX

A

warfarin - anti coag effect

39
Q

what is the moa of polymyxins

A

cationic detergents that bind to the lipopolysaccharide molecules of the outer cell membrane causing displacement of Ca and Mg that changes cell wall permeability

40
Q

what kind of killers are polymyxins

A

concentration-dependent bactericidal activity

41
Q

what is the resistance against polymyxins

A

alteration of outer cell membrane

42
Q

are polymyxins absorbed in the GI

43
Q

dose adjustments for polymyxins

A

yes, CrCl < 80

44
Q

adverse effects of polymyxin

A

nephrotoxicity
neurotoxicity

45
Q

clindamycin moa

A

inhibits protein synthesis by binding to the 50S ribosomal subunit

46
Q

what kind of killer is clindamycin

A

primarily bacteriostatic but can display time-dependent bactericidal activity

47
Q

what is the resistance against clindamycin

A

alteration of the ribosomal binding site

48
Q

does clindamycin penetrate the CSF

49
Q

where is clindamycin metabolized

50
Q

adverse effects of clindamycin

A

N/V/D
C. diff colitis
one of the worst inducers
hepatotoxicity

51
Q

metronidazole moa

A

prodrug that is activated by a reductive process from ferredoxins

52
Q

what kind of killer is metronidazole

A

rapidly bactericidal in concentration-dependent manner

53
Q

what is the resistance against metronidazole

A

very uncommon
altered growth requirements
decreased levels of ferredoxin gene

54
Q

does metronidazole penetrate the CSF

A

YES and the brain tissue

55
Q

does metronidazole require dose adjustment

A

yes, renal and hepatic dysfunction

56
Q

what are the adverse effects of metronidazole

A

GI
peripheral neuropathy
mutagenicity and carcinogenicity

57
Q

who should avoid metronidazole

A

pregnant and breastfeeding

58
Q

DDI of metronidazole

A

warfarin
alcohol

Infectious Diseases (11 decks)

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