Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm I > Surgical Prophylaxis > Flashcards

Surgical Prophylaxis Flashcards

1
Q

Risk factors for VRE (vancomycin-resistant enterococci)

A 
Concomitant diseases
Immunosuppression
ICU admission
Previous intraabdominal or cardiothoracic surgery
Indwelling catheters
Prolonged course of abx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

IDSA guidelines of preadministration of abx

A

Within 60 mins of incision; FQs and vanc should begin within 120 mins of incision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Duration of prophylaxis

A

New recommendations short course of post-operative course of abx
Majority of post-op abx course must complete within 24 hrs of anesthesia close time
Cardiothoracic x 48 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Cefazolin in obesity

A

Dosing shown in obese pts to lead to more SSIs for surgical prophylaxis
2 gms for pts >80 kg
3 gms for pts >120 kg
PK/PD data conflicting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Bacterial colonization with MRSA

A

Presence of bacteria on a body surface without causing an infection- colonization
Long-lasting
Pt with MRSA colonization has increased risk for MRSA infections
MRSA carriers also serve as reservoirs for future transmission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

IDSA guidelines for MRSA colonization

A

Vanc + abx of choice for procedure should be used for institutions that have a high prevalence of MRSA SSIs and for pts who are known to be colonized with MRSA and/or have a hx of a MRSA infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Urologic preop

A

E. coli
First line: FQ (levofloxacin 500 mg IV/po) x 1 dose
Allergy: Aminoglycoside (gentamicin 5 mg/kg) with or without clindamycin (900 mg) IV x 1 dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Colorectal (enteric gm-neg bacilli and anaerobes) preop

A

First line: ceftriaxone 2 gm IV x 1 dose + metronidazole 500 mg IV x 1 dose or ertapenem 1 gm IV x 1 dose
Ceftriaxone preferred over ertapenem
Beta-lactam allergy: Clindamycin 900 mg IV + aminoglycoside (gentamicin 5 mg/kg) IV OR
Metronidazole 500 mg IV + aminoglycoside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Colorectal postop

A 
Ceftriaxone and Ertapenem (no postop)
Metronidazole 500 mg IV q8h x 24 hrs
Duration: Preop single dose or <24 hrs
Ceftriaxone is preferred over Ertapenem
Flagyl causes a reaction with EtOH (disulfuram)- not even mouthwash or cough syrup
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Neuro preop

A

S. aureus
First line: Cefazolin 2 gms (>80 kg) IV x 1 dose
Beta-lactam allergy: Vanc (15 mg/kg) OR
Clindamycin 900 mg IV x 1 dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Gyn postop

A

Cefazolin 2 gms IV q8h x 24 hrs

Duration: <24 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Beta-lactams MOA

A

Inhibits bacterial cell wall synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

SEs of beta-lactams

A

Anaphylaxis, hives, pseudomembranous colitis, seizures (rare)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Examples of beta-lactams

A

Pen G
Nafcillin/Oxacillin
Ampicillin/sulbactam (beta-lactamase inhibitor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Indication for beta-lactams

A

Streptococci
Enterococcus
S. aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Cephalosporins MOA

A

Inhibits bacterial cell wall synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

SEs of cephalosporins

A

Skin rash
Diarrhea
Leukopenia

18
Q

Aminoglycosides MOA

A

Interferes with bacterial protein synthesis by binding to 30s and 50s ribosomal subunits

19
Q

SEs of aminoglycosides

A

Renal function, hearing impairment, ataxia, confusion, and C. difficile-associated diarrhea

20
Q

Examples of aminoglycosides

A

Gentamicin
Tobramycin
Amikacin

21
Q

Vancomycin MOA

A

Inhibits bacterial cell wall synthesis

22
Q

SEs of vancomycin

A

Associated with nephrotoxicity, Red Man Syndrome (histamine release)

23
Q

Pharmacokinetic monitoring of vancomycin

A

Peaks and troughs

24
Q

Indication of Vancomycin

A

Gram + (including methicillin resistant)

25
Q

FQs MOA

A

Inhibits DNA gyrase, promoting the breakage of DNA strands

26
Q

SEs of FQs

A

Associated with N/V, potential to prolong the QT interval, potential to produce hypoglycemia (elderly) tendon inflammation/rupture

27
Q

Examples of FQs

A

Levofloxacin
Ciprofloxacin
Moxifloxacin

28
Q

Indication for FQs

A

Broad-spectrum gram pos and gram neg +/- anaerobes, +/- pseudomonas

29
Q

Dosing of abx

A

Lipophilic drugs- use ABW

Hydrophilic drugs- use IBW

30
Q

Cardiac/thoracic preop

A

S. aureus
First line: Cefazolin 2 gms (>80 kg) IV x 1 dose
Beta-lactam allergy: Vanc 15 mg/kg or Clinda 900 mg x 1 dose

31
Q

Cardiac/thoracic postop

A

First line: Cefazolin 1 gm or 2 gms IV q8h < 24 hrs

Cardiac Thoracic surgery: 48 hrs

32
Q

Cardiac/thoracic hx of MRSA, colonization, and/or suspected MRSA

A

Add Vancomycin 15 mg/kg IV q12h x 24 hrs plus the abx of choice
Intranasal mupirocin
-Cardiac surgery high rate of S. aureus infection and increased MRSA infection
-Preoperative eradication

33
Q

Ortho preop

A

S. aureus
First line: Cefazolin 2 gms (>80 kg) IV x 1 dose
Beta-lactam allergy: Vanc 15 mg/kg or Clinda 900 mg IV x 1 dose

34
Q

Ortho postop

A

First line: Cefazolin 1 gm or 2 gms IV q8h < 24 hrs

35
Q

Ortho hx of MRSA, colonization, and/ or suspected MRSA

A

Add Vanc 15 mg/kg IV q12h x 24 hrs + the abx of choice

36
Q

Ortho antimicrobial-laden bone cement for hips/knees

A

FDA approved premixed aminoglycoside bone cement for use in hip, knee, and other joint in second-stage revision
Not approved in prophylaxis in primary joint replacement in US

37
Q

Urologic postop

A

No FQ

Gentamicin 5 mg/kg IV x 1 additional dose with or without clindamycin 900 mg IV q8hrs < 24 hrs

38
Q

FQ resistance with urologic

A

Increased resistance to E. coli
Increased risk of tendonitis and tendon rupture (not first-line in peds)
Peripheral neuropathy which may be permanent

39
Q

Mechanical bowel prep (MBP)

A

Neomycin (1 gm) + erythromycin (1 gm) OR

Neomycin (1 gm) + Metronidazole (1 gm) x 3 doses 10 hrs the afternoon or evening before surgery

40
Q

Neuro postop

A

Cefazolin 1 gm or 2 gms IV q8h <24 hrs

41
Q

Gyn preop

A

Enteric Gm neg bacilli, anaerobes, group B strep, enterococci
First line: Cefazolin 2 gms (>80 kg) IV x 1 dose
Second line: Cefotetan IV OR Cefoxitin IV OR ampicillin-sulbactam IV
Beta-lactam allergy: Clinda 900 mg IV x 1 dose OR Vanc 15 mg/kg IV x 1 dose + aminoglycoside OR aztreonam OR FQ

Pharm I (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions