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PHM603 > EXAM II - Principles > Flashcards

EXAM II - Principles Flashcards

1
Q

What are drugs effects? (2)

A

toxicodynamics on host and pharmacodynamics on bacteria

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2
Q

What are host effects? (2)

A

pharmacokinetics on drug and host defenses on bacteria

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3
Q

What are bacteria effects? (2)

A

resistance on drug and infection on host

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4
Q

What bacteria infects skin?

A

staphylococcus aureus

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5
Q

What bacteria infects the intestinal lining?

A

helicobacter pylori

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6
Q

What bacteria infects the urinary tract?

A

escherichia coli

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7
Q

What has no evidence based support for use?

A

combination therapy for carbapenem-resistant Gram-negatvie bacteria

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8
Q

What value denotes something that is bactericidal?

A

< 10^4 CFUs/mL

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9
Q

What are Gram-positive cocci in clusters?

A

coagulase negative (s. epidermidis) and coagulase positive (s. aureus)

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10
Q

What percents are MSSE and MRSE?

A

MSSE = 26%, MRSE = 74%

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11
Q

What percents are MSSA and MRSA?

A

MSSA = 50%, MRSA = 50%

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12
Q

How to treat susceptible staph versus resistant?

A

susceptible = nafcillin/dicloxacillin/cephalexin, resistant = vanco/daptomycin/linezolid/clindamycin/ceftaroline/TMPSMX

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13
Q

SPACE acronym stand for?

A

serratia, pseudomonas, acinetobacter/indole-positive, citrobacter, enterobacter

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14
Q

penicillins MOA?

A

bind to transpeptidase enzymes and prevent cell wall formation

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15
Q

penicillins spectrum of activity?

A

Gram + aerobes, some MSSA

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16
Q

cephalosporins MOA?

A

bind to transpeptidase enzymes and prevent cell wall formation

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17
Q

cephalosporins spectrum of activity?

A

ceftazidime - pseudomonas, cefepime - MRSA

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18
Q

What is the drug class of choice for ESBL producing organisms?

A

carbapenems

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19
Q

carbapenems spectrum of activity?

A

does not work on MRSA or atypicals

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20
Q

aminoglycosides MOA?

A

bind to 30S ribosomal subunit

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21
Q

What aminoglycoside is used in combination with cell wall active agents?

A

gentamicin

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22
Q

What are ADEs of aminoglycosides?

A

nephro/ototoxicity, neuromuscular blockade

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23
Q

aminoglycosides spectrum of activity?

A

does not work on Gram - anaerobes or atypicals

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24
Q

What class of drugs are bacteriostatic?

A

tetracyclines, macrolides, lincosamides, TMP/SMX, and oxazolidinones

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25
tetracyclines MOA?
reversibly bind to 30S ribosomal subunit
26
tetracyclines ADEs?
GI, phototoxicity, Fanconi syndrome
27
tetracyclines spectrum of activity?
work on atypicals, no pseudomonas coverage
28
macrolides MOA?
reversibly bind to the 50S ribosomal subunit
29
macrolides ADEs?
GI, phlebitis
30
macrolides spectrum of activity?
work on atypicals, not staph or pseudomonas
31
lincosamides MOA?
reversibly bind to the 50S ribosomal subunit
32
lincosamides ADEs?
GI, pseudomembranous colitis
33
lincosamides spectrum of activity?
No gram - or pseudomonas
34
fluoroquinolones MOA?
inhibit DNA gyrase
35
What drugs are affected by oral coadministration of di- and trivalent cations?
tetracyclines and fluoroquinolones
36
fluoroquinolones ADEs?
GI, HA, seizures, QTc prolongation
37
fluoroquinolones spectrum of activity?
pseudomonas and atypicals
38
What class of drugs are first-line for MRSA infections?
glycopeptides
39
glycopeptides MOA?
bind to the terminal residue in growing peptidoglycan chains and prevent cell wall formation
40
glycopeptides ADEs?
nephro/ototoxicity, Red Man's Syndrome, neutropenia, rash
41
What is not indicated for pneumonia?
daptomycin
42
What drug is first-line for pneumocystis carinii pneumonia?
TMP/SMX
43
trimotheprim/sulfamethoxazole MOA?
folate pathway inhibitor
44
trimethoprim/sulfamethoxazole ADEs?
GI, rash, anemia, crystalluria, neutropenia
45
nitroimidazoles MOA?
reduces to toxic intermediate that form DNA adducts
46
nitroimidazole ADEs?
GI, disulfiram reaction, metallic taste
47
nitroimidazole spectrum of activity?
Gram - anaerobes
48
oxazolidinones MOA?
bind to 50S ribosomal subunit
49
What generation cephalosporin has CSF penetration?
third (cefotaxime, ceftriaxone, cefixime, cefpodoxime, cefoperazone)
50
What generation cephalosporin has MRSA activity?
fifth (ceftaroline)
51
What is the formula for AUC of a given dose?
AUCdose = t_infusion * ((c_max + c_min)/2) + ((c_max - c_min)/k)
52
What is the dosing goal of penicillins, cephalosporins, carbapenems, macrolides, and oxazolidiones?
prolonged infusion time, continuous infusion, shorter dosing interval, increase dose
53
What is the key parameter of penicillins, cephalosporins, carbapenems, macrolides, and oxazolidiones?
%T>MIC
54
What is the dosing goal of aminoglycosides and fluoroquinolones?
extended interval dosing, maximize safe dose
55
What is the key parameter of aminoglycosides and fluoroquinolones?
Cmax:MIC, AUC:MIC
56
What is the dosing goal of vancomycin, azithromycin, and tetracycline?
optimize safe dose
57
What is the key parameter of vancomycin, azithromycin, and tetracycline?
AUC:MIC
58
What antibiotics do not require renal adjustment? (12)
metronidazole, azithromycin, nafcillin, tigecycline, oxacillin, linezolid, doxycycline, moxifloxacin, erythromycin, quinupristin/dalfopristin, ceftriaxone, clindamycin
59
What is the foremost factor controlling PD?
the bacteria species
60
What is the AUC MIC for vancomycin?
> 400 mg*h/L
61
What is the trough goal for vancomycin?
10-15 mcg/mL
62
purulent SSTI treatment (mild)?
I&D
63
purulent SSTI treatment (moderate, empiric)?
I&D, TMP/SMX, doxycycline
64
purulent SSTI treatment (moderate, defined)?
I&D, MRSA = TMP/SMX, MSSA = dicloxacillin, cephalexin
65
purulent SSTI treatment (severe, empiric)?
I&D, vanco/daptomycin, linezolid, telavancin, ceftaroline
66
purulent SSTI treatment (severe, defined)?
I&D, MRSA = empiric options, MSSA = nafcillin, cefazolin, clindamycin
67
nonpurulent SSTI treatment (mild)?
oral penicillin, cephalosporin, dicloxacillin, clindamycin
68
nonpurulent SSTI treatment (moderate)?
intravenous penicillin, ceftriaxone, cefazolin, clindamycin
69
nonpurulent SSTI treatment (severe, emergent surgical inspection/debridement)?
rule out necrotizing process
70
nonpurulent SSTI treatment (severe, empiric)?
vancomycin PLUS piperacillin/tazobactam
71
How long is the duration of therapy for purulent SSTIs?
5-10 days following I&D
72
purulent SSTIs classifications? (3)
mild = not systemic, moderate = systemic signs, severe = septic/immunocompromised/failed I&D and therapy treatment
73
What are the criteria for SIRS? (4)
at least two required: temp <36 or >38, tachypnea >24, tachycardia >90, WBC >120000 or <4000
74
How long is the duration of therapy for non-purulent SSTIs?
mild = 5 days, moderate-severe = 10-14 days

PHM603 (3 decks)

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