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IPAP > Pharm Block 3 Detailed > Flashcards

Pharm Block 3 Detailed Flashcards

1
Q

Define Chemotherapy

What other important group of meds fall under this class?

A

Use of meds to eradicate pathogenic organisms/neoplastic cells to Tx an infectious dz/ca

ABX

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2
Q

Define Anti-Microbial/Infective agent

What are the two types of anti-microbials

A

Any substance that suppresses/kills microbes

  • cidal- kills reqs no effort from immune system
  • static- prevents growth so immune system can catch up
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3
Q

Define Immunocompromised

What class of anti-microbial should be used in this PT group?

A

No complement or proper Ab function

Bactericidal

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4
Q

What drugs cover MRSA

A 
Vancomycin
Linezolid
Daptomycin
TMP/SMX
Clindamycin
Doxycycline
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5
Q

What is the only ABX for anaerobe only Tx?

What is the only ABX for Gram Pos only microbes?

A

Metrindazole

Vanomycin

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6
Q

Streptogramins and Oxazolidinones are used for Tx of ? only

Aztreonam is used only for the Tx of ? two microbe classes?

A

Gram Pos

Aerobic gram-neg
Pseudomonas

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7
Q

What drugs cover VRE?

A

Daptomycin
Linezolid
Doxycycline

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8
Q

What drugs provide Pseudomonas Spp coverage?

A 
Piper/Tazo
Aztreonam
Meropenem
Ciprofloxacin
Gent/Tobra/Amikarin
Colistin
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9
Q

What drugs provide Abdominal anaerobe coverage?

A 
Cefazolin
Amp/Sulbactam
Merpenam
Piper/Tazo
Ertampenam
Doxycycline
Meropenem
Clindamycin
Moxyifloxacin
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10
Q

What drugs provide Atypical microbe coverage

A 
Moxifloxacin
Ciprofloxacin
Azithromycin
Clindamycin
Doxycycline
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11
Q

A microbes ability to produce a B-lactamase is important to what 4 ABX?

What are the SPACE bugs?

A

PCN, Cephalosporins, Carbapenems, Aztreonam

Gram-  Extended Spectrum B-Lactamase (ESBL)
Serratia
Pseudomonas aeruginosa
Acinetobacter
Citrobacter
Enterobacter
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12
Q

PTs are more likely to have a resistant infection in what 3 scenarios?

What lab result would show a PT has an infection?

A

Prior ABX use
Hospitals w/ high resistance/ABX use
Inc duration of therapy

Shift to Left from inc Immature Band cells
More immature= greater the infection/further behind the immune system is

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13
Q

What are examples of infection sites that have poor perfusion to deliver ABX?

What adjustment has to be made when applying ABX to MDROs?

A

DM foot infxn
Bone, Lung, Abscess, CNS

Require broader coverage

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14
Q

What drugs are more likely to cause nephrotoxicity, and photosensitivity?

A

Aminoglycosides Vancomycin

Quinolones
Tetracyclines
Sulfonamides

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15
Q

Define Concentration dependent killing and an example

Define Time dependent and 2 examples

A

Inc in rate of killing as concentration increases 4-64x the MIC; Aminoglycosides

% of time that blood concentration must be above MIC, but is not enhanced by drug concentration above MIC; PCN, Cephalosporin

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16
Q

When are ABX combos used for Tx?

A

Life threatening infxn
Polymicrboial- DM foot wound, immunocompromised PTs
Empiric therapy when one agent isn’t effective- Comm Acq Pneumo
Resistant strain- Pseudomonas, TB
Dec toxicity by using lower doses

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17
Q

Define Synergism

A 
1 + 1= 3
PCM + Aminoglycoside
Combo give more than twice the benefits
PCN breaks cell wall
Aminoglycoside can now enter and effect protein synthesis
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18
Q

What would be a disadvantage of using an ABX combo?

Normal flora includes what 3 types of microbes?

A

-static w/ a -cidal
Tetracycline (static) inhibits protein synthesis, slows growth
PCN reqs bacterial growth to be effective, antagonized by tetracycline

Bacteria, fungi, protozoa

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19
Q

What are the two types of surgical prophylaxis and when are they given?

A

Surgical- dirty surgery
Prevention- TB, UTIs, GI bugs

Surgery- ABX in tissue at time of incision; redose if longer than 4hrs or two t1/2 of ABX

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20
Q

Most surgical procedures need protection from ? skin flora?

If a hollow/mucous organ is penetrated ? coverage is needed?

Colorectal surgery needs ? type of coverage?

A

Strep, Staph, Coag-neg Staph

Gram neg rods and Enterococci

Broad spectrum a/naerobic coverage

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21
Q

Surgical wound infection prophylaxis includes protection against ? with ?

Surgical abdominal infection prophylaxis includes protection against ? with ?

A

Staph A, Enteric Gram neg Rods w/ Cefazolin, Clindamycin

Enteric Gram neg bacilli, Anaerobes w/ Cefoxitin, Cefotetan, Ertapenem, Cefazolin + Metronidazole

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22
Q

What is the benefit of using Cefazolin + Metronidazole combo?

A 
Cefazolin= Gram Pos coverage
Metron= anaerobic coverage
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23
Q

What drugs MOA is cell wall synthesis inhibition?

A

B-Lactam (PCN, Carbapenem, Cephalosporin, Monobactam)
Vancomycin
Bacitracin
Fofomycin

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24
Q

What drugs MOA is cell membrane inhibition?

A 
Daptomycin
Ketoconazole
Polymyxin
Amphotericin
Colisin
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25
Q

Bacteriostatic agent coverage is often adequate in ? infections

When is bactericidal coverage necessary?

A

Uncomplicated

Neutropenic PTs will render this class ineffective
Protected areas from host immune response (endocarditis, CSF, blood infxn)
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26
Q

PCN, B-lactam, Cephalosporin ABXs are all ? and utilize ? dependent killing

A

-cidal
Time

Renal excretion
Safe for pregnancy

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27
Q

What are the only 4 B-lactams that are NOT renal excreted?

What is the MOA of B-Lactams?

A

PCN, Cephalosporin, Carbapenem, Monobactam

Interfere w/ last step of cell wall synthesis, transpeptidation/cross-linkage, creating unstable membranes and lysis

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28
Q

Most PCNs are incompletely absorbed after PO administration EXCEPT for ?

PCN has the ability to cross what two important barriers?

A

Amoxicillin- don’t use for GI infections

Placenta
CSF- empiric meningitis Tx

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29
Q

All B-Lactam PCNs are renally excreted except for what three?

What is the most common type of reaction to PCNs?

A

Nafcillin, Dicloxacillin, Oxacillin- no adjustments needed due to biliary excretion

Exanthematous (morbilliform) rash

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30
Q

If PT has anaphylactic reaction to PCN, what other ABXs need to be avoided?

What are the three more common s/e of PCN use?

A

B-lactams

Diarrhea-
Nephritis- use of high/combo doses
Neurotoxicity- irritation to neuronal tissue leading to somnolence, stupor, seizure, coma w/ high doses

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31
Q

Natural PCN use can be broken into what two groups?

A

Aminopenicillin/Antipseudomonal: better for Gran Neg rods

Anti-staph PCN

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32
Q

What are the four 1st Generation PCNs?

A

PCN G: produces high plasma levels, short duration of action

PCN G Benzathine- IM only, released over 28 days, DOC for syphilis

PCN G Procaine- IM only, released over 24hrs

PCN V- PO only, resists acid degradation for use against mild throat, ear, and UR infections

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33
Q

1st Generation PCNs can be effective against what three groups of microbes?

What are the anti-staph PCNs?

A

T Pallidum
Strep Spp
N Meningitidis

Methicillin
Oxacillin
Naficillin
Cloxacililn
Dicloxacillin
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34
Q

Why are anti-staph PCNs used for?

What can they be used against?

A

Resistant against destruction by penicillinase/B-lactamse

Staph/Strep infection
Prosthetic infection
Osteomyelitis
Skin infection
Septic arthritis
Impetigo
Endocarditis- Nafcillin w/ Gent
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35
Q

How are the anti-staph PCNs excreted?

Two of them can cause what two adverse effects?

A

Nafcillin- biliary, no renal adjustment needed
Oxa/Dicloxacillin- biliary and kidney

Nafcillin- neutropenia
Oxacillin- hepatotoxicity

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36
Q

What are the two aminopenicillins?

What B-lactam inhibitors can it be combined with and what form are they administerred?

A

Amoxicillin
Ampicillin

Clavulanic Acid/Amox- PO
Sulbactam/Amp- IV
Tazobactam/Piper- IV

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37
Q

When are aminopenicillins used for?

A 
Bite wound- dog, cat, man
Otitis media
UTI- only if pregnant or known susceptible
Listeria infection
Diabetic foot wound
Endocarditis
Respiratory infection
Skin/soft tissue
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38
Q

What respiratory infections can aminopenicillins be used against?

What do they have to be combined with for this use?

A

Community/Nosocomial pneumonia

Combo w/ Macrlide/Doxycycline

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39
Q

When is Amoxicillin used?

What is it combined w/ to provide B-lactam coverage?

A

Duodenal ulcer by H Pylori
Otitis media- only for non B-lactamase H Influenza
UTI- only if susceptible or pregnant
Endocarditis prophylaxis

Augmenten

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40
Q

When/why is Ampicillin used?

A

Same as Amoxicillin but in IV form

Meningitis/endocarditis + aminoglycoside
CAP w/ macrolide/doxy

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41
Q

Why are Ampicillin and Aminiglycosides used together so much?

When/why is Amoxicillin/Clavulanate combo used?

A

Synergy- PCN destroys cell wall to allow aminoglycoside entry to the cell

Otitis media resistant to Amoxiicillin

Comm Acq Pneumonia
Acute bacteria infxn
Uncomplicated endocarditis prophylaxis
SSTI
Animal bites- first line
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42
Q

By using Amox/Clavulanate for otitis media, the addition of Clavulanate increases coverage over what three microbes?

A

B-lactamse producing H Influenza, M Catarrhalis, Staph A

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43
Q

What is the first line agent against dog and cat bites?

What is used for early/late human bites?

A

Amoxicillin/Clavulanate

Early: Amox/Clavulanate
Late: Amp/Sulbactan
PCN allergy: Clindamycin + Cipro or TMP/SMX

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44
Q

What is Ampicillin/Sulbactam used for?

What three drug combos do provide some anaerobic coverage for infections?

A 
SSTI
Sepsis
Intrabdominal infxn
Nosocomial pneumo w/ macrolide/quinolone
Gyn infection

Amoxicillin/Claculanate
Ampicillin/Sulbactam
Piperacillin/Tazobactam

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45
Q

None of the PCNs have MRSA coverage except for which comb that has MSSA coverage?

What three drugs have MSAA coverage?

A

Anti-Pseudomonal PCN: Piper/Tazo

Dicloxacillin
Amp/Sulbactam
Piper/Tazo

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46
Q

What three groups of drugs can be used for pharyngitis?

What ABX is used for upper respiratory infections?

A

PCN, Anti-staph, Amino

Amino but better coverage w/ B-lactamase inhibitor

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47
Q

Which group out of PCN ABX do not need to have doses renally adjusted?

Don’t use Cephalosporins in PTs w/ ? allergy

A

Anti-Staph PCNs

PCN

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48
Q

Most Cephalosporins have renal clearance and require no adjustment except for ?

What are the only two ABXs in all of the B-Lactams that don’t require any renal adjustment?

A

Ceftriaxone- biliary

Ceftriaxone
Anti-Staph

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49
Q

Steven Johnson Syndrome is a toxic epidermal necrolysis reaction to ? ABX?

What are the names of Generation 1-5?

A

Cephalosporin

1st= Cefazolin
2nd= Cefuroxime
3rd= Ceftriaxone
4th= Cefepime
5th= Ceftaroline
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50
Q

What are the First Generation Cephalosporins good/used for?

A

Gram + MSSA, Strep
No BBB/CNS crossing

STI, Surgery prophylaxis, MSSA Endocarditis

51
Q

? are good alternative to anti-staph PCNs?

What is the DOC for pre/post surgery not involving the abdomen?

A

First Gen Cephalosporins

Cefazolin

52
Q

What are the First Generation Cephalosporins and their route of administration?

If PT is allergic to PCN and Cephalosprins, what ABX is next in line for use?

A

PO: Cephradine, , Cefadroxil, Cefalexin
Injectable: Cefazolin

Clindamycin

53
Q

What are the 2nd Generation Cephalosporins

What are they used for?

A

Cefuroxeime- alternative for cat bite
Cefoxitin/Cefotetan- pre/post surgery of the abdomen due to having ANAEROBIC coverage

No BBB/CNS coverage
Better Gram -: H Influenza, M Catarrhalis, Neisseria

54
Q

What are the ABX options for resistant Otitis Media and Pharyngitis?

A

Cefactor
Cefprozil
Cefuroxime Axetil

55
Q

3rd Generation Cephalosporins

A

Ceftazidime- Pseudomonas coverage
Ceftriaxone
Cefotaxime
Ceftazidime

Cross BBB
No anaerobe coverage

56
Q

What is the DOC for gonorrhea Tx?

Why would that drug be combined w/ Azithromycin?

A

Ceftriaxone
Azithromycin added for Clamydia Tx

Urethritis, Prostatitis, PID

57
Q

Which Cephalosporin has excellent CNS penetration?

What is another unique/identifying fact about this specific cephalosporin that alters who we can give it to?

A

Ceftriaxone

No renal adjustment needed, no neonate usage.
Will cause biliary sludge development

58
Q

What is the only 4th Generation Cephalosporin?

What combo of Cephalosporins makes this drug?

A

Cefepime- broadest spectrum, no anaerobic

Cefazolin + Ceftazidime

59
Q

What is the 4th Generation Cephalosporin used for?

What is the only 5th Genearation Cephalosporin and it’s unique fact?

A

Empiric therapy for febrile neutropenia/nosocomial pneumonia w/ MDR risk
Post-neurosurgical meningitis

Ceftaroline- MRSA coverage

60
Q

What ABX is an alternative for Vancomycin?

What is the original ABX used for?

A

Ceftaroline

Community acquired pneumonia
SSTI

61
Q

What are the two cephalosporin/B-lactamse combos?

What are these used for?

A

Ceftolozane/Tazobactam
Ceftazidime/Avibactam

Approved by infectious dz for Pseudomonas aeurginosa

62
Q

What ABX are used for Otitis Media and SSTI/MSSA Tx?

What ABX are used for surgical prophylaxis including anaerobic coverage?

A

1st and 2nd Gen Cephalosporins

Cefazolin
Cefoxitin, Cefotetan

63
Q

What two Cephalosporings provide Pseudomonas coverage?

What are the Carbapenems and what are they generally used for?

A

Ceftazidime
Cefepime

Imipenem/Cilastatin
Doripenem
Meropenem
Ertapenem
Very broad spectrum w/ anaerobic, no MRSA coverage
64
Q

What are the Carbapenems specifically used for?

What is an important/unique exception for Ertamenem?

A

Febrile neutropenia
Nosocomial infections
Mixed infections

No Pseudomonas
No Enterococci coverage
No Acinetobacter

65
Q

Why is Imipenem/Cilastatin only avail in combo?

What are the adverse effects of using Carbapenems?

A

Imipenem is metabolized in kidney to nephrotoxic product but Cilastatin blocks renal dehydropeptidase to prevent metabolism

N/V/Rashes
Imipenem has highest risk of seizure

66
Q

Aztreonam

A

Coverage similar to Ceftazidime and Aminoglycosides
+ Pseudomonas coverage
- Gram+/Anaerobic coverage
No cross reactivity w/ B-Lactams

67
Q

PCN/Cephalosporin allergic PTs can get what B-Lactam AMX with the condition that the PTs reaction wasn’t to ?

What is the MOA of the Glycopeptides and Lypoglycopeptide?

A

Aztreonam
Ceftazidime

Cell wall inhibition

68
Q

What is a unique adverse reaction Glycopeptides and Lypoglycopeptide can cause?

How can this adverse reaction be avoided?

A

Red neck/Red man syndrome- caused by histamine release

Vancomycin infusion 1hr prior to administration

69
Q

What are the more concerning adverse reactions when using Vancomycin?

What is are two adverse reactions of using Telavancin?

A

Nephrotoxicity
Ottotoxicity

Taste disturbance
Foamy urine

70
Q

What 3 ABX only have Gram + coverage?

Which Glycopeptides and Lypoglycopeptide are pregnancy safe or unsafe?

A

Vancomycin
Linezolid
Daptomycin

Vanc PO- safe, Cat B
Vanc IV- crosses, no adverse
Telavancin- adverse development

71
Q

Glycopeptides and Lypoglycopeptide are only effective against Gram + microbes that include what 3?

PO Vancomycin is used for ? while IV is used for treating ?

A

MRSA, Strep, C Diff

PO- DOC for C Diff
IV- systemic only

72
Q

What is the Cyclic Lipopeptide ABX and how is it different?

A

Daptomycin
-cidal, Concentration dependent
Safe for pregnancy
Gram + only- MRSA, VRE

73
Q

What is the MOA for Daptomycin

What type of monitoring must be done for these PTs?

A

Binds to bacterial cell membraine and causes rapid depolarization and death

CK weekly for rhabdo

74
Q

Daptomycin can’t be used for ? infections

What drug is included under Polymyxin?

A

Pulmonary- degraded by surfactant

Colistimethate

75
Q

What is the MOA for Colistimethate?

What are two adverse effects of this drug?

A

Acts as a detergent and damages bacterial cytoplasmic membrane

Nephrotoxicity
Neurotoxicity

76
Q

What type of infections would Colistimethate be selected for use?

Polymyxins are only used against ? organisms especially ?

A

Acenobacter infections

Gram Neg
Pseudomonas, Klebsiella, Acinetobacter

77
Q

What drug would be chosen for CF PTs w/ a Gram Neg pneumonia/pulmonary infections?

What topical ABX can be used for Gram +/- microbes?

A

Polymyxin due to inhalation delivery

Bacitracin: Gram +
Neomycin/Polymyxin: Gram -

78
Q

When would topical polymyxins be used?

A

External ear infection
Badder irrigation w/ Neomycin sulfate
Ocular infection

79
Q

What is the MOA of Bacitracin

What types of RNA subunits do mammal and bacterial cells have?

A

Cell wall synthesis inhibition for Gram + microbes

Mammal- 80S (60 and 40)
Bacteria- 70S (50 and 30)

80
Q

What ABX have a MOA of Protein Synthesis inhibition?

What is the only ABX w/ a MOA of DNA Gyrase inhibition?

A 
Mupirocin
Clindamycin
Strepgramins
Macrolides
Aminoglycosides
Chloramphenicol
Tetracyclines

Fluoroquinolones

81
Q

What ABX have a MOA of Folate Synthesis inhibition?

What ABX have a MOA of RNA polymerase inhibition?

A

Sulfonamides
Trimethoprim

Rifampin

82
Q

Which ABX that are protein synthesis inhibitors are -cidal/concentration dependent?

A

Aminoglycosides: GNATS

Gentamicin
Neomycin B
Amikacin
Tobramycin
Streptomycin
83
Q

Which ABX that are protein synthesis inhibitors are -static/time dependent?

A

Tetracylcines:
Tetra/Doxy/Minocycline

Glycylcyclines:
Tigecycline- IV, good coverage of MRSA including VRE

84
Q

Why are Tetracycline ABXs less effective at protein synthesis inhibition?

What are Tetracyline used for specifically?

A

Only incorporate incorrect amino acid, Step C

Atypical coverage (Rickettsia, Spirochetes, Plasmodium)

85
Q

Tetracycline ABXs are alternatives for what 3 things?

What are is an important PT education piece for PTs taking Doxy/Minocycline?

A

SSTI
Syphilis
PID in combo w/ Cefoxitin

Take w/ food

86
Q

What are the adverse reactions of using Tetracyclines/Glycylcyclines?

Where is there use c/i?

A

N/V- significant and severe w/ Tigecycline, pre-Tx prior to use
Tissue hyperpigmentation
Photosensitivity

Pregnancy
Breastfeeding
Kids under 8y/o

87
Q

What is usually not an adverse effect of use for aminoglycosides?

These ABX are very effective against what 4 microbes?

A

All depend on O2 transport channels to access bacteria meaning anaerobes are inherently resistant

E Coli
Klebsiella
Pseudomonas
Acinetobacter

88
Q

What is the only time Aminoglycosides would be used as monotherapy?

What ABX would be used for surgical prophylaxis in a PT having hip surgery w/ a PCN allergy?

A

Gram negative UTI

Clindamycin

89
Q

Why is Chloramphenicol used?

What is it’s unique s/e?

A

Last resort infection Tx

Gray Baby Syndrome- inability to glucoronidate for degredation/detox

90
Q

What meds are avoided in PTs w G6PD deficiency?

What is the MOA of Macrolides and Ketolides?

A 
Dapsone
Quinidine
Sulfonomides
Premiquine
ASA
Nitrofurantoin

Protein synthesis inhibitor

91
Q

What are the Macrolides?

What is the Ketolide?

A

Erythromycin
Azithromycin
Clarithromycin

Telithromycin

92
Q

When would the Ketolide ABX Telithromycin be used?

What type of coverage are these good for?

A

Macrolide resistant strains may be susceptible due to the additional binding site

Atypical

93
Q

What are the adverse effects of Macrolides/Ketolides?

What two are more likely to have heaptotoxicity?

A

GI and ATc prolongation- mostly Erythromycin

Telithromycin/Azithromycin
Teli- associated w/ failure leading to death/transplant

94
Q

What are the pregnancy categories of Macrolides/Ketolides?

What are Macrolide/Ketolides used against?

A

B- Ezith*/Azithromycin
C- Clari/Telithromycin

Upper/Lower Resp infection
Chlamydia- Azithromycin
H Pylori ulcer- Clarithromycin

95
Q

Macrolides/Ketolides are not good choices for infection that req ? activity for ? or ?

What is unique about Azithromycin use?

A

Bactericidal
Endocarditis, Meningitis

Long t1/2, 3-5 day usage

96
Q

What ABX are the ideal choice for Tx for mild-moderate community acquired pneumonia?

What class of ABX is used as an alternate for PTs allergic to B-Lactams?

A

Macrolide/Ketolide

Macrolides

97
Q

What is the MOR of Clindamycin?

Further testing of this MOR is only going to be done if suspected resistance to ?

A

Inducible is common

Erythromycin
Verify w/ D-Test: Inducible, Sudsceptible to Clinda, Susceptible to Clinda/Eryth

98
Q

What is the most common s/e of Clindamycin use in HIV PTs?

What is a more rare s/e?

A

Rash

Steven Johnson syndrome

99
Q

What is the unique fact about the Streptogramin ABX?

When are they used?

A

Quinupristin/Dalfopristin resistance is not common

Severe infection
MDRO

100
Q

Most protein synthesis inhibitors are bacterio- unless aminoglycosides are added which makes them bacterio-

What are the s/e of using Oxazolidinones?

A

Static
Cidal

Hematological- anemia, leukopenia, pancytopenia, thrombocytopenia
Serotonin syndrome

101
Q

When would Oxazolidinone be used?

When would they NOT be used?

A

Nosocomial pneumonia
CAP
SSTIs

Bacteremia

102
Q

What are the Generations of Fluoroquinolones?

What are each ones used for?

A

2nd: Cipro/Ofloxacin
3rd: Levofloxacin
4th: Moxifloxacin

Cipro/Oflo: GNR (Traveler Diarrhea)
Levo: Gram Neg, pseudomonas coverage
Moxi- Pseudomonas and Anaerobe coverage

103
Q

What is the difference between Moxifloxacin and Ciprofloxacin

A

Mox- Anaerobe, S Pneumo coverage, NO Pseudomonas

Levo- S Pneumo, Pseudomonas, NO anaerobes

Cipro: Gram Neg, Pseudomonas, NO anaerobes

ALL cover atypical

104
Q

What are the s/e of fluoroquinolones?

What pregnancy category are these and what education piece is needed?

A

Achilles tendon ruptures
CNS- hallucination, seizure
Rash/photosensitivity
GI

Preg Cat C
Take on empty stomach, reduced by anti-acids

105
Q

What is the agent of choice against anthrax?

When are fluoroquinolones used for UTIs?

A

Cipro

Cipro/Levo- prostatitis, GI infection
DONT use Moxi (low gram neg coverage, low urinary concentration)

106
Q

Which Fluoroquinolones are used for respiratory infections?

How would a respiratory infection by Pseudomonas be treated?

A

Levo/Moxi- Strep Pneumo coverage

Levo

107
Q

What are the Folate Antagonists and their primary uses?

A 
Sulfamethoxazole
Sulfadiazine- toxoplasma gondi
Sulfadoxine- malaria Tx
Sulfasalazine- UC
Sulfacetamide- skin condition
Silver Sulfadizine- burns
Mafenide- burn
108
Q

What are the alternate folate antagonists?

What is the MOA of Sulfonamides?

A

Trimethoprim
Dapsone- Leprosy
Pyrimethamine- anti-malarial

Inhibits utilization of PABA for synthesis of folic acid
Time dependent, -static
Preg Cat D

109
Q

What is an s/e of Sulfonamides?

At a molecular level, how do folate antagonists work?

A

Crystalurea

Bacteria make folic acid from p-arminobenzoic acid; suflonamides are analogs of PABA

110
Q

Folate antagonists don’t have good ? coverage and no coverage for ?

What is the only Sulfonamide used for monotherapy?

A

Strep
No atypical, anaerobes, Psuedomonas

Sulfadiazine- toxoplasma gondi

111
Q

PTs w/ G6PD need to avoid sufonamides due to inc risk for ?

What is the MOA of Nitroimidazoles?

A

Hemolytic anemia

Interact w/ DNA to cause loss of helical structure and strand breakage

112
Q

Majority of Nitroimidazole coverage is for ?

What are the major s/e?

A

Anaerobes

GI
Metalic taste
Warfarin interaction, lower Warfarin dose

113
Q

What is the name of the reaction that occurs if PTs taking Nitroimidazole drink alcohol?

Why does this reaction occur?

A

Disulfiram reaction- inc temp, projectile vomit

Build up of aldehyde dehydrogenase

114
Q

Nitroimidazoles are an alternative Tx for ? and the DOC for Tx of ?

What is the MOA and usage of Fidaxomicin?

A

C Diff
Trichomonas Vaginalis

Protein synthesis inhibitor
Tx of C Diff

115
Q

PTs w/ a macrolide allergy can’t take ? ABX

This same ABX has similar efficacy to PO ?

A

Fidaxomicin

Vancomycin

116
Q

What is the MOA of Mupirocin

What is the DOC for ?

A

Protein synthesis inhibitor

Impetigo
Eradication nasal MRSA colonization

117
Q

What are the 3 UTI treatment agents?

What types are they used in?

A

Nitrofurantoin
Fosfomycin
Methenamine

Uncomplicated cystitis Tx/Prophylaxis

118
Q

What is the MOA of Nitrofurantoin

What PT population can’t take this?

A

Inibits protein synthesis in the Tx of UTIs

G6PD deficient

119
Q

What is the MOA of Fosfomycin

What is the MOA of Methenamine but can only be used for ?

A

Inhibits bacteria wall synthesis by inactivating pyruvyl transferase

Hydrolyzed to formaldehyde/ammonia in acidic urine
Prophylaxis

120
Q

What med can be given during UTIs for analgesic relief but no anti-infective properties?

What is a s/e of this med?

A

Phenazopyridine

Colors urine orange

121
Q

If pediatric PT has Otitis media, what ABX is used?

What is given if the area has high resistance?

A

Amoxicillin

Amoxicillin/Clavulanate

122
Q

What ABX is used for Otitis Media if PT has PCN allergy?

When is watchful waiting conducted for these PTs?

A

2nd Gen Cephalosporin
Ceftriaxone

6-24mon w/ unilateral, non-severe
>24mon w/ uni/bilat non-severe AOM

123
Q

What are the criteria for PTs must not have in order to be Dx w/ CAP?

A

Hospitalization +2 days in past 90 days
Long term care resident
IV ABX therapy/Chemo/wound care in past 30 days
Hospital/hemodialysis attendance

124
Q

How CAP w/ no comorbidities Tx?

How is CAP w/ comorbidities Tx?

A

Clarith or Azithromycin
Doxycycline

Moxi or Levofloxacin
Macrolide or Doxycycline
Amoxicillin (clavulanate, cephalosporin)

IPAP (212 decks)

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