Antimicrobials

Question 0

community acquired pneumonia

• pathogens
• drugs

Answer 0

strep pneumo
- ceftriaxone

mycoplasma pneumoniae
- azithromycin (or doxy)

legionella
- azithromycin (or doxy)

Question 1

bacterial meningitis

• pathogens
• drugs

Answer 1

strep pneumo, neisseria meningitidis
- vancomycin + ceftriaxone

listeria
- ampicillin

rickettsia, ehrlichia
- doxycycline

Question 2

aspiration pneumonia (community acquired)

• pathogens
• drugs

Answer 2

oral anaerobes

- clindamycin (or ampicillin/sulbactam)

Question 3

bacteremia

• pathogens
• drugs

Answer 3

s. aureus
- nafcillin

MRSA
- vancomycin or dapto or linezolid

Question 4

endocarditis

• pathogens
• drugs

Answer 4

s aureus
- nafcillin

MRSA
- vancomycin or daptomycin (don’t use linezolid b/c it’s bacteriostatic)

streptococcal (strep pneumo)
- PCN G

enterococcus
- ampicillin + gentamicin

• so pt w/ endocarditis gets vancomycin + gentamicin

Question 5

toxic shock syndrome

• pathogens
• drugs

Answer 5

s. pyogenes

- clindamycin + PCN G

Question 6

necrotizing fasciitis

• pathogens
• drugs

Answer 6

s. pyogenes

- clindamycin + PCN G

Question 7

pharyngitis

• pathogens
• drugs

Answer 7

s. pyogenes

- PCN

Question 8

cystitis

• pathogens
• drugs

Answer 8

e. coli

- TMP/SXT (or nitrofurantoin if pregnant)

Question 9

pyelonephritis

• pathogens
• drugs

Answer 9

GNR
- gentamicin

Enterococcus
- ampicillin

Question 10

pseudomonas

Answer 10

aminoglycoside + ceftazidime

Question 11

intraabdominal/pelvic infections

• pathogens
• drugs

Answer 11

GNR
- gentamicin

anaerobes
- metronidazole

enterococcus
- ampicillin

Question 12

Syphilis

Answer 12

benzathine PCN IM

or

aqueous PCN G IV if neurosyph

Question 13

n. gonorrhea

Answer 13

ceftriaxone

Question 14

chlamydia trachomatis

Answer 14

azithromycin

Question 15

otitis media

• pathogens
• drugs

Answer 15

s. pneumo, h. flu

- amoxicillin

Question 16

sinusitis

• pathogens
• drugs

Answer 16

s. pneumo, h. flu

- amoxicillin

Question 17

outpatient cellulitis

• pathogens
• drugs

Answer 17

s aureus, GAS
- cephalexin or dicloxacillin or clindamycin

MRSA
- TMP/SXT

Question 18

inpatient cellulitis

• pathogens
• drugs

Answer 18

MRSA

- vancomycin

Question 19

diabetic lower extremity infxn

• pathogens
• drugs

Answer 19

aerobes and anaerobes

- vancomycin + ceftazidime (GN, pseudomonas) + metronidazole

Question 20

beta lactams

• examples
• ADRs

Answer 20

penicillins, cephalosporins, carbapenems

• anaphylaxis
• rashes
• NVD
• interstitial nephritis
• high dose/prolonged: BM suppression

Question 21

aminoglycosides

• examples
• ADRs

Answer 21

gentamycin, neomycin, amikacin, tobramycin, streptomycin

• nephrotoxic
• neuromuscular blockade
• ototoxicity
• teratogenic

Question 22

quinolones

• examples
• ADRs

Answer 22

ciprofloxacin, levafloxacin

• nausea
• CNS effects (hallucinations, confusion, seizures)
• QT prolongation
• tendon rupture, arthropathy
• photosensitivity
• hyper/hypo glycemia

Question 23

carbapenem ADRs

Answer 23

causes seizures

- avoid in CNS pathology, seizure disorders, renal failure

Question 24

vancomycin ADRs

Answer 24

- red man syndrome - phlebitis - rash - BM suppression - ototoxicity - nephrotoxicity

Question 25

macrolides - examples - ADRs

Answer 25

erythromycin, azithromycin, clarithromycin - NVD - QT prolongation - incr LFTs

Question 26

clindamycin ADRs

Answer 26

diarrhea, rash

Question 27

metronidazole ADRs

Answer 27

- antabuse rxn - peripheral neuropathy - ataxia

Question 28

TMP/SMX ADRs

Answer 28

- rash - BM supp - incr creat

Question 29

doxycycline ADRs

Answer 29

- photosensitivity rash - incr LFTs - pill esophagitis

Question 30

linezolid ADRs

Answer 30

- drug intxns (serotonin syndrome) - BM supp (WBC, plt) - lactic acidosis - retinopathy

Question 31

daptomycin ADRs

Answer 31

- incr creatinine kinase - myopathy - incr LFTs

Question 32

synercid (quinupristin/dalfopristin) ADRs

Answer 32

- incr LFTs - myalgias - arthralgias

Question 33

drugs to avoid in pregnancy

Answer 33

``` doxy dapto tetracycline tigecycline quinolones ```

Question 34

drugs to use in pregnancy

Answer 34

``` beta lactams (PCNs, cephalosporins, carbapenems) macrolides (azithromycin, erythromycin) ```

Question 35

MRSA pneumonia

Answer 35

Vancomycin or Linezolid (don't use dapto because broken down by surfactant in lungs)

Question 36

IV line infection - pathogens - drugs

Answer 36

Coag negative staph (s. Epi) | - vancomycin