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ID Exam 3 > Sing L2 > Flashcards

Sing L2 Flashcards

1
Q

what are the 5 aminoglycosides?

A
  1. Amikacin
  2. Gentamicin
  3. Tobramycin
  4. Streptomycin
  5. Plazomicin
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2
Q

what are the 5 tetracyclines?

A
  1. Doxycycline (Vibramycin)
  2. Minocycline (Minocin)
  3. Tetracycline
  4. Eravacycline
  5. Omadacycline
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3
Q

what is the 1 glycylcline?

A

tigecycline

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4
Q

what are the 3 macrolides?

A
  1. Azithromycin
  2. Clarithromycin
  3. Erythromycin
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5
Q

what is the 1 macrocylic?

A

fidaxomcin

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6
Q

what is the 1 lincosamide?

A

clindamycin

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7
Q

what are the 2 oxazolidinones?

A
  1. Linezolid
  2. Tedizolid
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8
Q

what is the 1 streptogramin?

A

quinupristin/dalfopristin

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9
Q

what is the 1 pleuromutilin?

A

lefamulin

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10
Q

which classes of drugs inhibit bacterial protein synthesis by binding to the 30S subunit?

A

aminogylcosides
tetracyclines
glycyclines

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11
Q

which classes of drugs inhibit bacterial protein synthesis by binding to the 50S subunit?

A

macrolides
lincosamide
oxazolidinones
streptogramins
chloramphenicol

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12
Q

which classes of drugs inhibits bacterial protein synthesis throught interactions with the A- and P- sites of the peptidyl transferase center in the 23s ribosomal RNA of the 50S subunit?

A

pleuromutilin

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13
Q

what class of drugs are bactericidal?

A

aminoglycosides

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14
Q

what class of drugs are bacteriostatic?

A

tetracyclines
glycyclines
macrolides
lincosamide
oxazolidinones

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15
Q

what class of drugs are bactericidal when used in synergy?

A

streptogramins

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16
Q

what class of drugs can be both bactericidal or bacteriostatic?

A

pleuromutilins

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17
Q

pleuromutilins can be bacteriostatic or bactericidal, what does this depend on?

A

the bug

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18
Q

what are the 2 dosing strageties for aminoglycosides?

A

traditional and extended interval dosing

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19
Q

are aminoglycosides typically used as monotherapy?

A

rarely

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20
Q

what class of drugs are concentration-dependent?

A

aminoglycosides

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21
Q

what class of drugs are AUC:MIC dependent?

A

tetracyclines
glycyclines
macrolides
streptogramins

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22
Q

what class of drugs are time-dependent?

A

lincosamide
oxazolidinones
pleuromutilines

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23
Q

when used alone aminoglycosides only cover what organism?

A

gram-negative

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24
Q

when used in synergy aminoglycosides can cover?

A

gram-positive
typically used with beta-lactams or vancomycin

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25
Q

which aminoglycoside has activity for P. aeruginosa?

A

amikacin

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26
Q

which tetracyclines cover MRSA?

A

doxycycline
minocycline
omadacycline

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27
Q

which aminoglycoside has activity for M. tuberculosis?

A

streptomycin

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28
Q

which tetracyclines cover VRE?

A

doxycycline

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29
Q

what respiratory pathogens do tetracyclines cover?

A

atypicals
streptococcus pneumoniae

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30
Q

which tetracyclines cover the respiratory pathogens?

A

doxycycline

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31
Q

which tetracyclines cover tick-borne/rickettsial disease?

A

doxycycline

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32
Q

is tetracycline used for the H. pylori reigmen?

A

yes

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33
Q

does tetracycline have activity against gram-negative bacilli?

A

no
poor activity

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34
Q

does tigecycline have broad or narrow activity?

A

broad

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35
Q

what MDROs does tigecycline cover?

A

MSSA
MRSA
VRE
and many gram-negative rods

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36
Q

what are macrolides mainly used for coverage against?

A

respiratory tract infections (atypicals)

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37
Q

what is fidaxomicin only used for coverage for?

A

C. diff

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38
Q

what MDRO does clindamycin have coverage against? community or hospital acquired?

A

MRSA
community

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39
Q

what two organisms does clindamycin mainly provide coverage against?

A

anaerobes
gram-positives

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40
Q

when do you use the D-test? what does it test for?

A

when using clindamycin for MRSA
it tests for inducible resistance

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41
Q

when performing the D-test if it is sensitive to clindamycin, but resistant to _________ additional screening should be done to to test for inducible resistance

A

erythromycin

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42
Q

how do you interpret to D-test?

A

A “D” shaped zone of inhibition will occur around erythromycin on the dish = positive result

AVOID clindamycin if the D-test is positive (especially in serious infections)

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43
Q

oxazolidinones provide broad coverage against what organisms?

A

gram-positive

44
Q

oxazolidinones provide broad coverage against what MRDOs?

A

MSSA
MRSA
VRE
atypicals

45
Q

quinupristin/dalfopristin provide broad coverage against what type of organism?

A

gram-positive only

46
Q

quinupristin/dalfopristin provide broad coverage against what MRDOs?

A

MSSA
MRSA
VRE
generally reserved for infections caused by MRSA or VRE that are refractory to other treatments – NOT a first line therapy

47
Q

is chloramphenicol broad or narrow?

A

broad

48
Q

pleuromutilins provide coverage against what disease? what organisms

A

CAP (only approved indication)
organisms: atypicals and strep pneumoniae

49
Q

pleuromutilins provide coverage against what MDROs?

A

MRSA
VRE

50
Q

aminoglycosides are used in synergy to treat what?

A

complicated UTI (typically combined with zosyn)

51
Q

what agent is used to treat drug-resistant TB?

A

streptomycin

52
Q

what agent is used in inhaled form to treat pneumonia in CF?

A

tobramycin

53
Q

which agent may have utility in treatment of UTI caused by CRE?

A

plazomicin

54
Q

tetracyclines are combined with beta-lactams for the treatment of what?

A

monotherapy for inpatient CAP

55
Q

doxycycline is DOC for treatment of what infections?

A

tick-borne diseases such as RMSF and lyme disease

56
Q

doxycycline is typically combined with rocephin to treat what?

A

gonococcal infections and C. trachomatis

57
Q

tetracyclines may be used chronically to treat what?

A

acne

58
Q

tetracycline may be used for the treatment and prophylaxis against what organism in some areas?

A

malaria

59
Q

is tigecycline a first-line or last-resort option?

A

last-resort

60
Q

what should tigecycline not be used to treat?

A

bacteremia (it distributes extensively into the tissues)

61
Q

macrolides are used in combination with beta-lactams to treat what?

A

CAP

62
Q

macrolides are used in HIV/AIDS patients for treatment/prevention of what?

A

MAC infection

63
Q

which macrolide is used to treat H. pylori?

A

clarithromycin

64
Q

which macrolide is used off label to stimulate GI motility?

A

erythromycin

65
Q

which macrolide is used for COPD exacerbations d/t a combined antibacterial and anti-inflammatory effect?

A

erythromycin

66
Q

what is used as an alternative to treat multiple infections when a patient has a penicillin allergy?

A

clindamycin

67
Q

topical clindamycin may be used for what?

A

acne

68
Q

clindamycin is used to treat what staph and strep coverage?

A

skin infectioins

69
Q

clindamycin is used to suppress toxin production in what syndrome? what organisms?

A

toxic shock syndrome
organisms: staph or group A strep

70
Q

oxazolidinones is primarily used to treat what type of infections?

A

MDROs such as MRSA and VRE

71
Q

is chloramphenicol commonly used?

A

no its a last line option

72
Q

what is pleuromutilins only label indication?

A

CAP

73
Q

what agent has a BBW for C. difficile infection, and is the highest risk CDI causing antibiotic?

A

clindamycin

74
Q

what class can cause nephrotoxicity and ototoxicity (BBW)?

A

aminoglycoside

75
Q

is aminoglycoside nephrotoxicity reversible or irreversible?

A

reversible

76
Q

is aminoglycoside ototoxicity reversible or irreversible?

A

irreversible

77
Q

what class has a BBW for fetal harm?

A

aminoglycoside

78
Q

what agent has a BBW for increased all-cause mortality?

A

tigecycline

79
Q

what agent has a BBW for potentially fatal blood dyscrasias (Gray Baby Syndrome)?

A

chloramphenicol

80
Q

what class can cause esophageal irritation? counseling points?

A

tetracycline
take with full glass of water and food
sit/stand upright for 30 min after taking

81
Q

what agent may cause arthralgias and myalgias?

A

quinupristin/dalfopristin

82
Q

what agent is associated with hepatotoxicity and pancreatitis?

A

tigecycline

83
Q

what agent can potential cause DILE?

A

minocycline

84
Q

what class can cause photosensitivity?

A

tetracycline

85
Q

what agent can cause phlebitis? what do you flush lines with?

A

quinupristin/dalfopristin

86
Q

what classes may cause QTc prolongation? except maybe what agent, which is generally well tolerated?

A

macrolides and lefamulin
except azithromycin

87
Q

what agent may cause severe hematologic (myelosuppression) and neurologic toxicities? when are these especially at risk?

A

linezolid
if the agent is used for more than 14 days

88
Q

who is at higher risk for aminoglycoside-associated nephrotoxicity?

A

Pre-existing renal impairment
Concomitant nephrotoxic medications
Advanced age
Dehydration

89
Q

who should avoid tetracycline agents? Why?

A

Children – accumulation may occur in the teeth (permanently discolor) and long bones (stunt growth)

Pregnant/breastfeeding – stunt skeletal development

90
Q

which class can chelate with multi-valent cations? what will this due to absorption?

A

tetracyclines
decrease absorption

91
Q

what agent may cause serotonin syndrome? what agents should you avoid co-adminstering?

A

linezolid
MAOIs

92
Q

what other class of antimicrobial may tetracyclines antagonize?

A

penicillins

93
Q

which macrolides are a potent CYP3A4 inhibitor? what agents can’t you give with these?

A

clarithromycin
erythromycin

cant:
simvastatin
lovastatin
amiodarone

94
Q

do aminoglycosides require renal adjustment?

A

yes

95
Q

which tetracycline requires renal adjustment?

A

tetracycline

96
Q

does tigecycline require renal adjustment?

A

no

97
Q

which macrolide requires renal adjustment?

A

clarithromycin

98
Q

does clindamycin require renal adjustment?

A

no

99
Q

do the oxazolidinones require renal adjustment?

A

no

100
Q

does Synercid require renal adjustment?

A

no

101
Q

does chloramphenicol require renal adjustment?

A

no

102
Q

does lefamulin require renal adjustment?

A

no

103
Q

does lefamulin require hepatic adjustment?

A

yes, child pugh C

104
Q

which antimicrobials have activity against pseudomonas?

A

Amikacin
Gentamicin
Tobramycin
Plazomicin

105
Q

which antimicrobials have activity against MRSA?

A

Doxycycline
Minocycline
Omadacycline
Tigecycline
Clindamycin
Linezolid
Tedizolid
Quinupristin/dalfopristin
Lefamulin

106
Q

which antimicrobials have activity against VRE?

A

Doxycycline
Tigecycline
Linezolid
Tedizolid
Quinupristin/dalfopristin
Lefamulin

ID Exam 3 (2 decks)

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