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NAPLEX STUDY > ID > Flashcards

ID Flashcards

1
Q

common resistant pathogens

A

Kill each and every strong pathogen

klebsiella
e. coli
acineobacter
enterococcus
staph aureus
psuedamonas

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2
Q

dose optimization strategies

A

time>MIC: beta lactams: representative of frequent dosing, extended infusion dosing

auc:mic. vanco, macrolides, tetracyclines,…

cmax:mic. amg, quinolones, dapto

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3
Q

natural pcns

A

penecillin vk. oral
pcn g(IV)

cover strep, enterococci, g+ anaerobes

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4
Q

aminopcns

A

amoxicillin
ampicillin IV

cover aboce + HNPE( haemophilus, neisseria, proteus
e.coli,

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5
Q

amino pcn/ beta lactamase inhibitors

A

amox clav (augmentin)
amp sulbavtam (unasyn)

covers same as natrual pcn and amino pcns

additonal coverage w MSSA, HNPEK, andG_anaerobes

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6
Q

extended spectrum beta lactams

A

zosyn
MSSA, CAPES, psudamonas, g_ anaerobes

(

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7
Q

capes

A

citropacter
acinetobacter
providencia
enterobacter
serratia

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8
Q

anti staff pcns

A

dicloxicillin (oral)
nafcilin (iv)

mssa AND streptococcus

ONLY PCNS that dont need renal adjustment

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9
Q

class effects of pcns

A

beta lactam allergy,
risk of seizures (if accumulates)

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10
Q

when can u use a pcn if pt has pcn allergy on exam

A

in a child who has pcn allergy and has acute otitis
syphillis

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11
Q

oral pcn things to remember

A

pcn vk : strep throat, mild non purulent skin infections

amoxicillin
AOM: 8–90 mg/kg/day
infective endocarditis ppx: 2g POx1
h. pylori reigmens

amox clav:
AOM: 90 mg/kg/day
use lowest dose of clavulanate possibler

dicloxacillkin
no renal adjustments

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12
Q

iv pcns pearls

A

pcn G benzathine
give IM only. fatal if given IV
used in syphillis. if pt has pcn allergy, desensitize and give. esp in pregnancy pts or pts w poor compliance

nafcillin: no renal adjustments

zosyn: only pcn active against pseudamonas

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13
Q

1st gen cphalosporins

A

streptococci
MSSA
PEK
G+ anaerobes

cefazolin (IV)
cephalexin (keflex) oral

surgical ppx

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14
Q

2ng gen

A

cefuroxime
cefotetan
cefoxitimme

covers all1st gen cef. covers + HN from HNPEK)

cefuroxime, cefotetan (good for surigcal procedure)- also cover

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15
Q

pearls of cefotetan

A

disulfuran reactions
can cause bleeding

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16
Q

3rd gen. group1

A

ceftriaxone (IV)
cefdininr (oral)

same as 2nd gen covers more resistent step and HNPEK

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17
Q

3rd gen group 2

A

ceftazidime

covers pseudamonas

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18
Q

4th gen

A

cefepime

:HNPEK
CAPES
PS
G+ similar to 3rd gen

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19
Q

5th gen

A

ceftarolane

broad G+ activity
MRSA
psuedamonas

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20
Q

cephalosporin coverage

A

no enteroccus
only ceftarolane covers MRSA
cefepime, ceftazidime (-/- avibactam or ceftolozane covers psa

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21
Q

cephalosporin class effects

A

allergies, risk of seizures

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22
Q

oral cephalosporin class effects

A

1 cephalzexin
strep throat, mssa skin infections

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23
Q

2nd gen

A

cefuroxime AOM, CAP, sinus infections

24
Q

3rd gen

A

cefdenir AOM

25
Q

carbapenems pearls

A

risk of seizures if accumulate, active against all esbl producing organisms

very broad. but do NOT cover
atypicals, VRE, MRSA, C. diff, stenotrophomonas

Ertapenem does not cover PEA: pseudamonas, enterococcus, acinobacter

common uses: ESBL

26
Q

aztreonam

A

can be used in pts w. pcn allergy
only covers gram- (including oseudamonas)

27
Q

aminoglycosides

A

gram-

dosing intervals-extended interval vs traditional dosing

toxicities. nephrotoxicity. ototoxicit

goal trough: generally <2

28
Q

quinolonwa

A

respiratory: Levo, moxi, gemifloxicin(my good lungs). reliable s. pneumonaie acitivty in pneumonia

antipseudamonal -ciprofloxacin, levofloxicin (covers pseudamonas)

29
Q

key features of fql

A

moxi. do not use for uti: not renall adjusted but does not concentrate in urine

iv to po ratio:1 to 1 (levo and moxi)

caution w cvd, qt prolongation, achilles tendon rupture, avoid in pts w seizures, neuropathy, photosensitivity ,blood glucose,

30
Q

macrolydes

A

atypical coverage
qt prolongation

GLOVES PACMAN( m satands for macrolides) clarithro and erythromycin inhoibitors of cyp3a4? use together CI w. lovastatin and simvastatin

31
Q

tetracyclines

A

avoid in pregnancy and children (abnormal discoloration fo teeth)<8
photosensitivity, chelation

32
Q

sulfonamides

A

SMX: TMP-5:1 ratio dose per tmp
se: photosensitivity, hemolytic anemia, +coombs test)
warfarin interaction

33
Q

dapto

A

cpk
only compatible w NS
cant use in lungs. inactivate dby lungs, muscle adverse reactions,monitor cpk

34
Q

linezolid

A

iv :po ratio
“seretonergic interactions
thrombocytopenia

35
Q

tigecycline

A

BBW: use last line. very broad. dont use in spectrum .
orange.
increased risk of death

36
Q

clindamycin

A

anaerobic coverage and gram positive
d test

37
Q

metronidazole

A

anerobic
disulfuram reactoins

38
Q

nitrofuranotin (microdantin or macrobis)

A

avoid use in rcl<60
urine discoloration

39
Q

perioperative abx

A

choice depends on abx type:
cardiac, vascular or orthopedic
*covers skin flora
*cefazolin (staph, step)

GI
*covers skin flora +GI flora
cefazolin+metronidazole
cefoxitine or cefotetan
amp/sulba

40
Q

meningitis organsims

A

strep pneumonair, n miningitis, listeria coverage in neonates and ppl >50

amp drug of choice for lysteria.

41
Q

CI for ceftriaxone

A

neonates

42
Q

AOM treatment

A

high dose amox or amox/clav
cephalosporins for mild pcn allergy
ceftriaxone IM for treatment failure

43
Q

upper respiratory tract infections

A

pharyngitis: most common cause group a strep: cna be treated w pcn or amox

acute sinustitiis
-symptomatic cre +/- audmentin

44
Q

CAP treatment outpt:

A

healthy: no comorbidities or riskf actors for mrsa or pseudamonas
*amox (high dose), doxycicline or macrolide

high risk: betalactam +macrolide or doxy
OR
respiratory fq

45
Q

cap inpt treatment

A

nonsevere(non ICU)
beta lactam+macrolide (or doxy if safety risks w macrolide)
OR
respiratory fq monotherapy

severe(ICU)
beta _macrolide
OR
meta+resp fq

in evere do not use fq monotherapy or beta lactam+doxy

46
Q

HAP/VAP

A

anx coverage needed for psa and mssa

cefepime
zosyn
levo

add vanco or linezolid if risk for mrsa

ex: cefepime +vsnc
meropenem+linezolid
aztreonam+vanc

use 2 abx if at risk for mdr gram neg organisms

47
Q

tb treatment general considerations

A

increase lft’s , total bilirubin

rifampin-turn fluids orange
isoniazid-peripheral neuropathy. give b6 to prevent tht (pyridoxine). cal cause DILE
pyrizonamide- increase uric acid and gout
ethambutol- visual damage

48
Q

TB treatment

A

RIPE
rifamipin
isoniazid
pyrazinomide
ethambutol

49
Q

latent tb treatment

A

shorter regimen
Rifapentine+I- 12 weeks weekly. cant be used in pregnancy

rifampin daily for 4 months

or RI daily for 3 months

last 2 can be used in pregnancy

50
Q

SBP abx treatment

A

target enterric gram- and streptococci

ceftriaxone 1g iv daily for 5-7 days

ppx if prior episode:

51
Q

utis

A

cyctities vs pyelonophrisits

uncommplicated: smx/tmp, nitrofurantoin, fosphomycin
pyelonephritis: smx/t,p, or ceftriazone (if inpt

asymptomatic bacteriuria is not treated unless pt is pregnant. amox or augment

52
Q

Cdif treatment

A

fidoxomicin 200 mg po BID or vancomycin 125 mg po bid

for 10 days

53
Q

treatment for syphillis

A

bicillin La 2.4 million units IM

54
Q

gonnorhea

A

ceftriaxone 500 mg IM x1

55
Q

chlamydia

A

cefuroxime AOM, CAP, sinus infections

56
Q

bacterial vaginosis

A

metronidazole po or gel

57
Q

trichonomoniasis

A

metronidazole 2 grams

NAPLEX STUDY (7 decks)

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