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Antiinfective
Antiinfective questions
| Question | Answer |
|---|---|
| Aminoglycosides and Fluoroquinolones are cidal or static? What about Macrolides? | Amino/Fluoro are cidal while macros are static |
| MOA of aminoglycosides? what type of gram infections are they used for? | binding to 30s and 50s causing defect in bacterial membrane; serious gram - infxn |
| How are aminoglycosides eliminated? What are there ADRs? do they cross BBB? are they time or conc dependent? | eliminated via glomerular filtration; watch for oto and nephrotoxicity; they do cross BBB; conc-dependent |
| What are the target serum troughs for these aminoglycosides: amikacin, gentamicin, tobramycin, and netromycin? | amikacin <8mcg/mL; Gent/tobra,netro <2mcg/mL |
| What class does Amphotericin B belong to? What premedication is needed? What is it mixed with (NS/D5W)? | Antifungal; premed 30-60mins w/ NSAID or APAP w/orw/out benadryl or hydrocortisone; mix with sterile H2O and D5W |
| What is the MOA of azoles? What is Itraconazole CI in? What is max dose of Itraconazole? | interfer w/ P450 and decrease ergosterol synthesis thus inhibiting cell membrane fxn; CHF pts; 200mg BID |
| What two antiviral inhibit both influenza A & B neuraminidases? | zanamivir(relenza) and Oseltamivir (Tamiflu) |
| Antiinfluenza drugs should be initiated within this period? Amantadine should be avoided in this patient population? | within 48 hrs of initial sx and cntinued for 7 to 10 days. Avoid in pts with sz. |
| ARDs of Amantadine, Rimantadine, Zanamivir, Oseltamivir? | GI (N/V/D), CNS dysfxn (dizziness, nervousness, confusion, slurred speech, blurred vision. sleep disturbances), with Zana (Upper respiratory sx) |
| What is the prophylaxis dosing of Tamiflu? | 75mg QD x 7 days, shuld begin within 2 days of contact w/ infected person |
| What is the TREATMENT dosing for Tamiflu? | 75mg BID x 5 days begin within 2 days of onset of SYMPTOMS |
| Name 3 antiviral agents commonly used for Herpes? How are these drugs eliminated? | Acyclovir, famciclovir, Valacyclovir; Renally thus dose adjust |
| What antifungals can be used to treat Aspergillus and which one can't be? | CAVI: Caspofungin, Amphotericin B, Voriconazole, Itraconazole; Can not use ketoconazole!! |
| What is DOC for Chlamydia? | doxycycline 100mg x 7days, 1gm single dose of Azithromycin, Erythromycin in Pg |
| Tetracyclines and quinolones are CI in these patients? | Pg and Children (tetra: yellow teeth; PO quinolones: >18 yrs due to cartilage growth suppression) |
| What kind of bacteria is C. Difficile (gram/shape)? What is DOC? Alternative? | Gram + anaerobic rob....DOC is metronidazole...Alt: Vancomycin |
| These drugs can be used to treat this Gram + bacterial infxn: PCN, ampicillin, vancomycin, linezolid, aminoglycosides, chloramphenicol, streptomycin, bactrim | Enterococcus faecalis |
| Enterococcus faecalis can not be treated with ...? | Clindamycin and cephalosporins |
| DOC for E. coli? | cefazolin, cephalixin, cefotaxime, gentamicin |
| MOA of quinolones? | inhibit bacterial DNA topoisomemrase and disrupt bcterial DNA replication |
| Important ADRs of quinolones? | QT prolongation, crystalluria, TENDON RUPTURE, CARTILAGE GROWTH SUPPRESSION in < 18yrs old |
| Drug used to treat Gonorrhea? | 3rd gen. Cepha. cefixime, ceftriaxone, cefpodoxime |
| Vacomycin, PCN, and Cephalosporins MOA is to inhibit....? | cell wall synthesis |
| DOC for Legionella pneumophilia? Alternative? | Azithro, Clarithro,Erythro;;;; Rifampin, cipro, levo |
| Clindamycin coverage? BBB y/n? ARDs? | covers gram +/- anaerobe and gram + aerobic; doesn't cross BBB; can cause diarrhea and pseudomembranous colitis by C. Difficlie |
| Lyme's Disease is a tick borne illness what is the DOC and dosage? | Doxcycline 100 mg bid, amoxicillin 500mg tid, cefuroxime 500mg bid for 14-21 days |
| Macrolides inhibit this CYP except for this macrolide? | All inhibit 3A4 except Azithromycin |
| Onychomycosis if the infection of the nail by fungi (dermatophytes, candida, molds)...What is the 3 antifungal agents used to tx and there dosage? | Fluconazole: 300mg po wkly x 6 months; Itraconazole 200mg bid x 1 wk per month for 2 months for finger and 3-4 months for toes; Terbinafine 250mg qd x 3 months |
| UTI(pyelonephritis) is caused by E. Coli. What is the DOC? What if a pt has a sulfa allergy? | bactrim, fluroquinolones (cipro), ampicillin + gentamicin; sulfa allergy use FQ but not in children. |
| What are ADRs of tetracyclines? Should be avoided with these? Good to use in this pt population? | Esophagitis, photosensitivity, ;; Aviod Cations;; use in renal impairment pts since it is eliminated via non-renal route |
| What is the common therapy for TB? How long is it? | inital therap involves RIPE (rifampin,INH, pyrazinamide, ethambutol)... then may go to RIP and then RI for 6 to 18 months |
| INH can cause this deficiency which lead to this side effect thus you should supplement with this! What is the tx if INH resistant strain? | vitamine B6 deficiency which leads to peripheral neuropathy thus add-on B6(pyridoxine) to INH therapy; use RP |
| DOC for Staphylococcus aureus? What if pt has PCN allergy? | dicloxacillin, nafcillin, oxacillin; PCN allergy then erythro, clinda, TCN, linezolid, synercid, vanco |
| What is the only sodium sulfa salt suitable for ophthalmic use? | sulfacetamide sodium |
| Bactrim ADRs? eliminated via? metabolized via? | SJS, crystalluria (drink water to prevent 2-3L/day);;; Renally;;; acetylation |
| pseudomonas is an aerobic, gram - bacillus which can be treated with? | Antipseudomonal PCN (mezlocillin, piperacillin, carbenicillin, ticarcillin); Ceftazidime, cefepim +aminoglycoside; Quinolone + imipenem |
| P. acne DOC? | clindamycin, erythromycin, tetracycline |
| Drugs that are lst line for treatment of otitis media: | ampicillin, amoxicillin, 2nd gen. ceph (cefaclor, cefuroxime, cefprozil) |
| If a patient has recurrent otitis media what should be used? If Augmentin is used how should it be dosed? | ZITHROMAX, biaxin, bactrim; Augmentin (> 3 months, < 40 kg) 90mg/kg/day divided q 12 x 10 days |
| What antifungal is effective for asergillosis, histoplasmosis and blastomycosis? | Itraconazole |
| When there is an acyclovir resistant strain what drug can be given? | Foscarnet |
| Are fluroquinolones time or conc dependent? do they have a post ABX effect? What is there coverage? | Conc dependent, have post ABX effect, gram +/- aerobic and atypical coverage |
| What is used to treat rocky mountian fever and Ehrlichiosis? | doxy 100mg bid |
| Erythromycin coverage? SE? conversion from EES to base? What can the IV be mixed in? | gram - and atypicals; GI upset; EES 400mg = 250mg base; NS |
| When is Azithromycin CI? | patient < 6 months |
| What happens to WBC, proteins, and glucose during meningitis? What is the tx? | increase in WBC and proteins and decrease in glucose; aminoglycosides, 3rd gen Ceph and vancomycin |
| What are the bacteria invovled in CAP? tx of choice? | H. flu, Staph aureus, Mycoplasma pneum. ; tx with Macrolides |
| For systemic fungal infectin use? | Fluconazole or AmphoB |
| Which Ceph should be take w/ food to increase absorption? w/out food? | cefuroxime (2nd), cefpodoxime (3rd), ceditoren(3rd); Loracarbef(2nd) |
| Which 3 2nd gen ceph cross BBB? name 4 3rd/4th gen ceph cross BBB? | cefotetan, cefoxitin, cefmetazole; ceftriaxone, ceftizoxime, cefotaxime, cefepime |
| Name cephs that have NMTT chain? | Cefotetan, cefmetazole, cefamandole; cefoperazone, moxalactam |
| Ceph with activity against gonorrhea | ceftriaxone, cefpodoxime, cefixime (all 3rd gen) |
| Cephs with Pseudomonas acitivity? | cefoperazone, ceftazidime, cefepime |
| Name ceph with biliary sludge as an AE? with serum sickness? Which cephs do not have to be renal adjusted? | ceftriaxone;cefaclor; cefoperazone, ceftriaxone |
| Which one cause more sz imipenem or meropenem? Which penem doesn't have Pseudomonas activity? | Imipenem; Ertapenem |
| Metronidazole is the DOC for these bacteria? does it penetrate BBB? it's ADR? DI? | trichomoniasis, B. frag, BV, C. diff; penetrates BBB, metallic taste, nausea, neutropenia (rev); EtOH, warfarin, red urine due to azo metabolite |
| What is Vanco coverage? it's ADRs? trough level? | MRSA, gram +, C. diff; ototoxic , nephro, red mans due to infusion rate (max 500mg/30min); 10mg/dL |
| Linezolid coverage? what is it's ADRs? | MRSA/VRE; thrombocytopenia and is a weak MOA inhibitor thus serotion syndrome |
| Daptomycin is used for what? should not be used for what? ADR? | use for bacteremia, don't use for pneumonia due to surfactant in the product; myopathy risk |
| Telithromycin ADR? CI? | hepatoxicity, QT prolongation, GI, blurred vision; myasthenia gravis |
Created by:
bhumz
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