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ID ch 22
seminar
| Question | Answer |
|---|---|
| which ones are the gram-positive clusters | staphylococcus spp |
| what is the gram stain for MRSA/MSSA | gram-positive clusters |
| gram-positive diplococci | streptococcus pneumoniae |
| listeria and coynebacterium are what? | gram-positive rods |
| gram-negative coccobacilli? | acinetobacter baumanni bordetella pertussis moraxella catarrhalis |
| which antibiotics are folic acid inhibitors? | sulfonamides, trimethoprim, dapsone |
| What is the MOA of Dapsone? | folic acid synthesis inhibitors |
| what abx are the cell wall inhibitors? | Beta-lactams (penicillins, cephalosporins, carbapenems), monobactams (aztreonam), vancomycin,dalbavancin, oritavancin, telvancin |
| What is the MOA of ceftriaxone? | cell wall inhibitors |
| what is the MOA of vancomycin | cell wall inhibitors |
| who are the protein synthesis inhibitors? | aminoglycosides, macrolides, tetracyclines, clindamycin, linezolid, tedizolid |
| what abx are the cell membrane inhibitors | polymyxins, daptomycin, telvancin, oritavancin |
| Oritavancin and telavancin have 2 MOAs, what are they? | cell wall and cell membrane inhibitors |
| who are the DNA/RNA inhibitors? | quinolones (DNA, gyrase, topoisomerase) metronidazole,tinidazole, rifampin |
| A patient is on metronidazole, what is the MOA of this drug? | DNA/RNA inhibitors |
| A pt is on gentamicin, what is the MOA? | protein synthesis inhibitors |
| Doxycycline and Azithromycin have the same MOA, what is it? | protein synthesis inhibitors |
| What are the aminopenicillins that have a history of cholestatic jaundice or hepatic dysfunction associated with previous use? | augmentin and unasyn |
| What is the CrCI cut off for using amox/clav ER or the 875mg strength? | 30 |
| what is the first-line treatment for pharyngitis ("strep throat")? | Penicillin VK |
| what is the DOC for infective endocarditis prophylaxis before dental procedure? | Amoxicillin 2g PO x 1 |
| What are the first-line treatments for acute otitis media? | amoxicillin or amox/clav |
| cefuroxime is what generation? | second |
| cefoxitin is what generation? | second |
| which cephalosporin can cause a disulfiram-like reaction with alcohol ingestion? | cefotetan |
| what is the CI of ceftriaxone? | hyperbilirubinemic neonates (causes biliary sludfing, kernicterus) |
| what generation is ceftazidime? | third |
| what is a patient is experiencing acute otitis media and has a PCN allergy so can't do amox? | cefdinir |
| can you use a carbapenem on a patient who has a penicillin allergy? | no |
| which carbapenem has the highest seizure risk? | imipenem/cilastatin |
| Ertapenem must be diluted in what? | NS |
| what are the boxed warnings to aminoglycosides? | nephrotoxicity, ototoxicity, neuromuscular blockade, fetal harm if given in pregnancy |
| which 2 are the respiratory quinolones? | levo and moxifloxacin |
| which 2 FQ cover PSA | cipro and levofloxacin |
| Which FQ has anerobic coverage and can be used for intra-abdominal infections? | moxifloxacin |
| what are the boxed warnings for FQ? | Tendon inflammation/rupture, peripheral neuropathy, CNS effects, and avoid with myasthenia gravis |
| what is the CI to using ciprofloxacin? | concurrent administration of tizanidine |
| what is the IV:PO ratio for levofloxacin and moxifloxacin? | 1:1 |
| Should you avoid FQ in patients with a seizure history or if using antiseizure medications? | yes |
| Which macrolides requires renal dose adjustment? | clarithromycin |
| what is the CI of using clarithromycin? | concurrent use with colchicine in patients with renal or hepatic impairment |
| what 2 macrolides should you NOT use with simvastatin or lovastatin? | clarithromycin and erythromycin |
| can all macrolides be used an alternatives to pharyngitis? | yes |
| which macrolide increases gastric motility and is used in gastroparesis? | Erythromycin |
| Which drug has a warning for drug induced lupus erythematosus? | Minocycline |
| what is the CI to all macrolides? | cholestatic jaundice/hepatic dysfunction with prior use |
| what are the warnings to using bactrim? | blood dyscrasias, hemolytic anemia, hypoglycemia, thrombocytopenia, pregnancy (congenital defects) |
| what are the side effects to using bactrim? | photosensitivity, increases K, crystalluria, anorexia, skin rash, decreases folate, false elevation in SCr, renal failure |
| what drug is given to a patient to decrease the therapeutic effects of bactrim? | leucovorin |
| what is the boxed warning of telavancin? | fetal risk and nephrotoxicity |
| what is the CI to telavancin? | concurrent use of IV UFH |
| what are the warnings to using linezolid? | duration-related myelosuppression (thrombocytopenia), anemia, leukopenia, peripheral and optic neuropathy, serotonin syndrome, hypoglycemia, hyponatremia, seizures, lactic acidosis |
| what is the BW to tigecycline? | Increased risk of death |
| Warning to tigecycline? | anaphylaxis - avoid with tetracycline class allergy due to similar structure |
| Which abx do you NOT use for bloodstream infections? | tigecycline |
| what is the BW to polymyxin B | dose-dependent nephrotoxicity, neurotoxicity, and respiratory paralysis from neuromuscular blockade |
| what are the CI to metronidazole? | pregnancy (1st trimester), alcohol |
| What drug has a warning for vulvovaginal candidiasis? | secnidazole (solosec) |
| Fidaxomicin and rifaximin are not effective for what? | systemic infections |
| Which drug is used off-label for C.diff? | rifaximin |
| what is the CI to using ceftriaxone? | hyperbilirubinemic neonates (causes biliary sludging, kernicterus) and concurrent use with calcium-containing IV products in neonates |
| which 2nd generation abx causes disulfiram-like reactions with alcohol ingestion? | cefotetan |
| what do you monitor with cephalosporins? | renal functions |
| which cephaloporin is available in a chewable tablet? | cefixime (suprax) |
| which cephalosporin has activity against some carbapenem-resistant enterobacterales (CRE) | ceftazidime/avibactam |
| what happens when ceftriaxone is administered in the same line as calcium-containing IV fluids? | insoluble precipitates |
| which cephalosporins should be separated by 2 hours from short-acting antacids? | cefuroxime, cefpodoxime, and cefdinir |
| can you use H2RAs and PPIs with cefuroxime, cefpodoxime, and cefdinir? | no they should be avoided |
| what is the common use for cefazoline? | surgical prophylaxis |
| what is the common use of cephalexin? | MSSA, strep throat |
| what is the common use for cefotetan and cefoxitin? | B,frag and surgical prophylaxis (GI procedures) |
| what is the common use for ceftaroline | CAP, SSTI |
| can you use a carbapenem on a patient with penicilling allergy? | no |
| with what carbapenem is there a higher risk of seizures? | imipenem/cilastin |
| what do you monitor if a patient is on a carbapenem? | renal function |
| Ertapenem is stable in what solution only? | NS |
| carbapenems can decrease what drugs concentration? | valproic acid which leads to a loss of seizure control |
| what organisms do carbapenems NOT cover? | Atypicals, VRE, MRSA, C.diff, stenotrophomonas |
| does aztreonam have positive or anaerobic activity? | no |
| Can you use aztreonam on a patient with a penicillin allergy? | yes |
| what is the brand name of aztreonam that is inhaled and used for cystic fibrosis? | cayston |
| what do you monitor on a patient who is on an aminoglycoside? | drug levels, renal function |
| MOA of quinolones: | inhibit bacterial DNA topoisomerase IV and DNA gyrase (topoisomerase II) |
| what type of antibacterial activity do the quinolones have? | concentration-dependent |
| which quinolones are the respiratory quinolones: | levofloxacin and moxifloxacin |
| which quinolones have coverage against PSA | levofloxacin and ciprofloxacin |
| which quinolone covers MRSA and is the preferred quinolone if treating skin infections that are suspected to be caused by MRSA | delafloxacin |
| what are the BOXED WARNINGS to quinolones | Tendom inflammation and/or rupture, peripheral neuropathy, seizures, avoid with myasthenia gravis |
| what is the CI of using ciprofloxacin? | concurrent administration of tizanidine |
| what are the warnings to using a quinolone | QT prolongation, hypo and hyperglycemia, psychiatric disturbances, avoid systemic quinolone in children, pregnancy, breastfeeding, and photosensitivty |
| can you put ciprofloxacin oral suspension through an NG tube or other feeding tube? | no |
| can you use moxifloxacin for UTI | no, it doesn't concentrate in the urine |
| which quinolone has no renal dose adjustments? | moxifloxacin |
| which phosphate binders can decrease the serum concentration of oral quinolones: | lanthanum carbonate and sevelamer |
| what drug does quinolone increase the effect of? | warfarin, sulfonylureas, insulin, and other hypoglycemic drugs |
| which drugs can increase quinolone levels? | probenecid and NSAIDs |
| since ciprofloxacin is a strong CYP1A2 inhibitor what drugs can it increase the levels of? | caffeine, theophylline, and tizanidine |
| which quinolones are 1:1? | levofloxacin and moxifloxacin |
| what is a CI to using clarithromycin and erythromycin? | do not use with lovastatin or simvastatin |
| which macrolide is the only one that requires renal dose adjustment | clarithromycin |
| which tetracycline does NOT require renal dose adjustments | doxycycline |
| what is the IV:PO ratio for doxycycline and minocycline? | 1:1 |
| which tetracycline has a warning for DILE | minocycline |
| how long before linezolid causes thrombocytopenia | if you use more than 14 days |
| how long before linezolid causes optic neuropathy | >28 days |
| why is chloramphenicol barely used? | causes gray syndrome |
| what is the warning on fidaxomicin | not effective for systemic infections |
| which antibiotic is used off-label for C.diff | rifaximin |
| what is mupirocin nasal ointment used for? | eliminate MRSA colonization of the nares |
| which liquid oral antimicrobials require refrigeration? | Pen VK and Augmentin |
| do not refrigerate | cefdinir |
| which IV medications do you not refrigerate | metronidazole, moxifloxacin, and bactrim |
Created by:
KaHerre12