High yield Flashcards
Pts creatinine clearance is slowly dropping over time what should you be doing?
Lowering dose of Antibiotic, because drug will continue to accumulate if not
Penicillins and all of B-lactams target?
transpeptidase (late step in cell wall synthesis)
the drug that targets transglycosylase (early step in cell wall synthesis)?
Vancomycin!!! (only kills gram positives!!! too big!!!)
Why do some antibiotics only kill gram positives?
cant fit through the pore of gram negative bacteria
Is clavulanic acid + amoxicillin an example of synergy?
NO, because clavulanic acid can not kill bacteria by itself!! (clavulanic acid acts like a booster to amoxicillin)
What does Benzathine pen G do?
increases half life
What do you treat syphyllis (treponema pallidum) with?
Benzathine Pen G, (A SLOW RELEASE FORM OF PENICILLIN, or A penicillin with a long half life, A B-lactam formulated to have a long half life)
What do you treat Neisseria Gonorrhea with?
Ceftriaxone
What do you treat chlamydia trachomatis with?
Azithromycin or Doxycycline
ANti-staph pens kill what?
Staph (MSSA)
Pen G kills what?
Gram + cocci and treponema
Amoxicillin kills what?
gram + and some gram - (OTITIS MEDIA/ EAR INFECTIONS)
How does MRSA get its resistance?
Modify the PBPs
Anti-pseudomonal pens kill what?
pseudomonas and lots of gram- (BROADEST SPECTRUM of all PENS)
If you want to kill MRSA what do you want to use?
DRUG OF CHOICE FOR MRSA= CEFTAROLINE
If you dont know what pt has and you want to give imperic treatment… what do you give?
Imipinem
Add antibiotic to a culture, you saw growth stop, but took antibiotic away and there was growth again…
Bacteriostatic
Add antibiotic to a culture, and you see a drop in # of organisms?
Bacteriocidal
What does a penicillin bind to?
PBP: Penicillin binding protein
ONe type of penicillin that can survive an organism thats producing B-lactamase?
Anti-staphs (nafcillin)
Drugs not eliminated by kidney (not adjusted in renal failure?
Cephtriaxone
Doxycycline
Metronidazole
Which penicillin below has broadest spectrum of activity?
Anti-pseudomonal
Which penicillin below has narrowest spectrum?
Anti-staphs
If you want to kill MRSA, do you want to give a penicillin? no, why?
Modify PBPs
What drug do you give a neonate with meningitis?
Cefotaxime
What is the drug for meningitis?
Ax’s
Ceftriaxone for adults
Cefotaxime for neonates
Pt comes in with serious life threatening infection, we start on imipinem, why?
Pts kidney function is monitored and starts as normal, but then starts to decline, what are they at an increased risk for?
Imipinem is very broad
Seizures
Want to kill pseudomonas what drug do you give?
“2 drug bug”
pipericillin and Gentamicin
If pt has C. diff superinfection, then you suspect it is cause by what?
Clindamycin
Give metronidazole
What drugs are static?
PSIs except for AMinoglycosides and sulfonamides
2 examples of synergy?
TMP-SMX
Penicillin and Gentamicin
Drugs that are cidal vs. static w/ antibiotics?
Penicillins and DNA antibiotics are cidal
PSIs (except aminoglycosides) and antifolates are static
Chlamydia drug?
Azithromycin
Gonorrhea drug?
Ceftriaxone
Syphyllis drug?
Bezathine Penicillin G
Why take Vitamin B6?
to overcome peripheral neuritis (Isoniazid looks like Vit B6 deficiency)
What causes hyperuricemia?
Pyrazinamide and Loops and Thiazides
what is rifampins main side effect?
REd orange urine (P450 inducer)
Prophylaxis for MAC?
CAR
Clarithromycin
Azithromycin
Rifabutin
Pt has a fluke… what is preffered?
Praziquantel,,,,,,hllhlhlhlhhhlhllhlhlhlhlhhlhhlhlhlhlhlhllhhlhllhllhh
Pt has a fluke… put on praziquantel what is its action?
Increase membrane permeability to calcium… muscles contract and cause paralysis
Which reverse transcriptase inhibitor is not a prodrug?
Efavirenz
Pt is on a combination of drugs, one of those drugs causes central adiposity and hyperglycemia, which virus were they being treated for, and what drug were they on?
Protease Inhibitor for HIV (AVIRS)
Pt has a very painful rash in a dermatomal pattern?
Shingles
Which ovir is useful in TK- strains?
Cidofovir
WHich ovir has a side effect of bone marrow suppression?
Gancyclovir (Gangcyclovir gangs up on bone marrow)
WHich 2 drugs are used for CMV retinitis?
Gancyclovir
Foscarnet
Which B lactam is going to kill MRSA?
Cephtaroline
Pt on antiarrythmic and is being monitored fro thyroid function, what drug are they on?
Amiodarone
Most commonly used drug for stable angina?
Nitroglycerin
Most commonly used drug to prevent stable angina?
Beta blockers (DONT USE WITH VASOSPASTIC ANGINA)
Obvious antidote for warfarin overdose?
Vitamin K
MAtch up diuretics with site of action? Acetazolamide
Furosemide, HCTZ, Spironolactone
Acetazolamide (PCT), Furosemide (Loop of henle- TAL), HCTZ (DCT), Spironolactone (Collecting duct)
Which drug increases K+? K+ sparing?
Spironolactone
