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NAPLEX Review > Infectious Disease Background > Flashcards

Infectious Disease Background Flashcards

1
Q

Common bacterial pathogens for infections in

CNS/Meningitis

A 
Strep pneumo
N meningitidis
H. influ
Group B strep/E coli (young)
Listeia (young/old)
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2
Q

Common bacterial pathogens for infections in

Upper respiratory

A

Strep pyogenes
Strep pneumo
H. influ
Moraxella catarrhalis

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3
Q

Common bacterial pathogens for infections in

heart/endocarditis

A

Staph aureus (MSSA, MRSA)
Staph epidermidis
Streptococci
Enterococci

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4
Q

Common bacterial pathogens for infections in

Skin/soft tissue

A

Staph aureus
Strep pyogenes
Staph epidermidis
Pasturella multocida +/- aerobic/anaerobic GNR (diabetics)

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5
Q

Common bacterial pathogens for infections in

Bone and joint

A 
Staph aureus
Staph epidermidis
Strep
N gonorrhoeae
GNR
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6
Q

Common bacterial pathogens for infections in

Mouth

A 
mouth flora (peptostreptococcus, actinomyces)
Anaerobic GNR (prevotella)
Viridans group strep
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7
Q 
Common bacterial pathogens for infections in 
Lower respiratory (community acquired)
A

Strep pneumo
H. influ
Atypicals (legionella, mycoplasma)
Enteric GNR (alcoholics)

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8
Q 
Common bacterial pathogens for infections in 
Lower respiratory (hospital acquired)
A

Staph aureus (including MRSA)
Pseudomonas
Enteric GNR
Strep pneumo

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9
Q

Common bacterial pathogens for infections in

urinary tract

A

E. coli, proteus, klebsiella
Staph saprophyticus
Strep
Enterococci

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10
Q

What color do gram positive organisms stain?

A

Purple

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11
Q

What color do gram negative organisms stain?

A

Pink

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12
Q

What color do atypicals stain?

A

They don’t stain - no cell wall

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13
Q

What organisms are

gram positive cocci clusters?

A

Staphlococcus (MSSA, MRSA)

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14
Q

What organisms are

tram positive cocci pairs (diplococci) and chains (cocci)

A

Strep pneumo
Strep
Enterococcus

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15
Q

What organisms are

gram positive rods (bacilli)

A

Lysteria

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16
Q

What organisms are

gram positive anaerobes (spores)

A

peptostreptococcus
Actinomyces
Clostridium

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17
Q

What organisms are

atpyicals?

A

Chlamydia
Legionella
Mycoplasma pneumoniae
Mycobacterium tuberculosis

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18
Q

What organisms are

gram negative cocci

A

Nesseria

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19
Q

What organisms are

gram negative anaerobes

A

bacteriodes fragilis

Prevotella

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20
Q

What organisms are

gram negative coccobacilli

A

Acinetobacter baumannii
Bordetella pertussis
Moraxella catarrhalis

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21
Q

What organisms are

gram negative rods (gut)

A 
Proteus mirabilis
E coli
Klebsiella
Serratia
Enterobacter cloacae
Citrobacter
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22
Q

What organisms are

gram negative rods (not gut)

A

Pseudomonas aeruginosa
H. influ
Providencia

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23
Q

What organisms are

gram negative curved or spiral shaped rods

A 
H. pylori
Campylobacter Spp
Treponema spp
Borrelia spp
Leptospira spp
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24
Q

Which 2 antibiotics can be used to treat certain invasive gram-positive infections?

A

aminoglycosides and beta lactams

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25
Q

How are ESBL infections treated?

A

carbapenems or cephalosporin/beta-lactamase inhibitors

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26
Q

How are CRE (carbapenem resistant enterobacteriaceae) treated?

A

Polymyxins

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27
Q

Common resistant pathogens

A 
Kill Each And Every Strong Pathogen
Klebsiella pneumo (ESBL, CRE)
E coli (ESBL, CRE)
Acinetobacter baumannii
Enterococcus (VRE)
Staph aureus (MRSA)
Pseudomonas
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28
Q

Which abx are folic acid synthesis inhibitors?

A

Sulfonamides
Trimethoprim
Dapsone

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29
Q

Which abx are Cell wall inhibitors

A

Beta lactams
Monobactams
Vancomycin, dalbavancin, televancin, oritavancin

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30
Q

Which abx are protein synthesis inhibitors

A 
Aminoglycosides
Macrolides
Tetracyclines
Clindamycin
Linezolid, tedizolid
Quinupristin/Dalfopristin
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31
Q

Which abx are cell membrane inhibitors

A

polymyxins
daptomycin
telavancin
oritavancin

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32
Q

Which abx are DNA/RNA inhibitors

A

quinolones
metronidazole, tinidazole
rivampin

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33
Q

Which abx have concentration-dependent killing?

What is the PK goal and what are the dosing strategies?

A

Aminoglycosides, quinolones, daptomycin
Goal: high peak, low trough
Large doses, long intervals

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34
Q

Which abx have AUC:MIC dependent killing?

What is the PK goal and what are the dosing strategies?

A

Vancomycin, macrolides, tetracyclines, polymyxins
Goal: exposure over time
Variable dosing strategies

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35
Q

Which abx have Time>MIC dependent killing?

A 
Beta lactams (PCN, cephalosporins, carbapenems)
Goal: maintain drug level > MIC for most of the dosing interval
Dosing strategies: shorter dosing interval, extended or continuous infusion
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36
Q

What drugs are aminopenicillins and what are they active against?

A

Amoxicillin +/- clavulanate, ampicillin +/- sulbactam
Streptococci, enterococci, gram-positive anaerobes (mouth flora) plus gram negative Haemophilus, neisseria, proteus, E. coli

+ BLI have added activity against MSSA, klebsiella (HNPEK) and gram-negative anaerobes (b fragilis)

HNPEK

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37
Q

What drugs are natural penicillins and what are they active against?

A

Penicillin V, PCN G aqueous, PCN G benzathine

strep and enterococci (NOT STAPH) and gram positive anaerobes (mouth flora)

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38
Q

What drugs are extended spectrum penicillins and what are they active against?

A

Piperacillin/tazobactam
Gram-positive (strep, MSSA, enterococci) Gram-positive anaerobes (mouth flora), gram-negative anaerobes (B fragilis) PLUS citrobacter, acinetobacter, providencia, enterobacter, serratia (CAPES) and pseudomonas

HNPEK CAPES

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39
Q

What drugs are antistaphylococcal penicillins and what are they active against?

A

Dicloxacillin, nafcillin, oxacillin

Strep, MSSA

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40
Q

beta lactam MOA

A

inhibit bacterial cell wall synthesis by binding to penicillin binding proteins, preventing the final step of peptidoglycan synthesis in bacterial cell wall

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41
Q

What medications are beta lactam antibiotics?

A

PCN, caphalosporins, carbapenems

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42
Q

Which PCN has a boxed warning and what is it?

A

Penicillin G benzathine

Not for IV use - can cause cardiorespiratory arrest and death

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43
Q

PCN contraindications, side effects, monitoring

A

Augmentin and Unasyn: hx of cholestatic jaundice or hepatic dysfunction with previous use

CrCl < 30, do NOT use extended release oral forms or 875mg strength of amox/clav

SE: seizures (accumulation), GI upset, diarrhea, rash (SJS/anaphylaxis), hemolytic anemia, renal failure, increased LFTs

Monitoring: renal fxn, CBC and LFTs with prolonged use

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44
Q

When switching from IV ampicillin to PO, what medication should be chosen?

A

amoxicillin b/c ampicillin has poor PO bioavailability

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45
Q

What is the only thing IV ampicillin can be diluted in?

A

NS

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46
Q

How much sodium does zosyn contain?

A

65 mg per 1g piperacillin

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47
Q

Which PCN is a vesicant? How do you treat it’s extravasation?

A

Nafcillin (administer through central line preferred)

Cold packs and hyaluronidase injections

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48
Q

Which penicillins do not require renal adjustments?

A

Antistaphylococcal (diclox, naf, oxacillin)

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49
Q

What are some drug interactions with PCN abx

A

Probenecid - increase beta lactam levels (interfere with renal excretion)

Warfarin (except naf and diclox) - increase INR

Increase level of methotrexate

Decrease level of mycophenolate

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50
Q

Which patients should penicillins be avoided in?

A

Pts with beta lactam allergy

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51
Q

What is there an increased risk of with accumulation of any PCN antibiotic?

A

seizures

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52
Q

What is PCN VK first-line for?

A

strep throat and mild nonpurulent skin infections (no abscess)

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53
Q

What is amoxicillin first line for?

A

otitis media, infective endocarditis prophylaxis before dental procedures, H. pylori

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54
Q

What is PCN G benzathine first line for?

A

syphilis

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55
Q

What is Amox/clav first line for?

A

acute otitis media and sinus infections

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56
Q

What is the only PCN that is active against pseudomonas?

A

pip/tazo

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57
Q

What are first gen cephalosporins and what do they cover?

A

Cefazolin, cephalexin

Gram positive cocci (strep and staph - MSSA), Proteus, E. coli, Klebsiella (PEK)

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58
Q

What are second gen cephalosporins and what do they cover?

A

cefuroxime, cefotetan
Staph, Strep, Haemophilus, neisseria, proteus, e. coli, klebsiella (HNPEK)
Cefotetan and cefoxitin - gram negative anaerobes (B. fragilis)

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59
Q

What are third gen cephalosporins and what do they cover?

A

cefdinir, ceftriaxone, cefotaxime, ceftazidime
Ceftriaxone, cefotaxime: Strep, staph (MSSA), gram positive anaerobes (mouth flora)
Ceftazidime: pseudomonas
Ceftaz/avibactam and ceftolozane/tazo: MDR pseudomonas

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60
Q

What are fourth gen cephalosporins and what do they cover?

A

Cefepime
MRSA (only beta-lactam that covers this)
Gram negative (HNPEK, CAPES, pseudomonas)
Gram positive (strep, staph, mouth flora)

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61
Q

What are fifth gen cephalosporins and what do they cover?

A

Ceftaroline
MRSA (only beta-lactam that covers this)
Gram negative (HNPEK, CAPES, pseudomonas)
Gram positive (strep, staph, mouth flora)

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62
Q

What adverse effect can occur if there is cephalosporin accumulation?

A

Seizures - watch for in renal failure

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63
Q

What cephalosporine does not need renal adjustment?

A

ceftriaxone - excreted renally and hepatically but liver picks up if kidneys are slacking

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64
Q

What is the only beta lactam active against MRSA?

A

ceftaroline

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65
Q

What types of infections are carbapenems used for?

A

multidrug resistant gram-negative

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66
Q

What drugs are carbapenems?

A

Dori, imi, mero, ertapenem

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67
Q

What carbapenem does not cover pseudomonas, acinetobacter or enterococcus?

A

ertapenem

ErtAPenem

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68
Q

What is imipenem combined with and why?

A

cilastatin

prevents drug degredation by renal tubular dehydropeptidase

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69
Q

What antibiotics should not be used in someone with a PCN allergy?

A

Penicillins, cephalosporins, carbapenems,

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70
Q

Class effect of carbapenems

A

Cover ESBL producing organisms
Cover pseudomonas except ertapenem
Do not use with PCN allergy
Seizure risk with high dose and renal failure

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71
Q

What do carbapenems NOT cover?

A

Atypicals, VRE, MRSA, C. diff, stenotrophomonas

72
Q

Common uses for carbapenems

A 
Polymicrobial infections (broad)
Empiric therapy when resistant organisms are suspected
Resistant pseudomonas or acinetobacter (except ertapenem)
73
Q

What is the only monobactam?

A

aztreonam

74
Q

Aztreonam MOA

A

inhibits bacterial cell wall synthesis by binding to PCN binding protein (PBP) which prevents peptidoglycan synthesis in bacterial cell walls

75
Q

Why is cross reactivity unlikely between Aztreonam and PCN?

A

Aztreonam only has one circle (monobactam) in its structure

76
Q

What does aztreonam cover?

A 
Gram negative (including pseudomonas)
does NOT cover gram positive or anaerobic activity
77
Q

Aminoglycoside MOA

A

bind to ribosome preventing bacterial protein synthesis causing defective cell membrane

78
Q

What bacteria are AG active against?

A

gram negative (including pseudomonas)

79
Q

What AG are used with beta lactams or vancomycin for synergy? What infections is this used to treat?

A

gentamycin and streptomycin

Gram positive infections

80
Q

Which type of dosing is attributed to less accumulation of AG? traditional or extended?

A

extended

81
Q

BBW for AG?

A

nephrotoxicity, ototoxicity, avoid with other neurotoxic/nephrotoxic meds, neuromuscular blockade and respiratory paralysis

82
Q

AG warnings and SE?

A

Warnings: caution in impaired renal function, elderly, and using other nephrotoxic drugs
SE: nephrotoxicity, hearing loss, vestibular toxicity (balance issues)

83
Q

Quinolones MOA

A

inhibit bacteiral DNA topoisomerase IV and DNA gyrase (topoisomerase II) preventing supercoiling of bacteria and promotes breakage of DNA

84
Q

What abx are concentration dependent?

A

AG and FQ

85
Q

What bacteria do quinolones cover?

A

Gram positive, negative, and atypicals

86
Q

What are the respiratory quinolones? What do they have an increased coverage of?

A

Levo, moxi, and gemifloxacin

Strep pneumo and atypical

87
Q

What FQ are used in combo with beta lactam when treating pseudomonas?

A

cipro and levofloxacin

88
Q

What is the only FQ that cannot be used to treat UTI?

A

moxifloxacin

89
Q

What is the only FQ that does not have a high resistance to MRSA?

A

Delafloxacin

Newer to the market

90
Q

BBW for FQ

A

tendon inflammation and/or rupture within hours/days or up to several months after, peripheral neuropathy, CNS effects (seizures, tremor, hallucinations, etc)

91
Q

FQ warnings and SE

A

warnings: QT prolongation, hypo/hyperglycemia, psychiatric disturbances, photosensitivity

92
Q

What patients should FQ not be used in?

A

Pregnant and children

Risk of musculoskeletal toxicity

93
Q

What medications interact with FQ

A

Antacids (polyvalent cations chelate)
Lanthanum (Fosrenol) and sevelamer (Renvela)
Warfarin (increase INR)
Sulfonylureas (increase effect and cause hypoglycemia)
Probenecid and NSAIDs increase FQ levels

94
Q

Do not administer ciprofloxacin with what medication?

A

Tizanidine

95
Q

What is the only FQ that is not renally adusted?

A

Moxifloxacin

96
Q

What medications are macrolides?

A

Azithromycin, clarithromycin, erythromycin

97
Q

Macrolide MOA

A

bind 50S robosomal subunit, inhibiting RNA dependent protein synthesis

98
Q

What do macrolides cover?

A

atypicals and haemophilus

99
Q

Macrolide CI

A

Hepatic dysfunction

100
Q

What medication should NOT be given with clarithromycin and erythromycin

A

lovastatin or simvastatin

101
Q

Macrolide Warnings and SE

A

Warnings: QT prolongation, hepatotoxicity
SE: GI upset, ototoxicity

102
Q

What macrolides go through what CYP enzymes?

A

Erythromycin and clarithromycin major CYP3A4 inhibitors

Azithromycin 3A4 substrate and 1A2 inhibitor

103
Q

Azithromycin common uses

A

COPD exacerbations
Chlamydia monotherapy
Gonorrhea combo therapy
Travelers diarrhea

104
Q

Clarithromycin common uses

A

H. pylori

105
Q

What drugs are tetracyclines

A

Doxycycline, minocycline

106
Q

Tetracycline MOA

A

inhibit protein synthesis by reversibly binding to 30S ribosomal subunit

107
Q

What do tetracycline cover?

A

gram-negative, atypicals

108
Q

What tetracycline does not need to be renally adjusted?

A

Doxycycline

109
Q

Tetracycline warnings

A

photosensitivity
Children <8 years, pregnancy, breastfeeding
minocycline: drug-induced lupus erythematosis (DILE)

110
Q

Tetracycline drug interactions

A

Antacids/polyvalent cations
Lanthanum (Fosrenol) - decreases tetracycline
Use with caution in CYP3A4 inhibitors (increase levels) and CYP3A4 inducers (decrease levels)
Warfarin - increase INR

111
Q

Sulfonamides abx and MOA

A

TMP/SMX
SMX - inhibits dihydrofolic acid formation and interferes with bacterial folic acid synthesis
TMP - inhibits folic acid pathway

112
Q

What does bactrim cover?

A

Staph (MRSA and CA-MRSA), gram negative, pneumocystis, toxoplasmosis

113
Q

Bactrim CI

A

Sulfa allergy, pregnancy (b/c folic acid), anemia d/t folate deficiency

114
Q

Bactrim warnings and SE

A

Warnings: skin reactions (SJS/TEN), G6PD deficiency
SE: photosensitivity, hyperkalemia, hemolytic anemia, crystalluria

115
Q

What CYP enzymes does bactrim go through? What significant drug does it interact with

A

2C8 and 2C9 inhibitor

Increase INR when used with warfarin

116
Q

Vancomycin MOA

A

inhibits bacterial cell wall synthesis by binding D-alanyl-D-alanyl cell wall precursor and blockign peptidoglycan polymerization

117
Q

What bacteria does vancomycin cover?

A

gram positive - MRSA, strep, enterococci (not VRE), and C. diff

118
Q

What antibiotic is used to treat C. diff?

A

ORAL vancomycin

IV vanc will NOT work

119
Q

Vancomycin warnings and SE

A

Warnings: ototoxicity and nephrotoxicity, infusion reaction (red man syndrome)
SE: phlebitis, skin reactions

120
Q

What abx are lipoglycopeptides?

A

Telavancin
Oritavancin
Dalbavancin

121
Q

Lipoglycopeptide MOA

A

inhibit bacterial cell wall synthesis by binding to D-alanyl-D-ALANINE blocking polymerization and cross-linking of peptidoglycan and disrupting bacterial cell membrane potential and changing permeability

122
Q

Telavancin BBW

A

Fetal risk, nephrotoxicity

123
Q

Lipoglycopeptide CI, warnings, SE

A

CI: concurrent use of UFH (except dalbavancin)
Warnings: can falsely elevate PT/INR
SE: Telavancin - metallic taste, N/V, foamy urine, increase SCr; Oritavancin/Dalbavancin - infusion reaction (red man syndrome)

124
Q

Daptomycin MOA

A

inhibits protein synthesis through rapid depolarization of cell membrane –> cell death

125
Q

What bacteria does daptomycin work against?

A

gram positive including MRSA and VRE

126
Q

Daptomycin warnings and SE

A

Warnings: myopathy and rhabdomyolysis, can fasely increase PT/INR but does not increase bleeding risk, neuropathy, eosinophilic pneumonia
SE: increased CPK, rash, edema, chest pain, HTN, AKI

127
Q

Why does daptomycin not work in the lungs?

A

Drug is inactivated by the surfactant

128
Q

What drugs are oxazolidinones

A

Linezolid (Zyvox) and tedizolid (Sivextro)

129
Q

Oxazolidinones MOA

A

bind to 5OS subunit of ribosome inhibiting translation and protein synthesis

130
Q

Oxazolidinones vs vancomycin coverage

A

Same (gram positive and MRSA) except oxazolinones cover VRE

131
Q

Oxazolidinones contraindication

A

Do not use within 2 weeks of MAOI

132
Q

Oxazolidinones warnings and SE

A

Warnings: duration related myelosuppression, peripheral and optic neuropathy when >28 days use, serotonin syndrome, hypoglycemia
SE: decreased platelets, Hgb, WBC, HA, N/D, increased LFTs

133
Q

Oxazolidinones interactions

A

Avoid tyramine containing foods and serotonergic drugs

134
Q

Synercid generic name

A

quinupristin/dalfopristin

135
Q

quinupristin/dalfopristin class

A

streptogramin

136
Q

quinupristin/dalfopristin MOA

A

binds to 50S ribosomal subunit inhibiting protein synthesis

137
Q

What does quinupristin/dalfopristin cover?

A

Gram positive including MRSA and VRE but NOT E. faecalis

138
Q

Why is quinupristin/dalfopristin not usually used?

A

Not well tolerated

139
Q

quinupristin/dalfopristin SE

A

SE: arthralgias/myalgias, infusion reaction, phlebitis, hyperbilirubinemia (all above 35%), CPK elevations, GI upset, increased LFTs
***administer via central line

140
Q

What can daptomycin be diluted in?

A

NS but NOT DEXTROSE

141
Q

What can quinupristin/dalfopristin be diluted in?

A

D5 ONLY

142
Q

Tigecycline class and MOA

A

Glycylcycline

Binds 30S ribosomal subunit inhibiting protein synthesis

143
Q

Tigecycline works against what bacteria?

A

Gram-positive including MRSA and VRE, gram-negative, anaerobes, and atypicals
Does not work against the 3 P’s: pseudomonas, proteus, providencia

144
Q

Tigecycline BBW, warnings, and SE

A

BBW: increased risk of death (LAST LINE ONLY)
Warnings: hepatotoxicity, pancreatitis, photosensitivity, teeth discoloration in children <8
SE: N/V/D, HA, dizziness, increased LFTs, SJS

145
Q

What type of infections should tigecycline not be used for and why?

A

bloodstream - super lipophilic so does not reach adequate concentrations in bloodstream

146
Q

What drugs are polymyxins

A

Colistimethate sodium and polymyxin b

147
Q

Polymyxin MOA

A

Colistin (cationic detergent) damages bacterial cytoplasmic membrane causing leakage of intracellular substances and cell death

148
Q

Polymyxin coverage

A

gram-negative (not proteus)

Usually used for MDR gram-negative pathogens in combo with other abx

149
Q

Polymyxin BBW and warnings

A

Colistimethate sodium
Warning: dose dependent nephrotoxicity, neurotoxicity

Polymyxin BBW: nephrotoxicity, neurotoxicity, respiratory paralysis from neuromuscular blockade

150
Q

What polymyxin is a prodrug and what is it metabolized to?

A

colistin (colistimethate) is hydrolyzed to colistin (cationic detergent)

151
Q

Chloramphenicol MOA

A

reversibly binds to 50S subunit of the baterial ribosome inhibiting protein synthesis

152
Q

Chloramphenicol coverage

A

gram positive, gram negative, anaerobes, and atypicals

153
Q

Chloramphenicol BBW and warnings

A

BBW: serious and fatal bloody dyscrasias (aplastic anemia, pancytopenia)
Warnings: gray syndrome with high serum levels - circulatory collapse, yanosis, acidosis, abdominal distention, myocardial depression, coma, death

154
Q

Clindamycin MOA

A

reversibly binds to 50S subunit of bacterial ribosome inhibiting protein synthesis

155
Q

Clindamycin coverage

A

most anaerobes and gram-positive bacteria

156
Q

Clindamycin BBW, warnings, SE

A

BBW: C. diff
Warning: severe or fatal skin reactions
SE: N/V/D, rash, increased LFTs

157
Q

Nitroimidazole drugs

A

Metronidazole, tinidazole, secnidazole

158
Q

nitroimidazole MOA

A

cause loss of helical DNA structure and strand breakage resulting in inhibited protein synthesis

159
Q

Metronidazole activity

A

anaerobes and protozoal infections

Bacterial vaginosis, trichomoniasis, giardiasis, amebiasis, D. diff, and intra-abdominal infections

160
Q

nitroimidazole BBW, CI, Warnings, SE

A

BBW: possibly carcinogenic
CI: pregnancy (first trimester), alcohol or propylene glycol use during or within 3 days after treatment
Warnings: CNS effects (seizures, peripheral neuropathy) metronidazole can cause aseptic meningitis, encephalopathy, or optic neuropathy
SE: metallic taste, HA, nausea, furry tongue, darkened urine, dizziness, rash/SJS

161
Q

Lefamulin MOA

A

inhibits bacterial protein synthesis by binding to the peptidyl transferase center of the 50S ribosomal subunit

162
Q

Lefamulin CI, warnings, SE

A

CI: use with CYP3A4 substrates that prolong the QT interval
Warnings: avoid in pregnancy, QTc prolongation, C diff
SE: diarrhea, nausea, injection site reaction

163
Q

Fidaxomicin MOA

A

inhibits RNA polymerase, resulting in inhibition of protein synthesis and cell death

164
Q

Fidaxomicin warnings and SE

A

Warnings: not effective for systemic infections (No IV dosage)
SE: N/V, abdominal pain, GI bleeding, anemia

165
Q

Rifaximin MOA

A

inhibits bacterial RNA synthesis by binding to bacterial DNA-dependent RNA polymerase

166
Q

Rifaximin SE and notes

A

SE: peripheral edema, dizziness, HA, flatulence, nausea, abdominal pain, rash
Notes: not effective for systemic infections; used off-label for C. diff

167
Q

Fosfomycin MOA

A

inhibits bacterial cell wall synthesis by inactivating the eyzyme pyruval transferase, disrupting cell wall synthesis

168
Q

Fosfomycin coverage

A

E. coli (including ESBL) and E. faecalis (including VRE)

169
Q

What is fosfomycin used for?

A 
UTI - single dose for uncomplicated
1 packet (3g) mixed in 3-4 oz water
170
Q

Nitrofurantoin MOA

A

bacterial cell wall inhibitor

171
Q

Nitrofurantoin coverage

A

E. coli, Klebsiella, Enterobacter, S. aureus, and VRE

***used for UTI

172
Q

Nitrofurantoin dosing

A

MacroBID is used BID

Macrodantin is QID

173
Q

Nitrofurantoin CI, warnings, and SE

A

CI: renal impairment (CrCl < 60)
Warnings: optic neuritis, hepatotoxicity, peripheral neuropathy, pulmonary toxicity, hemolytic anemia (caution in pts with G6PD deficiency)
SE: GI upset, HA, rash, brown urine (harmless)

174
Q

What is mupirocin used for?

A

Nasal ointment used to eliminate MRSA colonization of nares

175
Q

What ORAL abx need to be refrigerated after reconstitution?

A

Penicillin VK
Ampicillin
Amox/clav
Vanc

176
Q

What ORAL abx should NOT be refrigerated after reconstitution?

A

Cefdinir

177
Q

What IV abx should not be refrigerated?

A

Metronidazole, moxifloxacin, bactrim, acyclovir

NAPLEX Review (79 decks)

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