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NAPLEX BITCH > ID 1 Light Bulb Points > Flashcards

ID 1 Light Bulb Points Flashcards

(103 cards)

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1
Q

Atypical Organisms:

A

Chlamydia
Legionella
Mycoplasma Pneumoniae
Mycobacterium TB

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2
Q

Gram Positive Rods:

A

Listeria monocytogenes
Corynebacterium

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3
Q

Gram Positive Clusters:

A

Staphylococcus (MRSA,MSSA)

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4
Q

Gram Positive Pairs and Chains (cocci)

A

Strep. Pneumoniae (Diplococci)

Streptococcus (Pyrogens, enterococcus, VRE)

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5
Q

Gram Negative Cocci:

A

Neisseria

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6
Q

Gram Negative Anaerobes:

A

Bacteroides Fragilis

Prevotella

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7
Q

Gram Negative Coccobacilli:

A

Acinetobacter baumannii

Bordetella Pertussis

Moraxella Catarhalis

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8
Q

Gram Negative Enteric Rods (Gut colonizer)

A

Proteus mirabilis
E.Coli
Klebsiella
Serratia
Enterobacter Cloacae
Citrobacter

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9
Q

Gram Negative Rods (Non gut colonizing)

A

Pseudomonas Aeruginosa
Haemophilus Influenza
Providencia

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10
Q

Gram Negative Curled or Spiral Shaped Rods

A

H. Pylori, Campylobacter, Treponema, Borrelia, Leptospira

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11
Q

What are the common resistant pathogens?

A

Klebsiella Pneumoniae
Escherichia Coli
Acinetobacter
Enterococcus Faecalis/ Facial (VRE)
Staphylococcus Aureus (MRSA)
Pseudomonas Aeruginosa

“Kill Each And Every Strong Pathogen”

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12
Q

Cell Wall inhibitor MOA agents:

A

Beta Lactams
Monobactam
Vancomycin
Dalbavancin, Telavancin, Oritavancin

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13
Q

Folic Acid Synthesis Inhibitor Agents:

A

Sulfonamides
Trimethoprim
Dapsone

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14
Q

DNA/RNA Inhibitor Agents:

A

Quinolones (DNA gyros, topoisomerase IV)
Metronidazole
Tinidazole
Rifampin

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15
Q

Cell Membrane Inhibitor Agents:

A

Polymyxins
Daptomycin
Telavancin
Oritavancin

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16
Q

Protein Synthesis Inhibitor Agents:

A

AMG
Macrolides
Tetracyclines
Clindamycin
Linezolid, Tedizolid
Quinupristin / Dalfopristin

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17
Q

Aminopenicillins are active against:

A

When put with a beta-lactamase inhibitor:

MSSA and gram negative bacteria (HNPEK) and gram negative anaerobes (B. fragilis)

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18
Q

Extended Spectrum Penicillins when combined with a Beta Lactamase Inhibitor cover:

A

Streptococci and Enterococci

HNPEK + CAPES (citrobacter, acinetobacter, providencia, enterobacter, serratia) AND PSEUDOMONAS

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19
Q

Names of Natural PCN:

A

Penicillin V potassium
Penicillin G Aqueous
Penicillin G Benzathine (Bicillin L-A)

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20
Q

Names of Antistaphylococcal PCN:

A

(MSSA Coverage)
Naficillin
Dicloxacillin
Oxacillin

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21
Q

Names of Aminopenicillins:

A

Amoxicillin
Augmentin
Ampicillin
Unasyn (ampicillin/sulbactam)

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22
Q

Extended Spectrum PCN Name:

A

Zosyn (Pipperacillin / Tazobactam)

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23
Q

BBW for Penicillin G Benz:

A

Not for IV use! (Cardio - respiratory arrest)

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24
Q

SE of PCN:

A

Hemolytic Anemia
Seizures with accumulation (monitor RF)
Diarrhea
SJS/TEN

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25
Which PCN do not require Renal Dose Adjustments
Antistaphylococcal (Diclo, Nafci,Oxac)
26
What is important to know about Naficillin?
It is a vesicant! If extravasation occurs need to utilize COLD packs and hyaluronidase injections
27
What must IV Ampicillin (Unasyn included) be diluted in?
NS ONLY
28
in the outpatient setting is used 1st line to treat strep throat and mild non purulent skin injections
PCN VK
29
First Line to treat Otitis Media and Bacterial Sinusitis?
Augmentin
30
What is the pediatric dosing of Augmenting in Otitis Media?
90 mg/kg/d (use the lowest dose of clavulanate to decrease diarrhea)
31
Important points on Dicloxacillin (2)
Covers MSSA only (no MRSA) NO RENAL DOSE ADJUSTMENT
32
DOC for endocarditis prophylaxis Treats H. Pylori Used in Acute Otitis Media
Amoxicillin Otitis media peds dose: 80 - 90 mg/kg/d
33
DOC for Syphilis?
Penicillin G Benzathine (2.4 mil IM x 1)
34
What is the only penicillin against pseudomonas?
Zosyn (extended infusions maximize T>MIC)
35
1st generation cephalosporins:
Cefazolin Cephalexin (Reflex - PO) Cefadroxil (PO)
36
typical cephalexin (Keflex) dose:
250 - 500 mg Q6-12 H
37
2nd Generation Cephalosporins:
Cefuroxime (PO/IV/IM) Cefoteten (Cefotan IV/IM) Cefaclor Cefoxitin Cefprozil
38
3rd Generation Cephalosporins:
Cefdinir (PO) Ceftriaxone (IV/IM) Cefotaxime (IV/IM)
39
3rd Generation Cephalosporins (Grp 1)
Cefidinir Ceftriaxone Cefotaxime Cefditoren, Cefpodoxime, Ceftibuten
40
3rd Generation Cephalosporins (Grp 2)
Ceftazidime (Fortaz)
41
4th Generation Cephalosporins:
Cefepime
42
5th Generation Cephalosporins
Ceftaroline Fossil (Teflaro)
43
Ceftriaxone Contraindications
Hyperbilirubinemic Neonates - causes biliary sludging, kernicterus Concurrent use with calcium containing IV products (precipitate forms) in neonates (<28do)
44
Cefotetan contains a side chain called NMTT. What does this side chain cause?
Increased risk of bleeding and causes a disulfiram like reaction with alcohol consumption
45
Ceftazidime/Avibactam (Avycaz) has some activity against some:
CRE
46
Cefpodoxime (3), Cefuroxime (2), and Cefdinir (3) need to be separated from???
Antacids! (at least 2 hours in short acting H2RAs) PPI should be avoided
47
Cephalexin in the OP setting can be used for:
MSSA and Strep
48
Cefuroxime can be used in the OP setting for:
CAP, Acute Otitis Media
49
Cefidinir can be used for X in the OP Setting.
Acute otitis media
50
2nd Generation Cefotetan and Cefoxitin common uses:
Surgery prophy (GI), and anaerobic coverage of B. Fragilis
51
Common uses of 3rd gen Rocephin and Cefotaxime:
CAP, Meningitis, Spontaneous Bacterial Peritonitis, Pylenophritis
52
Which generations are active against pseudomonas?
3rd and 4th Ceftazidime Cefepime
53
Who is the only BL that is active against MRSA?
Ceftaroline Common Uses: CAP and SSTI 9
54
Carbapenems decrease the serum concentration of what seizure med?
VPA
55
What are the class effects of Carbamenems? (3 point)
All active against ESBL organisms and Pseudomonas (except ertapenem) DO NOT USE IN PCN allergy Seizure risk! (imipenem/cilastatin - Primaxin has the highest risk)
56
What does ErtAPenem not cover?
PEA Pseudomonas Enterococcus Acinetobacter
57
What do Carbapenems NOT cover?
Atypicals VRE MRSA C.Diff Stenotrophomonas
58
Common Uses of Carbapenem (Doripenem, Imipenem/Cilastatin, Meropenem, Ertapenem)
"Reserved for MDR gram negative infection. If a patient has ESBL THINK CARBAPENEM" Polymicrobial infections (diabetic foot) Empiric tx when resistant organisms are suspected Resistant Pseudomonas or Acinetobacter infections (EXCEPT Ertapenem)
59
Ertapenem must be diluted in:
Normal Saline!
60
What are the benefits of utilizing extended interval dosing for AMGs?
Utilizing higher doses lead to higher peaks = less dosing frequency Pro: Less accumulation Lower risk of nephrotoxicity Decreased $$$
61
When dosing an AMG for a patient what weight do you use?
Underweight: TBW Normal: IBW Obese: AjBW
62
Common uses of Quinolones:
Pneumonia (not Cipro) UTI (not moxi) Intra abdominal infection travelers diarrhea
63
Name the respiratory quinolones and why they are classified as this:
Levofloxacin, Gemifloxacin, Moxifloxacin (Breathy Men Love Girls) They have S. Pneumoniae activity
64
Please name the Antipseudomonal Quinolones
Ciprofloxacin Levofloxacin Pseudomonas coverage
65
What Quinolone does not require renal adjustment?
Moxifloxacin (Moxi isn't for the girls! - No UTI usage)
66
What quinolones are 1:1 in IV:PO?
Levofloxacin Moxifloxacin
67
What things should we look for in patients profiles prior to starting quinolones? (3 things)
1. hx of CVD, low K/Mg, QT , QT prolonging agents 2. Do they have seizure history? - AVOID (can increase theophylline levels) 3. Avoid in peds
68
What are counseling points for Quinolones? (~4)
Avoid Sun Exposure Separate from polyvalent cations (phosphate binders too) Monitor Glucose Watch for tendon rupture, neuropathy, CNS/Psych SE
69
Macrolides: How much of E.E.S = Erythromycin
400 mg = 250 mg
70
Common uses for ALL macrolides:
CAP Alternative for Strep Throat
71
Common uses for Azithromycin:
COPD Exacerbation Pertussis Chlamydia (pregnant patients) Prophy for Mycobacterium avium Severe travelers diarrhea
72
Common Uses for Clarithromycin:
H. Pylori
73
Why is erythromycin used in gastroparesis?
Increases gastric motility
74
Do Macropodes cause QTc prolongation?
yes! Caution in: CVD, decrease Mg/K, other QT drugs
75
When looking at statins, which are contraindicated with Clarithromycin and Erythromycin?
Lovastatin and Simvastatin (Due to clarithro + Erythromycin being strung CYP3A4 inhibitors, it can increase the risk of muscle toxicity)
76
Which tetracycline has noted DILE?
Minocycline
77
Common uses of Minocycline:
CA- MRSA Skin infection Acne
78
Common uses of Doxycycline (a lot)
CA - MRSA Skin infection Acne Lyme disease Rocky Mountain fever Spotted Fever CAP COPD exacerbations bacterial sinusitis VRE UTI Chlamydia
79
What is the common uses of tetracycline? (1)
H. Pylori
80
What populations should be avoided in Tetracyclines? (3)
Pregnancy , Breastfeeding , Little Kids <8
81
Sulfonamides do not have activity against? (4) A PEA
A: Anaerobes P: Pseudomonas E:Enterococci A: Atypicals
82
What the common uses of Bactrim: (3)
CA - MRSA skin infection UTI Pneumocystis Pneumonia (PCP)
83
When thinking of the 5:1 ratio of SMX/TMP how much TMP is in the single and double strength tablets?
SS: 80 DS: 160 **dosing is done off of TMP**
84
If a patient has _____ deficiency then Bactrim should be avoided due to increased risk of hemolysis.
G6DP
85
For a patient on warfarin what should be discussed when thinking of using Bactrim?
It increases INR significantly. Use alternative if possible
86
What are the three lipoglycopeptides?
Telavancin (Vibativ) Oritavancin (Orbactiv) Dalbavancin (Dalvance)
87
What is the BBW with Telavancin? (2)
Fetal risk! ( avoid pregnancy) Nephrotoxicity
88
What do lipoglycopeptides (-vancin) falsely elevate?
aPTT, INR, PT
89
A provider wants to start Oritavancin for a SSTI in a patient that is currently on a Heparin Drip for AFib. What do you say?
Oritavancin cannot be used. IV UFH cannot be used for up to 120 hours after Oritavancin Administration due to the prolonged interaction with falsely elevating aPTT
90
When is Metronidazole contraindicated (2 )
1st trimester of pregnancy Alcohol or Propylene glycol (during or within 3 days after) **increases INR but not a CI**
91
What is the dosing for Nitrofurantoin (frequency)
Macrobid = BID Macrodantin = QID
92
A patient's CrCl comes back at 55 ml/min and the doc wants to start Macrobid for CA-UTI. What do you say?
Nitrofurantoin is contraindicated in CrCl < 60
93
Two main counseling points for Macrobid (Nitro)
Can make your urine brown Can cause nausea and stomach cramping - take with food
94
Drugs for CA-MRSA and SSTI
SMX/TMP Doxycycline , Minocycline Clindamycin Linezolid
95
Drugs for VRE (E. Facecalis)
Pen G or Ampicillin Linezolid Dapto Cystitis Only: Fosfomycin, Doxycycline, NitroF
96
Drugs for ESBL gram negative rods
Carbapenems Ceftazidime/Avibactam (avycaz) Ceftolozane/Tazobactam (zerbaxa)
97
Drugs for Carbapenem resistant gram negative rods (CRE):
Avycaz Colistimethate Polymyxin B
98
Drugs for Atypical Organisms:
Azithromycin Doxycycline Quinolones
99
Drugs for Bacteroids Fragilis (anaerobe)
Flagyl BL /BLI Cefotetan Cefoxitin Carbapenems
100
What drugs (2) require protect from light during admin?
Doxycycline Micafungin
101
What drugs are compatible with dextrose only?
Quinupristin / Dalfopristin Bactrim Amphotericin B
102
What drugs are compatible with NS only?
Ampicillin Unasyn (duh) Ertapenem Daptomycin (Cubicin RF)
103
What drugs are compatible with NS/LR only?
Capsofungin Daptomycin (Cubicin)

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