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NAPLEX 21 > ID I: BACKGROUND > Flashcards

ID I: BACKGROUND Flashcards

1
Q

What antibiotic has a BBW for c diff?

A

clindamycin

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2
Q

Small Vd (poor tissue penetration)

Renel elimination

Low intracellular concentration, not active vs atypical

Increase CL/distribution during sepsis

Poor-moderate bioavailability

A

HYDROPHILLIC AGENTS

beta-lactams

AG

glycopeptides

daptomycin

polymyxins

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3
Q

What abx are lipophilic agents?

A

Quinolones

Macrolides

Rifampin

Linezolid

Tetracyclines

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4
Q

What possible organisms?

Gram stain: purple

cocci pairs & chains:

A

strep pneumoniae

streptococcus spp (including strep pyogenes)

enterococcus spp (including VRE)

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5
Q

AG + beta-lactams are commonly used in synergy treating what

A

gram positive infections (infective endocarditis)

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6
Q

Which abx are hydrophilic agents?

A

beta-lactams

AG

glycopeptides

daptomycin

polymyxins

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7
Q

Intra-abdominal organisms?

A

Enteric GNR (Proteus, E. coli, Klebsiella, Enterobacter) Enterococci/streptococci bacteroides species

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8
Q

The preferred agent for MSSA soft tissue, bone and joint, endocarditis and bloodstream infections?

A

anti staphylococcal penicillins

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9
Q

What drugs are concentration dependent (Cmax:MIC)

A

AG

Quinolones

Daptomycin

LARGE dose!!! High peak!! continues to kill after fallen below MIC

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10
Q

gram stain provides what information?

A

quick, preliminary results (not an actual organism) so it will give a description – rod, gram -/+

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11
Q

What possible organisms?

Gram stain: pink

cocci:

A

Neissera spp

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12
Q

Skin soft tissue organisms?

A

APE pasturella +/- anaerobic GNR diabetes

staph aureus

strep pyogenes

staph epidermidis

pasturella multocida +/- anaerobic GNR (diabetes)

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13
Q

HNPEK

A

haemophilus,

neisseria,

proteus,

e coli,

klebisella

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14
Q

What possible organisms?

Gram stain: purple

anaerobes:

A

peptostreptococcus

Actinomyces spp

clostridium (clostridiodes)

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15
Q

What drugs are time dependent (Time>MIC)

A

Beta lactams (penicillins, cephalosporins, carbapenems)

*want drug level >MIC for most of dosing interval

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16
Q

What organisms are in the heart/endocarditis?

A

SESE + MRSA

Staphylococcus aureus (including MRSA)

Staphylococcus epidermidis

Streptococci

Enterococci

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17
Q

Lower respiratory (hospital) organisms?

A

staph aureus (MRSA)

pseudomonas aurginosa

Enteric GNR (Proteus, E. coli, Klebsiella, Enterobacter)

Strep pneumoniae

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18
Q

Mouth organisms?

A

Mouth flora - peptostreptococcus, actinomyces

Anaerobic GNR (Prevotella)

Viridans group streptococcu

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19
Q

what is CRE?

A

carbapenem-resistant enterobacteriaceae

MDR gram negative (klebsiella, e coli)

tx: polymyxins

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20
Q

Large Vd (good tissue penetration)

Hepatic metabolism

high intracellular concentrations (active against atypical)

CL/distribution is changed minimally in sepsis

Excellent bioavailability 1:1

A

LIPOPHILLIC AGENTS

Quinolones

Macrolides

Rifampin

Linezolid

Tetracyclines

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21
Q

What possible organisms?

Gram stain: pink

curved or spiral shaped

A

H pylori

Campylobacter

Treponema spp

Borrelia spp

Leptospira spp

22
Q

DNA/RDNA inhibitors

A

Quinolones (DNA gyrase, topoisomerase IV)

Metronidazole, tinidazole

Rifampin

23
Q

What organisms are in the CNS/Meningitis?

A

SNL HG

S. pneumoniae

N. meningitis

H. influenzae

Group B streptococcus/E. coli (young)

Listeria (young/old)

24
Q

MOA: Cell membrane inhibitors

A

polymyxins

daptamycin

telavancin oritavancin

25
Q

What possible organisms?

Gram stain: pink

rods –> colonize gut

A

Proteus mirabilis

Escherichia coli

Klebsiella spp

Serratia spp

Enterobacter cloacae

Citrobacter spp

26
Q

Lower respiratory (community) organisms?

A

streptococcus pneumoniae

Haemophilus influenzae

Atypicals: legionella, mycoplasma

Enteric GNR (Proteus, E. coli, Klebsiella, Enterobacter) – alcoholic, IC

27
Q

thin cell wall take up the safranin counterstain pink or reddish

A

gram negative piNk

28
Q

What are the different types of antibiotic resistance?

A

intrinsic selection pressure (VRE)

enzyme inactivation (ESBL, CRE)

29
Q

What organisms are in the upper respiratory?

A

SMHS

Streptococcus. pyogenes

Streptococcus. pneumoniae

Haemophilus. influenzae

Moraxella catarrhalis

30
Q

What are common resistant pathogens?

A

Kill Each And Every Strong Pathogen

Klebsiella pneumoniae (ESBL, CRE)

E coli (ESBL, CRE)

Acinetobacter baumannii

Enterococcus faecalis, Enterococcus faecium (VRE)

S. aureus (MRSA)

Pseudomonas aeruginosa

31
Q

What possible organisms?

Gram stain: purple

cocci clusters:

A

staphylococcus spp. (including MRSA, MSSA)

32
Q

What color do atypical stain?

A

they don’t, they don’t have a cell wall

33
Q

How are drugs that are concentration-dependent killing dosed?

A

less frequently, higher dose to maximize concentration above the MIC

34
Q

What is used to treat ESBL infections?

A

carbapenems or cephalosporin/beta-lactamase inhibitors

35
Q

MOA: cell wall inhibitors

A

BMV

Beta-lactams [penicillins, cephalosporins, carbapenems]

Monobactams

Vancomycin [dalbavancin, telavancin, oritavancin]

36
Q

PEK

A

proteus

e coli

klebisella

37
Q

How are drugs that are time-dependent killing dosed?

A

more frequently, longer duration administration to maximize time above MIC

38
Q

Urinary tract organisms?

A

E. coli,

Proteus,

Klebsiella

Staphylococcus

saprophyticus

streptocci

enterocci

39
Q

What possible organisms?

Gram stain: purple

diplococci:

A

strep pneumoniae

40
Q

What possible organisms?

Gram stain: purple

Rods:

A

gram positive rods: listeria monocytogenes

41
Q

What possible organisms?

Gram stain: did not stain well

A

ATYPICALS!!! *think doxy

Chlamydia spp

legionella spp

mycoplasma pneumoniae

mycobacterium tuberculosis

42
Q

What possible organisms?

Gram stain: pink

Anaerobes:

A

Bacteroides fragilis

Prevotella spp

43
Q

thick cell wall dark purple or bluish

stain from the crystal violet stain

A

gram positive organisms

Purple

44
Q

What possible organisms?

Gram stain: pink

rods –> do not colonize in gut

A

pseudomonas aeruginosa

haemophilus influenzae

providencia spp

45
Q

MOA: folic acid synthesis inhibitors

A

STD

Sulfonamides

Trimethoprim

Dapsone

46
Q

MOA: Protein synthesis inhibitors

A

MATCLQ AG

Macrolides

Tetracyclines

Clindamycin

Linezolid, tedizolid

Quinupristin/Dalfopristin

47
Q

What should be considered when deciding empiric treatment?

A

local resistance patterns (antibiogram) antibiotic use guidelines likely organisms basked on location

48
Q

What possible organisms?

Gram stain: pink

coccibacilli:

A

Acinetobacter baumannii

Bordetella pertussis

Moraxella catarrhalis

49
Q

CAPES

A

Citrobacter

Acinetobacter

Providencia

Enterobacter

Serratia

50
Q

Bone & joint organisms?

A

staph aureus

staph epidermis

streptococci

neiserra gonorrhoeae GNR (only in specific situations)

NAPLEX 21 (60 decks)

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