Section 1: Antimicrobials Flashcards
List the I.V. Rx for Sensitive staph (MSSA)
- Oxacillin
- Nafcillin
- Cefazolin (first-generation cephalosporin)
List the oral Rx for Sensitive staph (MSSA)
- Dicloxacillin
- Cephalexin (first-generation cephalosporin)
Rx for severe infection with resistant staph (MRSA)
- Vancomycin
- Linezolid
- Daptomycin
- Ceftaroline
- Tigecycline
- Telavancin
Rx for minor infection with resistant staph (MRSA)
- Trimethoprim/sulfamethoxazole (TMP/ SMX)
- Clindamycin
- Doxycycline
Side effects of:
- Linezolid
- Daptomycin
- Imipenem
- Thrombocytopenia
- Myopathy and a rising CPK
- Seizures
Rx of staph infection in the presence of penicillin allergy in the form of RASH
Cephalosporins are a safe choice
Rx of staph infection in the presence of penicillin allergy in the form of anaphylaxis
- Macrolides (azithromycin, clarithromycin)
- Clindamycin
Rx of severe staph infection in the presence of penicillin allergy
- Vancomycin
- Linezolid
- Daptomycin
- Telavancin
Rx of minor staph infection in the presence of penicillin allergy
- Macrolides (azithromycin, clarithromycin),
- Clindamycin
- TMP/ SMX
List medications that will cover for both Staphylococcus aureus and Streptococcus
- Oxacillin
- Nafcillin
- Cefazolin
- Dicloxacillin
- Cephalexin
- Vancomycin
- Linezolid
- Daptomycin
- Ceftaroline
- Tigecycline
- Telavancin
- Trimethoprim/ sulfamethoxazole (TMP/ SMX)
- Clindamycin
- Doxycycline
List 3 medications specific for Streptococcus
- Penicillin
- Ampicillin
- Amoxicillin
List six gram-negative bacilli (rods)
- Escherichia coli
- Enterobacter
- Citrobacter
- Morganella
- Pseudomonas
- Serratia
List the class of drugs used in the Rx of gram negative bacilli (rods)
- Cephalosporins
- Penicillins
- Monobactam
- Quinolones
- Aminoglycosides
- Carbapenems
List the cephalosporins used in the Rx of gram negative bacilli (rods)
- Cefepime (4th generation)
- Ceftazidime (3rd generation)
List the penicillins used in the Rx of gram negative bacilli (rods)
- Piperacillin
- Ticarcillin
List the monobactam used in the Rx of gram negative bacilli (rods)
Aztreonam
List the quinolones used in the Rx of gram negative bacilli (rods)
- Ciprofloxacin
- Levofloxacin
- Moxifloxacin
- Gemifloxacin
List the aminoglycosides used in the Rx of gram negative bacilli (rods)
- Gentamicin
- Tobramycin
- Amikacin
List the carbapenems used in the Rx of gram negative bacilli (rods)
- Imipenem
- Meropenem
- Ertapenem
- Doripenem
Which carbapenem does not cover Pseudomonas
Ertapenem
True or False
- Piperacillin and ticarcillin also cover streptococci and anaerobes
- Levofloxacin, gemifloxacin, and moxifloxacin are excellent pneumococcal drugs
- Aminoglycosides work synergistically with other agents to treat staph and strep
- Carbapenems are excellent antianaerobic medications. They cover streptococci and all sensitive staphylococcus (MSSA)
- Tigecycline covers MRSA and is broadly active against gram-negative bacilli.
Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 316-353). Kaplan Publishing. Kindle Edition.
- True
- True
- True
- True
- True
Gastrointestinal anaerobes
- Another for gastrointestinal anaerobes
- Best medication for abdominal anaerobes
- List 3 medications with equal efficacy for abdominal anaerobes compared to metronidazole
- List the two cephalosporins with anaerobic coverage. What subclass do they belong to?
- Bacteroides
- Metronidazole
- Carbapenems, piperacillin, and ticarcillin
- Cefoxitin and cefotetan. in the cephamycin class
Respiratory anaerobes
- Another name for respiratory anaerobes
- Best drug for (1)
- Anaerobic streptococcus
- Clindamycin
List the medications with no anaerobic coverage
- Aminoglycosides
- Aztreonam
- Fluoroquinolones
- Oxacillin/ nafcillin
- All the cephalosporins except cefoxitin and cefotetan
A man is admitted for endocarditis. His blood cultures grow S. aureus, and vancomycin is started while awaiting sensitivity testing. He develops red skin, particularly on the neck. What should you do?
Slow the rate of the infusion. Vancomycin is associated with “red man syndrome,” which is red, flushed skin from histamine release. This happens from rapid infusion of vancomycin. There is no specific therapy, and you do not need to switch the medication. If the rate of infusion is slowed, the reaction will not occur.
Antiviral agents for the Rx of herpes simplex, varicella zoster
- Acyclovir
- Valcyclovir
- Famciclovir
All 3 agents are equal in efficacy
Antiviral agents for the Rx of cytomegalovirus (CMV)
- Ganciclovir
- Valganciclovir
- Foscarnet
These are essentially equal in efficacy. They _also cover herpes simplex and varicella_
Best long term therapy for CMV retinitis
Valganciclovir
Side effects of:
- Valganciclovir and ganciclovir
- Foscarnet
- Neutropenia and bone marrow suppression
- Renal toxicity
- Antiviral agents for the Rx of Influenza A and B
- What class of drugs are these agents?
- Oseltamivir and zanamivir
- Neuraminidase inhibitors
Ribavirin is used for the Rx of what conditions?
- Hepatitis C (in combination with interferon)
- Respiratory syncytial virus (RSV)
Medications for the Rx of chronic hepatitis B
- Lamivudine
- Interferon
- Adefovir
- Tenofovir
- Entecavir, and
- Telbivudine
Indications for fluconazole
- Candida
- Cryptococcus
List the candida infections not treated with fluconazole
- Candida krusei
- Candida glabrata
- What is the best antifungal agent against Aspergillus?
- Side effect of (1)
- What other fungi does it cover?
- Voriconazole
- Visual disturbance
- Covers all candida
- List three examples of echinocandins
- Main indication if (1)
- Name one fungi (1) does not cover
- List adverse effect(s) of (1)
- Why is echinocandins preferred to amphotericin B for (2) above?
- Caspofungin, micafungin, anidulafungin
- Rx of fungal infection in neutropenic fever patients
- Cryptococcus
- None. Echinocandins have no significant human toxicity because they affect/inhibit the 1,3 glucan synthesis step, which does not exist in humans
- Echinocandins is associated with less mortality
Indications for amphotericin B
- All candida
- Cryptococcus
- Aspergillus
- Voriconazole
- Amphotericin
- Caspofungin
- Fluconazole
From the above choices, what is the drug of choice for
- Aspergillus
- Neutropenic fever
- Candida
- Voriconazole
- Caspofungin
- Fluconazole
List the side effects of amphotericin
- Renal toxicity (increased creatinine)
- Hypokalemia
- Metabolic acidosis
- Fever, shakes, chills
