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Infectious Disease > Miscellaneous Abx > Flashcards

Miscellaneous Abx Flashcards

1
Q

FLuoroquinolones (FQ)

  • distribution
  • excretion
A
  • good distribution to tissue and fluids except for CNS.

- all undergo renal elimination except for moxafloxacin (dont have to adjust the dose)

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2
Q

FQ Clinical Uses

A

Urinary Tract (Drug of Choice)

pneumonia

STI

Skin and soft tissue (not usually first line)

GI infections

Travelers Diarrhea

Osteomyelitis

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3
Q

Black Box Warning for FQ

A
  • levoquin(levofloxacin) is associated w/ increased risk of tendinitis and tendon rupture, especially in pts taking corticosteroids and patients w/ kidney, heart, or lung transplant.
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4
Q

Side Effects of FQ

A
  • nausea
  • diarrhea
  • dizziness
  • confusion
  • tendon rupture
  • QT prolongation
  • tendonitis
  • peripheral neuropathy
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5
Q

What are major drug interactions of FQs?

A

warfarin, antidiabetics, antacids, propranolol, magnesium, calcium, iron

Coritcosteroids increase risk of tendon rupture

Cirpofloxacin is potent inhibitor of CYP450

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6
Q

Which drug type contains the only oral agents against pseudomonas?

A

-FQs!

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7
Q

FQ are not to be used in which populations?

A
  • pregnancy, lactation, pediatrics

- caution in hepatic dysfunction

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8
Q

Sulfonamides

  • metabolism
  • distribution
  • excretion
A
  • metabolized in the liver
  • good distribution to all body tissues and fluids… CSF, pleural fluid, and synovial fluid.
  • eliminated through liver and kidney
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9
Q

Sulfa Clinical Use

A
  • UTI
  • PCP (pneumonia in immunocompromised pt)
  • Toxoplasmosis
  • Gram +/-
  • MRSA***
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10
Q

SE of Sulfa

A
  • Rash*
  • Fever
  • GI (nausea, vommiting, diarrhea)
  • Stevens-Johnsons Syndrome*
  • Vasculitis
  • Hemolytic Anemia if underlying G6PD deficiency*
  • Thrombocytopenia
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11
Q

Sulfa Drug Interactions

A

sulfa is 70% protein bound and displaces other drugs.

Potentiates the effects of:

  • warfarin
  • phenytoin
  • hypoglycemic agents
  • methotrexate
  • beta blockers
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12
Q

What are the routes of administration of sulfas? What is sulfa most commonly used for?

A
  • ORAL ONLY!!!

- most commonly used for UTI, MRSA skin infections

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13
Q

Nitrofurantion

  • route of administration
  • use for prevention and tx of what?
  • How long is it in the serum?
  • excretion
  • CI
A
  • oral
  • uncomplicated UTI
  • in serum for 30minutes before it knows to go to the urinary tract.
  • renal clearance
  • CI in kidney dysfunction. creatinine clearance
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14
Q

What are some common organisms that cause UTIs?

A
  • E. Coli
  • Citrobacter
  • Staph saprophyticus
  • Enterococcus faecalis
  • Enterococcus faecium
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15
Q

SE of Nitrofurantion

A
  • nausea/vominting*
  • pulmonary rxn : pulmonary infiltrates, pneumonitis, pulmonary fibrosis
  • hepatic effects (rare)
  • Peripheral neuropathy in long term use
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16
Q

pulmonary rxns of Nitrofurantion sx and precautions

A
  • sudden, sever dyspnea, chill,s chest pain, fever, and cough
  • pulmonary infiltration w/ consolidation or pleural effusion
  • usually evident within first week of treatment, reversible w/ drug discontinuation.
  • avoid in older adults and avoid using for long term suppression of infection.
17
Q

Drug interactions of Nitrofurantion

A

NONE!!!!!!!!!!!!!!! …only in plasma for 30mins

18
Q

Metronidazole (Flagyl)

  • metab
  • absorption
  • tx of choice for,….
  • routes of admin
A
  • metabolized in liver
  • absorbed PO, good penetration in most locations
  • anerobic infections, bacterial vaginosis, trichomoniasis, c. diff.

-Oral, IV, topical, intravaginal

19
Q

Black Box warning fo Metronidazole (Flagyl)

A

-shown to be carcinogenic in mice an rats. unnecessary use should be avoided.

20
Q

SE of Metronidazole (Flagyl)

A
  • nausea, vomiting, abd pain, metallic taste
  • seizure at high dose
  • peripheral neuropathy
  • pancreatitis
21
Q

Drug Interactions of Metronidazole (Flagly)

A
  • enhances warfarin
  • alcohol (flushing, palpitation, nausea, vomiting)
  • inhibitor of CYP34A, potential for many drug interactions
  • phenobarbital, phenytoin, rifampin (these increase the metabolism of flagyl decreasing serum conc. leading to tx failure.)

Infectious Disease (10 decks)

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