LG 3.8 Pharm of Joint Infections Flashcards
Someone has a joint infection on their knee and after gaining information about your hospitals biogram you see that many people get these from Staphlococcus aureus, after treating with Nafcillin the patients infection seems to be unaffected!! In a panic because your attending physician just left you in charge and you don’t want to call him on his only day off you prescribe what type of cephalosporin with confidence?
Ceftaroline
You determine that someone has a joint infection caused by a diplococci gram - bacteria, and it seems they may have acquired this bacteria from a radical trip to Disneyland where they attempted to have sex with a different cartoon character on each ride! What is the cephalosporin of choice to treat this?
Ceftriaxone
What are cephalosporins MOA? Daptomyocin? Lenezolid? Clindamyocin?
Cephalosporins: B-lactam (stops cell wall formation).
Daptomyocin: embeds itself in cell membrane, creates a pore, causes cell to die.
Lenezolid: binds RNA polymerase stops translation.
Clindamyocin: same ^.
Someone presents to your clinic with an infection that has a blue/green tinge to it, just to be safe you gram stain and it comes back Gr-, you plate it too because you are a first year resident and don’t want to mess things up, you find that it is oxidase + and rod shaped, it even smells a bit fruity and makes you hungry. What type of cephalosporins would you choose to use against this agent?
Cefapime.
Ceftazidime.
You are doing rounds in second year and come upon a patient with a joint infection, you don’t know jack so your preceptor lets ya in on a little info and tells ya the infection is caused by B. Fragilis, but then he pimps you and says what type of antibiotic would you prescribe? You are with your classmates and want to show them up because you are a gunner and you quickly shout out……..?
Cefoxitin.
In your clinic a little snot nosed kid comes in with a joint infection from pricking himself with sewing needles, the gram stain shows a Gr+ bacteria, since this kid always picks his nose and eats his boogers you pretty sure you know what type of bacteria we are dealing with. Due to a lack of penicillin antibiotics at your clinic you prescribe what type of cephalosporin?
Cefazolin. MSSA infection.
With cephalosporins you need to watch out for ADRs.
Allergic reactions with what drugs do you need to look out for BEFORE prescribing a cephalosporin?
What side chain on cefotetan can cause what?
With pediatric patients what type of ceph is no good?
Cross-sensitivity to other B-lactams.
MTT side chain, causes bleeding and alcohol reaction.
Ceftriaxone can cause death in neonates and calcium precipitates.
Someone has been hiking the Appalachian trail in Virginia for three months, they come directly to your clinic when they get back and present with an arthritic knee. They have had no sex with anyone during this time and saw a “wierd round” rash on their leg during some point of their trip. You know what’s up so you prescribe what type of cephalosporin?
Ceftriaxone - Lyme disease.
Someone presents with pneumonia, your buddy tells you “hey bro give that dude some ______ to fix that infection”, you go behind his back and prescribe something else instead because you know better.
Daptomycin - lipid tail will bind surfactant in lung and will not work with pneumonia.
After prescribing something different for the pneumonia patient your buddy gets mad at you beause his patient presents with some myopathy and now you buddy has to stay late monitoring the creatine phosphokinase levels of his patient. As you leave the clinic to go get a beer you let you buddy know he should also take his patient off of his ______ medications, because _______ (antibiotic) has these 2 adverse side affects.
Discontinue statins.
Daptomycin
A patient of yours comes in and has a knee infection, after doing an aspirate you find out it is MRSA, the infection is bad and you want to do an IV to stop it in its tracks and monitor him in the hospital, but then you are able to de-escalate and send your patient home with oral dosages the next day. What drug did you prescribe?
Linezolid.
Oral and IV doses deliver similar serum levels.
A patient has necrotizing fasciitis, you prescribe a drug and everything seems fine. In an hour a nurse comes and tells you that your patient is complaining of diarrhea. You calmly go and decrease the dosage of medication a little bit and don’t worry about the diarrhea, it later goes away that same day. What antibiotic are you playing with here?
Clindamycin - may cause C. diff. diarrhea.
