NAPLEX: Infectious Disease I (Bacterial) Flashcards
Gram positive cocci in clusters indicates _______ whereas pairs indicates ________ or _____________.
clusters: staph
Pairs: strep, enterococcus
SPACE bugs
Serratia
Pseudomonas
Acinetobacter
Citrobacter
Enterobacter
HNPEK bugs
Haemophilus, Neisseria, Proteus, E. coli, Klebsiella
Selection pressure definition
resistance occurs when ABX kill off susceptible bacteria and leave the resistance strains that multiply more
Ex. VRE
Zosyn covers what additional bugs on top of aminopenicillins with a b lactamase inhibitor
pseudomonas
SPACE bugs
Which abx has BBW for C. Diff?
Clindamycin
The addition of a beta-lactamase inhibitor adds activity for what?
Klebsiella (Aminopenicillins only cover HNPE- no K)
MSSA
B frag
(Aminopenicillins already cover strep, enterococci, mouth flora, and HNPE (no k)
Which is IV, PO, and IM
Penicillin VK
Bicillin L-A
Penicillin G Aqueous
PO: Penicillin VK
IM: Bicillin L-A
IV: Penicillin G Aqueous
Which abx class has risk for seizures with accumulation
(All beta lactams)
Penicillins
Cephalosporines
Carbapenems
Quinolones- DO NOT USE W SEIZURE DISORDER
Which abx class has a risk for hemolytic anemia
Penicillins
Cephalosporines
Bactrim
Nitrofurantoin
IV amp and unasyn have to be diluted in
NS
Which generation?
Cefazolin
Cefotetan
Cefepime
Cefuroxime
Cefazolin 1
Cefotetan 2
Cefepime 4
Cefuroxime 2
Which generation?
Cephalexin
Ceftaroline
ceftazidime
Cephalexin 1
Ceftaroline 5
ceftazidime 3
all cephalosporines cover HNPEK except for which generation
1
Which generation?
ceftriaxone
cefotaxime
cefdinir
cefoxitin
ceftriaxone 3
cefotaxime 3
cefdinir 3
cefoxitin 2
Which abx class should not be used in neonates due to risk of kernicterus
cephalosporines
Which TWO ABX can cause a disulfram reaction with alcohol
Cefotetan
Metronidazole
Ceftriaxone + ___________ in the same line can cause precipitation
calcium
Ertapenem doesn’t cover against _______ like the other carbapenems
PEA:
Pseudomonas
Enterococcus
Acinetobacter
Aztreonam indication
Pseudomonas or Gram -
Plus B lactam allergy
Goal trough for aminoglycosides (treatment)
<2
Traditional IV dosing for aminoglycosides (mg/kg)
1-2.5mg/kg/dose
Extended IV dosing interval for aminoglycosides (mg/kg)
7mg/kg/dose
When is a level drawn for extended dosing aminoglycosides
random level after the first dose (6-14 hours after)
What does the Hartford diagram demonstrate
Used to plot the patient’s level on the Ainoglycoside curve to determine interval
If the gent level falls on the line of the Hartford nomogram, use (higher/lower) interval
Higher (more spaced out)
Which ABX MOA?
Inhibit DNA topoisomerase IV and DNA gyrase (topo ii)
Quinolones
Tendon rupture SE- which ABX
quinolones
Quinolones:
Which is not a respiratory quinolone?
Which 2 have activity against pseudomonas?
Which is not for treatment of UTI?
Which is not a respiratory quinolone? Cipro
Which 2 have activity against pseudomonas? Cipro, levo
Which is not for treatment of UTI? Moxi
Peripheral neuropathy SE- Which ABX
Quinolones
ABX that cause glycemic changes
Quinolones
QT Prolonging ABX
Quinolones (highest with Moxi)
Macrolides
ABX that cause psychiatric disturbances
Quinolones
ABX that have interactions with antacids
Quinolones
Tetracyclines
Cefuroxime, cefpodoxime
MOA: bind 50S ribosomal subunit and inh RNA dependent protein synthesis
Macrolides
Which ABX has a SE of Hepatotoxicity
Macrolides
MOA: Bind to the 30S ribosome. Which ABX?
tetracycline
Which abx have a risk for DILE
minocycline
Doxycycline IV to PO
1:1
Which ABX should not be used with a G6PD deficiency
Bactrim
MOA: inhibit the folic acid pathway
sulfonamides
Which Abx have a risk of SJS
Bactrim
Bactrim increases which electrolyte
K
Which abx has a risk of crystaluria
Bactrim
The SMX to TMP dosing ratio is ____:____ and dosed off the _____ component
5:1
TMP
Which ABX has a increased risk INR when used with Warfarin
Bactrim
At what crcl should vanco be dosed as q24h?
20-49
Which ABX cannot be administered concurrently with UFH
Which ABX requires a washout of 5 days before using UFH
- Televancin
- Oritavancin
MOA: Bind D-ala-D-ala
Vanco
AND Lipoglycopeptides (-vancin)
Which abx causes incr CPK
Daptomycin
Which drug requires caution with serotonin drugs
Linezolid
MOA Binds 50S subunit
Linezolid
Clindamycin
Which abx has a BBW of death and is not used often
Tigecycline
Which abx are used for MDR gram negative pathogens and have a neprotoxicity risk
Polymixin V
Which drug cannot be used with a + D test? What is the appearance of the disks to indicate + D test?
Clinda
Flattened zone in the middle
Metronidazole is CI in ____ trimester of pregnancy
1
At what crcl can Nitrofurantoin not be used?
<60
List the drugs that cover pseudomonas
(7)
Zosyn
Cefepime
Ceftazidime
Aztrenam
Cirpo
Levo
TIC
Tobramycin
Imipenem + carbapenem
Which abx cover MRSA
(7)
Vanco
Dapto
Linezolid
Doxycycline
Ceftaroline
Bactrim
Clindamycin
Which abx cover atypicals?
(3)
Azithro
Doxyxycline
Quinolones
Which ABX cover HNPEK bugs
ABBCCQ
Aminoglycosides
Beta lactams
Bactrim
Cephalosporines (not first gen)
Carbapenems
Quinolones
First line CRE
Avycaz
Which abx cover SPACE bugs
(4)
Zosyn
Cefepime
Carbapenems
Aminoglycosides
Which Abx can you not refrigerate
Cefdinir
Bactrim IV
Metronidazole IV
Moxiflox IV
Which 2 cephalosporines should be seperated from antacids
Cefuroxime
Cefpodoxime
Which antibiotic leaves a metallic taste in your mouth
metronidazole
How long should you not drink alcohol after taking metronidazole
3 days
3 days
There is Bactrim and Bactrim DS- what are the dosages of each
Bactrim: S 400/ T 80
Bactrim DS (double strength): 800/160
Which covers MRSA?
Ortavancin
Tedizolid
Polymixin
Ortavancin
Which quinolone covers MRSA?
Delafloxacin
Which are oral?
Cefuroxime
Cefpodoxime
Cefotaxime
Cefotetan
Cefuroxime
Cefpodoxime
Cefotaxime (ALSO IV)
Which of the following interfere with coagulation lab assays?
Bactrim
Daptomycin
Linezolid
Ortavancin
Televancin
Daptomycin
Ortavancin
Televancin
Which are side effects of gentamycin?
Cardiotoxicity
Neurotoxicity
Pulmonary toxicity
Nephrotoxicity
Ototoxicity
Neurotox
Nephrotox
Ototox
Which abx requires a negative pregnancy test before use
Televancin
Which antibiotic IV has to be kept at room temperature
Clinda
Metronidazole
Ampicillin
Cipro
Vanco
Metronidazole