Abx for GI

Question 1

Flourorquinolones

Answer 1

Ciprofloxacin

Levofloxacin

Question 2

Trimethoprim-sulfamethoxazole

Answer 2

bactrim

Question 3

antiprotozoals

Answer 3

metronidazole

Question 4

others

Answer 4

Vancomycin

Question 5

inflammatory diarrhea

Answer 5

Hx- fever, tenesmus, dysentery

confirmed by fecal leukocytes or fecal lactoferrin

Question 6

other testing

Answer 6

bloody diarrhea ->shiga toxin and EHEC
bloddy diarrhea w/travel Hx -> Entamoeba histolytica
recent ingestion of shellfish -> vibrio
hospitalized -> C. diff

Question 7

mild-moderate dehydration

Answer 7

oral rehydration therapy (ORT) superior to IV

has glucose, sodium, potassium, chloride, and water

Question 8

when should you Tx w/Abx

Answer 8

shigellosis
travelers diarrheas when severe or bloody
C. diff
Campylobacteriosis
persistent diarrhea

Question 9

travelers diarrhea

Answer 9

fluoroquinolone
Rfaximin for NIEC
quinilone resistent campylobacter in S. Asia -> azithromycin

Question 10

C. diff

Answer 10

discontinue offending Abx
metronidazole (PO or IV)
if fails or severe infection vacno PO only

Question 11

glycopeptides

Answer 11

vanco

Question 12

vanco spectrum

Answer 12

broad farm pos

all gram neg and mycobacteria resistant

Question 13

vanco adverse effects

Answer 13

macular skin rash, chills, fever, rash
red man syndromeL extreme flushing, tachycardia, hypotension
ototoxic and nephrotoxic

Question 14

vanco MOA

Answer 14

inhibits cell wall synthesis

Question 15

fluoroquinolones MOA

Answer 15

targets bacterial DNA gyrase and topoisomerase IV

Question 16

fluoroquinolones adverse effects

Answer 16

GI
CNS (HA, dizzy, rare hallucinations)
rash
photosensitive
achilles tendon rupture in kids

Question 17

aminoglycosides MOA

Answer 17

binds 30S

Question 18

aminoglycosides adverse rxns

Answer 18

ototoxic and nephrotoxic

neuromuscular block and apnea

Question 19

tetracyclines MOA

Answer 19

binds 30S

Question 20

tetracyclines adverse effects

Answer 20

GI
C. diff
photosensitive
teeth discoloration
thrombophlebitis

Question 21

macrolides MOA

Answer 21

binds reversibly to 50S

Question 22

macrolides

Answer 22

azythromycin, erythromycin

Question 23

macrolides adverse effects

Answer 23

GI
hepatotoxic
arrhythmia
OT prolongation

Question 24

bactrim MOA

Answer 24

inhibits dihyropteroate synthase and dihydrofolate reductase

Question 25

bactrim adverse effects

Answer 25

allergic skin rashes, GI, HA, depression, photosensitive, renal dysfunction, stevens-Johnson syndrome potentiates warfarin

Question 26

when is Tx w/Abx CI

Answer 26

EHEC (shigga-like toxin) | salmonella

Question 27

EHEC

Answer 27

aka STEC abx may increase production/release of toxin abx may increase hemolytic-uremic syndrome

Question 28

salmonella

Answer 28

abx may increase fecal shedding of pathogen | exception if patient immunocompromised to prevent bacteremia

Question 29

idoquinol MOA

Answer 29

unknown | only effective for luminal organisms

Question 30

indoquinol uses

Answer 30

adjunct to metronidazole for amebiasis

Question 31

indoquinol ADRs

Answer 31

infrequent GI, HA, rash, pruitis, taken w/food increase serum iodine (CI in iodine allergies) use with caution with optic neuropathy, renal or thyroid disease, or nonamebic hepatic disease

Question 32

nitazoxanide MOA

Answer 32

inhibits pyruvate-ferredoxin oxireductase pathway

Question 33

Nitrazoxanide uses

Answer 33

cryptosporidium alternative to metronidazole in giardia metronidazole resistant protozoa

Question 34

paromomycin

Answer 34

aminoglycoside 30S, but only luminal acute and chronic intestinal amebiasis cryptospordium

Question 35

paromomycin ADRs

Answer 35

occasional GI | accumulate in renal insufficiency

Question 36

albendazole

Answer 36

broad spectrum anti-helminthic

Question 37

albendazole MOA

Answer 37

inhibits microtubules synthesis

Question 38

albendazole PK

Answer 38

taken with fatty meal or tissue parasite, but on empty stomach for GI parasite

Question 39

rifaximin uses

Answer 39

luminal only prevention of hepatic encephalopathy travelers diarrhea cased by NIEC IBS, and C. diff

Question 40

fidaxomicin

Answer 40

macrolide inhibits RNA polymerase used for C. diff

Question 41

fidaxomicin ADRs

Answer 41

GI | hypersensitivity rxns