Pharm Exam 4 Specifics

Question 1

What are the drugs of choice for MSSA?

Answer 1

Penicillinase-resistant pencillins.

Nafcillin
Oxacilin
Dicloxacillin

OR

First gen cephalosporins

Cefazolin
Cephalexin
Cefadroxil

Question 2

What drugs undergo biliary excretion and are the only penicillins that do NOT require renal dosing?

Answer 2

Nafcillin and Oxacillin

Question 3

Which penicillinase-resistant penicillin is most preferred and why?

Answer 3

Oxacillin.

Nafcillin has a higher incidence of acute interstitial nephritis.

Question 4

What is the drug of choice for Enterococcus spp?

Answer 4

Aminopencillins

Ampicillin
Amoxicillin

Question 5

What drug has almost identical coverage to an aminopencillin with added G- coverage?

Answer 5

ES penicillins

Piperacillin

Question 6

What drugs can cover acinetobacter spp?

Answer 6

Piperacillin/Tazobactam
Ampicillin/sulbactam
Cefepime

Question 7

What is the only beta-lactamase inhibitor that can function alone?

Answer 7

Sulbactam

Question 8

What are common adverse effects of all cephalosporins?

Answer 8

Pain at injection site (IM)

Hypersensitivity cross-reactivity with penicillin at a 1% rate.

Question 9

What drug is more commonly used for minor MSSA?

Answer 9

Oxacillin

Question 10

What cephalosporin has major interaction potential with warfarin and why?

Answer 10

Cefotetan, because it has MTT side chains.

Question 11

Which cephalosporin is good for respiratory tract infections?

Answer 11

Cefuroxime

Question 12

What two 2nd gen cephalosporins have anaerobic coverage?

Answer 12

Cefotetan
Cefoxitin

Question 13

Which two cephalosporins have antipseudomonal activity?

Answer 13

Ceftazidime
Cefepime

Question 14

What cephalosporin has very poor G+ activity?

Answer 14

Ceftazidime

Question 15

What cephalosporin specifically has 0 anaerobic coverage?

Answer 15

Cefepime

Question 16

What is the only cephalosporin that works against MRSA?

Answer 16

Ceftaroline

Question 17

What drug is mainly used for DTR/MDR pseudomonas?

Answer 17

Ceftolozane/tazobactam

Question 18

What drug requires 2x dosing against pseudomonas?

Answer 18

Ceftolozane/tazobactam

Question 19

What drug is mainly used for KPCs/CRE’s?

Answer 19

Ceftazidime/avibactam

Question 20

What drugs can be used on CREs?

Answer 20

Ceftazidime/avibactam
Cefiderocol

Question 21

What is the drug of choice for ESBL infections?

Answer 21

Carbapenems

Question 22

Which carbapenem CANNOT be used for pseudomonas?

Answer 22

Ertapenem

Question 23

What drugs can be used for KPCs/CRE?

Answer 23

Ceftazidime/avibactam (main?)
Meropenem/vaborbactam
Imipenem/relebactam
Eravacycline
Gentamicin
Tobramycin
Amikacin
Plazomicin

Question 24

What drugs can treat MRSA?

Answer 24

Vancomycin
Daptomycin
Telavancin (2nd line)
Delafloxacin
Sulfamethoxazole
Trimethoprim
Tetracycline
Doxycycline
Minocycline
Omadacycline
Eravacycline
Plazomicin
Clindamycin
Linezolid

Question 25

What drugs can treat VRE?

Answer 25

Daptomycin
Oritavancin
Omadacycline
Eravacycline
Linezolid
Tedizolid

Question 26

What drug is used for MDR G- bacteria?

Answer 26

Cell membrane agents:
Colistin
Polymixin E
Polymixin B

Question 27

What drug classes can treat atypicals?

Answer 27

Tetracyclines
FQs
New tetracyclines
Macrolides
Pleuromutilins

Question 28

What drugs can treat pseudomonas?

Answer 28

Choose 1 from each Row:

Row 1:
Piperacillin/tazobactam
Ceftazidime
Cefepime
Imipenem/cilastatin
Meropenem
Doripenem (no longer used clinically)
Aztreonam

Row 2:
Ciprofloxacin
Levofloxacin
Amikacin
Tobramycin
Gentamicin

Note:
FQs preferred over aminoglycosides dt nephrotoxicity

Question 29

What drugs can treat C. diff?

Answer 29

Oral vancomycin
Fidaxomicin

Question 30

What drugs can cause C. diff symptoms?

Answer 30

FQs (extended use)
Clindamycin (BBW)

Question 31

What drugs have anaerobic coverage?

Answer 31

Moxifloxacin (somewhat)
Metronidazole (specifically for anaerobes)
Tetracyclines (except bacteroides)
New tetracyclines
Clindamycin (except B. fragilis)

Natural pencillins (Mouth ones)
Aminopenicillins
ES Penicillins
Cefotetan
Cefoxitin
Carbapenems

Note:
Bacteroides is specifically G-, and has more specific coverage than G+ anaerobes.