Antibiotics (Final Exam-Spring Semester) Flashcards Preview

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Flashcards in Antibiotics (Final Exam-Spring Semester) Deck (30):
1

For what pathogens would you want to use synergy (two abx together)?

Enterococcus endocarditis or bacteremia

Sepsis

Pseudomonal infections

2

What is PAE and what drug is an example of this?

Post Antibiotic Effect - organism growth is suppressed for a period of time after drug concentration falls below MIC

Aminogylcosides --> why they are dosed once daily!

3

What are the two types of antibiotic resistance?

Intrinsic and Acquired

Intrinsic: naturally occuring
Acquired: normally sensitive organism becomes resistant

4

What is staphylococcus' resistance pattern and what drugs will not treat it?

They produce beta-lactamase

Don't use penicillins
(Can use penicillinase-resistant PCN)

5

MRSA resistance pattern and what drugs cannot be used to tx?

Alterations in penicillin binding protein

Can't use any penicillins, cephalosporins, some fluroquinolones

6

Strep resistance pattern and what drugs cannot be used to tx?

Alterations in binding sites

Penicillins and macrolides

7

Enterococcus resistance pattern and what drugs cannot be used to tx?

Alterations in target site

Vancomycin

8

Pseudomonas resistance patterna nd what drugs cannot be used to tx?

Reduced permeability and Beta lactamase production (which is not inhibited by b-lactamase inhibitors)

PCN, cephalosporin, carbepenems, aminoglycosides, fluroquinolones

9

Advantages of oral administration of abx?

Dec. cost
Patient's prefer it
Reduce exposure to pathogens via IV site
Increases pt motility
Potential for early discharge
Decreases personnel time

10

MOA of beta lactams

Bind to penicillin binding proteins and inhibit cell wall synthesis --> cell death

11

What are the 4 penicillins?

1. Natural penicillins
2. Aminopenicillins
3. Penicillinase Resistant Penicillins
4. Extended spectrum penicillins

12

Cephalexin and Cefazolin are what generation cephalosporins?

1st generation

13

Cefuroxime and Cefoxitin are what generation cephalosporins?

2nd generation

14

Cefpodoxime and ceftriaxone are what generation cephalosporins?

3rd generation

15

Cefepime is what generation cephalosporin?

4th generation

16

Ceftaroline is what generation cephalosporin?

Newer generation

17

You are giving penicillins to a patient. What drug interactions must you worry about?

Probenicid

It decreases renal tubular secretion of PCN causing inc. serum levels

18

What should you warn a patient of when prescribing a 2nd generation penicillin?

GI upset or diarrhea...especially if giving amox/clavulanate

19

Name the types of antibiotics that work to inhibit penicillin binding protein to inhibit cell wall synthesis and therefore promote cell death

Penicillins
Cephalosporins
Monobactams (Aztreonam)
Carbapenems

20

If a patient is allergic to PCN (a true allergic reaction) then what antibiotics should be avoided?

Penicillin
Cephalosporins
Carbapenems

21

You are treating a patient with vancomycin IV. Their labs come back and the culture shows vancomycin resistant enterococci. Would you switch this patient to a different antibiotic? If so, which one?

Daptomycin

22

What are the two abx that can be used to tx VRSA?

Newer gen. cephalosporin --> ceftaroline (IV)

Daptomycin

23

Your patient shows symptoms consistent w/ cellulitis. What tx do you initially give?

Penicillinase resistant PCN
- Docloxacillin
- Oxacillin (IV)
- Nafcillin (IV)

24

A patient comes to the ER with community acquired pneumonia and also states that they stop breathing when given penicillin. What is a good drug choice to treat this patient?

Macrolide...I would use azithromycin

25

Which abx bind to the 30S ribosomal subunit and therefore inhibit protein synthesis leading to cell death?

Tetracyclines
Aminoglycosides

26

Which abx bind to the 50S ribosomal subunit and therefore inhibit protein synthesis leading to cell death?

Macrolides
Clindamycin

27

What is the first line tx for CA-MRSA?

Sulfamethoxazole/Trimethoprom (Bactrim)

28

What are some options in treating uncomplicated UTIs

Bactrim
Nitrofurantoin
Fluoroquinolone (Cipro, Levo, Oflo, Norf,) .....NOT Moxifloxacin

29

What are some options in treating complicated UTIs

Bactrim
Fluoroquinolones (Ciprofloxacin, Ofloxacin, Norfloxacin, Levofloxacin)

30

ED is a 68 year old man who presents to your pharmacy with a prescription for azithromycin for community acquired pneumonia. He tells you that he currently takes lisinopril because “his kidneys were starting to not work as well”. He also takes warfarin for his atrial fibrillation. Is azithromycin an appropriate treatment option in this patient?

Yes, azithromycin is appropriate

However, this pt will need to be closely monitored d/t his warfarin.
Azithromycin doesn't need to be renally adjusted

Consider adding beta-lactam d/t his renal dysfunction (amoxicillin or amoxicillin-clavulanate)