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Pharmacology & Drugs > Renal- Renal Infxs and Antibiotics > Flashcards

Renal- Renal Infxs and Antibiotics Flashcards

1
Q

What is the typical presentation of cystitis

A

-Young, nonpregnant female

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2
Q

What is the pathogenesis of UPEC

A
  • Biofilm like intracellular Bacterial communities

- Type 1 pili, antigen 43, Curli

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3
Q

In the case of a complicated severe pyelonephritis, what drug can be used

A

Beta lactam + beta lacamase inhibitor or a carbapenem

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4
Q

What is the treatment for acute proliferative glomerulitis

A
  • Aka post streptococcal glomerulonephritis
  • Loop diuretic, antihypertiesive, dialysis
  • Antibiotics
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5
Q

In the case of a complicated mild pyelonephritis, what drug can be used

A

Ceftriaxone, Ciprofloxacin, levofloxacin, or aztreonam

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6
Q

How is imipenem metabolized

A

By dihydropeptidase in the kidney

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7
Q

Which common causing complicated UTI are good inhibitors of the class A beta lactamases

A

E. Coli and Klebsiella

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8
Q

What are the adverse effects in the use of Fluoroquinolones

A

Tendinitis and tendon rupture
Peripheral neuropathy
CNS effects

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9
Q

During complicated UTI, was is usually the pathogenesis occurring

A

Inflammatory response in the bladder due to neutrophils, along with fibrinogen accumulation in the case of catheters

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10
Q

What is the most common clinical presentation of complicated UTI and what is the most common cause

A

Severe dysuria, with 70-80% being due to indwelling catheters

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11
Q

Complicated UTI is normally occurring in which conditions

A

-Compromised urinary tract or host defenses (such as catheters, urinary obstructions, renal failure, etc.)

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12
Q

What drug is given in the cause of cystitis with resistance

A

Ertapenem (except ineffective against P. Aeruginosa

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13
Q

What are the clinical symptoms of pyelonephritis

A

-Unilateral back or flank pain with a fever

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14
Q

Which bacteria are very vulnerable to clindamycin

A
  • Anaerobes

- strep, staphyl and pneumococci

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15
Q

What are the contraindications for nitrofurantoin

A
  • Antagonizes nalidixic acid (synthetic quinolone antibiotic)
  • Not to be used in patients G6PDH deficiency
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16
Q

Which bacteria should not be treated with nitrofurantoin

A

P aeruginosa and Proteus are resistant

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17
Q

What are the fluoroquinolones used to treat pyelonephritis

A

Ciprofloxacin or levofloxacin

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18
Q

What is the pathogenesis of P. Aeruginosa

A
  • Microcolony formation by changing hydrophobicity of the surface
  • Lectins, rhamnolipids
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19
Q

What is an adverse effect of using clindamycin for treatment

A

C. Difficile induced diarrhea and colitis

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20
Q

Which of the first line beta lactams is not given with a beta lactamase inhibitor

A

Cefepime

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21
Q

What are the drugs used in the treatment of complicated pyelonephritis that are classified as beta lactamase inhibitors

A
  • Tazobactam

- Avibactam

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22
Q

What is the pathogenesis of P. Mirabilis

A
  • Produces urease
  • Calcium crystals and magnesium phosphate precipitates
  • Crystaline biofilms
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23
Q

Which drug 3rd line drug should not be used to treat cystitis

A

-Moxifloxacin

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24
Q

What is the treatment of a prostatitis

A

TMP-SMZ, Ciprofloxacin, levofloxacin

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25
Q

What are Fluoroquinolones commonly used in cystitis

A
  • Ciprofloxacin
  • Levofloxacin
  • Oflaxacin
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26
Q

What is the pathogenesis of E. Faecalis

A

Fibrinogen

27
Q

Which drugs should not be used to empirically treat uncomplicated cystitis

A

Ampicillin and amoxicillin

28
Q

What can be used to treat a complicated pyelonephritis in a pt with beta lactam allergy

A

Aztreonam

29
Q

What are the adverse effects with nitrofurantoin

A

-Anorexia, nausea, vomiting

30
Q

Which drug should be given to treat a complicated cystitis caused by gram positive cocci on gram stain

A

*Suggests enterococcus UTI (E.faecalis, faecium)
Ampicillin or amoxicillin
Phenazopyridine

31
Q

What is the second line for treatment of cystitis

A

-Oral beta lactams

32
Q

Which bacteria are targeted by fosfomycin

A

Gram positive and negative bacteria

33
Q

What are the pharmokenetics of nitrofurantoin

A

Metabolized and excreted by kidneys very quickly, so there is no systemic antibacterial effect

34
Q

What are the agents used for first line of treatment for cystitis

A

Nitrofurantoin
Fosfomycin
Trimethoprim-sufamethoxazole (TMP-SMX)

35
Q

Which drug will cause urine to change orange or red

A

Phenazopyridine

36
Q

Which bacteria are not affected by aztreonam

A

Gram positive or anaerobes

37
Q

Can fosfomycin be used in pregnancy

A

Yes

38
Q

Majority of cases of a prostatitis is caused by which pathogen

A

E. Coli

39
Q

What are the adverse effects of fosfomycin

A

Limited headaches

40
Q

What are the pharmokenetics of fosfomycin

A

Oral form with 40% bioavailability

41
Q

What is the mechanism of action for fosfomycin

A

-Cell wall synthesis inhibitor by blocking enolpyruvate transferase Via binding to the cysteine residue of the active site

42
Q

What are the symptoms of cystitis

A
  • Dysuria, urinary frequency and urgency

- Nocturia, hesitancy, suprapubic discomfort, gross hematuria

43
Q

Which bacteria are affected by aminoglycosides

A

Aerobic gram negative with P.aeruginosa

44
Q

When is the second line of treatment for pyelonephritis used

A

When pt has Fluoroquinolone hypersensitivity or resistance

45
Q

What are the oral beta lactams used in the treatment

A
  • Amoxicillin (aminopenicillin)
  • Cefpodoxime (3rd gen)
  • Cefdinir (3rd gen)
  • Cefadroxil (1st gen)
46
Q

When is aztreonam used in the treatment of pyelonephritis

A

When patients can not handle the other treatment drugs

47
Q

What is a common characteristic of bacteria causing a complicated UTI

A

More likely to be resistant to commonly used oral agents used in the treatment of uncomplicated UTI

48
Q

When are fluoroquinolones used in the treatment of pyelonephritis

A

Severe cases or where there is resistance

49
Q

What are the adverse effects of aminoglycosides

A
  • CN VII toxicity with vertigo and hearing loss
  • Renal toxicity
  • NM blockage
50
Q

What are the aminoglycosides used in the treatment of pyelonephritis

A

Gentamicin or tobramycin

51
Q

Which common causing complicated UTI are good inhibitors of the class C beta lactamases

A
  • Enterobacter spp.

- P. aeruginosa

52
Q

When should nitrofurantoin and fosfomycin not be given

A

If there is suspicion of early pyelonephritis because does not have the adequate renal tissue levels

53
Q

What are the symptoms and clinical presentation of a case of asymptomatic bacteriuria (ASB)

A

No symptoms and will only present with bacteria in the urine

54
Q

What is the mechanism of action for nitrofurantoin

A

Bacterial reductases converts nitrofurantoin into highly reactive intermediate that targets bacterial machinery and DNA/RNA

55
Q

What are the second line of treatments for pyelonephritis

A
  • TMP-SMX
  • Oral beta lactams
  • aztreonam
56
Q

What is the most common cause of UTI

A

UPEC or uropathogenic E.Coli

57
Q

How are dori-,mero-, and Erta- metabolized

A

Not by dihydropeptidase

58
Q

What are the bacterial that can cause complicated UTI

A
  • E. Coli
  • K. Pneumonia
  • Enterobacter spp.
  • P. Aeruginosa
59
Q

What are the first line treatment for pyelonephritis

A

-Fluoroquinolones and aminoglycosides

60
Q

In the case of a complicated cystitis, what drug can be used

A

Ciprofloxacin or levofloxicin

61
Q

What are the uncomplicated UTI

A

Acute cystitis or pyelonephritis (usually in a nonpregnant outpatient women without an atomic abnormalities)

62
Q

What is the mechanism of action for aminoglycosides

A

Irreversible protein synthesis inhibator on 30S
Interference with the initiation complex
Misreading of mRNA

63
Q

What is the third line for treatment of cystitis

A

Fluoroquinolones

64
Q

Which bacteria are targeted with Nitrofurantoin

A

Gram positive and negative

Pharmacology & Drugs (43 decks)

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