Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Therapeutics 3 > Intro to ID > Flashcards

Intro to ID Flashcards

1
Q

S. pneumoniae

A

GRAM + Cocci, pair
Aerobic
Community Acquired pneumonia, meningitis, sinusitis, and bacteremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Group A Strep (GAS)

S. Pyogenes

A

GRAM+ Cocci, chain
Aerobic
Skin/soft tissue infections (SSTI), Upper Respiratory Infection (URI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Staph aureus (including MRSA)

A

GRAM+ Cocci, cluster
Aerobic
SSTI, bacteremia/line infections, pneumonia, endocarditis, osteomyelitis
MRSA is a rising problem
Typical skin flora, but commonly associated with sepsis and line infections in hospital due to improper sterilization of line site.
Treat bacteremia for 14 days
B-lactams are not reliable empiric therapy for MRSA. Vanco usually first line
MSSA - use B-lactams over vanco

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Enterococcus

faecalis or faecium

A 
GRAM+ Cocci
faecalis = single, pair, or chain
faecium = pair or chain
Aerobic
UTI, intra-abdominal infections, and endocarditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

S. epidermidis

Coagulase-negative Staph

A

GRAM+ cocci, cluster
Aerobic
Typically not pathogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Nesseria

A

GRAM- Cocci
Aerobic
URI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Moraxella catarrhalis

A

GRAM- cocci
Aerobic
Respiratory infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

H. influenza

A

GRAM- Rod
Aerobic
URI, community acquired pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

H. Pylori

A

GRAM- Rod
Aerobic
Stomach/Gut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q 
Enterobacteriaceae
E. coli
Klebsiella sp.
Proteus sp.
Enterobacter sp.
Citrobacter sp.
A

GRAM- Baccili, oxicase negative, gut colonizing rods
Aerobic
UTI, IA, health care acquired pneumonia, bacteremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Non-fermenting
Pseudomonas
Acinetobacter
Stenotrophomonas

A

GRAM- Cocco-bacilli, bacilli, or rods
Aerobic
HCAP, diabetic foot infections, nosocomial infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Bacteroides sp

A

GRAM-
Anaerobic
IA, colitis, “Aspiration” pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Clostridium difficile or perfringens

A

GRAM- bacilli, spore forming
Anaerobic
IA, colitis, “aspiration” pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Legionella sp.

A

Atypical infection

CAP, worst offender of Legionella infection, STD’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Mycoplasma sp

A

Atypical infection

STD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Chlamydia

A

Atypical infection

STD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Penicillin

A

Covers GRAM+
DOC for GAS, S. pyogenes, Treponemia
Not very good anymore because of resistance. Must test S. pneumonia for susceptibility before using

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Amoxicillin and Ampicillin

A

Covers GRAM+

Only effective for GRAM- organisms that do not product beta-lactamases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Nafcillin (IV)
Dicloxacillin (PO)
(Methicillin class)

A

Covers GRAM+
DOC for GAS, S. pyogenes, MSSA
Known as the “Anti-Staph” class, Dicloxicillin is under used!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Augmentin (PO)

ampicillin/sulbactam (IV)

A

Broad Spectrum, covers GRAM+/-, Anaerobes, and MSSA

Beta-lactamase inhibitor doesn’t improve pseudomonas coverage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Ticarcillin/clavulanate

Pipercillin/tazobactam

A

Broad Spectrum, covers GRAM+/-, Anaerobes, and MSSA

Beta-lactamase inhibitors provide good GRAM- coverage (esp pseudomonas)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Imipenem/Cilastin
Meropenem
Doripenem

A

Broad Spectrum, covers GRAM+/-

Not good for MRSA and Non-fermenting GRAM- (pseudomonas, acinetobacter, stenotrophomonas)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Ertapenem

A

Broader Spectrum, covers GRAM+/- and Anaerobes

No efficacy against pseudomonas, but good for diabetic and long-term infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Aztreonam

A

GRAM-, including pseudomonas

Good for use in PCN allergy!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Cephalexin (PO)

Cefazolin (IV)

A

Expected to cover MSSA, GAS, S. pyogenes, and E. coli
Poor S. pneumonia coverage
1st Gen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Cefuroxime (IV/PO)

A

Expected to cover H. influenza, S. pneumonia, and MSSA

Gen 2A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Cefotetan (IV)

A 
Expected to cover Gut GRAM-
poor coverage on anaerobes, increasing resistance
supply problems
Can increase INR
Gen 2B
28
Q

Ceftriaxone (IV/IM)

A 
Good GRAM- coverage
DOC for S. pneumonia
Renally cleared
Does not cover Pseudomonas
3A Gen
29
Q

Ceftazadime (IV)

A

Expected to cover Pseudomonas and other GRAM-
Poor GRAM+ coverage
Can induce resistance
3B Gen

30
Q

Cefepime (IV)

A

Expected to cover Pseudomonas and other GRAM- organisms
Improved GRAM+ coverage (MSSA)
Reports of neurotoxicity, monitor
4th Gen

31
Q

Ceftaroline (IV)

A

Covers Enterococcus

5th Gen

32
Q

Typical beta-lactam antibiotic ADRs (Penicillins, carbapenems, cephalosporins)

A

Allergic reaction/Rash
Diarrhea
Occasional neutropenia/thrombocytopenia
Intestinal Nephritis (Rare, more common with Nafcillin) May be seen as allergy-induced renal failure
Seizures (more common with Imipenem)
Drug fever (overall Rare)
Suprainfection (more common with carbapenems)

33
Q

Macrolide antibiotic coverage and uses

A

Excellent: Atypical infections
Good: H. influenza, M. catarrhalis
Decent: S. pneumonia
Uses: URI and CAP

34
Q

Macrolide antibiotic ADRs

A 
Azith: Fever, different chemical class than others
GI problems
QT prolongation
Inhibits CYP system, watch drug interactions
35
Q

Ciprofloxacin

A

Excellent GRAM- coverage
Poor GRAM+ coverage (not good for CAP)
Inhibition of CYP1A2 (theophylline)
Rising resistance rates!!!

36
Q

Levofloxacin

A

Enhanced GRAM+ coverage with same GRAM- coverage as cipro

Excellent Atypical coverage (better than macrolides)

37
Q

Moxifloxacin

A

Enhanced GRAM+ coverage with same GRAM- coverage
Excellent Atypical Coverage (better than macrolides)
Not effective for UTIs because it doesn’t enter urine (use “above the belt”)

38
Q

Use of fluoroquinolones in pseudomonas infections

A

This is the ONLY oral agent that covers pseudomonas!!
Cipro only covers GRAM-, so not effective for some pseudomonas cases (Ex: CAP)
Levo/Moxi have improved GRAM+ coverage, useful against all pseudomonas

39
Q

fluoroquinolone ADRs

A

Tendonitis/tendon rupture
Glucose disturbances
QTC prolongation
Photosensitivity

40
Q

Aminoglycoside Coverage

A

Covers Aerobic GRAM-

Reserved for “SPACE” drugs

41
Q

SPACE drugs

A 
Serratia
Pseudomonas
Acinetobacter
Citrobacter
Enterobacter
42
Q

Aminoglycoside Toxicities

A

Nephrotoxicity - usually reversible, incidence declining
Ototoxicity - can induce deafness or balance problems. Usually irreversible, difficult to monitor
Paralytic at high doses - minimized through once daily dosing

43
Q

Antibiotics used in double-coverage

A

Beta-lactams + aminoglycosides for the first 3-5 days

Why? SPACE bugs are serious systemic infections, need to limit resistance developed!

44
Q

Vanco coverage

A

Cell Wall antibiotic, similar to beta-lactams
Good GRAM+ coverage (MRSA and C. diff)
**Increasing MRSA resistance

45
Q

Vanco ADRs

A

Red Man Syndrome (flushing) - caused by histamine, give antihistamine to block reaction. can prevent or reverse by slowing the infusion
Nephrotoxicity and Ototoxicity - overall rare, more common at high doses
Drug Rash with Eosinophilia and Systemic Symptoms (DRESS)

46
Q

When should metronidazole be used?

A

Gold standard for anaerobes such as B fragilis

DOC for C. diff

47
Q

Metronidazole ADRs

A

neuropathies
metallic taste
disulfaram-like rxn (EtOH)

48
Q

what does a positive D Test indicate?

A

potential for clindamycin resistance to develop over course of treatment for MRSA

49
Q

clindamycin coverage

A

Anaerobes and GRAM+
good for aspiration pneumonia and MRSA
bad for bacteremias and endocarditis because it is bacteriostatic

50
Q

clindamycin ADRs

A

rash

can cause C. diff infection

51
Q

Doxycycline coverage

A

GRAM+ (MRSA and varying S. pneumonia)
GRAM-
Some Atypical
Used in COPD bacterial exacerbations, MRSA, and SSTI

52
Q

Doxycycline ADRs

A

N/V
Rash
phototoxicity

53
Q

Linezolid coverage

A

Broad GRAM+, good for MRSA

54
Q

Linezolid ADRs

A

thrombocytopenia
N/V/D
Headache
neuropathies
Mild MAOI, potential for drug interactions (serotonin syndrome, etc.)
**Not well tolerated, do not use beyond 4 weeks!! Likely to develop neuropathies, lactic acidosis, and maybe blindness past this.

55
Q

Daptomycin coverage

A

Broad GRAM + with bactericidal activity
good for MRSA, bacteremias, and endocarditis
***DO NOT USE WITH PNEUMONIAS

56
Q

Daptomycin ADRs

A

Rhabdomyolysis

Reduce dose with statins

57
Q

Tigecycline Coverage

A

Very broad spectrum
GRAM+ (including MRSA and VRE)
GRAM - (acinetobacter and stenotrophomonas)
Anaerobes
***DO NOT USE WITH PSEUDOMONAS AND PROTEUS

58
Q

Tigecycline ADRs

A

N/V

59
Q

Televancin Coverage

A

aerobic and anaerobic, GRAM+

60
Q

Televancin ADRs

A

N/V
Metallic taste
Insomnia

61
Q

Pearls to Prevent Antimicrobial Resistance

A 
Vaccinations
Remove unnecessary indwelling catheters
Determine the appropriate time to stop Vanco
Know local antibiograms
Wash hands
62
Q

Best choices for anaerobes

A

Metronidazole
Clindamycin
Beta-Lactamase inhibitors
Carbapenems

63
Q

Worst choices for anaerobes

A

fluoroquinolones
some cephalosporins
tetracyclines
macrolides

64
Q

SMZ/TMP ADRs

A 
Allergy
Rash (SJS)
Agranulocytosis
anemia
drug interactions
65
Q

why is it important to note intra-abdominal abscesses on a CT?

A

Often means anaerobes are present (most often many GRAM-, anaerobes, and enterococcus (if healthcare-acquired))
Start with broad-spectrum therapy, narrow when cultures are available
Probably requires surgical intervention

Therapeutics 3 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions