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micro pharm > overview > Flashcards

overview Flashcards

1
Q

PCN coverage

A

viridans group strep, Strep pyogenes, oral anaerobes, syphilis, leptospira

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2
Q

ampicillin and amoxicillin coverage

A

same as PCN plus E.coli, lyme disease and a few gram negatives

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3
Q

Gram negatives covered by amoxicillin

A

Helps- H.influenzae, E.coli, Listeria, Proteus, Salmonella

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4
Q

Best initial therapy for otitis media, dental infection, endocarditis prophylaxis, lyme disease (less invasive), UTI in pregnant pt, Listeria monocytogenes, enterococcal infections

A

ampicillin, amoxicillin

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5
Q

Drugs to treat skin infections (cellulitis, impetigo, erysipelas), endocarditis, meningitis, and bacteremia from staph, osteomyelitis and septic arthritis when sensitive

A

PRPs- oxacillin, cloxacillin, dicloxacillin and nafcillin

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6
Q

Methicillin is never the right answer because

A

renal failure from allergic interstitial nephritis

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7
Q

Piperacillin, ticarcillin, azlocillin, mezlocillin coverage

A

gram negative bacilli (E.coli, Proteus) from the large enterobacteriaciae group as well as pseudomonads.

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8
Q

Best initial therapy for cholecystitis and ascending cholangitis, pyelonephritis, bactermia, hospital acquired and ventilator-associated pneumonia, neutropenia and fever

A

Piperacillin, ticarcillin, azlocillin, mezlocillin

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9
Q

all cephalosporins cover

A

group A, B, C strep, viridans strep, E.coli, Klebsiella and proteus mirabilis

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10
Q

listeria, MRSA and Enterococcus are resistant to all forms of

A

cephalosporins

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11
Q

Used to treat methicillin sensitive staph, streptococci (except Enterococcus), some gram-negative bacilli such as E.coli, but not pseudomonas, osteomyelitis, spetic arthritis, endocarditis, cellulitis

A

first generation cephalosporin- cefazolin, cephalexin, cephradrine, cefadroxyl

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12
Q

covers staph, strep, increased gram negative bacilli and anaerobes

A

second generation cephalosporins- Cefotetan, Cefoxitin, Cefaclor, Cefprozil

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13
Q

Best initial therapy for PID combined with Doxy

A

Cefotetan or cefoxitin (2nd generation)

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14
Q

Warning with Cefotetan and cefoxitin

A

may increase the risk of bleeding and give a disulfiramlike reaction with alcohol

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15
Q

Cephalosporin choice for respiratory infections such as bronchitis, otitis media and sinusitis

A

Cefuroxime, loracarbef, cefprozil, cefaclor (2nd generation)

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16
Q

First line tx for pneumococcus, including partially insensitive organisms- meningitis, CAP (in combination with macrolides), gonorrhea, lyme involving the heart or brain

A

Ceftriaxone (3rd generation)

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17
Q

avoid ceftriaxone in

A

neonates due to impaired biliary metabolism

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18
Q

Advantage to cefotaxime over ceftriaxone (3rd generation)

A

superior in neonates, spontaneous bacterial peritonitis

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19
Q

ceftazidime

A

pseudomonal coverage

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20
Q

Better staph coverate, used to tx neutropenia and fever, vent associated pneumonia

A

cefepime, 4th generation

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21
Q

Adverse effects of cefoxitin and cefotetan

A

deplete prothrombin and increase risk of bleeding

22
Q

Adverse effects of ceftriazone

A

inadequate biliary metabolism

23
Q

Covers gram-negative bacilli, including many that are resistant, anaerobes, streptococci, and staphylococci. Used to treat neutropenia and fever.

A

Carbapenems

24
Q

carbapenem drugs

A

imipenem, meropenem, ertapenem, doripenem

25
Q

How does Ertapenem differ from the other carbapenems?

A

does not cover pseudomonas

26
Q

Exclusively used for gram-negative bacilli including Pseudomonas. Does not cross react with PCN.

A

Aztreonam

27
Q

Fluoroquinolone drugs

A

ciprofloxacin, gemifloxacin, levofloxacin, moxifloxacin

28
Q

Best therapy for CAP, including PCN resistant pneumococcus

A

Flouroquinolones

29
Q

For tx of gram negarive bacilli including most pseudomonads

A

Fluoroquinolones

30
Q

Best fluoroquinolone for cystitis and pyelonephritis

A

Cipro, moxifloxacin will not enter the urine in high enough concentration

31
Q

Fluoroquinolone use for diverticulitis and GI infections?

A

Moxifloxacin as single agent, others cover with Metronidazole for anaerobes

32
Q

Adverse effects of Fluoroquinolones

A

Bone growth abnormalities in children and pregnant patients, tendonitis and achilles tendon rupture, gatifloxacin removed because of glucose abnormalities

33
Q

Aminoglycoside drugs

A

Gentamicin, tobramycin, Amikacin

34
Q

Used for gram-negative bacilli (bowel, urine, bacteremia), Synergistic with beta-lactam antibiotics for enterococci and staphylococci

A

Aminoglycosides

35
Q

Do aminoglycosides work against anaerobes?

A

no, they require oxygen to work

36
Q

Adverse effects of Aminoglycosides

A

nephrotoxic and ototoxic

37
Q

Used to treat Chlamydia, limited lyme disease infections, Rickettsia, primary and secondary syphilis in pts allergic to PCN, Borrelia, Ehrlichia and mycoplasma

A

Doxycycline

38
Q

Doxy adverse effects

A

Tooth discoloration in children, Fanconi syndrome, photosensitivity, esophagitis/ulcer

39
Q

Nitrofurantoin indication

A

cystitis, especially in pregnant patients

40
Q

Trim/Sulfa indications

A

cystitis, pneumocystis pneumonia, MRSA of skin and soft tissue

41
Q

Trim/Sulfa Adverse effects

A

rash, hemolysis with G6PD deficiency and bone marrow suppression because it is a folate antagonist

42
Q

beta lactam/beta-lactamase combination benefit (Augmentin, Unisyn, Zosyn)

A

Adds coverage against sensitive staphylococci to these agents (not MRSA)

43
Q

Gram-positive Cocci: Staph and Strep, best initial tx

A

Oxacillin, cloxacillin, dicloxacillin, nafcillin, first generation cephalosporins (cefazolin, cephalexin), fluoroquinolones (except cipro), Macrolides (azithromycin, clarithromycin, erythromycin)- third line agents, less efficacy than axocillin or cephalosporins, erythromycin is also more toxic

44
Q

Oxacillin (Methicillin)- resistant staph tx

A

Vancomycin, Linezolid, Daptomycin, Tigecycline

45
Q

Linezolid adverse effects

A

reversible bone marrow toxicity, platelet inhibition

46
Q

Daptomycin effect

A

elevated CPK, not effective in lung tissue

47
Q

Minor MRSA infections of the skin are treated with

A

TMP/SMX, Clindamycin, Doxycycline

48
Q

Anaerobe tx for oral infection

A

PCN (G, VK, ampicillin, amoxicillin), clindamycin

49
Q

Anaerobe tx for GI infections

A

Metronidazole

50
Q

Gram negative bacilli (E.coli, Klebsiella, Proteus, Pseudomonas, Enterobacter, citrobacter coverage

A

Quinolones, aminoglycosides, carbapenems, piperacillin, ticarcillin, aztreaonam, cephalosporin

51
Q

Additional anaerobe coverage

A

piperacillin, carbapenesm and second generation cephalosporins

micro pharm (6 decks)

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