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Naplex 2025 > Infectious Disease I > Flashcards

Infectious Disease I Flashcards

1
Q

What are some of the common bacterial pathogens in CNS/Meningitis?

A
  • Strep Pneunomoniae
  • Neisseria Meningitis
  • Hemophilus Influenzae
  • Group B Strep/E. Coli
  • Listeria (in young/old)
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2
Q

What are some of the common bacterial pathogens in the Upper Respiratory?

A
  • Strep Pyogenes
  • Strep Pneumoniae
  • Heamophilus Influenzae
  • Moraxella Catarrhalis
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3
Q

What are some of the common bacterial pathogens in the Heart/Endocarditis?

A
  • Staph Aureus (including MSSA)
  • Staph Epidermidis
  • Streptococci
  • Entercocci
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4
Q

What are some of the common bacterial pathogens on the skin/soft tissue?

A
  • Staph Aureus
  • Staph Epidermidis
  • Strep Pyogenes
  • Pasterulla Multocida
  • +/- areobic/anareobic GNR (in diabetes)
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5
Q

What are some of the common bacterial pathogens in the Bone/joint?

A
  • Staph Aureus
  • Staph Epidermidis
  • Streptococci
  • Neisseria Gonorrhoeae
  • GNR
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6
Q

What are some of the common bacterial pathogens in the Mouth?

A
  • Mouth Flora (Peptostreptococcus)
  • Anaerobic GNR (Prevotella, other)
  • Viridans Group Strep
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7
Q

What are some of the common bacterial pathogens in the Lower Respiratory (community)?

A
  • Strep Pneumoniae
  • Haemophilus Influenzae
  • Atypicals: Legionella, Mycoplasma
  • Chlamydophila
  • Enteric GNR (Alcohol use disorder?)
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8
Q

What are some of the common bacterial pathogens in the lower respiratory (hospital)?

A
  • Staph Aureus (including MRSA)
  • Pseudomonas
  • Acinetobacter Baumannii
  • Enteric GNR (including ESBL+, MDR)
  • Strep Pneumoniae
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9
Q

What are some of the common bacterial pathogens in the Urinary Tract?

A
  • E. Coli
  • Proteus
  • Klebsiella
  • Staph Saprophyticus
  • Enterococci
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10
Q

What is important to know about Gram Positive Organisms?

A
  • THICK cell wall
  • Stain purple to blue from crystal violet
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11
Q

what is important to know about Gram Negative Organisms?

A
  • THIN cell wall
  • Stain pink from safranin
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12
Q

Which Antibotics are Hydrophilic?

A
  • Beta Lactams
  • Aminoglycosides
  • Vancomycin
  • Daptomycin
  • Polymyxins
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13
Q

What dose it mean when an antibiotic is Hydrophilic?

A
  • Less tissue penetration
  • Reanlly eliminated (does adjustments possible)
  • Not good against atypicals
  • Poor Bioavailability
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14
Q

Which Antibiotics are Lipophilic?

A
  • Quinolones
  • Macrolides
  • Rifampin
  • Linezoild
  • Tetracyclines
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15
Q

What dose it mean when an Antibiotic is Lipophilic?

A
  • Better tissue Penetration
  • Hepatically eliminated (more toxicity and drug-drug interactions)
  • Good for atypicals
  • Good Bioavailability
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16
Q

Which medication are Cmax:MIC and what does this mean?

Concentration-dependent

A
  • Aminoglycosides, Quinolones, Daptomycin
  • Can be dosed less and have higher doses
  • High Peak and Low Trough
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17
Q

Which medications are AUC:MIC and what does this mean?

exposure-dependent

A
  • Vancomycin, Macrolides, Tetracyclines, Polymyxins
  • Exposure over time
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18
Q

Which medications are TIME > MIC and what does this mean?

A
  • Beta Lactams
  • Given more frequently for longer times
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19
Q

What are the Beta Lactams?

A
  • Penicillins
  • Cephalosporins
  • Carbapenams
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20
Q

What is the MOA for the Beta lactams

A
  • Inhibits bacterial cell wall synthesis by binding to PBPs; stoping the final step of Peptidoglycan synthesis
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21
Q

What are Natural Penicillins good for?

A
  • Gram Positive Cocci (Strep & Entero)
  • Gram Positive Anaerobes (Mouth Flora)
  • LACK gram negatives
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22
Q

What are the Antistaphylococcal Penicillins good for?

A
  • Streptococci
  • MSSA
  • LACK for Enterococci, gram negatives and anaerobes
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23
Q

What are the Aminopenicililns good for?

A
  • Streptococci
  • Enterococci
  • Gram Positive Anaerobes
  • + Haemophilus, Neisseria, Proteus, E. Coli
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24
Q

What are the Natural Penicillin that are used?

A
  • Penicillin V Potassium: PO
  • Penicillin G Benzathine [Bicillin L-A]: IM
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25
What are the **Antistaphylococci Penicillins** that are used?
- Dicloxacillin - Nafcillin - Oxacillin
26
What are the **Aminopenicillins** that are used?
- Amoxicillin (or Amoxicililn/Clavuanate) - Ampicillin (or Ampicillin/Sulbactam [Unasyn])
27
What are the **Extended Spectrum Penicillins** that are used?
- Piperacillin/Tazobactam (Zoysn)
28
What are the **boxed warnings** for the **Penicillins**?
- Pen G Benzathne; **ONLY IM** [IV could be fatal]
29
What are the **Contraindications** for the **Penicillins**?
- Hypersentivity Reaction to other penicillins or cehalosporins - CrCl < 30 DO NOT use augmentin XR or 875 mg
30
What are the **Side Effects** for the **Penicillins**?
- Seizures (with accumulations) - GI Upset, Diarrhea - Skin Rash (could lead to SJS, TEN) - Allergic Reactions/Anaphylaxis
31
What are some **additional notes** for the **Antistaphylcocci Penicillins**?
- Best for MSSA (in soft tissue, bones, endocarditis) - NO Renal Adjustments
32
What are some **additional notes** for the **Aminopenicillins**?
- Ampicillin PO is rarely used due to bad Bioavailability
33
What are the **1st Generation Cehalosporins** good for
- Gram Positive Cocci [Strep and Staph] - MSSA - Gram Negative Rods [Proteus, E. Coli, Klebisella (**PEK**)
34
What are the **2nd Generation Cehalosporins** good for
- Haemophilus, Neisseria, Proteus, E. Coli, Klebisella [**HENPEK**] - Some anaerobic
35
What are the **3rd Generation Cehalosporins** good for
- Resistanct Streptococci [group & viridans] - MSSA - Gram Positive Anaerobes - HENPEK
36
What are the **4th Generation Cehalosporins** good for
- HENPEK - CAPES - Pseudomonas
37
What are the **5th Generation Cehalosporins** good for
- Basically everything that 3rd gens do - **ONLY CEPHALO** for MRSA
38
What are the **1st Generation Cephalosproins** that are used?
- Cefazolin IV - Cephalexin PO 250 - 500 mg q6-12 h
39
What are the **2nd Generation Cephalosproins** that are used?
- Cefuroxime PO - Cefotetan IV - Cefoxitin IV
40
What are the **3rd Generation Cephalosproins** that are used?
- Cefdinir PO - Ceftriaxone IV - Ceftazidime IV [covers pseudo]
41
What are the **4th Generation Cephalosproins** that are used?
- Cefepime IV [covers Pseudo]
42
What are the **5th Generation Cephalosproins** that are used?
- Ceftaroline Fosamil (Terflaro) [covers MRSA]
43
What are the **contraindictions (Ceftriaxone)** for the **Cephalosproins**?
- Biliary Sludging and Kernicterus in Neonates
44
What are the **Warnings** for the **Cephalosproins**?
- Cross reactivity wihth penicillin alleragy - Cefotetan can cause a disulfram like reaction with alcohol
45
What are the **Side Effects** for the **Cephalosproins**?
- Seizures (with accumulations) - GI Upset, Diarrhea - Skin Rash (could lead to SJS, TEN) - Allergic Reactions/Anaphylaxis ## Footnote the same as the Penicillin
46
What are some **additional notes** for the **Cephalosproins**?
- Ceftriaxone: NO Renal adjustments - Cefixime is a chewable tab - Cefotetan & Cefoxitin have activity for B. Fragils - Ceftazidime/Avibactam is good for CRE
47
What are the **Carbapenams** good for? | -
- Most Gram Positive, Gram Negative [Even ESBL], and Anaerobics - **LACKS** coverage for Atypcials, MRSA, VRE - Ertapenam **DOES NOT** cover Pseudo, Acinetobacter, or enterococcus
48
What are the **Carbapenams** that are used?
- Meropenam [Merrem] - Ertapenam [Invanz]
49
What are the **warnings** for the **carbapenams**?
- Cross reactive with pencillin allergy
50
What are some of the **side effects** for the **carbapenams**?
- Diarrhea - Rash/Severe Skin Reactions [DRESS] - Bone Marrow Suppression - Incresaed LFT
51
What are some **additional notes** for **Carbapenams**?
- Ertapenam **DOES NOT** cover Pseudo, Acinto, Enterococcus
52
What is the **monobactam** that is used?
- Aztreonam [Azatam]
53
What is important to know about **Aztreonam**?
- Covers Gram Negatives; **NO** coverage for Gram Positive - **NO** Cross reactivity with Beta Lactam Allergies
54
What is the **MOA** for the **Aminoglycosides**?
- Binds to ribosome, which interferes with bacterial protein synthesis and resutls in a defective cell membrane
55
What are the **Aminoglycosides** good at?
- Active toward Gram Negatives [Even Pseudo] - Part of Empiric therapies [non monotherapy] with other agents for Gram positives
56
What are the **Aminoglycosides** that are used?
- Gentamicin - Tobramycin - Amikican
57
What is important to know about the **dosing** of **Aminoglycosides**? ## Footnote Traditional vs Extended dosing
- If underweight = Total body weight; if obese = adjusted body weight - Traditional: 1 - 2.5 mg/kg/dose - Extended: 4 - 7 mg/kg/dose
58
What are the **Boxed Warnings** for the **Aminoglycosides?**
- Nephrotoxicity - Ototoxicity - Neuromuscular Blockade [even respiratory paralysis] - AVOID other neurotoxic/nephrotoxic agents
59
What are the **warnings** for the **Aminoglycosides?**
- Caution in imparied renal function, older patients and those taking other nephrotoxic drugs
60
What is the **MOA** for the **Quinolones**?
- Inhibits DNA topoisomerase IV and DNA gyrase [Topo II]; preventing supercoiling and promotes DNA breaking
61
Which **Quinolones** are known as the **respirtory quinolones** and why?
- Levo and Moxi - better coverage of S. Pneuomonia and Atypicals
62
Which **quinolones** have coverage toward **Pseudomonas**?
- Cipro and Levo
63
What is important to know abotu **Moxifloxican**?
- better activity to Gram Positives and Anaerobics - NOT used for UTI
64
What is important to know about **Delafloxican**?
- active against MRSA
65
What are the **Quinolones** that are used?
- Ciprofloxican [Cipro] + Dexamethasone [Ciprodex] - Levofloxican - Moxifloxican (no renal adjustments) - Delafloxican - Gatifloxican - Ofloxican [Ocuflax eye drops]
66
What are the **boxed warnings** for the **Quinolones**?
- Tendon Inflammation and/or Rupture - Peripheral Neuropathy - CNS Effects
67
What are the **warnings** for the **Quinolones**?
- QTc Prolongation [Highest risk with M>L>C] - Hypo or Hyperglycemia - Avoid Systemic in kids and pregnancy/breastfeeding
68
What are some **additional notes** for the **Quinolones**?
- Cipro suspension does NOT go into NG - Moxi NOT for UTI
69
What is the **MOA** of the **Macrolides**? ## Footnote -
- Bind to 50S subunit causing inhibition of protein synthesis
70
What are the **Macrolides** good at?
- Atypicals [Legionella, Chlamydia, Mycoplasmia, Mycobacterium] - S. Pneumo, Haemophilus, Moraxella [CAP]
71
What are the **Macrolides** that are used?
- Azithormycin [Zithromax, Z-Pak] - Clarithromycin - Eythromycin [E.E.S, Ery-Tab, Erythrocin]
72
What are the **contraindications** for the **Macrolides**?
- Clarith & Eryth: DO NOT use with Lovstatin and Simvastatin
73
What are the **Warnings** for the **Macrolides**?
- QTc Prolongation [highest risk E>A>C] - Hepatotoxicity - Clarith: caution in patients with CAD [increase mortality]
74
What are the **Side Effects** for the **Macrolides**?
- GI Upset [Diarrhea, Cramping] - Ototoxicity - Severe Skin Reactions [Rare]
75
What is the **MOA** for the **Tetracyclines**?
- Inhibits protein synthesis by binding to 30s ribosomal subunit
76
What are the **Tetracyclines** good at?
- Gram Positive [Staph, Strep, Entro, Propionibacterium] - Gram Negitive [Haemophilus, Moraxella, atypicals] - Other pathogens [Rickettsiaem Bacillus anthracis, treponema pallidum]
77
What are the **tetracyclines** that are used?
- Doxycyline [Vibramycin] - Minocycline [Minocin, Solodyn]
78
What are the **warnings** for the **Tetracyclines**?
- Kids < 8 and Pregnancy/Breastfeeding - Photosensitivity - Mino: DILE
79
What are the **Side Effects** for the **Tetracyclines**?
- N/V/D - Skin rashes
80
What are some **additional notes** for the **Tetracyclines**?
- IV:PO = 1:1 - Doxycyline: take with 8oz on water and sit upright for 30 mins after taking it
81
What is the **MOA** for **SMX/TMP**
- inhibits dyhydrofolic formation and acid reduction = inhibition of folic acid pathways
82
What is **SMX/TMP** good at?
- Staph [even MRSA] - Gram Negatives [Haemophilus, Proteus, E. Coli, Klebsiella, Enterobacter, **Shigella, Salmonella, Strenotrophomonas** - Some OIs [Pneumocystis, Toxo]
83
What are the different dosage forms for **SMX/TMP**
- Single Strength: 400/80mg - Double Strength: 800/160mg
84
What are the **contraindications** for the **SMX/TMP**?
- Sulfa allergy
85
What are the **Warnings** for the **SMX/TMP**?
- SKin Reactions [SJS/TEN; TTP] - Hemolytic Anemia: immune mediated or **G6PD Deficieny**
86
What are the **Side Effects** for the **SMX/TMP**?
- Photosensitivity - Increase Potassium - Crystalluria
87

Naplex 2025 (57 decks)

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