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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
Bacteriostatic agent coverage is often adequate in ? infections When is bactericidal coverage necessary?
Uncomplicated ``` Neutropenic PTs will render this class ineffective Protected areas from host immune response (endocarditis, CSF, blood infxn) ```
26
PCN, B-lactam, Cephalosporin ABXs are all ? and utilize ? dependent killing
-cidal Time Renal excretion Safe for pregnancy
27
What are the only 4 B-lactams that are NOT renal excreted? What is the MOA of B-Lactams?
PCN, Cephalosporin, Carbapenem, Monobactam Interfere w/ last step of cell wall synthesis, transpeptidation/cross-linkage, creating unstable membranes and lysis
28
Most PCNs are incompletely absorbed after PO administration EXCEPT for ? PCN has the ability to cross what two important barriers?
Amoxicillin- don't use for GI infections Placenta CSF- empiric meningitis Tx
29
All B-Lactam PCNs are renally excreted except for what three? What is the most common type of reaction to PCNs?
Nafcillin, Dicloxacillin, Oxacillin- no adjustments needed due to biliary excretion Exanthematous (morbilliform) rash
30
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?
B-lactams Diarrhea- Nephritis- use of high/combo doses Neurotoxicity- irritation to neuronal tissue leading to somnolence, stupor, seizure, coma w/ high doses
31
Natural PCN use can be broken into what two groups?
Aminopenicillin/Antipseudomonal: better for Gran Neg rods Anti-staph PCN
32
What are the four 1st Generation PCNs?
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
33
1st Generation PCNs can be effective against what three groups of microbes? What are the anti-staph PCNs?
T Pallidum Strep Spp N Meningitidis ``` Methicillin Oxacillin Naficillin Cloxacililn Dicloxacillin ```
34
Why are anti-staph PCNs used for? What can they be used against?
Resistant against destruction by penicillinase/B-lactamse ``` Staph/Strep infection Prosthetic infection Osteomyelitis Skin infection Septic arthritis Impetigo Endocarditis- Nafcillin w/ Gent ```
35
How are the anti-staph PCNs excreted? Two of them can cause what two adverse effects?
Nafcillin- biliary, no renal adjustment needed Oxa/Dicloxacillin- biliary and kidney Nafcillin- neutropenia Oxacillin- hepatotoxicity
36
What are the two aminopenicillins? What B-lactam inhibitors can it be combined with and what form are they administerred?
Amoxicillin Ampicillin Clavulanic Acid/Amox- PO Sulbactam/Amp- IV Tazobactam/Piper- IV
37
When are aminopenicillins used for?
``` 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 ```
38
What respiratory infections can aminopenicillins be used against? What do they have to be combined with for this use?
Community/Nosocomial pneumonia Combo w/ Macrlide/Doxycycline
39
When is Amoxicillin used? What is it combined w/ to provide B-lactam coverage?
Duodenal ulcer by H Pylori Otitis media- only for non B-lactamase H Influenza UTI- only if susceptible or pregnant Endocarditis prophylaxis Augmenten
40
When/why is Ampicillin used?
Same as Amoxicillin but in IV form Meningitis/endocarditis + aminoglycoside CAP w/ macrolide/doxy
41
Why are Ampicillin and Aminiglycosides used together so much? When/why is Amoxicillin/Clavulanate combo used?
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 ```
42
By using Amox/Clavulanate for otitis media, the addition of Clavulanate increases coverage over what three microbes?
B-lactamse producing H Influenza, M Catarrhalis, Staph A
43
What is the first line agent against dog and cat bites? What is used for early/late human bites?
Amoxicillin/Clavulanate Early: Amox/Clavulanate Late: Amp/Sulbactan PCN allergy: Clindamycin + Cipro or TMP/SMX
44
What is Ampicillin/Sulbactam used for? What three drug combos do provide some anaerobic coverage for infections?
``` SSTI Sepsis Intrabdominal infxn Nosocomial pneumo w/ macrolide/quinolone Gyn infection ``` Amoxicillin/Claculanate Ampicillin/Sulbactam Piperacillin/Tazobactam
45
None of the PCNs have MRSA coverage except for which comb that has MSSA coverage? What three drugs have MSAA coverage?
Anti-Pseudomonal PCN: Piper/Tazo Dicloxacillin Amp/Sulbactam Piper/Tazo
46
What three groups of drugs can be used for pharyngitis? What ABX is used for upper respiratory infections?
PCN, Anti-staph, Amino Amino but better coverage w/ B-lactamase inhibitor
47
Which group out of PCN ABX do not need to have doses renally adjusted? Don't use Cephalosporins in PTs w/ ? allergy
Anti-Staph PCNs PCN
48
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?
Ceftriaxone- biliary Ceftriaxone Anti-Staph
49
Steven Johnson Syndrome is a toxic epidermal necrolysis reaction to ? ABX? What are the names of Generation 1-5?
Cephalosporin ``` 1st= Cefazolin 2nd= Cefuroxime 3rd= Ceftriaxone 4th= Cefepime 5th= Ceftaroline ```
50
What are the First Generation Cephalosporins good/used for?
Gram + MSSA, Strep No BBB/CNS crossing STI, Surgery prophylaxis, MSSA Endocarditis
51
? are good alternative to anti-staph PCNs? What is the DOC for pre/post surgery not involving the abdomen?
First Gen Cephalosporins Cefazolin
52
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?
PO: Cephradine, , Cefadroxil, Cefalexin Injectable: Cefazolin Clindamycin
53
What are the 2nd Generation Cephalosporins What are they used for?
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
What are the ABX options for resistant Otitis Media and Pharyngitis?
Cefactor Cefprozil Cefuroxime Axetil
55
3rd Generation Cephalosporins
Ceftazidime- Pseudomonas coverage Ceftriaxone Cefotaxime Ceftazidime Cross BBB No anaerobe coverage
56
What is the DOC for gonorrhea Tx? Why would that drug be combined w/ Azithromycin?
Ceftriaxone Azithromycin added for Clamydia Tx Urethritis, Prostatitis, PID
57
Which Cephalosporin has excellent CNS penetration? What is another unique/identifying fact about this specific cephalosporin that alters who we can give it to?
Ceftriaxone No renal adjustment needed, no neonate usage. Will cause biliary sludge development
58
What is the only 4th Generation Cephalosporin? What combo of Cephalosporins makes this drug?
Cefepime- broadest spectrum, no anaerobic Cefazolin + Ceftazidime
59
What is the 4th Generation Cephalosporin used for? What is the only 5th Genearation Cephalosporin and it's unique fact?
Empiric therapy for febrile neutropenia/nosocomial pneumonia w/ MDR risk Post-neurosurgical meningitis Ceftaroline- MRSA coverage
60
What ABX is an alternative for Vancomycin? What is the original ABX used for?
Ceftaroline Community acquired pneumonia SSTI
61
What are the two cephalosporin/B-lactamse combos? What are these used for?
Ceftolozane/Tazobactam Ceftazidime/Avibactam Approved by infectious dz for Pseudomonas aeurginosa
62
What ABX are used for Otitis Media and SSTI/MSSA Tx? What ABX are used for surgical prophylaxis including anaerobic coverage?
1st and 2nd Gen Cephalosporins Cefazolin Cefoxitin, Cefotetan
63
What two Cephalosporings provide Pseudomonas coverage? What are the Carbapenems and what are they generally used for?
Ceftazidime Cefepime ``` Imipenem/Cilastatin Doripenem Meropenem Ertapenem Very broad spectrum w/ anaerobic, no MRSA coverage ```
64
What are the Carbapenems specifically used for? What is an important/unique exception for Ertamenem?
Febrile neutropenia Nosocomial infections Mixed infections No Pseudomonas No Enterococci coverage No Acinetobacter
65
Why is Imipenem/Cilastatin only avail in combo? What are the adverse effects of using Carbapenems?
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
Aztreonam
Coverage similar to Ceftazidime and Aminoglycosides + Pseudomonas coverage - Gram+/Anaerobic coverage No cross reactivity w/ B-Lactams
67
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?
Aztreonam Ceftazidime Cell wall inhibition
68
What is a unique adverse reaction Glycopeptides and Lypoglycopeptide can cause? How can this adverse reaction be avoided?
Red neck/Red man syndrome- caused by histamine release Vancomycin infusion 1hr prior to administration
69
What are the more concerning adverse reactions when using Vancomycin? What is are two adverse reactions of using Telavancin?
Nephrotoxicity Ottotoxicity Taste disturbance Foamy urine
70
What 3 ABX only have Gram + coverage? Which Glycopeptides and Lypoglycopeptide are pregnancy safe or unsafe?
Vancomycin Linezolid Daptomycin Vanc PO- safe, Cat B Vanc IV- crosses, no adverse Telavancin- adverse development
71
Glycopeptides and Lypoglycopeptide are only effective against Gram + microbes that include what 3? PO Vancomycin is used for ? while IV is used for treating ?
MRSA, Strep, C Diff PO- DOC for C Diff IV- systemic only
72
What is the Cyclic Lipopeptide ABX and how is it different?
Daptomycin -cidal, Concentration dependent Safe for pregnancy Gram + only- MRSA, VRE
73
What is the MOA for Daptomycin What type of monitoring must be done for these PTs?
Binds to bacterial cell membraine and causes rapid depolarization and death CK weekly for rhabdo
74
Daptomycin can't be used for ? infections What drug is included under Polymyxin?
Pulmonary- degraded by surfactant Colistimethate
75
What is the MOA for Colistimethate? What are two adverse effects of this drug?
Acts as a detergent and damages bacterial cytoplasmic membrane Nephrotoxicity Neurotoxicity
76
What type of infections would Colistimethate be selected for use? Polymyxins are only used against ? organisms especially ?
Acenobacter infections Gram Neg Pseudomonas, Klebsiella, Acinetobacter
77
What drug would be chosen for CF PTs w/ a Gram Neg pneumonia/pulmonary infections? What topical ABX can be used for Gram +/- microbes?
Polymyxin due to inhalation delivery Bacitracin: Gram + Neomycin/Polymyxin: Gram -
78
When would topical polymyxins be used?
External ear infection Badder irrigation w/ Neomycin sulfate Ocular infection
79
What is the MOA of Bacitracin What types of RNA subunits do mammal and bacterial cells have?
Cell wall synthesis inhibition for Gram + microbes Mammal- 80S (60 and 40) Bacteria- 70S (50 and 30)
80
What ABX have a MOA of Protein Synthesis inhibition? What is the only ABX w/ a MOA of DNA Gyrase inhibition?
``` Mupirocin Clindamycin Strepgramins Macrolides Aminoglycosides Chloramphenicol Tetracyclines ``` Fluoroquinolones
81
What ABX have a MOA of Folate Synthesis inhibition? What ABX have a MOA of RNA polymerase inhibition?
Sulfonamides Trimethoprim Rifampin
82
Which ABX that are protein synthesis inhibitors are -cidal/concentration dependent?
Aminoglycosides: GNATS ``` Gentamicin Neomycin B Amikacin Tobramycin Streptomycin ```
83
Which ABX that are protein synthesis inhibitors are -static/time dependent?
Tetracylcines: Tetra/Doxy/Minocycline Glycylcyclines: Tigecycline- IV, good coverage of MRSA including VRE
84
Why are Tetracycline ABXs less effective at protein synthesis inhibition? What are Tetracyline used for specifically?
Only incorporate incorrect amino acid, Step C Atypical coverage (Rickettsia, Spirochetes, Plasmodium)
85
Tetracycline ABXs are alternatives for what 3 things? What are is an important PT education piece for PTs taking Doxy/Minocycline?
SSTI Syphilis PID in combo w/ Cefoxitin Take w/ food
86
What are the adverse reactions of using Tetracyclines/Glycylcyclines? Where is there use c/i?
N/V- significant and severe w/ Tigecycline, pre-Tx prior to use Tissue hyperpigmentation Photosensitivity Pregnancy Breastfeeding Kids under 8y/o
87
What is usually not an adverse effect of use for aminoglycosides? These ABX are very effective against what 4 microbes?
All depend on O2 transport channels to access bacteria meaning anaerobes are inherently resistant E Coli Klebsiella Pseudomonas Acinetobacter
88
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?
Gram negative UTI Clindamycin
89
Why is Chloramphenicol used? What is it's unique s/e?
Last resort infection Tx Gray Baby Syndrome- inability to glucoronidate for degredation/detox
90
What meds are avoided in PTs w G6PD deficiency? What is the MOA of Macrolides and Ketolides?
``` Dapsone Quinidine Sulfonomides Premiquine ASA Nitrofurantoin ``` Protein synthesis inhibitor
91
What are the Macrolides? What is the Ketolide?
Erythromycin Azithromycin Clarithromycin Telithromycin
92
When would the Ketolide ABX Telithromycin be used? What type of coverage are these good for?
Macrolide resistant strains may be susceptible due to the additional binding site Atypical
93
What are the adverse effects of Macrolides/Ketolides? What two are more likely to have heaptotoxicity?
GI and ATc prolongation- mostly Erythromycin Telithromycin/Azithromycin Teli- associated w/ failure leading to death/transplant
94
What are the pregnancy categories of Macrolides/Ketolides? What are Macrolide/Ketolides used against?
B- Ezith*/Azithromycin C- Clari/Telithromycin Upper/Lower Resp infection Chlamydia- Azithromycin H Pylori ulcer- Clarithromycin
95
Macrolides/Ketolides are not good choices for infection that req ? activity for ? or ? What is unique about Azithromycin use?
Bactericidal Endocarditis, Meningitis Long t1/2, 3-5 day usage
96
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?
Macrolide/Ketolide Macrolides
97
What is the MOR of Clindamycin? Further testing of this MOR is only going to be done if suspected resistance to ?
Inducible is common Erythromycin Verify w/ D-Test: Inducible, Sudsceptible to Clinda, Susceptible to Clinda/Eryth
98
What is the most common s/e of Clindamycin use in HIV PTs? What is a more rare s/e?
Rash Steven Johnson syndrome
99
What is the unique fact about the Streptogramin ABX? When are they used?
Quinupristin/Dalfopristin resistance is not common Severe infection MDRO
100
Most protein synthesis inhibitors are bacterio- unless aminoglycosides are added which makes them bacterio- What are the s/e of using Oxazolidinones?
Static Cidal Hematological- anemia, leukopenia, pancytopenia, thrombocytopenia Serotonin syndrome
101
When would Oxazolidinone be used? When would they NOT be used?
Nosocomial pneumonia CAP SSTIs Bacteremia
102
What are the Generations of Fluoroquinolones? What are each ones used for?
2nd: Cipro/Ofloxacin 3rd: Levofloxacin 4th: Moxifloxacin Cipro/Oflo: GNR (Traveler Diarrhea) Levo: Gram Neg, pseudomonas coverage Moxi- Pseudomonas and Anaerobe coverage
103
What is the difference between Moxifloxacin and Ciprofloxacin
Mox- Anaerobe, S Pneumo coverage, NO Pseudomonas Levo- S Pneumo, Pseudomonas, NO anaerobes Cipro: Gram Neg, Pseudomonas, NO anaerobes ALL cover atypical
104
What are the s/e of fluoroquinolones? What pregnancy category are these and what education piece is needed?
Achilles tendon ruptures CNS- hallucination, seizure Rash/photosensitivity GI Preg Cat C Take on empty stomach, reduced by anti-acids
105
What is the agent of choice against anthrax? When are fluoroquinolones used for UTIs?
Cipro Cipro/Levo- prostatitis, GI infection DONT use Moxi (low gram neg coverage, low urinary concentration)
106
Which Fluoroquinolones are used for respiratory infections? How would a respiratory infection by Pseudomonas be treated?
Levo/Moxi- Strep Pneumo coverage Levo
107
What are the Folate Antagonists and their primary uses?
``` Sulfamethoxazole Sulfadiazine- toxoplasma gondi Sulfadoxine- malaria Tx Sulfasalazine- UC Sulfacetamide- skin condition Silver Sulfadizine- burns Mafenide- burn ```
108
What are the alternate folate antagonists? What is the MOA of Sulfonamides?
Trimethoprim Dapsone- Leprosy Pyrimethamine- anti-malarial Inhibits utilization of PABA for synthesis of folic acid Time dependent, -static Preg Cat D
109
What is an s/e of Sulfonamides? At a molecular level, how do folate antagonists work?
Crystalurea Bacteria make folic acid from p-arminobenzoic acid; suflonamides are analogs of PABA
110
Folate antagonists don't have good ? coverage and no coverage for ? What is the only Sulfonamide used for monotherapy?
Strep No atypical, anaerobes, Psuedomonas Sulfadiazine- toxoplasma gondi
111
PTs w/ G6PD need to avoid sufonamides due to inc risk for ? What is the MOA of Nitroimidazoles?
Hemolytic anemia Interact w/ DNA to cause loss of helical structure and strand breakage
112
Majority of Nitroimidazole coverage is for ? What are the major s/e?
Anaerobes GI Metalic taste Warfarin interaction, lower Warfarin dose
113
What is the name of the reaction that occurs if PTs taking Nitroimidazole drink alcohol? Why does this reaction occur?
Disulfiram reaction- inc temp, projectile vomit Build up of aldehyde dehydrogenase
114
Nitroimidazoles are an alternative Tx for ? and the DOC for Tx of ? What is the MOA and usage of Fidaxomicin?
C Diff Trichomonas Vaginalis Protein synthesis inhibitor Tx of C Diff
115
PTs w/ a macrolide allergy can't take ? ABX This same ABX has similar efficacy to PO ?
Fidaxomicin Vancomycin
116
What is the MOA of Mupirocin What is the DOC for ?
Protein synthesis inhibitor Impetigo Eradication nasal MRSA colonization
117
What are the 3 UTI treatment agents? What types are they used in?
Nitrofurantoin Fosfomycin Methenamine Uncomplicated cystitis Tx/Prophylaxis
118
What is the MOA of Nitrofurantoin What PT population can't take this?
Inibits protein synthesis in the Tx of UTIs G6PD deficient
119
What is the MOA of Fosfomycin What is the MOA of Methenamine but can only be used for ?
Inhibits bacteria wall synthesis by inactivating pyruvyl transferase Hydrolyzed to formaldehyde/ammonia in acidic urine Prophylaxis
120
What med can be given during UTIs for analgesic relief but no anti-infective properties? What is a s/e of this med?
Phenazopyridine Colors urine orange
121
If pediatric PT has Otitis media, what ABX is used? What is given if the area has high resistance?
Amoxicillin Amoxicillin/Clavulanate
122
What ABX is used for Otitis Media if PT has PCN allergy? When is watchful waiting conducted for these PTs?
2nd Gen Cephalosporin Ceftriaxone 6-24mon w/ unilateral, non-severe >24mon w/ uni/bilat non-severe AOM
123
What are the criteria for PTs must not have in order to be Dx w/ CAP?
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
How CAP w/ no comorbidities Tx? How is CAP w/ comorbidities Tx?
Clarith or Azithromycin Doxycycline Moxi or Levofloxacin Macrolide or Doxycycline Amoxicillin (clavulanate, cephalosporin)

IPAP (212 decks)

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