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IPCS 3 > Institutional stuff > Flashcards

Institutional stuff Flashcards

1
Q

Natural PCN good coverage

A

Strep
Treponema pallidum

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2
Q
A
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3
Q

Natural PCN mod coverage

A

Enterococci

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4
Q

Natural PCN duration

A

Short T1/2 = frequent admin
Procaine/Benzathine are IM and longer duration

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5
Q

DOC for syphillis

A

PCN G Benzathine

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6
Q

Anti-staph good coverage

A

MSSA
Strep

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7
Q

Anti-staph ADE

A

AIN
Phlebitis- can use first gen ceph bc same coverage but less frequent admin and less renal dysfunction and less phlebitis

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8
Q

Anti-staph PCNs

A

Nafcillin, Oxacillin, Methcillin, Dicloxacillin

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9
Q

Aminopenicillin good coverage

A

Enterococci
Streptococci

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10
Q

Aminopenicillin mod coverage

A

Enteric GNRs
Haemophilus

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11
Q

Aminopenicillins

A

Amoxicillin
Ampicillin

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12
Q

Aminopenicillin ADE

A

Diarrhea! when PO

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13
Q

DOC for Enterococcus faecalis

A

Ampicillin

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14
Q

PCN/B-lactamase inhibitors

A

Amoxicillin/Clavulanate
Piperacillin/Tazobactam
Ampicillin/Sulbactam

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15
Q

PCN/B-lactamase inhibitors good coverage

A

MSSA
Strep
Enterococci
Anaerobes
Enteric GNRs
Pseudomonas (Zosyn)

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16
Q

PCN/B-lactamase inhibitors mod coverage

A

GNRs w/ advanced beta-lactamases

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17
Q

DOC for Acinetobacter

A

Unasyn (Sulbactam)

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18
Q

1st gen ceph

A

Cefazolin
Cephalexin
Cefadroxil

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19
Q

1st gen ceph good coverage

A

MSSA
Strep

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20
Q

1st gen ceph mod coverage

A

some enteric GNRs

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21
Q

1st gen ceph cross-reactivity

A

Cephalexin/Cefadroxil same side chain as Amoxillin/Ampicillin so high cross reaction
(also 2nd gen Cefaclor and Cefprozil)
Cefazolin does not have side chain so low cross reaction

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22
Q

2nd gen ceph

A

Cefuroxime
Cefoxitin
Cefotetan
Cefprozil
Cefaclor

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23
Q

1st gen ceph general coverage

A

Good Gram+ bad Gram -

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24
Q

2nd gen ceph general coverage

A

better Gram - than 1st gen but slightly less Gram +

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25
Q

2nd gen ceph good coverage

A

Some enteric GNRs
Haemophilus
Neisseria

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26
Q

2nd gen ceph mod coverage

A

Strep
Staph
Anaerobes (Cefotetan and Cefoxitin)

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27
Q

2nd gen ceph ADEs

A

Cefotetan has N-MTT side chain= Vit K inhibition and disulfiram rxn w/ EtOH

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28
Q

2nd gen ceph cross reactivity

A

Cefaclor and Cefprozil same side chain as Amoxillin/Ampicillin/Cephalexin/Cefadroxil so high cross reaction

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29
Q

3rd gen ceph

A

Ceftriaxone
Cefuroxime
Cefotaxime
Ceftazidime
Cefdinir
Cefpodoxime
Cefixime

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30
Q

3rd gen ceph general coverage

A

better Gram- than 1st/2nd
Good strep but less good staph

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31
Q

3rd gen ceph good coverage

A

Strep (not Ceftazadime)
Enteric GNRs
Pseudomonas (only Ceftazadime)

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32
Q

3rd gen ceph mod coverage

A

MSSA (not ceftazadime)

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33
Q

3rd gen ceph ADEs

A

C. diff
Cefpodoxime has N-MTT

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34
Q

4th gen ceph

A

Cefepime

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35
Q

4th gen ceph general coverage

A

G- and +
1st + 3rd gen coverage basically

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36
Q

4th gen ceph good coverage

A

MSSA
Strep
Pseudomonas
Enteric GNRs

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37
Q

4th gen ceph mod coverage

A

Acinetobacter

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38
Q

4th gen ceph ADE

A

neurotoxicity

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39
Q

anti-MRSA ceph

A

Ceftaroline

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40
Q

ceftaroline good coverage

A

MSSA
MRSA
Strep
Enteric GNRs (E. coli, Klebsiella, Proteus)

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41
Q

ceftaroline mod coverage

A

E. faecalis

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42
Q

ceftaroline ADE

A

neutropenia

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43
Q

Siderospore ceph

A

Cefiderocal (fetroja)

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44
Q

Fetroja MOA

A

complex w/ iron and brought into cel where it destroys cell wall

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45
Q

fetroja good coverage

A

Pseudomonas
Enteric GNRs (ESBL, carbapenemase producers)
Stenotrophomonas matophilia

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46
Q

fetroja mod coverage

A

A. baumannii

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47
Q

Ceph/B-lactamase inhib

A

Ceftazadime/Avibactam (Avycaz)
Ceftolozane/Tazobactam (Zerbaxa)

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48
Q

Avycaz/Zerbaxa good coverage

A

Pseudomonas
Enteric GNRs (Enterobacter- avycaz>zerbaxa)

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49
Q

avycaz/zerbaxa mod coverage

A

some strep (zerbaxa)

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50
Q

Carbapenems

A

Imipenem/Cilastatin
Meropenem
Ertapenem

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51
Q

Carbapenem good coverage

A

MSSA
Strep
Anaerobes
Enteric GNRs
Pseudomonas (Not erta)
ESBL producing GNRs

52
Q

carbapenem mod coverage

A

Enterococci (not erta)
Acinetobacter (not erta)

53
Q

carbapenem ADEs

A

seizures (esp primaxin)
C/I w/ VPA

54
Q

Monobactam

A

Aztreonam

55
Q

aztreonam good coverage

A

Pseudomonas
GNRs

56
Q

aztreonam mod coverage

A

Acinetobacter

57
Q

aztreonam cross reaction

A

safe for beta lactam allergies except ceftazidime

58
Q

glycopeptides

A

vancomycin
telavancin

59
Q

glycopeptide MOA

A

D-ala-D-ala on PG chains

60
Q

glycopeptide good coverage

A

MSSA
MRSA
Strep
C. diff (oral vanco only)

61
Q

glycopeptide mod coverage

A

Enterococci

62
Q

glycopeptide ADEs

A

Redman syndrome- decrease rate
Ototoxicity
Nephrotoxicity

63
Q

Fluoroquinolones

A

Cipro
Levofloxacin
Moxifloxacin
Delafloxacin

64
Q

FQ MOA

A

topoisomerase inhibitor

65
Q

cipro good coverage

A

enteric GNRs (E. coli, Klebsiella, Proteus)
H. influenzae

66
Q

cipro mod coverage

A

Pseudomonas
Atypicals

67
Q

levo/moxi good coverage

A

Enteric GNRs
S. pneumoniae
Atypicals
H. influenzae

68
Q

levo/moxi mod coverage

A

Pseudomonas (Levo)
MSSA
Anaerobes (Moxi)

69
Q

FQ ADEs

A

dizziness
QT prolongation
tendon rupture
photosensitivity

70
Q

FQ BBW

A

tendon rupture
myasthenia gravis
peripheral neuropathy
seizures
separate cations by 2 hours

71
Q

Aminoglycosides

A

Gentamycin
Tobramycin
Amikacin
Streptomycin
Plazomicin

72
Q

AG MOA

A

30S subunit

73
Q

AG good coverage

A

GNB (E. coli, Klebsiella, Pseudomonas)
-Pseudomonas: A>T>G>P
-Klebsiella: P>A=G>T
Mycobacterium (Amikacin)

74
Q

AG mod coverage

A

Staph (in combo)
Viridans strep
Enterococci
Acinetobacter

75
Q

AG ADEs

A

nephrotoxicity
ototoxicity
neuromuscular blockade activation

76
Q

AG levels

A

concentration dependent killing
draw peak 30 min after infusion ends
draw trough w/in 30 min of next dose

77
Q

Tetracyclines

A

Doxycycline
Minocycline
Tetracycline
Tigecycline
Eravacycline
Omadacycline

78
Q

TC MOA

A

30S subunit

79
Q

Tetra/doxy/mino good coverage

A

Atypicals
Rickettsia
Spirochetes (H. pylori, Borrelia burgdorferi)
Plasmodium (malaria)

80
Q

tetra/doxy/mino mod coverage

A

Staph (including MRSA)
S. pneumoniae

81
Q

Tige/erav/omad good coverage

A

atypicals
enterococci (including VRE)
staph (including MRSA)
S. pneumoniae
S. agalactiae
S. pyogenes

82
Q

TC ADEs

A

GI irritation- take w/ water standing up
Photosensitivity
Dizziness/vertigo (Mino)
teeth discoloration
cation chelation- admin 2 hours apart

83
Q

Macrolides

A

Azithromycin
Erythromycin
Clarithromycin

84
Q

Macrolide MOA

A

50S subunit

85
Q

Macrolide good coverage

A

Atypicals
H. influenzae
Moraxella
H. pylori
Mycobacterium

86
Q

macrolide mod coverage

A

S. pneumoniae
S. pyogenes

87
Q

macrolide ADEs

A

significant GI- Ery for GI motility
hepatic issues
QT prolongation

88
Q

Oxazolidinones

A

Linezolid
Tedizolid

89
Q

Linezolid MOA

A

50S subunit

90
Q

Linezolid good coverage

A

MSSA
MRSA
Strep
Enterococci (including VRE)
Nocardia

91
Q

Linezolid mod coverage

A

some atypicals
mycobacterium tuberculosis

92
Q

Linezolid ADEs

A

BMS (thrombocytopenia)- don’t use longer than 2 weeks
Peripheral neuropathy
Lactic acidosis

93
Q

Linezolid DDI

A

SSRIs

94
Q

Nitromidazoles

A

Metronidazole
Tinidazole

95
Q

Metronidazole MOA

A

form free radicals that damage DNA

96
Q

Metronidazole good coverage

A

Anaerobes (Bacteroides, Fusobacterium, Clostridium,
Protozoa (trichomonas, entamoeba, giardia)

97
Q

metronidazole mod coverage

A

H. pylori

98
Q

Metronidazole ADEs

A

GI
peripheral neuropathy
seizures
disulfiram Rxn
warfarin interaction

99
Q

Fosfomycin MOA

A

inhibits cell wall synthesis

100
Q

Nitrofurantoin and Fosfomycin good coverage

A

E. coli
S. saprophyticus

101
Q

Nitrofurantoin and Fosfomycin mod coverage

A

Citrobacter
Klebsiella
Proteus
Enterococci
Serratia (Fosfo)

102
Q

Nitrofurantoin and Fosfo ADEs

A

GI
Nitro can cause acute pneumonitis or chronic pulmonary fibrosis

103
Q

Lipopeptide

A

Daptomycin

104
Q

Dapto MOA

A

depolarization and cell death due to leakage of intracellular cations

105
Q

Dapto good coverage

A

MSSA
MRSA
Strep

106
Q

Dapto mod coverage

A

Entercocci (including VRE)

107
Q

Dapto ADEs

A

myalgias/rhabdo- monitor CK weekly
inactivated by pulmonary surfactants

108
Q

Dapto dosing

A

approved: 4-6mg/kg/d
8-10mg/kg/d for severe staph
10-12mg/kg/d for enterococcal endocarditis

109
Q

Folate antagonists

A

Sulfa/Trimeth
Dapsone
Pyrimetamine
Sulfadiazine

110
Q

Folate antagonist MOA

A

depete folate and inhibit DNA

111
Q

Folate antag good coverage

A

S. aureus
H. influenzae
Stenotrophomonas
Listeria
Pneumocycsitis jirovecii
Toxoplasma gondii

112
Q

folate antag mod coverage

A

enteric GNRs
S. pneumoniae
Salmonella
Shigella
Nocardia
S. pyogenes

113
Q

Folate antag ADEs

A

rash
SJS
BMS w/ bactrim
crystalluria and AINF

114
Q

folate antag DDIs

A

avoid warfarin w/ bactrim

115
Q

Lincosamides

A

Clindamycin

116
Q

Clinda MOA

A

50S ribosome

117
Q

Clinda good coverage

A

G+ anaerobes
Plasmodium (malaria)
S. pyogenes

118
Q

Clinda mod coverage

A

S. aureus
S. agalactiae
G- anaerobes
chlamydia trachomatis
Pneumocystis jirovecii
Actinomyces
Toxoplasma

119
Q

Clinda ADEs

A

GI- diarrhea –> C. DIFF!!!
rash
SJS

120
Q

Polymyxins

A

Colistin
Polymyxin B

121
Q

Polymyxin MOA

A

bind to outer membrane of G- bacteria and disrupt membrane stability causing leakage

122
Q

Polymyxin good coverage

A

Many GNRs (including MDR A. baumannii, pseudomonas, K. pneumoniae)

123
Q

polymyxin mod coverage

A

stenotrophomonas maltophilia

124
Q

Polymyxin ADEs

A

acute tubular necrosis
Neurotoxicity
neuromuscular blockade

125
Q

Polyene antifungals

A

Amphotericin B (liposomal)

IPCS 3 (5 decks)

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