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Advanced Pharmacology > Infections > Flashcards

Infections Flashcards

1
Q

What is the spectrum of activity of natural PCNs?

A

Gram +

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2
Q

True of False:

Very little resistance has occurred to natural PCNs.

A

False

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3
Q

What class of drugs is used to treat MSSA? (Methicillin-sensitive Staph aureus)

A

Pencillin-resistant penicillins or anti-staphyloccal penicillins

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4
Q

Name the most commonly used anti-staph PCNs.

A

Methicillin

Nafcillin

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5
Q

What is the spectrum of coverage for aminopenicillins?

A

Gram + and Gram -

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6
Q

Name the most common aminopenicillin that is used IV.

A

Unasyn.

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7
Q

Why are beta-lactamase inhibitors sometimes added to aminopenicillins?

A

They protect the penicillins from inactivation by beta-lactamases.

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8
Q

Are anti-pseudomonal penicillins used more in the outpatient or inpatient setting?

A

Inpatient (ex: Zosyn)

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9
Q

What is the spectrum of coverage for anti-pseudomonal penicillins?

A

Gram + and -

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10
Q

What is the main adverse effects of beta-lactams?

A

GI (specifically diarrhea)

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11
Q

GI side effects of beta-lactams: do they increase or decrease with broader spectrum coverage?

A

The broader the coverage, the more likely the GI side effects.

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12
Q

What is the spectrum of coverage for each generation of cephalosporins?

A

1st: +
2nd: + and -
3rd: -
4th: + and -
5th: + and -

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13
Q

What are the most common first generation cephalosporins?

A

Keflex (cephalexin) and Ancef (cefazolin)

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14
Q

What setting are third generation cephalosporins mostly used in?

A

Inpatient

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15
Q

What are the two most commonly used IV preparations of 3rd generation cephalosporins?

A

Ceftriaxone (Rocephin)

Ceftazidime (Fortaz)

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16
Q

Which cephalosporin has good CNS penetration, making it a good choice in meningitis treatment?

A

Ceftriaxone (Rocephin)

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17
Q

What is the 4th generation cephalosporin?

Describe it’s spectrum of coverage and uses.

A

cefepime (Maxipime)
Gram + and -
IV
febrile neutropenia, peritonitis, HCAP

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18
Q

What is the 5th generation of cephalosporins unique coverage?

A

MRSA, but not psuedomonas

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19
Q

What is the primary adverse effect of cephalosporins?

A

GI upset

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20
Q

What do we generally see the carbapenems reserved for?

A

“Heavy hitters.”

Resistant infections.

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21
Q

What is the spectrum of coverage for carbapenems?

A

Broad

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22
Q

If a patient has a PCN allergy, is it safe to prescribe a cephalosporin?

A

Generally, yes.

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23
Q

True or false:

Judicious use of fluoroquinolones had led to resistance.

A

True

24
Q

Which second generation fluoroquinolone has good pseudomonas coverage?

A

Ciprofloxacin

25
Q

What are the two most common uses for levofloxacin?

A

UTI

URI

26
Q

Which two fluoroquinolones are “respiratory”?

A

Levofloxacin

Moxifloxacin

27
Q

What is the boxed warning for fluoroquinolones?

A

Tendon rupture.

28
Q

What CNS adverse effects of fluoroquinolones are more prominent in the elderly?

A

Headache, dizziness, drowsiness

29
Q

What setting are aminoglycosides generally used in?

A

Inpatient

30
Q

What spectrum are aminoglycoside agents used for?

A

Gram -

31
Q

Pharmacokinetic monitoring of aminoglycosides is used for what toxicities for peaks and troughs?

A

Peak: Efficacy and Ototoxicity
Troughs: Nephrotoxicity

32
Q

Macrolides are commonly used for:

A

URI

H. Pylori

33
Q

Erythromycin is no longer generally used to treat infection, but rather used for:

A

prokinetic properties in GI (diabetic gastroparesis)

34
Q

What cardiac side effect of macrolides requires close monitoring?

A

QT prolongation

35
Q

What type of bacteria is clindamycin most well-known for treating?

A

Anaerobic

36
Q

What complication of clindamycin is most common?

A

C-diff

37
Q

What is the mechanism of action of clindamycin?

A

Protein synthesis inhibitor

38
Q

What is the spectrum of coverage for tetracyclines?

A

Broad

39
Q

Why should tetracyclines be taken on an empty stomach?

A

They bind with cations.

40
Q

Why are tetracyclines contraindicated in those under 8 years of age and in pregnancy/lactation?

A

Permanent yellow-brown staining of teeth.

41
Q

True of false:

Vancomycin has good oral absorption.

A

False

42
Q

What is oral vanco usually used for?

A

Cdiff

43
Q

For Vanco, what are the peaks and troughs used for?

A

Peaks: toxicity (oto/nephro)
Troughs: Efficacy

44
Q

Besides oto/nephro toxicity, what is the other common side effect of vanco?

A

“Red man” or “Red neck” Syndrome

Histamine release causing a flushed look

45
Q

What is the most common sulfonamide drug used?

A

trimethoprim/sulfamethoxazole (Bactrim)

46
Q

What is the mechanism of action of sulfonamides?

A

Inhibit bacterial growth by blocking folic acid synthesis.

47
Q

For patients with sulfa allergy, what are some drugs/drug classes to use caution with?

A

Loop diuretics, thiazides, sulfonylureas, sumatriptan, topiramate.

48
Q

What is a drug very commonly used to treat UTI?

A

Nitrofurantoin

49
Q

What toxicity is known to Nitrofurantoin?

A

Neuropathy and lung toxicity

50
Q

What drug can be used as one time dose for UTI?

A

Fosfomycin

51
Q

Does flagyl have anaerobic coverage?

A

Yes

52
Q

Why shouldn’t patients on Flagyl drink alcohol?

A

Disulfiram-like reaction.

53
Q

What two medications are used in latent TB treatment?

A

Rifampin

Isoniazid

54
Q

What is a known adverse effect of Rifampin?

A

Red secretions

55
Q

What is side effects of Isoniazid?

A

Isolated nerve problems

Advanced Pharmacology (9 decks)

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