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CPR 2 Exam 2 > Wolff cardiopulm infection - crossword > Flashcards

Wolff cardiopulm infection - crossword Flashcards

1
Q

notable among the “cefs” for being ~only agent eliminated by the liver rather than the kidneys

A

ceftriaxone

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2
Q

common reason for adding vancomycin or linezolid to pneumonia, both during empiric therapy and lab-guided therapy; ceftaroline also has activity

A

MRSA

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3
Q

4th gen cephalosporin meaning it has greater gram negative outer membrane penetration, active against psudomonas

A

Cefepime

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4
Q

macrolide-like with 15-aom ring, does not block cytochrome P450 and has unusual pharmacokinetics in that a single dose becomes concentrated in cells, especially phagocytes, and is then solwly released at bacteriostatic levels over several days to give it a half-life of 3-4 days

A

Azithromycin

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5
Q

Risk of this is increased by some cephalosporins

A

Bleeding

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6
Q

Neuraminidase inhibitor effective against influenza A and B, administered IV and having a longer half-life, it can reduce the severity and duration of the flu by 1-2 days if administered within 48 hrs

A

Peramivir

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7
Q

3rd gen fluoroquinolone, “respiratory” activity but also useful against Pseudomonas

A

Levofloxacin

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8
Q

Important consideration when toxic drugs requiring monitoring are administered IV over short periods of time (30 min); in the case of gentamicin with irreversible effects on bacterial ribosomes, the concentration needs to be high enough to reliably exert those effects but then low enough as indicated by this to allow for the toxic drugs to exit the host cells (eg proximal tubules, vestibulocochlear hair cells) where they can exert deleterious effects

A

Trough

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9
Q

Overgrowth of this anaerobe can occur in GI tract when broad spectrum abx are administered, leads to severe diarrhea, can be a major problem in healthcare facilities, and has a worrisome mortality rate

A

C. difficile

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10
Q

Characterized as an extended spectrum penicillin because of its activity against P. aeruginosa, used in both CAP and HAP when pseudomonas is a concern

A

Piperacillin

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11
Q

An orally active and inexpensive ergosterol synthesis inhibitor, and drug of choice for yeast infections; has no activity against molds

A

Fluconazole

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12
Q

Aminoglycoside used to treat community-acquired pneumonia in hospitalized pts with severe beta-lactam allergy and in those who acquired pneumonia in hospital (eg VAP or HAP) when there is concern for multi-drug resistant gram-positive and/or gram-negative infections

A

Gentamicin

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13
Q

Gram-positive cause of endocarditis more commonly than cause of pneumonia, vancomycin is indicated if the endocarditis does not respond to beta-lactams

A

Enterococcus

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14
Q

A penicillin-binding protein drug notable for having useful activity only against gram-negative aerobic pathogens including Pseudomonas; a monobactam held in reserve for treating more serious infections such as HAP and VAP

A

Aztreonam

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15
Q

A 4th gen “respiratory” fluoroquinolone

A

Gemifloxacin

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16
Q

Crucial bacterial enzyme preferentially blocked by 1st and 2nd gen fluoroquinolones and is arguably the main target that makes fluoroquinolones active against susceptible gram-negative infections

A

DNA gyrase

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17
Q

Acronym for the multidrug resistant bacterial of greatest concern, members are responsible for ~80% of ventilator-associated pneumonia

A 
ESKAPE
E. coli
Staphylococcus pseudintermedis/schleiferi/aureus
Klebsiella Pneumonia
Acinetobacter Baumannii
Psuedomonas Aeruginosa
Enterococcus Faecalis/Faecium
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18
Q

minimum number of drugs required to treat multi-drug resistant TB

A

Five

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19
Q

Getting the annual version of this vaccine is the best protection against the virus

A

Influenza

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20
Q

Among the respiratory pathogens for which there is no preventative therapy

A

Adenovirus

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21
Q

An orally administered 2nd gen cephalosporin

A

Cefaclor

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22
Q

Development of a candida infection here

A

Prosthetic valve

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23
Q

Notable among the 3rd gen cephalosporins for having activity against Pseudomonas

A

Ceftazidime

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24
Q

Can rupture during fluoroquinolone therapy, especially in the young, old, and in others who subject them to significant stress

A

Tendons

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25
Q

Also exhibited by erythromycin, further extends its spectrum of potential drug interactions

A

P Glycoprotein

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26
Q

Used in first-line treatment cocktail for active TB and sometimes for tx of latent TB

A

Rifampin

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27
Q

Negatively impacted in the weight-bearing joints of immature animals by fluoroquinolones, the potential for damage to it is a reason to avoid fluoroquinolones in children if possible but case-by-case benefits may outweigh risks

A

cartilage

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28
Q

Prototype of recent echinocandin antifungal drug class, it weakens fungal cell walls by blocking glucan crosslinking

A

Caspofungin

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29
Q

Well-known adverse effect of aminoglycosides, can be exacerbated by other drugs such as furosemide

A

Ototoxicity

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30
Q

Refers to multi-drug resistant strains of enterococcus that will still hopefully respond to linezolid

A

VRE (vancomycin-resistant enterococci)

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31
Q

5th gen cephalosporin, spectrum much like 3rd gen with addition of activity against MRSA

A

Ceftaroline

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32
Q

In addition to rare but serious CNS adverse effects including psychosis, seizures, and memory loss, levofloxacin has a black box warning due to its potential exacerbation of _______

A

Myasthenia Gravis

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33
Q

Principal cause of tricuspid valve endocarditis, creates a population of patients that is especially challenging to treat

A

Injection drug use

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34
Q

Well known adverse effect of tetracyclines, but fluoroquinolones and voriconazole are among other agents that also cause this

A

Photosensitivity

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35
Q

Drug class preferred for addition to beta-lactam antibiotic for treating community acquired pneumonia

A

Macrolide

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36
Q

Syndrome caused by infusing vancomycin too fast, generally does not cause hypotension, shortness of breath, etc but draws attention

A

Redman

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37
Q

Metabolizes a number of abx and many other drugs which therefore predisposes to many unwanted drug interactions

A

CYP3A4

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38
Q

characteristic of Mycobacterium tuberculosis growth that makes it hard to kill

A

slow

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39
Q

Ideal status of respiratory fluoroquinolones in the treatment of CAP

A

Reserve
generally more effective than tetracyclines or macrolides for pneumonia, but
should be reserved to minimize appearance of tolerance
– use is discouraged in ambulatory patients with CAP unless:
• comorbid conditions
• recent antimicrobial use
• high prevalence of high-level macrolide-resistant S. pneumoniae in the local community
– fluoroquinolones continue to be given, often inappropriately, for CAP

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40
Q

Acronym used for nosocomial pneumonia; ie, that acquired in hospital where multiresistant strains of microbes are more prevalent and the leading cause of infection-related death in hospital

A

HAP

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41
Q

Orally administered 1st gen cephalosporin, this class has better gram-positive activity than 2nd gen

A

Cephalexin

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42
Q

Organ adversely affected to varying degrees by many abx drugs including macrolides, fluoroquinolones, azole antifungals and several anti-tuberculosis agents

A

Liver

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43
Q

Ergosterol synthesis inhibitor with activity against aspergillus, blastomycoses, and histoplasmosis along with other fungal infections, has a black box warning due to its negative inotropic effects that can precipitate/worsen heart failure

A

Itraconazole

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44
Q

Can occur in topoisomerases to render them insensitive to fluoroquinolones, a reason abx stewardship is so important for this class of drugs

A

Mutations

45
Q

Among the safest abx, allergic reactions are the biggest problems

A

Penicillins

46
Q

Orally-administered penicillin, an agent of choice for CAP and multiple other infections

A

Amoxicillin

47
Q

Enzyme inhibited by linezolid, responsible for rather unusual adverse effects for and abx including serotonin syndrome

A

MAO - monoamine oxidase

48
Q

Susceptible to treatment by newer agents posaconazole and isavuconazole but not to voriconazole

A

Mucormycosis

49
Q

Has high affinity for ergosterol leading to pore formation in fungal cell membrane, standard treatment for many severe invasive fungal infections but multiple significant adverse effects

A

Amphotericin b

50
Q

At least 4 ____ must pass with daily drug administration for most endocarditis treatment regimens

A

weeks

51
Q

Initial indication was for its antiviral activity against influenza A (not B), no longer recommended but likely to still show up in textbooks; now used primarily to treat Parkinson disease

A

Amantadine

52
Q

S. pneumoniae vaccine administered to newborns at 2, 4, 6 and 12-15 mo, and sometimes to those >age 65

A

Prevnar 13

53
Q

Among the “biggest guns,” stable against beta-lactamases and having a wide spectrum of gram-positive and gram-negative activity, abx stewardship dictates that it is kept in reserve for use against microbes cannot be killed with narrower spectrum abx (ie, microbes that are multi-drug resistant)

A

Imipenem

54
Q

MRSA and metronidazole-resistant C. difficile infections are reasons to use this abx, but IV and orally, respectively

A

Vancomycin

55
Q

Well known adverse effect of aminoglycosides, can be exacerbated by other drugs

A

Nephrotoxicity

56
Q

Not a substitute for vaccination, this generally well-tolerated antiviral with activity against influenza A and B exerts its effects by blocking an ednonuclease that is required for the viral gene transcription

A

Baloxavir

57
Q

Inhaled neuraminidase inhibitor that can hasten recovery from flu if administered within 48 h of symptom onset

A

Zanamivir

58
Q

Lacking in mammalian cells but constructed from peptidoglycan in bacteria, the crosslinking component of its synthesis is blocked by beta-lactam abx making it essential for their efficacy

A

cell wall

59
Q

Should not be consumed with tetracycline drugs because of precipitates that form in the GI tract and disrupt drug absorption

A

Milk

60
Q

Common invasive fungal mold infection, especially in neutropenic patients where it can manifest as fever, chest pain, shortness of breath, etc. OR just fever with imaging evidence of pulmonary nodules? can cause a chronic slowly progressive pulmonary disease with pulmonary infiltrates and cavities

A

Aspergillus

61
Q

Name given to bacterial pulmonary infections that develop secondary to viral infections or when there is an overgrowth of selected bacteria that are not susceptible to broad spectrum abx

A

Superinfection

62
Q

AKA penicillinase, clavulanate, tazobactam, and sulbactam are among the agents added to abx therapies to inhibit this

A

beta lactamase

63
Q

Refers to formulation of amphotericin B in which the drug is administered in 100 nm phospholipid vesicles in an effort to minimize its adverse effects

A

Liposomal

64
Q

acronym that means the pneumonia developed after the pt required mechanical ventilation

A

VAP

65
Q

Component of first drug cocktail used to treat active TB and the typical agent used prophylactically in those with latent TB

A

Isonazid

66
Q

Target of multiple drugs with antimicrobial selectivity, also means a cell wall is not required for it to work

A

Protein synthesis

67
Q

Macrolide with less epigastric pain than erythromycin, but does block cytochrome P450

A

Clarythromycin

68
Q

Adding activity against these bacteria is what makes ampicillin and amoxicillin “broad spectrum” penicillins

A

gram-negative

69
Q

This for a cultured bacterial pathogen to abx is determined either by a disk diffusion assay or by 1:2 dilutions of abx in a 96-well plate

A

susceptibility

70
Q

Reason gram-negative cells are gram-negative and serves as a barrier to many abx

A

outer membrane

71
Q

Responsible for the elimination of many abx that often do not undergo metabolism such as beta-lactam abx, for example, as well as some drugs that have undergone metabolism; insufficiency of this organ frequently necessitates changes in drug dosage

A

Kidney

72
Q

A 2nd gen cephalosporin given parenterally and also orally as its “axetil” prodrug

A

Cefuroxime

73
Q

Metabolized to a pyridine analog that disrupts

A

Flucythosine

74
Q

Broad spectrum orally available class of drugs with activity against gram-neg bacteria; current agents now also target gram-pos bacteria

A

Fluoroquinolones

75
Q

Category of abx that generally should not be administered at the same time as bactericidal drugs, but happens when doxycycline and beta-lactams are combined to treat pneumonia

A

Bacteriostatic

76
Q

Macrolide that is a frequent substitution for penicillin can cause epigastric pain and is a “classic” inhibitor of CYP3A4 and p-glycoprotein meaning that it has many drug interactions

A

Erythromycin

77
Q

Refers to micro-organism strains that are resistant to all abx that might otherwise be used against them, so totally reliant on immune system to clear from body

A

Pan-drug-resistant

78
Q

3rd gen cephalosporin administered as a pro-drug that can be used for outpatient therapy of community acquired pneumonia

A

Cefpodoxime

79
Q

Often does not require adjustment for ceftriaxone when there is kidney or liver failure because it undergoes elimination by both organs

A

dosage

80
Q

Orally active and also administered parenterally, this bacterial protein synthesis inhibitor agent is orally active against most gram-pos pathogens including methicillin-resistant staphylococcus and vancomysin-resistant enterococcus

A

Linezolid

81
Q

2nd gen cephalosporin, a cephamycin administered parenterally, not in notes but cephamycins tend to have better activity against anaerobes when compared to other cephalosporins

A

Cefotetan

82
Q

Tetracyclines turn them gray/brown while developing

A

teeth

83
Q

Member of the newer echinocandin class of antifungal agents with excellent activity against invasive yeast infections, it also has few adverse effects especially when compared to amphotericin B

A

Micafungin

84
Q

Careless use of abx here has contibuted to the development of abx resistance

A

Agriculture

85
Q

approaches 100% when aspergillus mold is the cause of endocarditis

A

Mortality

86
Q

infection for which UpToDate recommends monotherapy with voriconazole as the initial therapy

A

Invasive aspergilliosis

87
Q

Was a drug of choice for aspiration pneumonia due to its spectrum of activity that includes most anaerobic bacteria (eg abundant in oral cavity); frequent cause of C. difficile colitis on exam questions

A

Clindamycin

88
Q

Active against aspergillus mold and fluconazole-resistant yeast, this ergosterol synthesis inhibitor has some unique adverse effects for the class including a propensity for causing flashes of light in many at lower doses and visual hallucinations at higher doses

A

Voriconazole

89
Q

Yeast that is the most common fungal cause of endocarditis; initial therapy is liposomal amphotericin B +/- flucytosine or a high does of an echinocandin

A

candida

90
Q

the only route by which fixed-charge drugs such as gentamicin and large abx such as the glycopeptide vancomycin can reach the bloodstream? but can be a convenient/quick route when patients are hospitalized

A

Parenteral

91
Q

Parenteral 1st gen cephalosporin, this class has better gram-pos activity than 2nd gen

A

Cefazolin

92
Q

Type of pneumonia seen more often in the very young, elderly, and - in its more severe forms - those who are immunocompromised

A

viral

93
Q

Beta-lactam-containing abx divided into 5 generations

A

Cephalosporins

94
Q

Component of 1st drug cocktail used to treat active TB, it is the only agent in the cocktail that does not have hepatic injury as a worrisome adverse effect

A

Ethambutol

95
Q

A tetracycline useful in combination with a beta-lactam for CAP in those who cannot tolerate a macrolide, its low pH can cause local damage - esophageal ulceration

A

Doxycycline

96
Q

Refers to a large group of commensal gram-pos streptococci that are alpha-hemolytic, producing a green discoloration on blood agar plates? these critters can cause endocarditis that responds to IV ampicillin of ceftriaxone over 4 weeks unless/until there is abx resistance

A

viridans

97
Q

Arguably the primary target of 3rd and 4th gen fluoroquinolones that expands their coverage to include gram-pos bacteria (makes them “respiratory” fluoroquinolones)?
this enzyme is crucial during bacterial cell division for separating their replicated circular DNA (ie newly replicated rings are cross-linked)

A

Topoisomerase IV

98
Q

Penicillinase-resistant penicillin

A

Nafcillin

99
Q

Used in 1st line tx cocktail for TB, exact mechanism of action is unknown? and is hepatotoxic

A

Pyrazinamide

100
Q

Vaccine against a broader range of S. pneumoniae serotype, but does not elicit a satisfactory immune response in those younger than age 2 yrs? Recommended for those over 65 and younger people who smoke

A

Pneumovax 23

101
Q

Among the 3rd gen abx administered orally to treat community acquired pneumonia, also is among the cephalosporins that increases INR

A

Cefditoren

102
Q

At least 6 of these are required to pass with regular drug administration for successful treatment of TB, contributes to adherence challenges

A

6 months

103
Q

A 4th gen “respiratory” fluoroquinolone

A

Moxifloxacin

104
Q

A pleuromutilin with that unique mechanism of action, its only indication is CAP in patients with normal lung when other drugs are not effective

A

Lefamulin

105
Q

Neuraminidase inhibitor effective against influenza A and B, it can reduce the duration of the flu by 1-2 days if administered within 48 h of the onset of influenza symptoms and be used prophylactically by those exposed to people with the flu

A

Oseltamivir

106
Q

Regularly issues reports on the biggest abx resistance threats and guidelines for abx stewardship

A

CDC

107
Q

Generation of cephalosporins that is especially useful in CAP bc of its wide spectrum against gram-pos and gram-neg bacteria and stability in the presence of beta-lactamases

A

Third

108
Q

Component of mycobacterium tuberculosis cell wall that contributes to their resistance to disinfectants, detergents, common abx, dyes, stains, osmotic lysis, and lethal oxidation?
Queue classic Monty Python line from “Frenchman” at top of the castle

A

Wax

CPR 2 Exam 2 (17 decks)

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