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NAPLEX BITCH > ID Take two (Part 1) > Flashcards

ID Take two (Part 1) Flashcards

1
Q

Gram Positive Cocci

A

Clusters: Staphylococcus (MSSA, MRSA)

Pairs/Chains: Strep Pneumonia, Streptococcus, Enterococcus

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2
Q

Gram Positive Rods

A

Listeria
Corynebacterium

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3
Q

Gram Positive Anaerobes

A

Peptostreptococcus
Propionibacterium
C. diff
Clostridium

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4
Q

Atypical Organisms

A

Chlamydia
Legionella
Mycobacterium TB
Mycoplasma Pneumonia

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5
Q

Gram Negative Cocci

A

Neisseria

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6
Q

Gram Negative Rods: Curved or Spiral

A

H pylori
Camplyobacter
Borrelia
Treponema

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7
Q

Gram Negative Rods: Non Gut Colonizing

A

Pseudomonas aeruginosa
Haemophillus Influenza
Providencia

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8
Q

Gram Negative Rods: Gut Colonizing

A

E.Coli
Proteus Mirabillis
Klebsiella
Serratio
Enterobacter Cloacae
Citrobacter

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9
Q

Gram Negative Anaerobes

A

Bacteroids Fragillis
Prevotella

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10
Q

Gram Negative Coccobacilli

A

Acinetobacter
Bordetella Pertussis
Moraxella

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11
Q

name the four different antibiotic resistance types

A

Intrinsic - natural

Selection Pressure - removes the good

Acquired

Enzyme Inactivation
ESBL, CRE

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12
Q

Common Resistant Pathogens

A

Kill Each And Every Strong Pathogen

K: Klebsiella
E: E.Coli
A: Acinetobacter
E: Enterococcus (VRE, CRE)
S: Staphylococcus
P: Pseudomonas aeruginosa

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13
Q

sulfonamides MOA

A

Folic Acid Inhibitors

(sulfonamides have an S, A, I in name)

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14
Q

Dapsone MOA

A

Folic Acid Inhibitors

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15
Q

Trimethoprim MOA

A

Folic Acid Inhibitor

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16
Q

Beta Lactams and Monobactams MOA

A

Cell Wall Inhibitors

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17
Q

Vancomycin
Dalbavancin
Telvancin
Oritavancin

MOA

A

Cell Wall Inhibitors

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18
Q

Protein Synthesis Inhibitors

A

AMG
Macrolides
Tetracyclines
Clindamycin
Linezolid
Quinupristin

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19
Q

Metronidazole and Tinidazole MOA

A

DNA/RNA inhibitors

20
Q

Quinolones MOA

A

DNA/RNA Inhibitors

Inhibit DNA topoisomerase IV and DNA Gyrase

21
Q

Rifampin MOA

A

DNA/RNA inhibitor

22
Q

Cell Membrane Inhibitors

A

Polymyxins
Daptomycin

Telavancin + Oritavancin = Also cell wall inhibitors

23
Q

Natural PCN cover: Gram Positive (Streptococcus, Enterococcus)

What Agents are those?

A

PCN VK (tab/susp)
PCN G Aqueous - IV

PCN G Benzathione (Bicillin LA)

  IM!!!!! IV has BBW for Cardio tox
24
Q

Antistaphylococcal PCN Cover: Streptococcus and MSSA

They have NO RENAL ADJUSTMENTS

WHAT AGENTS ARE THOSE?

A

Dicloxacillin
Oxacillin

Nafacillin
- IV Vesicant: Need cold compress and Hyaluronidase

25
Q

AminoPCN cover: Streptococcus, Enterococcus, And Postive Anaerobes

WHEN paired with BLI: MSSA, Gram Negatives (HNPEK), and Gram negative anaerobes

WHAT AGENTS ARE THOSE?

A

Amoxicillin –> Augmenting (14:1)
Ampicillin –> Unasyn
PO has ass bioA

CI: history of cholestatic jaundice or hepatic dysfunction

CrCl < 30 = NO ER Formulation or 875 mg of Augmentin

Ampicillin requires NS for dilution

26
Q

Extended Spectrum PCN cover: Streptococcus, Enterococcus, Mouth Flora, Gram Neg (HNPEK), Gram Neg Anaerobes, CAPES (gram negatives), Pseudomonas!!!

WHAT AGENTS?

A

Zosyn (pipperacillin/tazobactam)

27
Q

As a class, PCN have what SE and what DDI?

A

Seizures that occur with accumulation, GI uses, diarrhea, rash, hemolytic anemia

Probenecid = Increase BL Levels

28
Q

1st Generation Cephalosporins: Gram + (Preferred agent for MSSA if a cephalosporin is used), Gram - (PEK)

WHAT AGENTS

A

Cefazolin

Cephalexin (Keflex): 250 - 500 mg Q6-12H

Cefadroxil

Common uses: MSSA and Strep

29
Q

2nd Generation Cephalosporins:
Streptococcus Pneumonia, HNPEK

Cefotetan + Cefoxitin have additive effects with Anaerobes (B.frag)

NAME THE AGENTS

A

Cefuroxime
Cefotetan (Cefotan)

Cefactor, Cefoxitin, Cefprozil

30
Q

Cefotetan Has What Side Chain?

A

NMTT or 1-MTT and increased bleeding and can cause disulfiram like rxn with EtOH

31
Q

3rd Gen Group 1 cephalosporins: Streptococci, MSSA, HNPEK, Gram + Anaerobes

WHAT AGENTS ARE THESE?

A

Cefdinir
Cefotaxime
Ceftriaxone - No renal Adjustments, CI hyperbilirubinemia, in neonates do not use with Ca containing products if <28 d old. Precipitates form

Cefditonen, Cefixime (Suprax), Cefpodoxime, Ceftibuten

32
Q

3rd Generation Group 2 Cephalosporins: Lack gram positive activity but covers PSEUDOMONAS

WHAT AGENTS ARE THESE?

A

Ceftazidime - Fortaz

+ Avibactam = Avycaz (Some CRE activity)

33
Q

4th generation Cephalosporins: Broad Gram “-“ coverage
(HNPEK, CAPS, Pseudomonas)

WHAT AGENTS

A

Cefepime

34
Q

5th Generation Cephalosporin: HNPEK, MRSA, Broad Gram + Coverage

What agents???

A

Ceftaroline (teflaro)

35
Q

Other than Avycaz what other Cephalosporin has a BL-I added to it?

A

Ceftolozane/Tazobactam (Zerbaxa)

Similar to gen 3 group 2 + MDR Pseudomonas, MDR gram “-“ rods

36
Q

Hydrophilic Agents!
-Small Vd
- Renal Elimination
- Low Intracellular Conc
- increased Cl +/- distribution in sepsis
- Poor BioA

What agents!!!

A

BL
AMG
Vanco
Dapto
Polymyxins

37
Q

Lipophilic Agents!
- Large Vd
- Hepatic Metabolism
- good with atypical
- CL +/- distribution minimally changes in sepsis
- IV: Po is usually 1:1

What agents!!!

A

Quinolones
Macrolides
Tetracyclines
Rifampin
Linezolid

38
Q

Cmax: MIC (Conc. Dependent)

A

AMG
Quinolones
Daptomycin

(large doses with long intervals)

39
Q

AUC: MIC (exposure dependent)

A

Vancomycin, Macrolides, Tetracyclines, Polymyxins

40
Q

Time > MIC (time dependent)

A

Beta Lactams

41
Q

Carbapenems - reserved for MDR Gram Negative agents (ESBL, No coverage with MRSA, VRE, Atypical

No PCN allergies!
Accumulation leads to seizure + confusion
DRESS
Decrease VPA

A

Doripenem
Imipenem/Cilastatin
Meropenem!!!
ErtAPenem (INVANZ)

  PEA: no pseudomonas, enterococcus, acinetobacter 
Stable in NS ONLY

Imipenem has the highest seizure risk

42
Q

Monobactams - Aztreonam

A

Used when BL allergy is present

Many gram “-“ (Pseudomonas)
NO GRAM POSITIVE or anaerobic activity

PEK
HNPEK
CAPES
Pseudomonas

43
Q

Aminoglycosides (Cover gram “–” pseudomonas included )

Extended interval OVERVIEW

A

uses higher doses to attain higher peaks and gives less accumulation, less nephrotoxin risk, more cost effective

4-7 mg/kg/dose, frequency is determines by a monogram

(gentamicin, tobramycin, amikacin)

44
Q

Aminoglycosides (Cover gram “–” pseudomonas included)

Traditional Dosing

A

IBW! if overweight then use AjBW, If underweight use TBW

obtain peak and trough in regards to 4th dosing

Gentamycin and Tobramycin 1-2.5 mg/kg/dose

Trough: <2 mcg/mL, Synergy < 1mcg/mL

45
Q

BBW with aminoglycosides

A

Nephro and Ototoxicity, Neuromuscular blockade + respiratory paralysis should be avoided

CAUTION in elderly, renal impaired, other nephrotoxic drugs

46
Q

Quinolones

  • atypical coverage
  • concentration dependent
A

Levofloxacin, Moxifloxacin, Gemifloxacin = Respiratory (S.Pneu)

Ciprofloxacin and Levofloxacin = Pseudomonas

Delafloxacillin = MRSA (SSTI)

Moxi = No renal adjustments

47
Q

Quinolones BBW / SE / DDI

A

BBW: tendon inflammation or rupture, peripheral neuropathy, CNS effects (seizures)

QT prolonging (moxi highest), Hypoglycemia/Hyperglycemia

Avoid in pregnancy/lactation, Kids

Can cause Photsensitivity

DDI: antacids + other polyvalent, Lanthanum, Renvela by at least 2 hours

Cipro 1A2 inhibitors = increase theophylline levels

NAPLEX BITCH (9 decks)

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