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
