Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Infectious Disease > Drugs: Basics > Flashcards

Drugs: Basics Flashcards

1
Q

What is the best drug to use for hospital-acquired MRSA?

A

-Vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is MRSA resistant to?

A
  • Penicillin

- Cephalosporin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is natural penicillin (Penicillin VK and aqueous Penicillin G) good at treating?

A
  • Gram positive (streptococci)

- Anaerobes (oral only)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is natural penicillin the drug of choice for?

A
  • N. meningitidis

- Syphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are aminopenicillins good at treating?

A
  • Gram positive (streptococci, enterococci)
  • Some gram negatives
  • Anaerobes (oral only)
  • Often resistance w respiratory infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the penicillinase-resistant penicillins?

A
  • Dicloxacillin

- Nafcillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the penicillinase-resistant penicillins good at treating?

A
  • Drug of choice for MSSA!
  • Gram positive: streptococcus, MSSA
  • Anaerobes (oral only)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the aminopenicillins?

A
  • Ampicillin

- Amoxicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the extended-spectrum penicillins?

A
  • Piperacillin

- Ticarcillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the extended-spectrum penicllins good at treating?

A
  • Broad spectrum, severe infections
  • Gram positive: streptococcus, staphylococcus
  • Gram negative: excellent! include coverage against pseudomonas
  • Anaerobes (oral); but there are better ones out there
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Are the extended spectrum penicillins available orally or IV?

A

-IV only. You reserve these for pretty severe issues, like pseudomonas and bad gram-negative pathogens.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does adding a beta-lactamase inhibitor to your penicillins do?

A

-It takes away the major resistance mechanism. Now, you have a drug that is 1) great against MSSA, 2) increases coverage against all enterobacteriacea, 3) great against anaerobes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What penicillins are best for treating MSSA?

A

Dicloxacillin and nafcillin (the penicillase-resistant penicillins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What penicillins are best for treating MRSA?

A

None!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What penicillins are best for treating psuedomonas?

A

Piperacillin and tazocillin (the extended-spectrum penicillins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What penicillins are best for treating anaerobes?

A
  • Penicillin for oral anaerobes

- Am/sulbactam and pip/tazo for B.fragilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are common adverse reactions to penicillins?

A
  • Allergic reactions

- Diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the first generation cephalosporins?

A
  • Cefazolin

- Cephalexin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the second generation cephalosporins?

A
  • Cefuroxime

- Cefoxitin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the third generation cephalosporins?

A
  • Ceftriaxone

- Ceftazidime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the fourth generation cephalosporin?

A

-Cefepime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which of the cephalosporins is only available orally?

A

-Cephalexin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which of the cephalosporins is available both IV and orally?

A

-Cefuroxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are first generation cephalosporins good at covering?

A
  • Great gram + coverage: streptococcus, MSSA
  • Not good gram - coverage; some e.coli, klebsiella
  • Anaerobes: oral only

Bottom line: good for skin infections, some respiratory. Main activity is against strep and staph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the second generation cephalosporins good at covering?
- Moderate gram + and gram - coverage - Some respiratory (oral) - Anaerobes: can cover b.fragilis!! Bottom line: they are moderately good for covering a lot of things, which is why they are not used a lot - don't have a niche.
26
What are the third generation cephalosporins good at covering?
- Great gram - coverage (includes pseudomonas wtih ceftazidime coverage) - Not good gram + coverage Bottom line: good for respiratory infections, serious infections
27
What is the fourth generation cephalosporin good at covering?
-Both gram - (inc. pseudomonas) and gram + (strept, MSSA)! -Anaerobes (oral only) But is $$$ Bottom line: used for serious hospital infections. Not so good for MRSA (use vanco instead).
28
What do none of the cephalosporins cover?
Enterococcus
29
What kind of infections might present with enterococcus?
Intraabdominal infections | Diabetic foot ulcers with mixed flora
30
What is the new cephalosporin on the market and what is it good for?
- Ceftaroline! - Covers MRSA (the only ceph to do so!) - Covers strep pneumo - Covers gram negative rods (doesn't cover pseudomonas)
31
When do we really use ceftaroline?
For MRSA. We don't use it widely, we are reserving this puppy for something really resistant.
32
What is the only cephalosporin that covers b.fragilis?
-Cefoxitin (a 2nd gen ceph)
33
What are the only cephalosporins that cover pseudomonas?
-Ceftazidime (a 3rd gen) and cefepime (4th gen)
34
What do ALL of the cephalosporins cover?
-MSSA, e.coli, klebsiella, h.flu, oral anaerobes
35
What are adverse reactions of the cephalosporins?
- Allergic reactions (3-7% cross resistance with PCN allergy) - Diarrhea
36
What are the carbapenems?
- Imipenem - Meropenem - Ertapenem - Doripenem
37
What can the carbapenems cover?
- Very broad spectrum! Only really used in severe infections - Excellent anaerobic coverage - Key forte: gram negatives; most can cover pseudomonas! - No MRSA coverage, not terrible MSSA drugs. Bottom line: use these for when you want to "throw the kitchen sink" at someone in a severe case where you need good broad spectrum coverage.
38
What is the one carbapenem that doesn't cover pseudomonas?
-Ertapenem
39
What are the adverse reactions of carbapenems?
-Gastrointestinal
40
Are the carbapenems available orally or IV?
IV only
41
What kind of patients should you NOT use carbapenems with?
Those with severe PCN allergies
42
What are the aminoglycosides?
- Gentamicin - Tobramycin - Amikacin
43
What is the coverage like for aminoglycosides?
- Good gram negative, includes pseudomonas coverage - Only synergistic gram + activity, so would not use this to cover gram +'s by themselves - Do not cover ANY anaerobes!!
44
What are the adverse reactions of aminoglycosides?
- Nephrotoxicity 10-15%! (usually reversible) - Ototoxicity 1-5% (often irreversible) Yikes. So dose very carefully due to toxicity potential. Dosage according to weight, renal function, and severity/site of infection.
45
What are the fluoroquinolones?
- Ciprofloxacin - Levofloxacin - Moxifloxacin - Gemifloxacin
46
What are the fluoroquinolones good at covering?
- Potent agents - Most gram - (including psuedomonas) - Some gram + (strept, MSSA) - Anaerobes: minimal Bottom line: good at covering atypical respiratory pathogens! Legionella, chlamydia pneumoniae, mycoplasma pneumoniae
47
Which fluoroquinolone is NOT good at covering MSSA or a respiratory infection caused by strep?
Ciprofloxacin - don't use it!
48
What are the adverse effects of the fluoroquinolones?
- Nausea | - HA, dizziness, insomnia
49
Which of the classes of drugs have faced major resistance issues recently (starting in 1994)?
Fluoroquinlones!! Use with caution!
50
What are the macrolides?
- Erythromycin - Clarithromycin - Azithromycin
51
What are the macrolides good at covering?
- Respiratory infections - Gram positive: strept - Anaerobes (oral only) - Atypical respiratory pathogens! Legionella, chlamydia pneumoniae, mycoplasma pneumoniae
52
What is the only gram negative that we cover with the macrolides?
H. influenzae
53
What are the adverse reactions of the macrolides?
- GI | - Phlebitis w IV erythro
54
Which macrolide is more commonly associated with the adverse reactions?
-Erythromycin
55
Which macrolide usually has less severe adverse reactions?
Azithromycin
56
What are the anti-anaerobe drugs?
- Metronidazole | - Clindamycin
57
For which anti-anaerobe drug does resistance more commonly occur?
-Clindamycin
58
What does metronidazole cover?
ONLY anaerobes!!! Great b.fragilis coverage, pretty good oral anaerobe coverage -No gram + or gram - coverage
59
What does clindamycin cover?
- Gram positives: strept, MSSA - Gram negative: none! - Anaerobes: great oral anaerobe coverage, ok w b.fragilis
60
What is the hallmark agent responsible for c.diff?
-Clindamycin
61
What are some common adverse reactions of clindamycin?
- Diarrhea | - C.diff
62
What are some adverse reactions to metronidazole?
- Nausea - Metallic taste - Drug interaction with alcohol - flushing, sweating, nausea
63
Are the anti-anaerobes available orally or IV?
Both are available in both formulations
64
What is the coverage of vancomycin?
- Gram +: covers strept, all staph, moderate enterococcus coverage - NO gram - coverage - Anaerobes: gram + oral only BOTTOM LINE: drug of choice for hospital-acquired MRSA
65
What is the coverage of linezolid?
- Gram +: strept, all staph, enterococcus - Gram -: none (eh, h.flu) - Anaerobes: none BOTTOM LINE: gram positives only, used for serious infections, resistance is rare for this. Drug of choice for VRE (vancomycin resistant enterococcus)!
66
What is the coverage of daptomycin?
- Gram +: strept, all staph, all entero - Gram -: none - Anaerobes: none BOTTOM LINE: gram +s only, for serious infections A second line agent used for resistant pathogens when vanco has failed.
67
What are the adverse reactions of vancomycin?
- "red man" syndrome: infusion related flushing - Nephrotoxicity with other agents and ototoxicity with high concentrations (but not as big a problem as with fluoroquinolones)
68
What are the adverse reactions of linezolid?
- Thrombocytopenia - Anemia - Neutropenia
69
What are some precautions that you should take when administering vancomycin?
- Weight and renal function based dosing (so do carefully!) | - Monitor renal function when using other nephrotoxins
70
What is the coverage of trimethoprim-sulfamethoxazole (bactrim)?
- Variable wide activity - Gram +: strept, MSSA - Gram -: most enterobacteriaceae - Anaerobes: oral only BOTTOM LINE: small pockets of use: UTIs, some skin infections, etc
71
What is the coverage of tetracyclines?
- Gram +: strept, MSSA - Gram -: h.flu - Anaerobes: mostly oral - Atypical respiratory pathogens: legionella, c.pneumoniae, m.pneumoniae BOTTOM LINE: used for respiratory and intracellular infections, includes coverage for atypical respiratory pathogens
72
What are the adverse reactions of TMP/SMX?
- Allergic reactions - GI effects - Neutropenia, thrombocytopenia
73
What are the adverse reactions of tetracyclines?
- Photosensitivity - Nausea and diarrhea - Tooth discoloration in kiddos
74
What do you need to be careful for with TMP/SMX?
Increases the effects of warfarin
75
What do you need to be careful about with tetracyclines?
-Don't take with dairy products/calcium/cations because they will chelate w these products
76
What drugs cover pseudomonas?
- Aminoglycosides (gentamicin, tobramycin, amikacin) - Cipro, levo (the only oral drugs) (fluoroquinolones) - Ceftazidime, cefepime (2nd and 4th gen cephs respectively) - Piperacillin, ticarcillin (the extended-spectrum penicillins) - Impenem, meropenem, doripenem (most of the carbapenems)
77
What drugs cover hospital-acquired MRSA?
- Vancomycin - Linezolid - Daptomycin
78
What are the best drugs for covering anaerobes?
- Metronidazole - Imipenem, meropenem, ertapenem - Beta lactam/beta lactamase inhibitors

Infectious Disease (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions