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Pharmacology > Q1 Abx > Flashcards

Q1 Abx Flashcards

1
Q

HNPEK stands for?
They are Gram ____ organizms

A

Hemophilis
Nysteria
Proteus
E-coli
Klebsiela

Gram NEGATIVE

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2
Q

VRE stands for?
Gram _____ organisms

A

Vanc resistant Enterococus
Gram POSITIVE

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3
Q

Antibiotic selection is made based on what 4 categories?

A

Infection site (and therefore likely organism)
Antibiotic characteristics
Patient characteristics
Treatment guidelines

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4
Q

What type of organisms are usually found in the oral site?

A

Gram-POS bacteria (usually streptococcus) and candida

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5
Q

What type of organisms are usually found on the skin and introduced through vascular access?

A

GPos and Gneg usually staphylococcus and candida

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6
Q

what type of organism is typically found in the intra-abdominal site

A

Gram NEG (usuallly Enterobacteriacae
And Gram POS usually Enterococcus
Candida

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7
Q

What type of bacteria is found in the urinary site typically introduced through catheters?

A

Gram Neg Psuedomonas and Enterobacteriacase
Gram POS E-coli
Candida

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8
Q

What organisms are found in respiratory tract (ventilator associated)

A

Gram neg pseudomonas, acinetobacter, enterobacteriacae
Gram pos staphylococcus
Fungi - candida and aspergillus.

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9
Q

2 main categories of abx based on excretion

A

Hydrophilic (Beta-lactate, aminoglycosides, Vanc, Daptomycin, Polymyxins)
Lipophilic (Quinolones, Macrolides, Rifampin, Linezolid, Tetracycline)

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10
Q

Characteristics of hydrophilic abx

A

Small Vd -> less tissue penetration
Most renally eliminated
Not active against atypical pathogens because of low intracellular concentration
Poor-moderate bioavailability

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11
Q

Characteristics of lipophilic abx

A

Large Vd -> better tissue penetration
Hepatically metabolized
Many DDIs
High Intracellular concentration so effective against atypical pathogens
Excellent bioavailability (IV:PO ratio is or close to 1:1)

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12
Q

Even though quinolones are lipophilic, they still require ______

A

Renal dose adjustments

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13
Q

If the term CYP (“sip”) is used in relation with a medication, what does this mean?

A

It is an enzyme in the liver that helps to clear/eliminate medications.

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14
Q

5 main classes of antibiotics based on __________

A

How they affect the target cell.

Cell-Wall Inhibitors
Folic Acid Synthesis Inhibitors
DNA/RNA inhibitors
Cell Membrane Inhibitors
Protein Synthesis Inhibitors

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15
Q

Beta-Lactams, Monobactams and Vanc are _______ kind of abx

A

Cell wall inhibitors

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16
Q

Aminoglycosides, Macrolides, Tetracyclines, Clindamycin, Linezolid are all _______

A

Protein Synthesis Inhibitors

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17
Q

Polymixins, Daptomycin, Telvancin and Oritavancin are all _______

A

Cell Membrane inhibitors

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18
Q

Quinolones (-floxacin), Metronidazole, Tinidazole and Rifampin are all ______

A

DNA/RNA inhibitors

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19
Q

Sulfonamides, Trimethoprim and dapsone are all _________

A

Folic Acid Synthesis inhibitors.

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20
Q

Penicillins, cephalosporins and carbapenems are ________ abx

A

Beta-Lactam Antibiotics

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21
Q

How do BLs work?

A

Inhibit bacterial cell wall synthesis by binding to Penicillin binding Proteins (PBPs)

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22
Q

GPos aerobe organisms

A

MRSA, MSSA, S Pneumoniae, Streptococcus viridans group, Enterococcus (not VRE)

MMSSE

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23
Q

GNeg aerobe organisms

A

HNPEK, CAPES, pseudomonas

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24
Q

Anaerobic organisms

A

Gram pos (mouth flora)
Gram negative (bactericides fragilis)

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25
Q

Atypical organisms

A

Chlamydia, legionella, mycoplasma

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26
Q

What abx are preferred for SSTI, bone and joint, endocarditis and bloodstream infections caused by MSSA?

A

Antistaphylococcal PCNs
Dicloxacillin, Nafcillin, Oxacillin

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27
Q

What does CAPES stand for?

A

Citrobacter, Acinetobacter, Provedencia, Enterobacter cloacae, Serratia spp

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28
Q

What is the most broad PCN and what does it cover?

A

Pip/Tazo (Zosyn)
HNPEK/CAPES and Psuedomonas

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29
Q

What do PCNs NOT cover?

A

MRSA and atypicals

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30
Q

DOC for otitis media?

A

Amoxicillin or augmentin

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31
Q

DOC for Bacterial sinusitis

A

Augmentin

32
Q

DOC for Infective endocarditis PROPHY

A

Amoxicillin

33
Q

DOC for dental procedure prophy?

A

Amox

34
Q

DOC for Pseudomonas

A

Zosyn

35
Q

DOC for syphilis

A

PCN G Benzathine (Bicillin L-A)

36
Q

Box warnings and contraindications for PCNs

A

Bicillin L-A - not for IV use.
Renal dosage in CrCl <30

37
Q

PCN drug interactions

A

Warfarin - PCNs inhibits the anti coagulation effects - may need increased warfarin dosing while on abx.
Methotrexate - serum concentration increased while PCNs.

38
Q

What do cephalosporins NOT cover?

A

Enterococus and atypicals

39
Q

DOC for MRSA?

A

Ceftaroline

40
Q

DOC for surgical prophy?

A

Cefazolin (1st gen)
GI surgery - cefotetan and cefoxitin (2nd gen)

41
Q

DOC for CAP

A

Cefuroxime (2nd gen)

42
Q

DOC for meningitis, pyelo?

A

Ceftriaxone, cefotaxime (3rd gen)

43
Q

DOC for PseudoMonas?

A

CefatazidiMe + CefepiMe

44
Q

What patient pop are cephalosporins contraindicated in?

A

Neonates.

45
Q

Box warnings and SEs of Cephalosporins

A

Do not use with IV Ca products.
Cross-reactivity with PCN allergies
Renally dose as appropriate
Separate from antacids by 2 hrs.

46
Q

What is a side effect of Cefotetan use?

A

Alcohol can cause a disulfiram-like reaction.

47
Q

What do carbapenems NOT cover?

A

MRSA, VRE, atypical pathogens or C-Diff.

48
Q

What does ErtAPenem NOT cover?

A

EAP
Enterococcus
Acinetobacter
Pseudomonas.

49
Q

Carbapenems are reserved for

A

MDR gram NEG infections and polymicrobial infections

50
Q

Box warning for carbapenem DIs

A

Any drugs used to prevent seizure (esp Valporic acid) - carbepenems may lower seizure threshold by lowering medication concentration.

51
Q

Monobactam (Aztreonam) cover all _________

A

Gram Neg including pseudomonas and CAPES (and HNPEK)

52
Q

Aztreonam is typically used when _______ is present

A

Beta-lactate allergy.

53
Q

What does Vanc cover? What type of abx is it?

A

Gram POS
NOT VRE

Cell-wall inhibitor

54
Q

Warnings for Vanc?

A

Can be nephrotoxic/ototoxic.

55
Q

What type of abx is SMX/TMP? DOC for?

A

Folic Acid Synthesis inhibitor
MRSA (2nd line), recurrent UTI

56
Q

SMX/TMP DIs?

A

Warfarin, methotrexate, ACE, ARB, NSAIDS, K-sparing diruetics.

57
Q

What are the 2 examples of DNA/RNA inhibitors?

A

Flouroquinolones and Metronidazole

58
Q

DOC for respiratory gram pos bacteria and atypical pathogens?

A

Levofloxacin and moxifloxacin (s. Pneumoniae)

59
Q

What flouroquinolone does not require renal adjustment?

A

Moxifloxacin

60
Q

What is a boxed warning for flouroquinolones?
DIs?

A

Tendon inflammation or rupture.

QT prolongations, warfarin, Glucose control agents

61
Q

1st line for MRSA?

A

VANC

62
Q

Could Moxifloxacin be used to treat UTIs?

A

No - it’s not renally cleared.

63
Q

Why is Daptomycin not used for pneumonia?

A

Inhibited by lung surfactant

64
Q

Daptomycin used to treat

A

MRSA, VRE, SSTI and S. Aureus blood stream infections, R -sided endocarditis

65
Q

Boxed warnings with Daptomycin

A

Muscle toxicity and increased risk for rhabdo especially with concurrent statin use.
Can falsely elevate PT/INR.

66
Q

Aminoglycosides are typically used ________

A

In conjunction with another therapy (not as a mono therapy)

67
Q

What are some examples of Aminoglycosides

A

Gentamicin Tobramycin and Amikacin, streptomycin.

68
Q

What are some examples of Macrolides?

A

Azithromycin, clarithromycin, erythromycin.

69
Q

Macrolides spectrum covers:

A

Atypicals (legionella, chlamydia, mycoplasma Dan mycobacterium and harmonious.

70
Q

Macrolides are used to treat

A

CAP, COPD exacerbations, chlamydia, h. Pylori and gastropareiss

71
Q

What abx is a good option for patients with renal impairment that need a Macrolides?

A

Azithromycin - not renally cleared.

72
Q

Box warning for Macrolides

A

Hepatotoxic, QT prolongation, increased risk for rhabdo with statins.

73
Q

Abx used for rickettsia, anthracite, treponema paliduum (syphilis), tickbourne illnesses.

A

Doxycycline/mini cycling (tetracyclines)

74
Q

Why are tetracyclines contraindicated in children <8yrs old and pregnancy/breastfeeding?

A

Suppresses bone and MSK growth/development.

75
Q

Linezolid is a type of ________ abx.
DI with ______

A

Protein synthesis Inhibitors.
MAOIs and oral hypoglycemics

76
Q

Metronidazole is a type of ________ abx and covers________

A

Protein synthesis inhibitor
Anaerobes.

77
Q

Drug of choice in uncomplicated UTIs

A

Nitrofurantoin.

Pharmacology (20 decks)

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