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1Fall24 PoA II > HAI & Abx pt2 (Ex2) > Flashcards

HAI & Abx pt2 (Ex2) Flashcards

1
Q

_________ β-lactams are more stable against β-lactamase.

A

Cephalosporin

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2
Q

Cephalosporin β-lactam antibiotics are the drug of choice for what?

A
  • Surgical prophylaxis
  • PCN allergy patients (except true anaphylaxis)
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3
Q

What drug was noted for treatment of gonorrhea?

A

Ceftriaxone (Rocephin)

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4
Q

What cephalosporins do not penetrate the blood brain barrier?

A

Generation 1: Cefazolin
Generation 2: Cefuroxime, Cefoxitin, Cefotetan

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5
Q

What generation of cephalosporins penetrate the blood brain barrier well?

A

Generation 4: Cefepime (maxipime)

Most resistant to β-lactamase.
Reserved for multi-resistant organisms.

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6
Q

What cephalosporins are third generation? How well do they cross the BBB?

A

Cefotaxime
Ceftriaxone
Ceftazidime

Some cross BBB.

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7
Q

What drugs should be used if true anaphylaxis to penicillin exists?

A

Vancomycin or clindamycin

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8
Q

What are the adverse effects that are associated with cephalosporins?

A
  • Rashes, fever, nephritis, anaphylaxis
  • Vitamin K production deficit
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9
Q

What drugs are a common cause of colitis?

A

3rd generation cephalosporins

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10
Q

Carbapenem β-lactams have good activity against _______ __ _______ and ________.

A

Gram - rods (Pseudomonas Aeruginosa) and enterobacter

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11
Q

What β-lactam drug class has the broadest spectrum of activity and can inhibit the β-lactamase enzyme?

A

Carbapenems

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12
Q

What type of infections are carbapenems saved for?

A
  • Intra-abdominal
  • resistant UTIs
  • pneumonia
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13
Q

What examples of carbapenems were given?

A
  • Ertapenem (Invanz)
  • Meropenem (merrem)
  • Imipenem (primaxin)

(-penem)

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14
Q

IM formulations of carbapenems contain _______.

A

Lidocaine

Consider LA allergies prior to IM administration.

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15
Q

Carbapenems can decrease what medication by up to 90%?
What can this precipitate?

A

Valproic Acid (Depakote); and can precipitate seizures

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16
Q

How does vancomycin work?

A

Inhibition of cell wall synthesis

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17
Q

Vancomycin is active against _____ bacteria but is too large to penetrate ______ bacteria.

A

Active against gram + ; too large for gram - bacteria

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18
Q

Vancomycin is most useful against what infections?

A

Blood stream MRSA
MRSA endocarditis

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19
Q

What are the most common adverse reactions to vancomycin? (4)

A
  • Phlebitis at site
  • Chills, fever
  • Nephrotoxicity
  • “Red man” syndrome

.

20
Q

How do Aminoglycosides work?

A

Inhibition of ribosomal proteins and cause mRNA misreading

21
Q

Aminoglycosides have a _________ post-antibiotic effect.

A

prolonged/significant

22
Q

Aminoglycosides are _______ w/ β lactams or vancomycin.

A

Synergistic

Especially useful for enterococcal endocarditis.

23
Q

What are the adverse reactions associated with gentamycin?

A
  • Ototoxicity
  • Nephrotoxicity
  • Curare-like affect
24
Q

Explain the curare-like effect of gentamycin (aminoglycoside).

A

Gentamycin can interfere with ACh receptors and potentiate effects of NMB drugs.

25
Q

What is the treatment for curare-like effects from gentamycin?

A

Ca⁺⁺

26
Q

How do fluoroquinolones work?

A

Inhibit bacterial DNA synthesis

27
Q

Fluoroquinolones are best used for what type of bacteria? What are examples of these infections? (3)

A

Gram (-) organisms:

  • UTI
  • Bacterial diarrhea
  • Bone/joint infections
28
Q

What examples are there of fluoroquinolones?

A
  • Ciprofloxacin (cipro)
  • Levofloxacin (levaquin)
29
Q

What are the adverse reactions for fluoroquinolones?

A
  • N/V/D
  • QT prolongation
  • Cartilage damage / Tendon rupture
30
Q

What three factors will contribute to cartilage damage and tendon rupture associated with fluoroquinolones?

A
  • Renal insufficiency
  • Concurrent steroids
  • Advanced age
31
Q

What type of antibiotic is metronidazole?

A

Antiprotozoal / Anaerobic antibacterial

32
Q

How does Metronidazole work?

A

Forms toxic byproducts that destabilize bacterial DNA.

33
Q

What is metronidazole (flagyl) indicated for? (3)

A
  • Intra-abdominal infections
  • Vaginitis
  • C-diff
34
Q

What drug should Flagyl not be combined with?

A

EtOH

Disulfiram effect induces hangover-like s/s (flushing, dizziness, HA, chest/abd pain)

35
Q

What are the adverse reactions associated with metronidazole?

A
  • Nausea
  • Peripheral neuropathy (w/ prolonged use)
  • Disulfiram-like effect
36
Q

What is the first line antibiotic for essentially all surgical prophylaxis (with no β-lactam allergy)?

A

Cefazolin (ancef)

37
Q

What is the most common alternative to cefazolin for surgical prophylaxis?

A

Clindamycin (or vancomycin)

38
Q

What drug(s) increases the likelihood of nephrotoxicity when paired with aminoglycosides?

A

Loop Diuretics (s/a furosemide)

39
Q

What generation(s) of cephalosporin has better gram - coverage?

A

Generation 2: better gram - coverage
Generation 3: even better gram - coverage

40
Q

What are the trade names for each:

  • cefazolin
  • cefuroxime
  • cefoxitin
  • cefotetan
  • cefotaxime
  • ceftriaxone
  • ceftrazidime
  • cefepime
A
  • cefazolin (ancef, kefzol)
  • cefuroxime (ceftin)
  • cefoxitin (mefoxin)
  • cefotetan (cefotan)
  • cefotaxime (claforan)
  • ceftriaxone (rocephin)
  • ceftrazidime (fortaz)
  • cefepime (maxipime)
41
Q

Do carbapenems penetrate the BBB?

A

Yes, most penetrate BBB

42
Q

What adverse reactions are associated with carbapenems?

A

-N/V/D
-Rashes

cross sensitivity to PCN <1%

43
Q

What specifics contribute to aminoglycosides nephrotoxic effects? (4)

A
  • elderly
  • use more than 5 days
  • higher doses
  • concurrent with loop diuretics (furosemide)
44
Q

What is the weight-based adult dosing parameters for Cefazolin?

A

≤ 80kg = 1 gram
81-119kg = 2 gram
≥ 120kg = 3 gram

45
Q

What is the administration time (min) and redose time (hours) for cefazolin?

A
  • Admin time: 3-5 min
  • Redose: 4 hours (1 gram)
46
Q

Review Chart for abx dosages and redosing times

A

Know trade names

47
Q

Crossword answers:

A

1Fall24 PoA II (34 decks)

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