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Kaplan ID > Introduction To Abx > Flashcards

Introduction To Abx Flashcards

1
Q

Penicillins are used to treat which bugs? (5)

A

Strep pyogenes: GAS, erysipelas, glomerulonephritis, pharyngitis
Strep viridans: found in mouth, causes endocarditis
Oral anaerobes: but less efficient than Clindamycin
Syphillis
Leptospirosis: kidney and liver disease
[P.VALS]

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2
Q

Ampicillin and amoxicillin both cover the same organisms than penicillin plus …

A

E.Coli: they can be used for UTI in pregnancy as they are safe for the foetus

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3
Q

Penicillin exists in 3 forms

A

Penicillin G: IV
Penicillin VK: oral
Benzothine: long acting IM used for syphillis

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4
Q

Which gram negative bacterias are covered by amoxicillin?

A 
H.Influenza
E.coli
Listeria
Proteus
Salmonella
[HELPS]
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5
Q

Amoxicillin is the best initial tx for (6)

A 
Otitis media
Dental infection, endocarditis prophylaxis
Lyme limited to 7th CN, rash, joint
UTI in pregnancy
Listeria
Enterococci
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6
Q

Oxacillin, cloxacillin, nafcillin, dicloxacillin can be used for tx of

A

Skin infections: cellulitis (bc it is staph)
Endocarditis, meningitis and bacteremia from staph
Osteo and septic arthritis when proven sensitive
NOT against MRSA or enterococcus

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7
Q

Piperacillin and Ticacillin cover which organisms?

A

Gram neg bacilli (E.coli and proteus)
Enterobacteriae
Pseudomonas

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8
Q

Piperacillin and Ticacillin are the best therapy for (6)

A 
Cholecystitis
Ascending cholangitis
Pyelonephritis
Bacteremia
Hospital acquired or ventilator assoc. pneumo
Neutropenia (absolute neutrophil count
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9
Q

Piperacillin, ticacillin, azlocillin, mezlocillin are generally combined with?

A

A beta-lactamase inhibitor such as taxobactam or clavulonic acid

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10
Q

Taxobactam and clavulonic acid add …. coverage to piperacillin and ticacillin

A

Staph

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11
Q

Cross reaction between penicillin and cephalosporins is

A

3-5%

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12
Q

Can you use cephalosporin in a penicillin allergic patient?

A

If pt only has a rash: yes

If anaphylaxis: no beta lactams

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13
Q

Which organisms are covered by any class of cephalosporins?

A 
Group A, B and C strep
Strep viridans
E.coli
Klebsiella
Proteus
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14
Q

Which organisms are resistant to all forms of cephalosporins? (3)

A

Listeria
MRSA
Enterococcus

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15
Q

Name 4 first generation cephalosporins

A

Cefazolin, cephalexin, cephradrine, cefadroxyl

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16
Q

First generation cephalosporins are used to treat

A

Staph (methicillin sensitive)
Strep (but not enterococcus)
Some gram neg like E.coli but not pseudomonas
Osteomyelitis, septic arthritis, endocarditis, cellulitis

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17
Q

Name 6 second generation cephalosporins

A

Cefotetan, cefoxitin, cefaclor, cefprozil, cefuroxime, loracarbef

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18
Q

Second generation cephalosporins cover

A

Cover the same organisms than first generation (staph and strep if methicillin sensitive) but a little more anaerobes (specially cefotetan and cefoxitin) and gram neg bacilli

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19
Q

Cefotetan and cefoxitin (2nd generation cephalosporins) are the best initial therapy for …. But increase risk of … and …

A

PID combined with doxy

Bleedind and disulfiram like reaction with alcohol

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20
Q

Cefotetan and cefoxitin should not be taken with… ; why?

A

Alcohol

Disulfiram like reaction

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21
Q

Cefuroxime, loracarbef, cefprozil, cefaclor (2nd gen cephalosporins) are used for which conditions?

A 
Respiratory infections (NOT PNEUMO)
bronchitis, otitis media, sinusitis
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22
Q

Name three third generations cephalosporins

A

Ceftriaxone, cefotaxime, ceftazidime

23
Q

Ceftriaxone (3rd generation ceph)is first line tx for (5)

A

Pneumococcus, including partially insensitive organisms: meningitis, CAP (combine with macrolide), gonorrhea, lyme involving heart or brain

24
Q

In whom ceftriaxone should be avoided?

A

Neonates, anaphylaxis to penicillin

25
Q

Cefotaxime (3rd generation ceph) is better than ceftriaxone in which population?
In which disease?
Has better … Coverage

A

Impaired hepatic metabolism (cefotaxime does not require metabolism by liver): Neonates
Spontaneous bacterial peritonitis
Pseudomonal

26
Q

Cefepime (4th gen ceph) has better … Coverage than third generation and is used for…

A

Staph

Used for : neutropenia and fever, ventilator associated pneumonia

27
Q

What cephalosporin covers MRSA?

A

Ceftaroline

28
Q

Carbapenems cover

A 
Gram negative bacilli
Anaerobes
Staph and strep
Neutropenia and fever
Pseudomonas (except ertapenem)
29
Q

Ertapenem is different than other carabapenems because

A

It does not cover pseudomonas

30
Q

Axtreonam is used exclusively for

A

Gram negative bacilli, like E.coli, enterobacter, citrobacter, pseudomonas

31
Q

Can you use aztreonam in a penicillin allergic patient?

A

Yes, there is no cross reaction

32
Q

Name 4 fluoroquinolones

A

Ciprofloxacon
Gemifloxavin
Levofloxacin
Moxifloxacin

33
Q

Fluoroquinolones are first line treatment for…

A

CAP: including penicillin resistant pneumococcus (except cipro!)
Gram negative bacilli including pseudomonas

34
Q

Ciprofloxacin is number one drug for

A

Cystitis and pyelonephritis

35
Q

Mocifloxacin is used for

It is the only quinolone covering

A

Lungs infections, diverticulitis and GI infections (no need to be combined with metronidazole)

It covers anaerobes

36
Q

Quinolones adverse effects

A

Bone growth abnormalities in children and pregnant woman (do not use them in kids and preg)
Tendonitis and achilles tendon rupture

37
Q

Gentamicin, tobramycin, amikacin (aminoglycosides) cover

A

Gram negative bacilli (bowel, urine, bacteremia): e.coli, enterobacter, citrobacter, pseudomonas, morganella, ceressia
+ synergistic with beta lactams for enterococci and staph

38
Q

Aminoglycoside are synergistic with … For … And … Infections

A

Beta lactams

Enterococci and staph

39
Q

Aminoglycoside no not cover

A

Anaerobes: they need oxygen to work

40
Q

Aminoglycoside side effects

A

Nephrotoxic : acute tubular necrosis

Ototoxic

41
Q

Doxycycline is a drug of choice for

A

Chlamydia
Lyme disease rash, joint, 7th CN palsy
MRSA of the skin
Rickettsia (rocky mountain spotted fever)
Syphillis primary and secondary but ONLY if allergic to penicillin
Borrelia (lyme), ehrlichia (also tick borne) and mycoplasma

42
Q

Adverse effects of doxy

A

Tooth discoloration (children)
Fanconi syndrome (type II RTA proximal)
Photosensitivity
Esophagitis (sit and drink a lot of water)

43
Q

TMP/SMX is used for

A

Cystitis (3d if uncomplicated)
Pneumocystis pneumonia tx and prophylaxis
MRSA of skin and soft tissue (not heart and brain!)

44
Q

TMP/SMX S.E

A

rash (sulfa drug)
Hemolysis, specially in G6PD deficiency
Bone marrow suppression (folate antagonist)

45
Q

Nitrofurantoin is used for

A

Cystitis in pregnancy

46
Q

Amoxicillin clavulonate
Ticacillin/clavulonate
Add what coverage?

A

Staph, covers only sensitive staph though

47
Q

Best initial tx for sensitive staph or strep?

A

Oxacillin, cloxacillin, nafcillin, dicloxacillin
(Ox and naf IV)
1st gen cephalo
Fluoroquinolones
Macrolides (axithromycin, claithro, erythro): less efficacy than ox or cephalo and erythro is more toxic

48
Q

Methicillin resistant staph first line tx?

A 
Vancomycin
Linezolid (careful, reversible BM tox)
Daptomycin (NOT for lung)
Tigecycline (does not cover pseudomonas)
Ceftaroline
49
Q

S.E of linezolid?

A

Reversible bone marrow toxicity (platelets!)

50
Q

Tx for minor MRSA infections of the skin (not for blood, brain or heart)

A

TMP/SMX
Clindamycin
Doxycycline

51
Q

Tx for anaerobes infections

A

Oral (above diaphragm) : penicillin (G, VK, ampi, amoxi), clindamycin
Under diaphragm: metronidazole (safe in pregnancy)
Piperacillin, carbapenems, second gen ceph also cover anaerobes

52
Q

Diseases caused and tx for gram neg bacilli (e.coli, enterobacter, pseudomonas, klebsiella, proteus, citrobacter)

A

Bowel (peritonitis, diverticulitis)
Urinary tract (pyelonephritis)
Cholecystitis or cholangitis

Quinolones, aminoglycosides, carbapenems, piperacillin, tocacillin, aztreonam, cephalosporins (not pseudomonas in first gen)

53
Q

Name beta lactams group of drugs (4)

A

Penicillins
Cephalosporins
Carbapenems
Aztreonams

Kaplan ID (11 decks)

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