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NAPLEX BITCH > ID 1 Light Bulb Points > Flashcards

ID 1 Light Bulb Points Flashcards

1
Q

Atypical Organisms:

A

Chlamydia
Legionella
Mycoplasma Pneumoniae
Mycobacterium TB

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2
Q

Gram Positive Rods:

A

Listeria monocytogenes
Corynebacterium

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3
Q

Gram Positive Clusters:

A

Staphylococcus (MRSA,MSSA)

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4
Q

Gram Positive Pairs and Chains (cocci)

A

Strep. Pneumoniae (Diplococci)

Streptococcus (Pyrogens, enterococcus, VRE)

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5
Q

Gram Negative Cocci:

A

Neisseria

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6
Q

Gram Negative Anaerobes:

A

Bacteroides Fragilis

Prevotella

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7
Q

Gram Negative Coccobacilli:

A

Acinetobacter baumannii

Bordetella Pertussis

Moraxella Catarhalis

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8
Q

Gram Negative Enteric Rods (Gut colonizer)

A

Proteus mirabilis
E.Coli
Klebsiella
Serratia
Enterobacter Cloacae
Citrobacter

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9
Q

Gram Negative Rods (Non gut colonizing)

A

Pseudomonas Aeruginosa
Haemophilus Influenza
Providencia

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10
Q

Gram Negative Curled or Spiral Shaped Rods

A

H. Pylori, Campylobacter, Treponema, Borrelia, Leptospira

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11
Q

What are the common resistant pathogens?

A

Klebsiella Pneumoniae
Escherichia Coli
Acinetobacter
Enterococcus Faecalis/ Facial (VRE)
Staphylococcus Aureus (MRSA)
Pseudomonas Aeruginosa

“Kill Each And Every Strong Pathogen”

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12
Q

Cell Wall inhibitor MOA agents:

A

Beta Lactams
Monobactam
Vancomycin
Dalbavancin, Telavancin, Oritavancin

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13
Q

Folic Acid Synthesis Inhibitor Agents:

A

Sulfonamides
Trimethoprim
Dapsone

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14
Q

DNA/RNA Inhibitor Agents:

A

Quinolones (DNA gyros, topoisomerase IV)
Metronidazole
Tinidazole
Rifampin

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15
Q

Cell Membrane Inhibitor Agents:

A

Polymyxins
Daptomycin
Telavancin
Oritavancin

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16
Q

Protein Synthesis Inhibitor Agents:

A

AMG
Macrolides
Tetracyclines
Clindamycin
Linezolid, Tedizolid
Quinupristin / Dalfopristin

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17
Q

Aminopenicillins are active against:

A

When put with a beta-lactamase inhibitor:

MSSA and gram negative bacteria (HNPEK) and gram negative anaerobes (B. fragilis)

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18
Q

Extended Spectrum Penicillins when combined with a Beta Lactamase Inhibitor cover:

A

Streptococci and Enterococci

HNPEK + CAPES (citrobacter, acinetobacter, providencia, enterobacter, serratia) AND PSEUDOMONAS

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19
Q

Names of Natural PCN:

A

Penicillin V potassium
Penicillin G Aqueous
Penicillin G Benzathine (Bicillin L-A)

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20
Q

Names of Antistaphylococcal PCN:

A

(MSSA Coverage)
Naficillin
Dicloxacillin
Oxacillin

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21
Q

Names of Aminopenicillins:

A

Amoxicillin
Augmentin
Ampicillin
Unasyn (ampicillin/sulbactam)

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22
Q

Extended Spectrum PCN Name:

A

Zosyn (Pipperacillin / Tazobactam)

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23
Q

BBW for Penicillin G Benz:

A

Not for IV use! (Cardio - respiratory arrest)

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24
Q

SE of PCN:

A

Hemolytic Anemia
Seizures with accumulation (monitor RF)
Diarrhea
SJS/TEN

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25
Q

Which PCN do not require Renal Dose Adjustments

A

Antistaphylococcal (Diclo, Nafci,Oxac)

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26
Q

What is important to know about Naficillin?

A

It is a vesicant!
If extravasation occurs need to utilize COLD packs and hyaluronidase injections

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27
Q

What must IV Ampicillin (Unasyn included) be diluted in?

A

NS ONLY

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28
Q

in the outpatient setting is used 1st line to treat strep throat and mild non purulent skin injections

A

PCN VK

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29
Q

First Line to treat Otitis Media and Bacterial Sinusitis?

A

Augmentin

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30
Q

What is the pediatric dosing of Augmenting in Otitis Media?

A

90 mg/kg/d (use the lowest dose of clavulanate to decrease diarrhea)

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31
Q

Important points on Dicloxacillin (2)

A

Covers MSSA only (no MRSA)

NO RENAL DOSE ADJUSTMENT

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32
Q

DOC for endocarditis prophylaxis

Treats H. Pylori

Used in Acute Otitis Media

A

Amoxicillin

Otitis media peds dose: 80 - 90 mg/kg/d

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33
Q

DOC for Syphilis?

A

Penicillin G Benzathine (2.4 mil IM x 1)

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34
Q

What is the only penicillin against pseudomonas?

A

Zosyn (extended infusions maximize T>MIC)

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35
Q

1st generation cephalosporins:

A

Cefazolin
Cephalexin (Reflex - PO)
Cefadroxil (PO)

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36
Q

typical cephalexin (Keflex) dose:

A

250 - 500 mg Q6-12 H

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37
Q

2nd Generation Cephalosporins:

A

Cefuroxime (PO/IV/IM)

Cefoteten (Cefotan IV/IM)

Cefaclor
Cefoxitin
Cefprozil

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38
Q

3rd Generation Cephalosporins:

A

Cefdinir (PO)

Ceftriaxone (IV/IM)

Cefotaxime (IV/IM)

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39
Q

3rd Generation Cephalosporins (Grp 1)

A

Cefidinir

Ceftriaxone

Cefotaxime

Cefditoren, Cefpodoxime, Ceftibuten

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40
Q

3rd Generation Cephalosporins (Grp 2)

A

Ceftazidime (Fortaz)

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41
Q

4th Generation Cephalosporins:

A

Cefepime

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42
Q

5th Generation Cephalosporins

A

Ceftaroline Fossil (Teflaro)

43
Q

Ceftriaxone Contraindications

A

Hyperbilirubinemic Neonates - causes biliary sludging, kernicterus

Concurrent use with calcium containing IV products (precipitate forms) in neonates (<28do)

44
Q

Cefotetan contains a side chain called NMTT. What does this side chain cause?

A

Increased risk of bleeding and causes a disulfiram like reaction with alcohol consumption

45
Q

Ceftazidime/Avibactam (Avycaz) has some activity against some:

A

CRE

46
Q

Cefpodoxime (3), Cefuroxime (2), and Cefdinir (3) need to be separated from???

A

Antacids! (at least 2 hours in short acting H2RAs)

PPI should be avoided

47
Q

Cephalexin in the OP setting can be used for:

A

MSSA and Strep

48
Q

Cefuroxime can be used in the OP setting for:

A

CAP, Acute Otitis Media

49
Q

Cefidinir can be used for X in the OP Setting.

A

Acute otitis media

50
Q

2nd Generation Cefotetan and Cefoxitin common uses:

A

Surgery prophy (GI), and anaerobic coverage of B. Fragilis

51
Q

Common uses of 3rd gen Rocephin and Cefotaxime:

A

CAP, Meningitis, Spontaneous Bacterial Peritonitis, Pylenophritis

52
Q

Which generations are active against pseudomonas?

A

3rd and 4th

Ceftazidime
Cefepime

53
Q

Who is the only BL that is active against MRSA?

A

Ceftaroline

Common Uses: CAP and SSTI 9

54
Q

Carbapenems decrease the serum concentration of what seizure med?

A

VPA

55
Q

What are the class effects of Carbamenems? (3 point)

A

All active against ESBL organisms and Pseudomonas (except ertapenem)

DO NOT USE IN PCN allergy

Seizure risk! (imipenem/cilastatin - Primaxin has the highest risk)

56
Q

What does ErtAPenem not cover?

A

PEA

Pseudomonas
Enterococcus
Acinetobacter

57
Q

What do Carbapenems NOT cover?

A

Atypicals
VRE
MRSA
C.Diff
Stenotrophomonas

58
Q

Common Uses of Carbapenem (Doripenem, Imipenem/Cilastatin, Meropenem, Ertapenem)

A

“Reserved for MDR gram negative infection. If a patient has ESBL THINK CARBAPENEM”

Polymicrobial infections (diabetic foot)

Empiric tx when resistant organisms are suspected

Resistant Pseudomonas or Acinetobacter infections (EXCEPT Ertapenem)

59
Q

Ertapenem must be diluted in:

A

Normal Saline!

60
Q

What are the benefits of utilizing extended interval dosing for AMGs?

A

Utilizing higher doses lead to higher peaks = less dosing frequency

Pro:
Less accumulation
Lower risk of nephrotoxicity
Decreased $$$

61
Q

When dosing an AMG for a patient what weight do you use?

A

Underweight: TBW

Normal: IBW

Obese: AjBW

62
Q

Common uses of Quinolones:

A

Pneumonia (not Cipro)
UTI (not moxi)
Intra abdominal infection
travelers diarrhea

63
Q

Name the respiratory quinolones and why they are classified as this:

A

Levofloxacin, Gemifloxacin, Moxifloxacin
(Breathy Men Love Girls)

They have S. Pneumoniae activity

64
Q

Please name the Antipseudomonal Quinolones

A

Ciprofloxacin
Levofloxacin

Pseudomonas coverage

65
Q

What Quinolone does not require renal adjustment?

A

Moxifloxacin

(Moxi isn’t for the girls! - No UTI usage)

66
Q

What quinolones are 1:1 in IV:PO?

A

Levofloxacin

Moxifloxacin

67
Q

What things should we look for in patients profiles prior to starting quinolones? (3 things)

A
  1. hx of CVD, low K/Mg, QT , QT prolonging agents
  2. Do they have seizure history? - AVOID (can increase theophylline levels)
  3. Avoid in peds
68
Q

What are counseling points for Quinolones? (~4)

A

Avoid Sun Exposure

Separate from polyvalent cations (phosphate binders too)

Monitor Glucose

Watch for tendon rupture, neuropathy, CNS/Psych SE

69
Q

Macrolides:

How much of E.E.S = Erythromycin

A

400 mg = 250 mg

70
Q

Common uses for ALL macrolides:

A

CAP
Alternative for Strep Throat

71
Q

Common uses for Azithromycin:

A

COPD Exacerbation
Pertussis

Chlamydia (pregnant patients)

Prophy for Mycobacterium avium
Severe travelers diarrhea

72
Q

Common Uses for Clarithromycin:

A

H. Pylori

73
Q

Why is erythromycin used in gastroparesis?

A

Increases gastric motility

74
Q

Do Macropodes cause QTc prolongation?

A

yes!

Caution in: CVD, decrease Mg/K, other QT drugs

75
Q

When looking at statins, which are contraindicated with Clarithromycin and Erythromycin?

A

Lovastatin and Simvastatin

(Due to clarithro + Erythromycin being strung CYP3A4 inhibitors, it can increase the risk of muscle toxicity)

76
Q

Which tetracycline has noted DILE?

A

Minocycline

77
Q

Common uses of Minocycline:

A

CA- MRSA Skin infection

Acne

78
Q

Common uses of Doxycycline (a lot)

A

CA - MRSA Skin infection
Acne

Lyme disease
Rocky Mountain fever
Spotted Fever
CAP
COPD exacerbations
bacterial sinusitis
VRE UTI
Chlamydia

79
Q

What is the common uses of tetracycline? (1)

A

H. Pylori

80
Q

What populations should be avoided in Tetracyclines? (3)

A

Pregnancy , Breastfeeding , Little Kids <8

81
Q

Sulfonamides do not have activity against? (4)

A PEA

A

A: Anaerobes

P: Pseudomonas
E:Enterococci
A: Atypicals

82
Q

What the common uses of Bactrim: (3)

A

CA - MRSA skin infection
UTI
Pneumocystis Pneumonia (PCP)

83
Q

When thinking of the 5:1 ratio of SMX/TMP how much TMP is in the single and double strength tablets?

A

SS: 80
DS: 160

dosing is done off of TMP

84
Q

If a patient has _____ deficiency then Bactrim should be avoided due to increased risk of hemolysis.

A

G6DP

85
Q

For a patient on warfarin what should be discussed when thinking of using Bactrim?

A

It increases INR significantly. Use alternative if possible

86
Q

What are the three lipoglycopeptides?

A

Telavancin (Vibativ)
Oritavancin (Orbactiv)
Dalbavancin (Dalvance)

87
Q

What is the BBW with Telavancin? (2)

A

Fetal risk! ( avoid pregnancy)
Nephrotoxicity

88
Q

What do lipoglycopeptides (-vancin) falsely elevate?

A

aPTT, INR, PT

89
Q

A provider wants to start Oritavancin for a SSTI in a patient that is currently on a Heparin Drip for AFib. What do you say?

A

Oritavancin cannot be used.

IV UFH cannot be used for up to 120 hours after Oritavancin Administration due to the prolonged interaction with falsely elevating aPTT

90
Q

When is Metronidazole contraindicated (2 )

A

1st trimester of pregnancy

Alcohol or Propylene glycol (during or within 3 days after)

increases INR but not a CI

91
Q

What is the dosing for Nitrofurantoin (frequency)

A

Macrobid = BID

Macrodantin = QID

92
Q

A patient’s CrCl comes back at 55 ml/min and the doc wants to start Macrobid for CA-UTI. What do you say?

A

Nitrofurantoin is contraindicated in CrCl < 60

93
Q

Two main counseling points for Macrobid (Nitro)

A

Can make your urine brown

Can cause nausea and stomach cramping - take with food

94
Q

Drugs for CA-MRSA and SSTI

A

SMX/TMP

Doxycycline , Minocycline

Clindamycin

Linezolid

95
Q

Drugs for VRE (E. Facecalis)

A

Pen G or Ampicillin

Linezolid
Dapto

Cystitis Only: Fosfomycin, Doxycycline, NitroF

96
Q

Drugs for ESBL gram negative rods

A

Carbapenems
Ceftazidime/Avibactam (avycaz)
Ceftolozane/Tazobactam (zerbaxa)

97
Q

Drugs for Carbapenem resistant gram negative rods (CRE):

A

Avycaz

Colistimethate

Polymyxin B

98
Q

Drugs for Atypical Organisms:

A

Azithromycin
Doxycycline
Quinolones

99
Q

Drugs for Bacteroids Fragilis (anaerobe)

A

Flagyl
BL /BLI
Cefotetan Cefoxitin
Carbapenems

100
Q

What drugs (2) require protect from light during admin?

A

Doxycycline
Micafungin

101
Q

What drugs are compatible with dextrose only?

A

Quinupristin / Dalfopristin

Bactrim

Amphotericin B

102
Q

What drugs are compatible with NS only?

A

Ampicillin
Unasyn (duh)
Ertapenem
Daptomycin (Cubicin RF)

103
Q

What drugs are compatible with NS/LR only?

A

Capsofungin
Daptomycin (Cubicin)

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