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NAPLEX 21 > ID I: ABX FOR GRAM POSITIVE INFECTIONS > Flashcards

ID I: ABX FOR GRAM POSITIVE INFECTIONS Flashcards

1
Q

Vancomycin is a glycopeptide that inhibits bacterial cell wall synthesis by binding to…

A

D-alanyl-D-alanine cell wall precursor and blocking peptidoglycan polymerization

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2
Q

Vancomycin coverage

A

Gram positive:

MRSA

Streptococci

Enterococci (not VRE obviously)

C diff (PO)

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3
Q

You patient has a systemic infection, IV Vanco dosing is

A

IV 15-20mg/kg Q8H-12H

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4
Q

Dosing for vancomycin is based on what weight

A

TOTAL body weight

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5
Q

When CrCl is 20-49 for vancomycin, what’s the interval

A

Q24H

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6
Q

Consider an alternate drug when MRSA MIC > ?

A

> 2mcg/mL

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7
Q

What are warnings for vancomycin?

A

ototoxicity

nephrotoxicity

red man syndrome

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8
Q

What is the vancomycin AUC/MIC ratio?

A

400-600

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9
Q

Goal trough for Vancomycin?

A

15-20mcg/mL

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10
Q

Vancomycin is first line for

A

MRSA

[pneumonia, meningitis, bacteremia, skin]

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11
Q

What are the lipoglycopeptides?

A

Telavancin
Oritavancin
Dalbavancin

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12
Q

Which lipoglycopeptide is approved for complicated skin and soft-tissue infections (SSTI) and hospital acquired and ventilator associated pneumonia?

A

telavancin

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13
Q

Telavancin is infused over ___ mins to avoid infusion reactions

A

60 mins

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14
Q

What are boxed warnings for lipoglycopeptides?

A

fetal risk

nephrotoxicity

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15
Q

Your patient is receiving UFH, what can they NOT receive?

A

a lipoglycopeptide! contraindication with IV UFH

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16
Q

What are the warnings for lipoglycopeptides?

A

can falsely INC coagulation tests (aPTT/PT/INR), does not increase bleeding risk

red man syndrome

17
Q

Oritavancin is contraindicated with

A

IV UFH - or 5 days

18
Q

What is a special note about lipoglycopeptides that is beneficial in terms of dosing?

A

extremely long half-life allows for a single dose regimen

19
Q

What is daptomycin’s MOA?

A

binds to cell membrane components, causing rapid depolarization; inhibits all intracellular replication processes, including protein synthesis and causes cell death

20
Q

What is the antibacterial activity of daptomycin?

A

concentration-dependent!

21
Q

Daptomycin coverage

A

staphylococci MRSA

and both VRE (E faecium and E faecalis)

22
Q

Brand: Cubicin

A

generic: daptomycin

23
Q

What infection do you absolutely NOT use daptomycin?

A

pneumonia!

the drug is inactivated in the lungs by surfactant

24
Q

Your patient is on daptomycin, what warnings should the healthcare team lookout for?

A

myopathy, rhabdomyolysis (D/C when CPK>1000u)

falsely increase PT/INR (no effect on bleeding)

25
Q

Your patient is receiving IV Cubicin, the nurse wants to know what it is compatible with

A

NS and LR (no dextrose)

26
Q

Daptomycin is approved for:

A

complicated SSTI

MRSA bloodstream infection including right sided endocarditis

27
Q

Linezolid and tedizolid bind to the ___ subunit of the bacterial ribosome, inhibiting translation and protein synthesis

A

50S

28
Q

Linezolid coverage

A

MRSA

VRE (E faecium and E faecalis)

29
Q

Brand: Zyvox

A

generic: linezolid

30
Q

The patient just received phenelizine (a MAO inhibitor) before linezolid…

A

NO!!!! do not use within 2 weeks

31
Q

Warnings for linezolid include…

A

duration-related myelosuppression (thrombocytopenia)

optic neuropathy

serotonin syndrome (SSRI, SNRI, TCAs!!!)

hypoglycemia

32
Q

What are side effects of linezolid?

A

decrased platelets

33
Q

IV:PO linezolid

A

1: 1
* no dose adjustment in renal impairment

***do not shake

34
Q

This drug is a treptogramin

A

Synervid (Quin/Dalfo)

35
Q

Synercid binds to the ____ ribosomal subunit inhibiting protein synthesis

A

50S

36
Q

Synercid coverage

A

most gram positive: MRSA, VRE (NOT E Faecalis)

approved for complicated SSTI, not well-tolerated

37
Q

Brand: synercid

A

generic: quinupristin/dalfopristin

38
Q

BIG side effects of synercid include…

A

arthralgias/myalgias

infusion reactions (over 60 mins)

hyperbilirubinemia

39
Q

Synercid is being administered to a patient, a nurse wants to know what it can be diluted in…

A

D5W only

via central line

NAPLEX 21 (60 decks)

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