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NAPLEX > Infectious Disease - Antibiotics > Flashcards

Infectious Disease - Antibiotics Flashcards

1
Q

What medication can be used to prolong penicillin serum levels?

A

Probenacid

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2
Q

Penicillin

Metabolism
Pregnancy

A

Kidney

Category B

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3
Q

Benzathine penicillin

Brand
ROA

A

Bicillin - LA

IM ONLY

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4
Q

Bicillin CR

Components
ROA

A

Procaine penicillin and benzathine penicillin

IM ONLY q

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5
Q

Can you substitute bicllin LA with bicillin CR?

A

no

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6
Q

Can you use bicillin CR for syphillis?

A

no

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7
Q

Pencillin G

ROA

A

IV

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8
Q

Penicillin V

ROA
Counseling

A

PO

Empty stomach

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9
Q

Pencillinase resistant penicillin

What are they
Which are IV
Which are OI

A

Oxacillin, nafcillin, dicloxacillin

Nafcillin and Oxacilin

Dicloxacillin

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10
Q

Ampicillin

Class
Counseling
DOC for…

A

Aminopenicillins

Empty stomach

Enterococcus

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11
Q

Amoxicillin otitis media dose

A

90mg/kg/day

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12
Q

Can you substitute lower dose of augmentin to make a higher dose?

A

no

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13
Q

Augmentin

Counseling
Frequency
CrCl

A

With food

BID (even for the XR version)

Don’t use <30

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14
Q

When do you use the higher dose for zosyn? And what is the dose?

A

Nosocomial pneumonia

4.5g IV Q6H

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15
Q

Coverage of first gen cephs

Pregnancy category

Excretion

A

PEK

Proteus
E.Coli
Klebsiella

Category B

Kidney

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16
Q

Coverage of second gen cephs

A

HENPEKS

H.influenza
Enterobacter
Neisseria
Proteus
E.Coli
Klebsiella
Serratia

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17
Q

Which second gen cephs are active against anerobes and what are their brand names?

A

Cefoxitin - mefoxin

Cefotetan - no brand name

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18
Q

Which second gen cep has a NMTT side chain? Why is this important?

A

Cefotetan

This increases risk of bleeding and disulfram like reaction

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19
Q

Brand name

Cefuroxime
Cefprozil

A

Ceftin

Cefzil

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20
Q

Which third gen ceph covers PSA?

Brand name
Formulations

A

Ceftazidime (Fortaz/tazicef)

Avycaz - ceftazidime/avibactam

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21
Q

Which third gen cephs come PO?

Which come IV?

A

Cefdinir
Cefixime
Cefpodoxime

Ceftazidime
Cefotaxime
Ceftriaxonef

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22
Q

Ceftriaxone is DOC for what ? What are the doses?

A

Meningitis/endocarditis - 2G IV Q12H

Gonorrhea - 500mg IM

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23
Q

Fourth gen cephs

Brand names
Coverage

A

Cefepime - Maxipime - PSA

Cefiderocol - Fetroja - PSA, pneumonia, complicated UTI

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24
Q

5th gen cephs

Brand names
Indications

A

Ceftaroline - Teflaro [ CAP, MRSA SSTI

Ceftolozane/tazobactam - Zerbaxa - IAI, complicated UTI

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25
What must you combine zerbaxa with if treating IAI?
Metronidazole
26
What are the 6 carbapenems and their brand names?
Imipenem + cilastatin (primaxin) Meropenem - merrem Ertapenem - Invanz Doripenem - Doribax Meropenem + vaborbactam - vabomere Imipenem + cilistatin + relebactam - Recarbrio
27
What is the coverage of carbapenems and what's the exception
Covers gram positive (except MRSA), gram negative, and anaerobes. All cover PSA, acinetobacter, and enterococcus EXCEPT for ertapenem
28
Azetreonam Brand Coverage ADE
Azactam Gram - and PSA Skin rash
29
Vancomycin MOA PD ADE
Inhibits synthesis of bacterial cell wall phospholipids AUC-dependent Nephrotoxicity and ototoxicity Vancomycin infusion reaction (rapid infusion can cause histamine release and hypotension)
30
Aminoglycosides MOA Coverage ADE PD
Inhibits protein synthesis by binding to ribosomal subunits PSA and gram negative Nephrotox, ototox, neuromuscular block, Concentration dependent
31
Daptomycin Brand MOA Excretion Stability
Cubicin , Dapzura binds bacterial cell membrane and causes rapid depolarization Renal Only mix with NS or LR
32
FQ MOA Coverage Drug interactions Pregnancy?
Inhibit bacterial DNA gyrase gram negative and atypicals Increase theophylline Increase warfarin
33
What is a second, third, and fourth gen FQ?
Second - Cipro , oflox Third - Levofloxacin Fourth - Gatifloxacin, moxifloxacin
34
Ciprofloxacin IV to oral PGX Brand name/formulation
IV is 80% of oral Inhibits 1A2 Cirpodex OTIC Otovel (cipro + fluocinolone) Ciloxan - OPTHALMIC
35
Levofloxacin IV to oral Counseling Urine testing?
IV/PO are the same Take on empty stomach Can cause false positives on opiate tests
36
Moxifloxacin Brand Dose Contraindication Renal ?
Avelox 400mg PO/IV Don't give with ziprasidone No renal adjustment needed
37
Besifloxacin Brand Indication
Besivance Opthalmic suspension for serious infections
38
Delafloxacin Brand Indication ROA Renal adjustment?
Baxdela SSTI - MRSA and PSA included CAP - new approval IV and PO ESRD / GFR <15
39
Macrolide MOA ADE what are the 4 and their brand names
Inhibit protein synthesis by binding to the 50s subunit QT prolongation Erythromycin Clarithromycin - Biaxin Azithromycin Fidaxomicin (Dificid)
40
Counseling for clarithromycin
Take Biaxin XL with food Do not refrigerate suspension
41
What is the benefit of using azithromycin?
No drug interactions because it doesnt inhibit P450
42
Azithromycin dose for otitis media or CAP in children
10mg/kg up to 500mg PO 1st day then 5mg/kg day 2-5 on empty stomach
43
Tetracyclines MOA Coverage
Binds 30s subunit to inhibit protein synthesis ATYPICALS and gram +/-
44
If renal impairment, which tetracycline would you recommend?
Doxycycline
45
Brand names Doxycycline Minocycline Tetracycline Sarecycline Eravacycline
vibramycin, oracea, acticlat Minocin, solodyn, ximino, amzeeq sumycin seysara xerava
46
Chloramphenicol MOA ADE
Binds 50s subunit hemolytic anemia, bone marrow suppression, leukemia, gray baby syndrome
47
Clindamycin MOA Coverage ADE
Inhibits 50s subunit gram + and ANAEROBES C.diff and pseudomembranous colitis
48
Lincomycin Brand Coverage ROA ADE Drug interaction
Lincocin Serious gram + infections IV Pseudomembraneous colitis Dont give with erythromycin because of antagonistic effect
49
Metronidazole Brand MOA Coverage Contraindication ADE Drug interaction
Flagyl Disruption of bacterial DNA synthesisis Anaerobes 1st trimester Disulfram reaction, dark urine, metallic taste, seizures Increase INR because it's a 2C9 inhibitor
50
Secnidazole Brand Indications ROA ADE
Solosec Vaginosis, trichomoniasis Oral packets HA, nausea
51
Nitrofurantoin Brand Coverage Caution
Macrobid Macrodantin UTI gram negative except PSA and proteus crcl <60 pregnancy >38 weeks <1 month old
52
Fosfomycin Brand Indication
Monurol Uncomplicated uti in women
53
Oxazolidinones MOA Coverage 2 options and brand name
inhibit 502 subunit Gram POSITIVE , VRE Linezolid (zyvox) Tedizolid (sivextro)
54
Linezolid Formulations ADE Renal adjustment?
Tablets Suspension IV in D5W Thrombocytopenia, MAOI, peripheral/optic neuropathy No adjustment neededTe
55
Tedizolid ROA ADE
Oral and IV in NS Myelosupression
56
Synercid Generic MOA Coverage ADE ROA
Quinupristine/dalfoprisitin Inhibits protein synthesis VRE, MRSA, gram + Venous irritation, arthralgia, myalgia IV
57
Tigecycline Brand Coverage MOA Indications ADE
Tygacil Gram +/- , anaerobic Binds 30s subunit with 5 times higher affinity Complicated SSTI Increase risk of death, N/V, photosensitivity
58
Telavacin Brand Class Indication ADE Renal adjustment?
Vibativ the first lipoglycoprotein Gram positive like MRSA and VRE Complicated skin and skin structure infections Fetal risk, nephrotox, QTc prolongation , foamy urine , red man syndrome Can use up to CrCl10
59
Dalbavacin Brand Coverage MOA Stability
Dalvance Gram + Interferes with cell wall synthesis and has a LONG plasma half life only mix with D5W
60
Oritavancin Brand MOA Coverage Stability Contraindication
Orbactiv Inhibit cell wall synthesis Gram + , including MRSA on skin Use D5W only IV heparin Orbactativ can increase risk of bleeding with warfarin
61
What are the three options for VRE?
LInezolid Daptomycin Quinupristin-dalfoprisitin
62
Bactrim MOA ADE Renal adjustment Coverage Indications Interaction
Inhibits bacterial DHFR RASH, hyperK+, thrombocytopenia, anemia Dont use CrCl <15 Gram - , MRSA, PCP UTI, PCP, MRSA Bactrim can increase INR
63
Bactrim Ratio Stability Storage
5:1 Trimeth : sulfa Dilute with D5W Don't refrigerate
64
Rifaximin Brand Indication
Xifaxan Traveler's diarrhea Prevention of HE due to cirrhosis IBS
65
Rifamycin Brand Indication Dose
Aemcolo Traveler's diarrhea 388mg BID x 3 days
66
Atovaquone Brand Indication
Mepron PCP treatment/prophylaxis if you have sulfa allergy
67
What ABX are safe in pregnancy?
Penicillin Cephs Erythromycin Azithromycin Clinda Nitro Dapto
68
Xacduro Generic Indication ROA Storage
Sulbactam/Durlobactam Carbapenem resistant acinetobacter baumannii IV Refrigerate

NAPLEX (42 decks)

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