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Clinical Pharmacology II > Antibiotic Questions > Flashcards

Antibiotic Questions Flashcards

1
Q

Which antibiotics must you monitor LFTs with?

A

2nd gen cephs
3rd gen cephs
Monobactams

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2
Q

What monitoring occurs with Glycopeptides?

A

IV Vancomycin concentrations

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3
Q

What do you need to monitor with Bactrim use?

A

SCr
BUN
K+ when initiating with other drugs known to cause hyperkalemia

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4
Q

What do you need to monitor with Aminoglycosides?

A

peaks and troughs

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5
Q

What links peptidoglycan together to form the cell walls of bacteria?

A

Penicillin binding protein

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6
Q

What is the MOA of betalactams?

A

inhibits the cross linking of peptioglycan by inhibiting PBP

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7
Q

What are the 4 different classes of Betalactams?

A

Penicillins
Cephalosporins
Monobactam
Carbapenems

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8
Q

Are betalactams bacteristatic or bactericidal?

A

Bactericidal

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9
Q

What PKPD parameters do betalactams have?

A

Time>MIC; low dose, high frequency

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10
Q

What do all members of the betalactams group have?

A

a 4 member ring

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11
Q

How do the members of the betalactam group differ?

A

The side ring that is attached to the main ring

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12
Q

What side ring does Penicillins have?

A

5 member ring

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13
Q

What side ring does Cephalosporins have?

A

6 membered ring

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14
Q

What side ring does Monolactams have?

A

no side ring

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15
Q

What side ring does Carbapanems have?

A

five membered ring

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16
Q

What is penicillinase/betalactamase?

A

enzymes created by the bacteria to destroy betalactams

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17
Q

What does Oxacillin cause?

A

liver damage

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18
Q

What does Ticarcillin cause?

A

bleeding

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19
Q

What is the trend of Cephalosporins?

A

as you continue through the generations, they GAIN Gram neg. coverage but LOSE Gram pos. coverage

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20
Q

What do Cephalosporings not cover?

A

Enterococcus

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21
Q

Which carbapenem has a DDI with valproic acid?

A

Meropenem

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22
Q

Which carbapenem is formulated to protect the kidneys?

A

Imipenem/Cilastatin

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23
Q

Which carbapenem doesn’t have coverage for pseudomonas?

A

Ertapenem

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24
Q

What is monobactams niche?

A

doesn’t have cross reactivty with allergies to penicillins, cephs, or carbapenems so it can be used in patients with allergies to them

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25
Q

What are the culprits for allergic reactions?

A

the side chains of betalactams

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26
Q

What is the best option if a patient has an allergy to a betalactam?

A

Use a higher generation cephalosporin

27
Q

What generation cephalosporin should you use if patient has allergy to betalactam?

A

2nd gen. or higher

28
Q

What is a test dose?

A

1/10th of the full dose

29
Q

What should you do if the patient has a rash reaction to betalactams?

A

Give FULL DOSE of 3rd gen. ceph or higher

Give TEST DOSE of 1st/2nd gen. ceph

30
Q

What should you do if the patient has a hives or anaphylaxis reaction to betalactams?

A

Give TEST DOSE of 3rd gen. ceph or higher

31
Q

What do you do if a patient needs a 1st/2nd gen. ceph and has hives or anaphylaxis?

A

desensitize them by giving the patient 1 millionth of a dose then increasing that dose 10 fold every 30 minutes until you reach the full dose

If patient has a reaction, give them benadryl but DON”T STOP the process

32
Q

What type of Vancomycin is used to treat C. Diff?

A

PO

33
Q

What are the doses of Vancomycin rounded to?

A

250 mg

34
Q

What must you do for IV Vancomycin?

A

check random and trough concentrations

35
Q

What is the target of IV Vancomycin for MRSA infections

A

Troughs 15-20 mcg/mL

36
Q

What is the target of IV Vancomycin for Non-MRSA infections?

A

Troughs 10-20 mcg/mL

37
Q

What is the trough?

A

The time before next dose when the drug concentration is lowest in the body

38
Q

Which tetracyclines should not be used in children under the age of 8 because of risk of vestibular toxicity?

A

Tetracycline

Doxycycline

39
Q

Which class of drugs must you avoid using in elderly and children due to risk of tendinopathies and delirium?

A

Fluoroquinolones

40
Q

Which macrolides are CYP inhibitors?

A

Clarithromycin

Erythromycin

41
Q

Which drug must be taken with food in order to decrease GI upset?

A

Clindamycin

42
Q

Which drug causes C. diff infection?

A

Clindamycin

43
Q

Which drug is used to treat C. diff from Clindamycin use?

A

Metronidazole

44
Q

Which drug can a patient NOT drink alcohol on?

A

Metronidazole

45
Q

Which drug is the DOC for anaerobes?

A

Metronidazole

46
Q

Which drugs are most often used in synergy to treat endocarditis and ophthalmic and otic solutions?

A

Aminoglycosides

47
Q

What must you monitor with aminoglycoside dosing?

A

peaks and troughs

48
Q

What is extended interval dosing for aminoglycoside dosing?

A

high dose, long interval

maximizes peak concentrations

random level determines frequency

49
Q

What patients can you NOT use extended interval dosing in?

A

patients with AKI, at risk for kidney injury or those with HD, or those using for synergy

50
Q

What is conventional dosing for aminoglycoside dosing?

A

smaller doses, dosed more frequently

based on renal function

using for synergy

monitor peaks and troughs

51
Q

What patients can you use conventional dosing in?

A

those with AKI, at risk for kidney injury, or on HD

52
Q

What is the monitoring level for Amikacin?

A 
Peaks = 20-30
Troughs = <5
53
Q

What is the monitoring level for Gentamicin?

A 
Peaks = 6-8
Troughs = <1
54
Q

What is the monitoring level for Gentamicin in synergy?

A 
Peaks = 3-4
Troughs = <1
55
Q

What is the monitoring level for Tobramycin?

A 
Peaks = 6-8
Troughs = <1
56
Q

Which drug do you avoid use in patients with CrCl <50?

A

Nitrofurantoin

57
Q

Which drugs only treat UTI’s?

A

Nitrofurantoin

Fosfomycin

58
Q

Which drug has DDIs with SSRI’s, TCA’s, and MOAI?

A

Oxazolidinones

59
Q

Which drug cannot be used to treat Pneumonia?

A

Daptomycin

60
Q

Which drug is used for refractory C. diff only?

A

Fidaxomicin

61
Q

Which drug can decrease the effectiveness of oral contraceptives?

A

Rifampin

62
Q

What do antibiotics cause?

A

yeast infections

diarrhea

63
Q

What can antibiotics predispose patients to developing?

A

C. diff

Clinical Pharmacology II (25 decks)

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