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3rd Year (Step 2) > ID 1 > Flashcards

ID 1 Flashcards

1
Q

Penicillin G/VK/benzathine - coverage?

A
  • Gram positives (Strep, Staph, Actinomyces)
  • Oral anaerobes (Actinomyces)
  • Neisseria meningitidis
  • Treponema Pallidum (Syphilis)
  • Spirochetes (Leptospira)
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2
Q

Ampicillin & Amoxicillin – coverage?

A

Same as Penicillin + …- H. influenzae- E. coli- Listeria- Proteus- Salmonella

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3
Q

Amp/Amoxicillin are best initial Tx for what?

A
  • Otitis media (Sinusitis, Pharyngitis)- Dental infection & endocarditis proph- Lyme disease limited to rash, joint, 7th CN involvement- UTI in pregnant women- Listeria monocytogenes- Enterococcal infections
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4
Q

Penicillinase-resistant penicillins (PRPs)?

A

Oxacillin, Cloxacillin, Dicloxacillin, & Nafcillin

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5
Q

PRPs are used to treat what?

A
  • Skin infections: cellulitis, impetigo, erysipelas- Endocarditis, meningitis, & bacteremia from staph- Osteomyelitis & septic arthritis only wen organism is proven sensitive
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6
Q

PRPs are not active against __ or __.

A

MRSA & Enterococcus

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7
Q

What’s always used instead of Methicillin? Why?

A

Oxacillin or Cephalosporin- b/c methicillin causes renal failure from allergic interstitial nephritis

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8
Q

Penicillins that cover gram-negative activity & pseudomonas?

A

Piperacillin, Ticarcillin, Azlocillin, Mezlocillin

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9
Q

Piperacillin/Ticarcillin, etc. are best initial Tx for what?

A

Cholecystitis & ascending cholangitis- Pyelonephritis- Bacteremia- HA- & VA- pneumonia- Neutropenia & fever

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10
Q

3 organisms that’re resistant to all forms of cephalosporins?

A

Listeria, MRSA, & Enterococcus

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11
Q

What organisms do all cephalosporins cover?

A
  • Group A, B, C, & viridans Streptococcus- E. coli- Klebsiella- Proteus mirabilis
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12
Q

Macrolides?

A

Azithromycin, Clarithromycin, Erythromycin (more toxic)

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13
Q

1 indication for Nitrofurantoin?

A

Cystitis (esp. in pregnant women)

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14
Q

Name the 1st gen Cephalosporins

A

Cefazolin, Cephalexin, Cephradrine, Cefadroxyl

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15
Q

1st gen cephalosporins – use?

A

Staph (meth = ceph sensitive)- Streptococci (except enterococcus)- Some gram-neg bacilli, like E. coli (NOT pseudamonas)- Osteomyelitis, septic arthritis, endocarditis, cellulitis

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16
Q

Name the 2nd gen Cephalosporins

A

Cefotetan, Cefoxitin, Cefaclor, Cefprozil, Cefuroxime, Loracarbef

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17
Q

2nd gen cephalosporins – use?

A

Same as first + add coverage for anaerobes & more gram-neg bacilli

18
Q

Name the 3rd gen Cephalosporins

A

Ceftriaxone, Cefotaxime, Ceftazidime

19
Q

Ceftriaxone – use?

A

1st line in Pneumococcus- Meningitis- CA pneumonia (in combo w/ macrolides)- Gonorrhea- Lyme involving heart or brain

20
Q

In whom should you avoid Ceftriaxone & why?

A

Neonates b/c of their impaired biliary metabolism

21
Q

Cefotaxime – use?

A
  • Superior to Ceftriaxone in neonates- Spontaneous bacterial peritonitis
22
Q

Ceftazidime – what differentiates it from other 3rd-gen cephalosporins?

A

Has pseudomonal coverage

23
Q

Which 3rd-gen Cephalosporin(s) have/has pseudomonal coverage?

A

Ceftazidime

24
Q

Which is the 1st cephalosporin to cover MRSA?

A

Ceftaroline

25
Q

Name the 4th-gen Cephalosporins

A

Cefepime

26
Q

Cefepime – use?

A

Has better staphylococcal coverage than 3rd gen cephalosporins. Used to treat:- Neutropenia & fever- Ventilator-ass’d pneumonia

27
Q

Cephalosporins – adverse effects?

A

Cefoxitim & Cefotetan – deplete prothrombin & increase risk of bleedingCeftriaxone – causes inadequate biliary metabolism

28
Q

Which of the Carbapenems does NOT cover Pseudomonas?

A

Ertapenem

29
Q

Carbapenems – coverage?

A

Gram-negative bacilli (including many that are resistant, anaerobes, strep, & staph)- used to treat neutropenia & fever

30
Q

Only drug in the class of Monobactams?

A

Aztreonam

31
Q

Aztreonam – type of drug?

A

Monobactam antibiotic

32
Q

Aztreonam – coverage?

A

Gram-negative rods only (including Pseudomonas) - NO activity against gram-positives or anaerobes - NO cross-rxn w/ Penicillin

33
Q

Name 4 Fluoroquinolones

A

Ciprofloxacin, Gemifloxacin, Levofloxacin, Moxifloxacin

34
Q

Ciprofloxacin – used for what?

A

Cystitis & Pyelonephritis

35
Q

Best therapy for C-A pneumonia?

A

UMass = Azithromycin IV + Ceftriaxone IVMTB2 = Fluoroquinolones (Levofloxacin)(including penicillin-resistant pneumococcus)

36
Q

What do Fluoroquinolones cover?

A
  • CA-pneumonia (best Tx)- Cipro for cystitis & pyelonephritis- Diverticulitis & GI infections (all but Moxi need combo w/ Metronidazole for Diverticulitis. Ciprofloxacin, gemifloxacin, & levofloxacin must be combined with metronidazole because they don’t cover anaerobes)- Gram-neg bacilli (including most pseudomonas)- Gram-pos cocci (Staph & Strep)
37
Q

Which of the Fluoroquinolones can be used by itself for Diverticulitis?

A

Moxifloxacin – b/c it covers anaerobes- others must be combined w/ Metronidazole

38
Q

Quinolones – adverse effects?

A
  • Bone growth abnormalities in children & pregnant women- Tendonitis & Achilles tendon rupture
39
Q

Aminoglycosides – use?

A

Gram-negative rods – severe (bowel, urine, bacteremia)- Synergistic w/ β-lactam antibiotics for enterococci & staph- Neomycin for bowel surgery- NO effect against anaerobes (need O2 to work)

40
Q

Aminoglycosides – adverse effects?

A

Nephrotoxic & Ototoxic

41
Q

Doxycycline – adverse effects?

A

Tooth discoloration (children), Fanconi syndrome (Type II RTA proximal), photosensitivity, esophagitis/ulcer

42
Q

Β Lactam/Beta-lactamase combos – uses?

A
  • cover anaerobes - 1st choice for mouth & GI abscessβ-lactamase adds coverage against sensitive staphylococci

3rd Year (Step 2) (44 decks)

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