Chapter 186- Systemic and Topical Antibiotics Flashcards

1
Q

First line options for empiric therapy for mild and moderate nonpurulent SSTIs (2)

A

B lactam antibiotics (penicillin &;; cephalosporins)

Clindamycin

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2
Q

Empiric therapy for moderate and severe purulent SSTIs should cover

A

MRSA

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3
Q

Inhibits 50s protein synthesis (4)

A

Lincosamides (clindamycine)
Macrolides
Streptogramins
Oxazolidinones

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4
Q

Mainstay of therapy for SSTIs

A

B lactams

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5
Q

Matching type

  1. Francisella tularensis
  2. HA-MRSA
  3. Bartonella sp.
  4. Pseudomonas aeroginosa
  5. Actinomyces israelii
A. Amino glycosides 
B. Ciprofloxacin
C. Penicillin
D. Streptomycin
E. Vancomycin
A
D
E
A
B
C
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6
Q

Doxycycline can be used for (6)

A
Borrelia burgdorferi, recurrentis
Coxiella burnetti
Ehrlichiosis
Rickettsia
Bacillus anthracis
Chlamydia trachomatis
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7
Q

Azithromycin can be used for (4)

A

Bartonella
Chlamydia trachomatis
Haemophilus ducreyi
Klebsiella granulomatis

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8
Q

Treatment for CA MRSA (5)

A
TMP-SMX
Clindamycin
Doxycyline
Minocycline
Rifampin
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9
Q

Treatment for HA MRSA (9)

A
Vancomycin
Linezolid/Tedizolid
Tigacycline
Daptomycin
Quinopristin + Dalfopristin
Ceftarolinr
Ontovancin/Dalbovancin
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10
Q

Pencillin can be used for (5)

A
Erysipelothrix rhusiopathiae
Pasteurella multocida
Streptococcus pyogenes
Treponema pallidum
Actinomyces israelli
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11
Q

Treatment for Vibrio vulnificus

A

Doxycycline + Ceftazidime

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12
Q

Treatment for Clostridum perfringens

A

Penicillin + clindamycin

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13
Q

Matching type

  1. Natural
  2. Extended spectrum
  3. Aminopenicillin
  4. B lactamase resistant penicillin

A. Broad spectrum, for URTI infection
B. All form of syphilis
C. Uncomplicated SSTIs
D. Pseudomonas

A

B
D
A
C

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14
Q

Penicillin wherein absorption is unaffected by food

A

Amoxicillin

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15
Q

Penicillin cannot enter BBB/ CSF, prostate, and intraocular fluid hence not effective for meningitis.
True or False

A

False, effective for meningitis

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16
Q

Added to penicillin to allow slower relase and prolonged drug delivery (2)

A

Procaine

Benazathine

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17
Q

Penicillins safe for patients with renal failure (3)

A

Nafcillin
Oxacillin
Ureidopenicillin

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18
Q

Most common ADE associated with penicillin use

A

Type 1 hypersensitive reaction

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19
Q

The ___ ring of cephalosporins provides resistance to some B lactamases

A

Dihydrothiazine

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20
Q

Cephalsoporin which crosses blood brain barrier and effective treatment for meningitis (2)

A

Ceftriaxone, cefotaxime

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21
Q

Cephalosporin active against Pseudomonas aeruginosa

A

Ceftazidime

22
Q

Cephalosporin used for empiric therapy of severe purulent SSTIs

A

Ceftaroline

23
Q

Most oral cephalosporins can be taken without food except (3)

A

Cefaclor
Cefuroxime
Cefpodoxime

24
Q

Cephalosporins safe for usage in patients with allergy to penicillin (3)

A

Cefdinir
Cefpodoxime
Cefuroxime

25
Q

Treatment for Lyme disease

A

Early: Cefuroxime
Late: Ceftriaxone

26
Q

Tetracyclines have greater activity than doxycyline and minocycline against S. aureus as they are less lipophilic.
True or False

A

False, less activity

27
Q

In patient allergic to penicillin, ___ is an alternative for animal bites and syphilis

A

Doxycycline

28
Q

For tetracyclines, avoid concurrent ingestion with (5)

A
Iron preparations
Aluminum hydroxide gels
Calcium salts
Magnesium salts
Milk products
29
Q

Facilitates opsonization and phagocytosis amd decreases bacterial adhesion to host cells and production of staphylococcal exotoxin

A

Clindamycin

30
Q

Clindamycin has antiparasitic activity that targets protein synthesis of ___ organelle essential for survival

A

Apicoplast

31
Q

Protozoal spectrum of clindamycin

A

Toxoplasma gondii
Babesia
Plasmodium falciparum

32
Q

Clindamycin has its impact on abscesses due to its preferential accumulation in ___

A

Polymorphonuclear leukocytes

33
Q

Contraindication of clindamycin therapy

A

Hepatic failure
Colitis
Enhancement of neuromuscular blockade with tubocurarine and pancuronium
Antagonism with erythromycin

34
Q

ADE of clindamycin

A

C. Difficile associated bacteria and pseudomembranous colitis

35
Q

Activity of macrolides to Gram positive pathogens from best to least

Azithromycin
Clarithromycin
Erythromycin

A

Clarithromycin
Erythromycin
Azithromycin

36
Q

Azithromycin has good activity against (2)

A

Pasteurella multocida

Eikinella corrodens

37
Q

Clarithromycin is the most active macrolide against (3)

A

Mycobacterium chenolae
Mycobacterium abscessus
Mycobacterium fortuitum

38
Q

Macrolide are associated with increased risk of

A

Sudden cardiac death or ventricular tachyarrythmias

39
Q

Inhibits the action of bacterial topoisomerase II (DNA gyrase) and topoisomerase IV

A

Fluoroquinolones

40
Q

Fluoroquinolone most active against P. Aeruginosa

A

Ciprofloxacin

41
Q

Effective for STIs

A

Levofloxacin

Ciprofloxacin

42
Q

Adverse effects of quinolones in the immature

A

Tendon rupture, arthropathy

43
Q

For SSTIs, levofloxacin should be given ____ if uncomplicated; and ____ if complicated

A

Levofloxacin 500mg q 24h

Levofloxacin 750mg q 24h

44
Q

MOA of TMP SMX

A
Inhibit DHFR (TMP)
Inhibit dihydropteroate synthetase (SMX)
45
Q

Contraindications of TMP SMX

A

MTX

HIV/AIDS

46
Q

TMP SMX is avoided for breastfeeding women, esp during the first ___ weeks of the newborn’s life

A

6

47
Q

Glycopeptide antibiotic, 1st line for HA MRSA

A

Vancomycin

48
Q

Red man syndrome is due to ___ release caused by drug impurities and fast infusions of vancomycin

A

Histamine

49
Q

Lipoglycopeptides with an increased risk of osteomyelitis

A

Oritavancin

50
Q

Lipoglycopeptides with increased risk of taste disturbances, nephrotoxicity, and QT prolongation

A

Telavancin

51
Q

First line option for empiric treatment of severe purulent SSTIs

A

Linezolid