Exam 1 - ABX, their bacteria, and indications (high yield) Flashcards
(162 cards)
1
Q
PCN G IV gram coverage?
A
Gram positive
2
Q
PCN G IV bacterial coverage?
A
Strep A-G
Enterococci (some)
Anaerobes
3
Q
PCN G route?
A
IV
4
Q
PCN G and PCN V good for which infections?
A
Dental, throat
5
Q
Which bacteria through birth canal? Which abx?
A
Group B Strep. Use PCN G or PCN V.
6
Q
If PT is noncomplaint or homeless how can PCN be given?
A
IM injection
7
Q
PCN V and PCN G are in which class?
A
Natural PCNs
8
Q
Nafacillin, Oxacillin what route? Great coverage for what? Gram?
A
IV. Great at MSSA coverage. Gram positive.
9
Q
Dicloxacillin route? Great coverage for what? Gram?
A
PO. Great MSSA coverage. Gram positive.
10
Q
Nafacillin, Oxacillin, and Dicloxacillin in what class?
A
Anti-staph PCN
11
Q
Anti-staph PCNs good for which infection?
A
Skin infection
12
Q
Does Anti-Staph PCN class require rental dosing?
A
Nope
13
Q
Which two abx are in the Amino PCN class?
A
Ampicillin
Amoxicillin
14
Q
Coverage for Amino PCNs (Amp, Amox)?
A
Gram positives
Gram negative +/-
Enterococcus
Listeria and Shigella
15
Q
Amino PCNs (Amp, Amox) good for?
A
OM
UTI and URI
Meningitis (use Ampicillin)
Listeria
16
Q
What is Drug of Choice for Listeria?
A
Ampicillin IV
17
Q
What is Drug of Choice for Urinary Tract Infections and Upper Resp Infections in pregnancy?
A
Amoxicillin BID
18
Q
How to overcome gram positive resistance with Amoxicillin? Gram negative resistance?
A
Gram positive=Increase dose
Gram negative=Add Beta-Lactamase Inhibitor
19
Q
How to overcome gram positive resistance with Amoxicillin?
A
Add Beta-Lactam
20
Q
Coverage for Beta-Lactamase Inhibitors?
A
Gram Positive
Gram Negative
Beta-Lactamase producing strains
21
Q
Beta-Lactamase Inhibitors good for what fort of infections?
A
Broad empiric coverage
Hospital acquired infections
Beta Lactamase producing infections
Human/animal bites
22
Q
What class is used for broad empiric coverage?
A
PCN + Beta-Lactamase Inhibitors
23
Q
What class is used for hospital acquired infections?
A
Beta-Lactamase Inhibitors
24
Q
What class used for human/animal bites?
A
Beta-Lactamase Inhibitors
25
Which abx used for Pseudomonas?
Zosyn ( (piperacillin + tazobactam)
26
Abx for Acinetobacter?
Unasyn (Ampicillin + Sulbactam)
27
1st gen Cephalosporins coverage?
```
Gram positive (MSSA, Step Pyogenes)
Some Gram negative
```
28
1st gen Cephalosporins second line good for?
MSSA skin and soft tissue infections
29
2st gen Cephalosporins coverage?
```
Gram Positive (Staph, MSSA, Strep Pyogenes)
Enhanced Gram Negative
```
30
Which 2nd gen Cephalosporin has anaerrobic B Fragilis coverage?
Cefotetan IV
31
Cefotetan IV covers what special bacteria?
Anaerobic B Fragilis
32
2nd gen Cephalosporins good for what?
Abdominal infections
GYN infections
Respiratory tract infections (sinutitis, OM, etc)
33
1st gen Cephalospirins have increased risk of what?
Cross reactivity in PCN allergic patients
34
3rd gen Cephalospirins have less activity against Gram ____ and broad coverage against Gram ____
Gram Positive=less
| Gram Negative=broad
35
Which abx class has less coverage against Gram Positive and broad coverage against gram negative?
3rd gen cephalosporins
36
3rd gen Cephalosporins good for what three things?
1. Community Acquired Pneumonia
2. Meningitis
3. Lyme
37
Which class for Gonorrhea tx?
3rd gen Cephalosporins
38
Which drug used for Hospital Acquired Pneumonia?
Ceftazidime, a 3rd gen Cephalosporin
39
4th gen Cephalosporin coverage? Except?
Everything except MRSA, Enterococcus, B. Fragilis
40
Does 4th gen Cephalosporins cover Pseudomonas?
Yes
41
Does 4th gen Cephalosporins cover Strep Pneumonias?
Yes
42
4th gen Cephalosporins good for what two things?
1. Hospital acquired infections
| 2. Neutropenic fever
43
What is the one drug in the 4th gen Cephalosporin class?
Cefepime
44
5th gen Cephalosporins coverage?
Gram positive
| Gram negative
45
Does 5th gen Cephalosporins cover Staph including MSSA, MRSA, and VRSA?
Yes
46
5th gen Cephalosporins good for?
Skin and skin structure infections
47
Do 5th gen Cephalosporins cover gram negative anaerobes?
Yes, but limited coverage
48
What is the route for the Carbapenems?
IV, except for Etrapenem IM
49
Gram coverage for Carbapenems?
Gram Positive
Gram Negatives, including Pseudomonas
Anaerobes
50
Do the Carbapenems cover Pseudomonas? Any exceptions?
Yes, except for Etrapenem
51
Carbapenems drug of choice for?
Infections caused by resistant organisms
Ceftriaxone-resistant E Coli, Klebsiella, P mirabilis
52
What is the drug of choice for Extended Spectrum Beta-Lactamases?
Carbapenems
53
Which Carbapenems has highest risk of seizures?
Imipenem
54
If a bacteria is resistant to Ceftriaxone what to use?
Carbapenems
55
Does Ertapenem cover Psueomonas?
No.
56
Monobactam gram coverage?
Gram negative aerobic only!
57
Monobactam good for what two?
Pseudomonas
| PCN allergic patient
58
Does Monobactam cover Pseudomonas?
Yes!
59
What is the name of the one Monobactam abx? Route?
Aztreonam
60
Can Monobactam (Aztreonam) be given when PT allergic to Ceftazidme?
No!
61
If PT allergic to PCN can give Monobactam (Aztreonam) as alternative?
Yes, but not if also allergic to Ceftazidme
62
Fluoroquinolones black box warning?
Tendonitis, tendon rupture, CNS issues
63
Fluoroquinolones reserved for what line in therapy? Due to what?
Last line therapy due to black box warnings
64
Fluoroquinolone coverage?
```
Gram positives
Gram negatives
Excellent atypical coverage
Pseudomonas
M Tuberculosis
```
65
Fluoroquinolones don't cover?
No gram negative anaerobes
66
Fluoroquinolone preggers rating?
C
67
Use Fluoroquinolones in children?
Nope
68
Fluoroquinolones good for what?
Systemic infections; soft tissue, bone, and join infx, intraabdominal infx, resp tract infx, UTI
69
Fluoroquinolones interact with which minerals?
Fe, Ca, Al, Mg
| FeCaAlMag
70
Three examples of atypical bacteria that Fluoroquinolones treat?
Chlamydia, Legionella, Mycoplasma
71
Does Cipro cover Gram Positive bacteria?
Nope
72
Levoflaxacin superior coverage for what two things?
Gram positive and atypicals
73
Coverage of gram negative anaerobes such as B Fragilis?
Flagyl + Cipro
74
Fluoroquinolones end in what?
"-oxacin"
75
Macrolides end in
"-mycin"
76
Macrolides cover?
Gram negative
| Atypicals
77
Macrolides good for what?
Respiratory infection
78
Macrolides not used for infections where?
Infections of soft tissue, blood, or urine
79
Macrolides and CAP?
Covers most common CAP bugs
80
Tetracyclines coverage?
Gram positive, including MSSA and MRSA
Some Gram neg
Some anaerobes and atypicals
81
Tetracyclines good for?
Resp tract infx
Skin and soft tissue MRSA infx
Tick-bourne infx (Lyme)
82
Tetracyclines resistance how?
Efflux pumps
83
Tetracyclines good for which Gram Negatives?
H Influenza
| M Cattrahlis
84
Which Tetracycline is anti-inflammatory in low doses? Good for what?
Doxycycline. Good for acne.
85
Tetracyclines in preggers?
Category D. Don't.
86
Tetracyclines in kids under 8?
Nope. Bones and teeth get messed up.
87
Tetracyclines ADRs?
GI upset, photosensitive, tooth discoloration, bone deposits
88
Aminoglycosides end in what?
"-mycin"
89
When to use Aminoglycosides?
Last resort
90
Are Aminoglycosides used alone?
No, except for UTIs
91
When are Aminoglycosides used alone?
UTIs
92
Aminoglycosides coverage?
Excellent Gram negative, including pseudomonas
93
Do Aminoglycosides cover Gram positives?
Only when used synergistically
| Ex: Ampacillin + Gentamycin
94
Aminoglycosides anaerobic coverage?
None
95
Aminoglycosides used as monotherapy against gram positive?
Nope
96
Aminoglycosides cover pseudomonas?
Yes! A better than T better than G.
97
Aminoglycosides and Endocarditis?
Use Streptomycin in combination with a beta-lactam
98
Aminoglycosides where in line with TB?
Second-line
99
Aminoglycosides good for
Hospital acquired infection, UTIs
100
Do Aminoglycosides penetrate CSF and lungs?
Not yer well
101
Aminoglycosides and preggers?
Category D. Nope!
102
Aminoglycoside drug monitoring
Monitor peak and trough level.
103
Aminoglycosides and kidneys?
Can become nephrotoxic
104
Aminoglycosides and "post antibiotic effect"? How?
Residual bactercial effect even after serum MIC. Remains intracellular.
105
Clindamycin gram coverage?
Broad gram positive. MRSA and MSSA. NO gram negative coverage.
106
Clindamycin and anaerobes?
Covers gram positive anaerobes, including Clostridium
107
Clindamycin good for?
Skin, soft tissue, dental, respiratory infections
108
Clindamycin special treatment for what very scary thing?
Necrotizing fasciitis
109
Clindamycin recommended for gram positive treatment if PT has what complication?
PCN allergy
110
Clindamycin ADR that sucks?
C Diff colitis, diarrhea
111
Clindamycin good for what special type of pneumonia?
Aspiration pneumonia
112
Clindamycin and B Fragilis coverage?
Minimal coverage
113
Trimethoprim/ sulfamethoxazole (Bactrim) gram coverage?
```
Gram positive (inc MSSA, MRSA)
Gram negative
No anaerobic, atypical, or pseudomonas
```
114
Does Trimethoprim/ sulfamethoxazole (Bactrim) cover anaerobic, atypical, or pseudomonas
Nope
115
Does Trimethoprim/ sulfamethoxazole (Bactrim) cover pneumocystis and toxoplasma gondii?
Yes it does
116
Trimethoprim/ sulfamethoxazole (Bactrim) good for?
UTIs
| MRSA-caused skin soft tissue infx
117
Trimethoprim/ sulfamethoxazole (Bactrim) ADRs?
So many. N/V/D, HyperK, photosensitive, hypersentisive, bone marrow suppression, thrombocytopenis, leukopenis, megaloblastic anemia in folate deficiency, hemolytic anemia in G6PD deficiency
118
Trimethoprim/ sulfamethoxazole (Bactrim) drug interctions?
Warfarin
| Phenytoin
119
Trimethoprim/ sulfamethoxazole (Bactrim) and kidneys?
Consider renal dose adjustments
120
Metronidazole (Flagyl) gram coverage?
Covers gram positive and gram negative anaerobes
121
What is "gold standard treatment" for anaerobes?
Metronidazole (Flagyl)
122
Metronidazole (Flagyl) first line treatment for which bacteria?
C. Diff
123
Which agent used to treat parasites?
Metronidazole (Flagyl)
124
C Diff first-line tx?
Metronidazole (Flagyl)
125
Metronidazole (Flagyl) and EtOH?
Don't mix due to disulfram like reaction
126
Metronidazole (Flagyl) ADR?
GI intolerance
127
Anaerobe treatment based off what anatomical part?
Diaphragm
Above diaphragm=Clindamyin
Below diaphram=Metronidazole (Flagyl)
128
Nitrofurantoin and UTIs drug of choice when?
Preggers
129
What does Nitrofurantoin and Fosfomycin do to UTIs?
Suppress UTIs
130
Nitrofurantoin for which bacteria causing UTI?
Enterococcus, some E. Coli
131
Nitrofurantoin and Fosfomycin good for?
Lower UTIs
| Cyctitis
132
Nitrofurantoin concerns?
Renal and elderly concerns
133
Fosfomycin dose frequency for UTIs?
Single dose for UTI
134
Vancomycin gram coverage
Gram positive aerobes and anaerobes
135
Vancomycin good for
Hospital acquired pneumonia, skin and soft tissue infx, meningitis, endocarditis caused by MRSA
136
Vancomycin for C. Diff?
Yes. PO route only.
137
Vancomycin contraindications
If hypersensitive to corn or prior Vancomycin hypersensitivity
138
Vancomycin ADRs?
Red man syndrome. Slow down infusion, give H1 blocker.
139
Vancomycin drug monitoring?
Check trough levels
140
Vancomycin covers which 3 gram positive anaerobes?
Clostridium, peptostreptococcus, Peptococcus
141
Telavancin gram coverage?
Gram positive only. MSSA, MRSA, strep, enterococci, some VRE and VISA.
142
What point to give Telavancin?
Reserved as later option with gram positive infections
143
Telavancin and preggers
Category C. Fetal abnormalities.
144
Telavancin dosing interval?
q24-48h
145
Does Telavancin require level monitoring?
Nope
146
Does Telavancin require renal adjustment?
Yes it does
147
Two major Telavancin ADRs?
Fetal abnormalities
| QTc prolongation
148
Other Telavancin ADRs
Red man syndrome, nephrotoxic, GI intolerance, metallic taste
149
Linezolid last resort when what happens?
When Vando doesn't work
150
Linezolid gram coverage?
Gram positive only!
151
Linezolid against which two superbugs?
MRSA, VRE
152
Linezolid bacterialcidal against which bug?
Steptococcus
153
Linezolid good for
Pneumonia, skin and soft tissue, bacteremia, sepsis
154
Linezolid and MAOIs?
Be careful with 5HT
155
Linezolid and tyramine foods?
Limit them: aged cheeses, chocolate, coffee, bananas, avocados, over-ripe fruit, fave beans, beer, red wine, sherry, soy sauce, fermented meats
156
Linezolid and tyramine food restrictions for how long after d/c?
2 weeks
157
Daptomycin gram coverage?
Gram positive only
158
Daptomycin against which superbugs?
MRSA, VRE
159
Daptomycin and pneumonia?
NO! Binds to lung surfactant!
160
Daptomycin and kidneys?
If CrCl less than 30 then lower dose
161
Daptomycin and CPK levels?
Monitor closely, might increase
162
Fetal abnormalities occur with which abx?
Telavancin
