Misc Questions Flashcards
Which drugs have an interaction with warfarin?
- metronidazole
- FQs
- TMP/SMX
- macrolides
Which drugs are CI in pregnancy?
- FQs
- TCNs
- sulfa (TMP/SMX)
What are the common intracellular pathogens?
- 3 types atypical pneumonia: Mycoplasma, Chlamydia, Legionella
- Mycobacterium
- Rickettsiae
Which abx classes have activity against intracellular pathogens?
- FQs
- TCNs
- macrolides
Which abx require adjusted dosing for renal dysfunction?
- penicillins (except nafcillin)
- most cephs (except ceftriaxone)
- vancomycin
- TMP/SMX
- aminogylcosides
- TCNs (except doxy and minocycline)
- FQs
Describe vancomycin monitoring.
- peak trough levels
- obtain around 4th dose (both or trough only)
- 10-15 mcg/mL recommended
- peak is controversial so many hospitals only do trough
Which abx class requires use of double coverage to treat Pseudomonas?
cephalosporins
What drug is used in treatment of CF?
monobactams
How is vancomycin administered and why?
- IV for systemic infections
- it is NOT absorbed via the GI tract
What are some ways to prevent vancomycin resistance?
Discouraged use in:
- prophylaxis for infection of vascular catheters
- eradication of MRSA/CA-MRSA
- primary tx for C diff
- routine prophylaxis for VLBW infants
- routine prophylaxis for peritoneal dialysis
What can be used to treat HCA-MRSA?
- *vancomycin DOC**
- TMP/SMX
- Linezolid
- Daptomycin
- Televancin
- Ceftaroline
What can be used to treat CA-MRSA?
- mild to moderate: TMP/SMX, clindamycin, doxy
- severe: vancomycin
What can be used to treat VRE?
- Linezolid
- Quinupristin/Dalfopristin
- Daptomycin
What drug interactions must be avoided with FQ use?
- chelation (decreased absorption) with metal cations eg antacids, iron salts (take 2 hrs before or after)
- theophylline (cipro)
- warfarin
- any meds that prolong QT interval (moxifloxacin)
What drugs can get to the CSF?
- TMP/SMX
- metronidazole
What are aminoglycosides used in combination with and why?
- beta lactams
- beta lactams affect bacterial cell wall
- weaker cell wall allows AGs to get in and affect protein synthesis
Which abx act on the 30S ribosome?
- aminoglycosides
- tetracyclines
Which abx act on the 50S ribosome?
- macrolides
- clindamycin
Which abx can be used to treat P. acnes?
-TCNs –> doxycycline
What is important to remember about erythromycin absorption?
- destroyed by gastric acid
- food decreases absorption
Which drugs may cause QT prolongation and must be administered carefully?
-macrolides and FQs
Which abx has C. diff as a potential adverse effect?
-clindamycin
What drug has a bad interaction w/ EtOH and what happens?
- metronidazole
- get a build up of acetaldehyde
- causes nausea and flushing
- no EtOH during tx or 3 days after
What is the chief avoidable cause of illness and death in the US?
smoking/tobacco use
What is the most common infectious cause of death in the US?
community acquired pneumonia
What are the top 2 nosocomial infections in the US?
- UTI
2. HAP
What 2 drugs are used to treat Enterococcus?
IV ampicillin and gentamicin
Which macrolide has the highest bioavailability?
clarithromycin
What are three respiratory FQs?
Levofloxacin
Moxifloxacin
Gemifloxacin
What is the dosage for an oral prednisone burst for COPD exacerbation?
40 mg PO qday x5 days
What are the options for H. pylori treatment?
amoxicillin
TCN
clarithromycin
metronidazole
What is used to treat Trichomoniasis?
metronidazole
Which abx require pharmacokinetic monitoring? Why?
vancomycin and AGs
due to ototoxicity and nephrotoxicity side effects
What is the FQ of choice for Pseudomonas?
cipro
Which macrolide has the most significant drug interactions?
erythromycin
Which macrolide has the fewest significant drug interactions?
azithromycin
Common Cervicitis/Proctitis/Urethritis Pathogens
Neisseria and Chlamydia
In asthma treatment, what are thrush, dysphonia and coughing side effects of?
Inhaled Corticosteroids
What are the 4th generation cephalosporins?
Cefipime
Ceftaroline
What asthma intervention prevents inflammation but does not treat it?
Leukotriene modifiers (Singulair/Montelukast)
What treatment can be used for nighttime asthma sxs or with prolonged exercise?
LAB2A
What is the treatment for atypical pneumonia?
resp FQs (eg moxifloxacin) macrolides doxycycline
What disease is caused by Rickettsiae?
Rocky Mtn Spotted Fever
What drug has good Gm+ and anaerobe coverage?
Clindamycin
For a decreased asthma response to PRN SABA, what is the treatment?
prednisone burst 3-10 days
Red Neck Syndrome is a side effect of what drug?
Vancomycin
Which cephalosporin has activity against MRSA?
Ceftaroline
What is indicated in Tx and Px of influenza A and B?
Oseltamivir and Zanamivir
Which cephalosporins has pseudomonas activity?
Ceftazidime, Cefipime
Which drug is most likely to cause seizures?
Imipenem
Which antibiotic has no absorption when given orally? What is the only indication for giving this drug orally?
- vancomycin
- c diff if it is unresponsive to metronidazole
What is essential therapy for persistent asthma?
ICS and PRN SAB2A
What agent is used to treat Chlamydia (STI)?
azithromycin or doxy
