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NAPLEx > Infectious disease I > Flashcards

Infectious disease I Flashcards

1
Q

What is collateral damage?

A

unintended consequences of antibiotic use

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2
Q

common resistant pathogens

A
  • Kill Each And Every Strong Pathogen
  • Klebsiella (ESBL, CRE)
  • E.coli (ESBL, CRE)
  • Acinetobacter
  • Enterococcus (VRE)
  • S.aureus (MRSA)
  • Pseudomonas
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3
Q

hydrophilic drugs

A
  • beta-lactams
  • aminoglycosides
  • glycopeptides
  • daptomycin
  • polymyxins
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4
Q

lipophilic drugs

A
  • quinolones
  • macrolides
  • rifampin
  • linezolid
  • tetracyclines
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5
Q

hydrophilic drugs PK parameter

A
  • small Vd -> poor tissue penetration
  • renal elimination -> nephrotoxicity possibility
  • low intracellular concentration -> not effective against atypical infections which is mostly intracellular
  • increased Cl and/or distribution in sepsis
  • poor/moderate bioavailability -> either no PO or IV:PO not 1:1
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6
Q

lipophilic drugs PK parameter

A
  • large Vd -> good issue penetration
  • hepatic metabolism -> hepatotoxicity possibility
  • good intracellular concentrations -> yes for atyipicals
  • Cl/distribution not changes in sepsis
  • good bioavailability -> IV:PO 1:1
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7
Q

beta-lactam MOA

A

bind to PCN-binding proteins (PBPs) -> inhibit bacterial wall synthesis

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8
Q

PCN coverage

A
  • gram positive cocci

- Streptococci, Enterococci

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9
Q

aminopenicillins coverage

A

PCN coverage + HNPEK

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10
Q

HNPEK

A
  • Haemophilus
  • Neisseria
  • Proteus
  • E.coli
  • Klebsiella
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11
Q

aminopenicillins + beta lactamase inhibitors coverage

A

same as aminopenicillins plus:

  • MSSA
  • more resistant HNPEK
  • anaerobe (B.fragilis)
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12
Q

Zosyn coverage

A

same as aminopenicillins + beta lactamase inhibitors plus:

  • CAPES
  • Pseudomonas
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13
Q

CAPES

A
  • Citrobacter
  • Acinetobacter
  • Providencia
  • Enterpbacter
  • Serratia
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14
Q

antistaph PCN

A
  • strep

- staph (MSSA)

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15
Q

PCN pearls

A
  • PCN G benzathine IM only; NOT for IV (can cause cardioresp arrest and death)
  • do not use extended forms of amox or augmentin or augmentin 875 in patients w/ CrCl < 30
  • ADE: seizure with accumulation, GI upset, diarrhea, rash
  • amox has chewable forms available
  • IV amp diluted in NS only
  • zosyn can be given via extended infusion (4h)
  • sodium in zosyn
  • no renal dose adjustments in antistaph pcn
  • nafcillin is vesicant; risk of extravasation; if happens, use cold packs and hyaluronidase
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16
Q

PCN drug interactions

A
  • probenecid can increase beta-lactams (interfere with renal excretion)
  • beta-lactams (except naf and dicloxacillin) enhance warfarin
  • PCNs increase methotrexate
  • PCNs decrease mycophenolate
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17
Q

Key: PCN VK

A

1st line for strep throat and mild nonpurulent

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18
Q

Key: amoxicillin

A
  • first line treatment for acute otitis media (80-90mg/kg/day)
  • 1st choice for infective endocarditis prophylaxis before dental procedure (2g 30-60 min before procedure)
  • used in H.pylori treatment
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19
Q

Key: augmentin

A
  • 1st line for acute otitis media (90mg/kg/day) and sinus infection if indicated
  • use lowest dose of clav to decrease diarrhea
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20
Q

Key: PCN G benzathine

A
  • 1st line for syphilis (2.4 millions units IM once)

- not for IV use; can cause death

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21
Q

Key: zosyn

A
  • active against psuedomonas

- can be used with extended infusion (4h)

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22
Q

Key: antistaph PCN

A
  • cover MSSA only

- no renal dose adjustments needed

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23
Q

T/F: cephalosporin not active against Enterococcus

A

True

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24
Q

first generation cephalosporins

A
  • *cefazolin (Ancef)
  • *cephalexin (Keflex)
  • cefadroxil
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25
Q

second generation cephalosporins

A
  • *cefuroxime (Ceftin)
  • *cefotetan (Cefotan)
  • cefaclor
  • cefoxitin
  • cefprozil
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26
Q

third generation cephalosporins

A
  • *cefdinir (Omnicef)
  • *ceftriaxone (Rocephin)
  • *cefotaxime
  • cefditoren (Spectracef)
  • cefixime (Suprax)
  • cefpodoxime
  • ceftibuten
  • *ceftazidime (Fortax, Tazicef) / avibactam (Avycaz)
  • ceftolozane/taxobactam (Zerbaxa)
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27
Q

fourth generation cephalosporins

A

*cefepime (Maxipime)

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28
Q

fifth generation cephalosporins

A

*ceftaroline fosamil (Teflaro)

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29
Q

first generation cephalosporins coverage

A
  • gram + cocci (strep, staph esp MSSA)

- a little gram -: PEK

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30
Q

second generation cephalosporins coverage

A
  • Staph
  • more resistant S.pneumoniae
  • HNPEK
  • cefotetan and cefoxitin: same plus anaerobes (B.fragilis)
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31
Q

third generation cephalosporins coverage

A

+ Group 1:
- more resistant Strep, HNPEK, and also gram + anaerobes and MSSA
+ Group 2:
- no gram + but covers psuedomonas; with beta lactamase inhibitor, can also cover MDR gram -‘s

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32
Q

fourth generation cephalosporins coverage

A
  • HNPEK
  • CAPES
  • pseudomonas
  • staph, strep
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33
Q

fifth generation cephalosporins coverage

A
  • MRSA
  • HNPEK
  • broad gram +
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34
Q

cephalexin dosing

A

250-500mg Q6-12h

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35
Q

cephalosporin pearls

A
  • ceftriaxone CI in neonates due to biliary sludging and kernicterus and in neonates 28 days or younger who are also receiving Ca products
  • 10% cross sensitivity with PCN allergy
  • cefotetan has side chain which can increase risk of bleeding and disulfiram-like reaction with etoh
  • ADE: seizure with accumulation, GI upset, diarrhea, rash
  • cefixime has chewable tablet
  • ceftaz/avibactam covers some CRE
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36
Q

cephalosporin pearls

A
  • ceftriaxone CI in neonates due to biliary sludging and kernicterus and in neonates 28 days or younger who are also receiving Ca products
  • 10% cross sensitivity with PCN allergy
  • cefotetan has side chain which can increase risk of bleeding and disulfiram-like reaction with etoh
  • ADE: seizure with accumulation, GI upset, diarrhea, rash
  • cefixime has chewable tablet
  • ceftaz/avibactam covers some CRE
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37
Q

cephalosporin drug interactions

A
  • decrease stomach acid can decrease bioavailability of some cephalosporins -> avoid H2RA and PPI
  • cefuroxime and cefpodoxime separated from short-acting antacids
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38
Q

Key: outpatient cephalosporins

A
  • cephalexin: common for MSSA skin infections or strep throat
  • cefuroxime: common for acute otitis media, CAP, sinus infection
  • cefdinir: common for CAP, sinus infection
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39
Q

Key: inpatient cephalosporins

A

ceftriaxone and cefotaxime used in CAP, meningitis, spontaneous bacterial peritonitis, pyelonephritis

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40
Q

carbepenem coverage

A
  • gram + and - (including ESBL)
  • anaerobes
  • DO NOT COVER: atypical, MRSA, VRE, C.diff, Stenotrophomonas
  • ertapenem DOES NOT COVER: pseudo, acinetobacter, enterococcus
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41
Q

carbepenem pearls

A
  • warning: in pts with seizures
  • do not use in pts with PCN allergy
  • ertapenem DOES NOT COVER: pseudo, acinetobacter, enterococcus
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42
Q

carbepenem drug interactions

A

decrease valproic acid

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43
Q

Key: carbepenems

A

commonly used for:

  • polymicrobial infections (like diabetic foot infection)
  • empiric when resistant organisms are suspected (pseudo and acinetobacter)
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44
Q

monobactam MOA

A

bind to PCN-binding proteins (PBPs) -> inhibit bacterial wall synthesis

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45
Q

monobactam coverage

A
  • gram - including pseudomonas

- NO gram positive

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46
Q

aminoglycoside MOA

A

bind to ribosome -> interferes with protein synthesis -> defective bacterial cell membrane

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47
Q

aminoglycoside coverage

A

gram - including pseudomonas

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48
Q

aminoglycoside pearls

A
  • if actual body weight < IBW, use actual body weight for dosing
  • if obese, use adjusted body weight for dosing
  • traditional: gentamicin and tobramycin: 1-2.5 mg/kg/dose
  • extended: gentamicin and tobramycin: 4-7 mg/kg/dose
  • traditional renal dose adjustments: CrCl >= 60 -> Q8h
  • extended interval frequency determined by nomogram
  • teratogenic
  • neuromuscular blockade
  • levels: for traditional, draw trough 30 min before 4th dose and peak 30 min after infusion of 4th dose; for extended, draw random level per timing on nomogram
  • goal trough for gent gram - infection and tobramycin: <2 mcg/mL
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49
Q

quinolone MOA

A
  • inhibit bacterial DNA topisomerase IV and DNA gyrase (topisomerase II)
  • concentration dependent antibacterial activity
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50
Q

quinolone coverage

A
  • gemi, levo, moxi are resp quinolones: enhanced coverage of S.pneumoniae
  • cipro and levo: enhanced gram - including pseudomonas; commonly used in combo with beta lactams when treating psuedomonas empirically
  • moxi: enhanced gram + and anaerobic
  • dela: MRSA
51
Q

quinolone pearls

A
  • warning: peipheral neuropathy, hypo- and hyperglycemia, psychiatric disturbances, avoid in children and pregnant/breastfeeding due to musculoskeletal toxicity, photosensitivity
  • caution: seizures
  • QT prolongation (highest risk with moxi)
  • cipro oral suspension: shake vigorously 15 min, NO NG tube
  • moxi: no urine concnetration, no UTI, no renal dose adjustments
52
Q

quinolone drug interactions

A
  • antacids and polyvalent cations chelate and inhibit quinolone absorption
  • lanthanum carbonate (Fosrenol) and sevelamer decrease concentration of oral quinolone; separate administration
  • quinolone increase effect of sylfonylureas, insulin, and hypoglycemic drugs
  • probenicid and NSAIDS can increase quinolone
  • levo and moxi: IV:PO 1:1
53
Q

What are the atypicals?

A
  • Legionella
  • Chlamydia
  • Mycoplasma
  • Mycobacterium
54
Q

macrolide MOA

A

bind to 50S ribosomal subunit -> inhibit RNA-dependent protein synthesis

55
Q

macrolide coverage

A

atypicals

56
Q

macrolide uses

A
  • CAP, LRTI

- STD (chlamydia, gonorrhea)

57
Q

macrolide pearls

A
  • Tri Pak: 500mg daily for 3 days
  • do not use clarithro or erythro with lovastatin or simvastatin
  • warning: QT prolongation, hepatotoxicity
  • clarithro: caution in pts with CAD (increased mortality)
  • ADE: GI upset
58
Q

macrolide drug interactions

A
  • erythro and clarithro are CYP3A4 inhibitors; close monitoring with colchicine, apixaban, dabigatran, rivaroxaban, theophylline, WARFARIN
  • azithro: fewer drug interactions
59
Q

Key: macrolides

A
  • used as alternative to beta-lactam for strep throat
  • azithro: monotherapy for chlamydia, combo therapy for gonorrhea, prophylaxis for MAC, choice for travelers’ diarrhea
  • clarithro: tx of H.pylori
  • erythro causes most GI upset
60
Q

tetracyclines MOA

A

bind to 30S ribosomal -> inhibit protein synthesis

61
Q

tetracyclines coverage

A
  • Gram positive: staph, strep, enterococci, nocardia, bacillus, propionibacterium
  • Gram negative: haemophilus, moraxella
  • Other: atypicals, rickettsiae, bacillus anthracis, treponema
62
Q

doxycycline

A
  • has broader coverage compared to other tetracyclines

- used for: CAP, tick/rickettesial diseases, STD (chlamydia and gonorrhea), CA-MRSA skin infections, VRE UTIs

63
Q

tetracycline pearls

A
  • no renal dose adjustments for doxycyline
  • minocycline: drug-induced lupus erythematosus (DILE)
  • mino and docy IV:PO 1:1
64
Q

tetracycline drug interactions

A
  • antacids, polyvalent cations, multivitamins, sucralfate, bismuth subsalicylate, bile acid resins can chelate and inhibit tetracycline absorption; separate administration
  • docy and mino taken with food to decrease GI upset
  • lanthanum carbonate (Fosrenol) decrease tetracyclines; separate administration
  • tetracyclines enhance effect of warfarin and neuromuscular blocking drugs
65
Q

Key: tetracyclines

A
  • doxy and mino used for CA-MRSA skin infections
  • doxy first line for lyme disease, rock mountain spotted fever, CAP, COPD exacerbations, sinusitis, VRE UTI
  • tetracycline used in H.pylori treatment
66
Q

sulfonamide MOA

A

inhibit bacterial folic acid production

67
Q

sulfonamide coverage

A
  • Staph (MRSA and CA-MRSA)
  • broad gram -: haemophilus, proteus, E.coli, klebsiella, enterobacter, shigella, salmonella, stenotrophomonas
  • opportunistic pathogens: nocardia, pneumocystis, toxoplasmosis
  • does NOT cover pseudo, entercocci, atypicals, anaerobes
68
Q

sulfonamide pearls

A
  • dose based on TMP component
  • DS: 800/160
  • uncomplicated UTI: 1 DS tab PO BID x 3d
  • warnings: SJS/TEN, thrombotic purpura (TTP), do not use if pt has G6PD deficiency
  • ADE: photosensitivity, increased K, hemolytic anemia (positive coombs test), crystalluria
69
Q

sulfonamide drug interactions

A
  • Bactrim is CYP2C9 inhibitor -> can increase INR
  • do not use with CYP2C9 inducers; levels can decrease
  • Bactrim therapeutic effects can decrease with use of leucovorin
70
Q

vancomycin MOA

A

bind to D-alanyl-D-alanine cell wall precursor -> inhibit bacterial wall synthesis

71
Q

vancomycin pearls

A
  • systemic infections: 15-20 mg/kg Q8-12h
  • dose based on actual body weight
  • CrCl 20-49: Q24H
  • C.Diff: 125-500mg QID x 10d
  • ototoxicity and nephrotoxicity
  • goal trough 15-20 mcg/mL for pneumonia, endocarditis, osteo, mening, bacteremia
72
Q

lipoglycopeptide MOA

A
  • bind to D-alanyl-D-alanine cell wall precursor -> inhibit bacterial wall synthesis
  • disrupt bacterial membrane potential
73
Q

lipoglycopeptide pearls

A
  • concentration dependent antibacterial activity
  • televancin approved for use of SSTI; boxed warning: fetal risk, nephrotoxicity
  • oritavancin & dalbavancin: do not use IV UFH 5 days after administration due to falsely elevated aPTT; long half life -> single dose regimen
  • can falsely increase caogulation tests; red man syndrome
74
Q

lipoglycopeptide drug interactions

A
  • televancin: use caution in QT prolongation or HF

- oritavancin: has effect on CYP2C9, CYP2C19, CYP3A4, CYP2D6

75
Q

daptomycin MOA

A

bind to cell membrane -> depolarization

76
Q

daptomycin pearls

A
  • concentration dependent antibacterial activity
  • falsely elevated PT/INR
  • check CPK weekly
  • use NS
77
Q

oxazolidinones MOA

A

bind to 50s subunit -> inhibit protein synthesis

78
Q

oxazolidinones pearls

A
  • no renal dose adjustments
  • Iv to PO 1:1
  • do not use within 2 weeks of MAOi
  • longer duration = higher risk for myelosuppression (common thrombocytopenia)
  • other warnings: peripheral and optic neuropathy, serotonin syndrome, hypoglycemia
  • ADE: low platelets
  • don’t shake suspension
79
Q

oxazolidinones coverage

A

like vanc + VRE

80
Q

quinupristin/dalfopristin MOA

A

bind to 50s subunit -> inhibit protein synthesis

81
Q

quinupristin/dalfopristin coverage

A
  • gram +
  • MRSA
  • VRE.faecium
82
Q

quinupristin/dalfopristin pearls

A
  • ADE: arthralgias/myalgias, infusion reactions, hyperbilirubinemia
  • D5W only
  • central line
83
Q

tigecycline MOA

A

bind to 30s subunit -> inhibit protein synthesis

84
Q

tigecycline coverage

A
  • gram +
  • MRSA
  • VRE
  • gram -
  • anaerobes
  • atypical
85
Q

tigecycline pearls

A
  • related to tetracyclines
  • increase risk of death
  • do not use for bloodstream infections
  • reconstituted solution should be yellow-orange
86
Q

polymyxin coverage

A
  • Enterobacter
  • E.coli
  • Klebsiella pneumoniae
  • Pseudomonas
87
Q

polymyxin pearls

A
  • MDR gram - pathogens
  • colistimethate prodrug converted to colistin
  • inhalations: mixed right before administration
  • nephro and neurotoxicity
  • resp paralysis from neuromuscular blockade
88
Q

chloramphenicol MOA

A

bind to 50s subunit -> inhibit protein synthesis

89
Q

chloramphenicol pearls

A

warning: Gray syndrome

90
Q

lincosamide MOA

A

bind to 50s subunit -> inhibit protein synthesis

91
Q

lincosamide coverage

A
  • anaerobes

- Gram + (ex. CA-MRSA)

92
Q

lincosamide pearls

A
  • no renal dose adjustments
  • warning: c.diff
  • induction test (D-test) on S.aureus -> flattened zone = resistance
93
Q

metronidazole MOA

A

loss of helical DNA structure and strand breakage -> inhibit protein synthesis

94
Q

metronidazole coverage

A
  • anaerobes

- protozoal infections

95
Q

metronidazole uses

A
  • bacterial vagionosis
  • trichomoniasis
  • IAI
96
Q

metronidazole pearls

A
  • IV:PO 1:1
  • CI in: 1st trimester, use of alcohol within 3 days after tx course
  • secnidazole can be taken as 2g single dose and can treat vulvovaginal candidiasis
97
Q

metronidazole drug interactions

A
  • disulfiram rxn: abd cramping, N/V, headaches, flushing

- can increase INR

98
Q

fidaxomicin MOA

A

inhibit RNA polymerase -> inhibit protein synthesis

99
Q

rifaximin MOA

A

inhibit RNA polymerase -> inhibit protein synthesis

100
Q

rifaximin uses

A
  • traveler’s diarrhea
  • reduce hepatic enceph. occurrence
  • IBS
  • not for systemic infections
101
Q

fosfomycin coverage

A
  • E.coli (+ ESBL)

- E.faecalis (+VRE)

102
Q

nitrofurantoin MOA

A

bacterial cell wall inhibitor

103
Q

nitrofurantoin coverage

A

uncomplicated UTI only

  • E.coli
  • Klebsiella
  • Enterobacter
  • S.aureus
  • Entreococcus (VRE)
104
Q

nitrofurantoin pearls

A
  • Macrobid: 100mg BID x 5 days
  • do NOT use if CrCl < 60
  • warning: hemolytic anemia, caution in pts with G6PD deficiency
  • ADE: GI upset (take with food to help with GI upset), brown urine discoloration
105
Q

Key: nitrofurantoin

A
  • drug of choice for uncomplicated UTI
  • Macrodantin is QID
  • take with food to avoid GI side effects
106
Q

drug of choice for CA-MRSA SSTI

A
  • Bactrim
  • doxy / mino
  • clindamycin
  • linezolid
107
Q

drug of choice for severe MRSA SSTI

A
  • vanc
  • dapto
  • linezolid
  • ceftaroline
108
Q

drug of choice for nosocomial MRSA

A
  • vanc
  • linezolid
  • dapto
109
Q

drug of choice for VRE.faecalis

A
  • PenG or ampicillin
  • linezolid
  • dapto
  • cystitis: nitroduran, fosfo, doxy
110
Q

drug of choice for VRE.faecium

A
  • dapto
  • linezolid
  • cystitis: nitroduran, fosfo, doxy
111
Q

drug of choice for pseudomonas

A
  • Zosyn
  • cefepime
  • ceftazidime +/- avibactam
  • ceftolozane/tazobactam
  • carbapenem (but not ertapenem)
  • cipro, levo
  • aztreonam
  • aminoglycosides
  • polymyxins
112
Q

drug of choice for acinetobacter baumannii

A

carbapenem (but not ertapenem)

113
Q

drug of choice for ESBL

A
  • carbapenems
  • ceftazidime/avibactam
  • ceftolozane/tazobactam
114
Q

drug of choice for CRE

A
  • ceftazidime/avibactam

- polymyxins

115
Q

drug of choice for bacteroides fragillis

A
  • metronidazole
  • beta-lactam +/- beta-lactamase inhibitor
  • cefotetan, cefoxitin
  • carbapenems
116
Q

drug of choice for atypical organisms

A
  • azithromycin
  • doxycyline
  • quinolones
117
Q

drug of choice for HNPEK

A

beta-lactam +/- beta-lactamase inhibitor

118
Q

Which oral suspensions require refrigeration after reconstitution?

A
  • PCN VK
  • ampicillin
  • Augmentin
  • recommend for amoxicillin to improve taste but not required
119
Q

Which oral suspensions does not require refrigeration after reconstitution?

A
  • cefdinir
  • cipro
  • azithromycin, clarithromycin
  • doxycycline
  • Bactrim
  • clinda
120
Q

Which medications make you more sensitive to the sun?

A
  • quinolones
  • tetracycline
  • bactrim
121
Q

Which medications should you take with food?

A
  • Biaxin XL
  • Augmentin
  • nitorfuran
122
Q

Which medications should you take with a full glass of water?

A
  • quinolones (crystal formation)
  • tetracycline (GI irritation)
  • bactrim (crystal formation)
  • clinda (GI irritation)
123
Q

Which key drugs do not have renal dose adjustments?

A
  • antistaph beta-lactam
  • clinda
  • doxy
  • macrolides (azithro and erythro)
  • metronidazole
  • moxifloxacin
  • linezolid

NAPLEx (13 decks)

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