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Pharm facts
Pharm facts from Dr. Elliott
| Question | Answer |
|---|---|
| Beta-lactams | penicillins, cephalosporins, carbepenams, monobactams |
| Penicillins not recommended | as monotherapy for infectinos of eye, prostate, CNS (except meningitis) |
| Cephalosporins 1st gen activity | Gram (+) with small Gram (-) activity |
| Cephalosporins 2nd gen activity | inc. Gram (-) activity |
| Cephalosporins 3rd gen activity | Gram (-) activity with small Gram (+) |
| Cephalosporins Cross-sensitivity | ≤5% pts with penicillin allergy BUT better safe (literature says 10%) |
| Macrolides in respiratory | generally good for respiratory infections |
| Azithromycin macrolide drug-drug interaction | doesn't inhibit P-450 |
| Erythromycin macrolide coverage & interactions | Similar antibacterial coverage as PenG, Inhibits cytochrome P450 & causes MANY drug-drug interactions |
| Adverse effects among macrolides | nausea, vomiting, diarrhea, upset stomach, gastric distress |
| Clindamycin MOA | 50S ribosome inhibits bacterial protein synthesis |
| UTI | Sulfonamides used primarily for UTI (FORCE oral fluids to prevent cystalluria) |
| DON'T use in G6PD | sulfonamides (hemolyze & become anemic) |
| TMP/SMX | trimethoprim sulfamethoxazole (tx & prophylaxis for P. jiroveci) |
| Respiratory infection prevelance | major cause of morbidity from acute illness in US & top 3-5 reason for pt visits |
| To dx uncomplicated LRI | Hx, PE, CXR, sputum smear/culture |
| Quinolones in LRI | sometimes useful but inc. resistance |
| Dec. bioaviability in floroquinolones | Divalent &/or trivalent cations dec. oral bioavailability of fluoroquinolones |
| Tetracyclines tx what? | clamydophylial, brucellosis, mycoplasma pneumonia, rickettsial, or Lyme |
| Tetacyclines category in pregnancy | Category D in pregnancy |
| Tetracyclines CI | in chidlren <8yo |
| CAP | S. pneumoniae |
| HAP | S. areaus & gram (-) |
| Aspiration pneumoniae | anaerobic bacteria |