GI Antibiotics - Kinder

Question 1

not treated with antibiotics

Answer 1

EHEC

salmonella

Question 2

tx shigellosis

Answer 2

antibiotic tx reduces duration by 2.4 days

Question 3

tx travelers diarrhea

Answer 3

mild to moderate

• loperamide or bismuth
• combine with fluoroquinolone

severe
-cipro, levo, norfloxacin, orfloxacin 3 day course

rifaximin - for noninvasive e coli

azithromycin - quinolone resistant campylobacter

Question 4

tx c dif infection

Answer 4

metrondiazole - mild to moderate

vancomycin - severe

Question 5

tx persistent diarrhea

Answer 5

suspect protozoal

giardia - tx metrondiazole

crypto hard to treat - especially in AIDS

Question 6

colitis due to overgrowth of c dif

Answer 6

clincamycin, ampicillin, cephalosporins, fluoroquinolones, PPIs

Question 7

metronidazole vs. vanco for c dif tx

Answer 7

metrondiazole - mild to moderate

vancomycin - severe

Question 8

cipro MOA

Answer 8

inhibit DNA gyrase (topoisomerase II)

inhibit supercoiling gram-negative bacteria

also inhibit topoisomerase IV in gram positive organisms

Question 9

cipro CI

Answer 9

don’t use in kids - achilles tendon rupture

Question 10

cipro side effect

Answer 10

nausea, vomiting, GI pain, rashes, fever

cartilage toxicity - achilles tendon rupture children

Question 11

levo MOA

Answer 11

inhibit DNA gyrase (topoisomerase II)

inhibit supercoiling gram-negative bacteria

also inhibit topoisomerase IV in gram positive organisms

Question 12

levo CI

Answer 12

dont use in kinds - achilles tendon rupture

Question 13

levo side effect

Answer 13

nausea, vomiting, GI pain, rashes, fever

cartilage toxicity

Question 14

trimethoprim sulfamethoxazole MOA

Answer 14

sulfonamide: bacteristatic and competetive inhibitors dihyropteroate synthase (needed for precursot to folic acid)
trimethoprim: inhibits microbial dihydrofolate reductase

Question 15

trimethoprim sulfamethoxazole side effect

Answer 15

allergic skin rashes, nausea, comtiing, CNS, photosensitivity, renal dysfunction, Stevens-Johnson syndrome

Question 16

metronidazole MOA

Answer 16

prodrug that requires reductive activation by susceptible organisms

don’t really know

Question 17

metronidazole clinical use

Answer 17

bacterial vaginosis, amebic liver abscess, Tx anaerobic bacterial infections
part of regimen prophylazis coloretal surgery, C difficile, Crohns

Question 18

metronidazle side effect

Answer 18

HA, nausea, dry mouth, metallic taste, vomiting, diarrhea, abdominal distress!! esp with alcohol!!!
dizziness, vertigo, encephalopathy

Question 19

vancomycin MOA

Answer 19

inhibits cell wasll synthesis binding with high affinity to D alanyl D alanine terminal cell wall unites

Question 20

vancomycin clinical use

Answer 20

orally for C difficle

Question 21

vancomycin side effect

Answer 21

macular skin rash, chills, fever, red man syndrome from rapid infusion
direct toxicity from vanco on mast cells causing release histamine
ototoxicity, nephrotoxicity

Question 22

diarrhea length

Answer 22

acute < 14 days
persistant 14-29 days
chronic >30 days

Question 23

bloody diarrhea

Answer 23

c dif

Question 24

inflammatory diarrhea

Answer 24

fever, tenesums, dysentery

fecal leukocytes and fecal lactoferrin

Question 25

tx diarrhea

Answer 25

prevent dehydration

Question 26

mild to moderate dehydration

Answer 26

oral rehydration solution - superior to IV

Question 27

ORS

Answer 27

glucose, Na, K, Cl, H20

Question 28

shigellosis, travelers diarrhea, salmonella

Answer 28

bactrim - TMP/SMX

Question 29

acute diarrhea

Answer 29

often viral

Question 30

fruit juice, soda, gatorad

Answer 30

not good for ORS - too much sugar

Question 31

cipro or levo use

Answer 31

travellers diarrhea

Question 32

severe c dif

Answer 32

vancomycin

Question 33

moderate c dif

Answer 33

metrondiazole

Question 34

giardia

Answer 34

metrondiazole

Question 35

salmonella

Answer 35

no antibiotics

unless immunocompromised

Question 36

tissue parasites

Answer 36

albendazole with fatty meal

Question 37

intraluminal organisms

Answer 37

albendazole on empty stomach

Question 38

nitazoxanide

Answer 38

giardia

Question 39

iodoquinol

Answer 39

antiprotozoal

Question 40

paromomycin

Answer 40

anti-protozoal

Question 41

anti-helminth

Answer 41

albendazole

Question 42

travelers diarrhea

Answer 42

rifaximin

Question 43

c dif

Answer 43

fidaxomicin