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ID Flashcards

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1
Q

common resistant pathogens

A

Kill each and every strong pathogen

klebsiella
e. coli
acineobacter
enterococcus
staph aureus
psuedamonas

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2
Q

dose optimization strategies

A

time>MIC: beta lactams: representative of frequent dosing, extended infusion dosing

auc:mic. vanco, macrolides, tetracyclines,…

cmax:mic. amg, quinolones, dapto

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3
Q

natural pcns

A

penecillin vk. oral
pcn g(IV)

cover strep, enterococci, g+ anaerobes

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4
Q

aminopcns

A

amoxicillin
ampicillin IV

cover aboce + HNPE( haemophilus, neisseria, proteus
e.coli,

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5
Q

amino pcn/ beta lactamase inhibitors

A

amox clav (augmentin)
amp sulbavtam (unasyn)

covers same as natrual pcn and amino pcns

additonal coverage w MSSA, HNPEK, andG_anaerobes

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6
Q

extended spectrum beta lactams

A

zosyn
MSSA, CAPES, psudamonas, g_ anaerobes

(

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7
Q

capes

A

citropacter
acinetobacter
providencia
enterobacter
serratia

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8
Q

anti staff pcns

A

dicloxicillin (oral)
nafcilin (iv)

mssa AND streptococcus

ONLY PCNS that dont need renal adjustment

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9
Q

class effects of pcns

A

beta lactam allergy,
risk of seizures (if accumulates)

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10
Q

when can u use a pcn if pt has pcn allergy on exam

A

in a child who has pcn allergy and has acute otitis
syphillis

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11
Q

oral pcn things to remember

A

pcn vk : strep throat, mild non purulent skin infections

amoxicillin
AOM: 8–90 mg/kg/day
infective endocarditis ppx: 2g POx1
h. pylori reigmens

amox clav:
AOM: 90 mg/kg/day
use lowest dose of clavulanate possibler

dicloxacillkin
no renal adjustments

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12
Q

iv pcns pearls

A

pcn G benzathine
give IM only. fatal if given IV
used in syphillis. if pt has pcn allergy, desensitize and give. esp in pregnancy pts or pts w poor compliance

nafcillin: no renal adjustments

zosyn: only pcn active against pseudamonas

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13
Q

1st gen cphalosporins

A

streptococci
MSSA
PEK
G+ anaerobes

cefazolin (IV)
cephalexin (keflex) oral

surgical ppx

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14
Q

2ng gen

A

cefuroxime
cefotetan
cefoxitimme

covers all1st gen cef. covers + HN from HNPEK)

cefuroxime, cefotetan (good for surigcal procedure)- also cover

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15
Q

pearls of cefotetan

A

disulfuran reactions
can cause bleeding

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16
Q

3rd gen. group1

A

ceftriaxone (IV)
cefdininr (oral)

same as 2nd gen covers more resistent step and HNPEK

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17
Q

3rd gen group 2

A

ceftazidime

covers pseudamonas

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18
Q

4th gen

A

cefepime

:HNPEK
CAPES
PS
G+ similar to 3rd gen

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19
Q

5th gen

A

ceftarolane

broad G+ activity
MRSA
psuedamonas

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20
Q

cephalosporin coverage

A

no enteroccus
only ceftarolane covers MRSA
cefepime, ceftazidime (-/- avibactam or ceftolozane covers psa

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21
Q

cephalosporin class effects

A

allergies, risk of seizures

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22
Q

oral cephalosporin class effects

A

1 cephalzexin
strep throat, mssa skin infections

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23
Q

2nd gen

Study These Flashcards
A

cefuroxime AOM, CAP, sinus infections

24
Q

3rd gen

25
carbapenems pearls
risk of seizures if accumulate, active against all esbl producing organisms very broad. but do NOT cover atypicals, VRE, MRSA, C. diff, stenotrophomonas Ertapenem does not cover PEA: pseudamonas, enterococcus, acinobacter common uses: ESBL
26
aztreonam
can be used in pts w. pcn allergy only covers gram- (including oseudamonas)
27
aminoglycosides
gram- dosing intervals-extended interval vs traditional dosing toxicities. nephrotoxicity. ototoxicit goal trough: generally <2
28
quinolonwa
respiratory: Levo, moxi, gemifloxicin(my good lungs). reliable s. pneumonaie acitivty in pneumonia antipseudamonal -ciprofloxacin, levofloxicin (covers pseudamonas)
29
key features of fql
moxi. do not use for uti: not renall adjusted but does not concentrate in urine iv to po ratio:1 to 1 (levo and moxi) caution w cvd, qt prolongation, achilles tendon rupture, avoid in pts w seizures, neuropathy, photosensitivity ,blood glucose,
30
macrolydes
atypical coverage qt prolongation GLOVES PACMAN( m satands for macrolides) clarithro and erythromycin inhoibitors of cyp3a4? use together CI w. lovastatin and simvastatin
31
tetracyclines
avoid in pregnancy and children (abnormal discoloration fo teeth)<8 photosensitivity, chelation
32
sulfonamides
SMX: TMP-5:1 ratio dose per tmp se: photosensitivity, hemolytic anemia, +coombs test) warfarin interaction
33
dapto
cpk only compatible w NS cant use in lungs. inactivate dby lungs, muscle adverse reactions,monitor cpk
34
linezolid
iv :po ratio "seretonergic interactions thrombocytopenia
35
tigecycline
BBW: use last line. very broad. dont use in spectrum . orange. increased risk of death
36
clindamycin
anaerobic coverage and gram positive d test
37
metronidazole
anerobic disulfuram reactoins
38
nitrofuranotin (microdantin or macrobis)
avoid use in rcl<60 urine discoloration
39
perioperative abx
choice depends on abx type: cardiac, vascular or orthopedic *covers skin flora *cefazolin (staph, step) GI *covers skin flora +GI flora cefazolin+metronidazole cefoxitine or cefotetan amp/sulba
40
meningitis organsims
strep pneumonair, n miningitis, listeria coverage in neonates and ppl >50 amp drug of choice for lysteria.
41
CI for ceftriaxone
neonates
42
AOM treatment
high dose amox or amox/clav cephalosporins for mild pcn allergy ceftriaxone IM for treatment failure
43
upper respiratory tract infections
pharyngitis: most common cause group a strep: cna be treated w pcn or amox acute sinustitiis -symptomatic cre +/- audmentin
44
CAP treatment outpt:
healthy: no comorbidities or riskf actors for mrsa or pseudamonas *amox (high dose), doxycicline or macrolide high risk: betalactam +macrolide or doxy OR respiratory fq
45
cap inpt treatment
nonsevere(non ICU) beta lactam+macrolide (or doxy if safety risks w macrolide) OR respiratory fq monotherapy severe(ICU) beta _macrolide OR meta+resp fq in evere do not use fq monotherapy or beta lactam+doxy
46
HAP/VAP
anx coverage needed for psa and mssa cefepime zosyn levo add vanco or linezolid if risk for mrsa ex: cefepime +vsnc meropenem+linezolid aztreonam+vanc use 2 abx if at risk for mdr gram neg organisms
47
tb treatment general considerations
increase lft's , total bilirubin rifampin-turn fluids orange isoniazid-peripheral neuropathy. give b6 to prevent tht (pyridoxine). cal cause DILE pyrizonamide- increase uric acid and gout ethambutol- visual damage
48
TB treatment
RIPE rifamipin isoniazid pyrazinomide ethambutol
49
latent tb treatment
shorter regimen Rifapentine+I- 12 weeks weekly. cant be used in pregnancy rifampin daily for 4 months or RI daily for 3 months last 2 can be used in pregnancy
50
SBP abx treatment
target enterric gram- and streptococci ceftriaxone 1g iv daily for 5-7 days ppx if prior episode:
51
utis
cyctities vs pyelonophrisits uncommplicated: smx/tmp, nitrofurantoin, fosphomycin pyelonephritis: smx/t,p, or ceftriazone (if inpt asymptomatic bacteriuria is not treated unless pt is pregnant. amox or augment
52
Cdif treatment
fidoxomicin 200 mg po BID or vancomycin 125 mg po bid for 10 days
53
treatment for syphillis
bicillin La 2.4 million units IM
54
gonnorhea
ceftriaxone 500 mg IM x1
55
chlamydia
cefuroxime AOM, CAP, sinus infections
56
bacterial vaginosis
metronidazole po or gel
57
trichonomoniasis
metronidazole 2 grams

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