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NAPLEX Review UWorld > ID Part 3 > Flashcards

ID Part 3 Flashcards

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1
Q

Which of the following statements are true regarding Zyvox? (Select ALL that apply.)

A. Myelosuppression can occur with the use of Zyvox.

B. It is cleared primarily by the kidney requiring dose adjustments in the setting of renal impairment.

C. There is a risk for serotonin syndrome if used with SSRI antidepressants.

D. Nephrotoxicity is a common toxicity with prolonged use.

E. It has excellent bioavailability, thus can transition from intravenous to oral formulations in a 1:1 fashion.

A

Myelosuppression can occur with the use of Zyvox.

There is a risk for serotonin syndrome if used with SSRI antidepressants.

It has excellent bioavailability, thus can transition from intravenous to oral formulations in a 1:1 fashion.

Zyvox is primarily cleared by the liver, not the kidney. It is an MAO inhibitor.

It is contraindicated within 2 weeks of MAO inhibitors. It should be used with other serotonergic drugs only when clearly indicated. Ideally, an SSRI would be stopped before starting linezolid.

Myelosuppression (e.g., thrombocytopenia) is a duration-related toxicity.

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2
Q

Oxazolidinones Meds

A

Linezolid (Zyvox)

Tedizolid (Sivextro)

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3
Q

Oxazolidinones Coverage

A

Similar to Vancomycin + VRE

Vancomycin covs gram (+) bacteria (including MRSA)

Linezolid & Daptomycin DOC for VRE

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4
Q

Linezolid Indications

A

Skin/soft-tissue infections (SSTIs)

VRE infections

Pneumonia

Bloodstream infections

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5
Q

Tedizolid Indication

A

SSTI only

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6
Q

Oxazolidinones Bioavailability

A

IV:PO ratio = 1:1

Both comes in IV & PO

Don’t shake linezolid (Zyvox) sus

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7
Q

Linezolid CI

A

MAO inhibitor use w/in 14 days

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8
Q

Linezolid Warnings

A

Duration related myelosuppression (thrombocytopenia) - monitor CBC weekly

Optic neuropathy

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9
Q

Oxazolidinones & Serotonin Syndrome

A

Both are weak MAO inhibitors

Caution w/ serotonergic drugs (e.g., SSRIs, SNRIs, TCAs, meperidine, buspirone)

Avoid tyramine-containing foods

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10
Q

CPis a 22-year-old female who has been started on Macrobid for a five day treatment course for a urinary tract infection. Counseling on Macrobid should include the following points?

A. Do not take antacids or calcium supplements at the same time as your Macrobid dose.

B. This medication should be taken four times daily in evenly spaced intervals (every 6 hours).

C. This medication may cause the urine to turn dark yellow or brown in color.

D. This medication can make the skin more sensitive to the sun. Use sunscreen and protective clothing.

E. This drug should be taken on an empty stomach.

A

This medication may cause the urine to turn dark yellow or brown in color.

Nitrofurantoin (Macrobid) is dosed twice daily, hence the brand name MacroBID.

Nitrofurantoin does not have chelation interactions and does not cause photosensitivity.

It is associated with GI upset and should be taken with food.

The urine discoloration is harmless.

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11
Q

Nitrofurantoin

Common Dosing regimen

A

Macrobid 100 mg BID x 5 d

Macrodantin QID

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12
Q

Nitrofurantoin

Warnings

A

Avoid in G6PD deficiency

Can cause hemolytic anemia (+ Coombs test)

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13
Q

What is the DOC for uncomplicated UTI?

A

Nitrofurantoin

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14
Q

Nitrofurantoin

Do not use when?

A

CrCl < 60

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15
Q

Nitrofurantoin

Counseling

A

Take w/ food

Can discolor urine (brown)

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16
Q

Wt: 105 lbs

The physician asks the pharmacist on rounds to assist with transitioning the patient to oral Bactrim20 mg/kg/day in preparation for hospital discharge. What is the correct dose?

A. Bactrim SS 2 tabs BID

B. Bactrim SS 2 tabs TID

C. Bactrim DS 1 tab TID

D. Bactrim DS 2 tabs BID

E. Bactrim DS 2 tabs TID

A

Bactrim DS 2 tabs TID

105 pounds = 47.7 kg. 47.7 kg x 20 mg/kg = 954 mg Bactrim/day.

Bactrim is dosed from the TMP component and DS tabs have 160 mg TMP per tab.

KS would need 6 tabs per day (954 mg Bactrim / 160 mg TMP per tab) to treat her infection.

To avoid errors, mg/kg doses should reference the TMP component.

When using higher SMX/TMP doses like this, monitor the patient carefully for side effects.

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17
Q

KS is diagnosed with PCP and stabilized. She is ready for discharge. Her provider is concerned that the cellulitis has not healed as well as he had hoped. He asks the pharmacist about a single dose medication for bacterial skin and skin structure infections that he heard about. He thinks this patient would be a good candidate for this drug. Which drug is he referring to?

A. Vancomycin

B. Telavancin

C. Oritavancin

D. Tedizolid

E. Polymyxin

A

Oritavancin

Oritavancin (Orbactiv) and dalbavancin (Dalvance) are lipoglycopeptides with similar spectrum of activity to vancomycin: both have activity against Staphylococci (MSSA and MRSA) and Streptococci.

Oritavancin and dalbavancin are a one-time dose.

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18
Q

Lipoglycopeptides

Meds

A

Telavacin (Vibativ)

Oritavancin (Orbactiv, Kymyrsa)

Dalbavancin (Dalvance)

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19
Q

Lipoglycopeptides

Coverage

A

Similar to IV Vancomycin:
Gram (+) Cocci including MRSA

Does not cover VRE

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20
Q

Lipoglycopeptides

Approved for

A

Skin infections

Telvancin (Vibativ) approved for HAP/VAP

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21
Q

Lipoglycopeptides

Which one is approved for HAP/VAP?

A

Telvancin (Vibativ)

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22
Q

Lipoglycopeptides

Can cause what syndrome?

A

Red Man

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23
Q

Lipoglycopeptides

Which ones are single-dose regimens?

A

Oritavancin (Orbactiv, Kymyrsa)

Dalbavancin (Dalvance)

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24
Q

Lipoglycopeptides: Tealvancin (Vibativ)

Boxed Warnings

A

Fetal risk, Nephrotoxicity, ↑ mortality compared to vancomycin in Pneumonia trials (pts w/ CrCl ≤ 50)

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25
# Lipoglycopeptides: Telavancin (Vibativ) CI
Concurrent use of IV UFH
26
# Lipoglycopeptides: Telvancin (Vibativ) Warnings
Falsely ↑ aPTT/PT/INR
27
# Lipoglycopeptides: Oritavancin (Orbactiv, Kymyrsa) CI
Use of IV UFH for 5d after
28
# Lipoglycopeptides: Oritavancin (Orbactiv, Kymyrsa) Warnings
↑ PT/INR (up to 12 hrs) & ↑ aPTT (up to 120 hrs)
29
Which two antibiotics should be separated from multivitamin supplements?  A. Flagyl and cefuroxime  B. Minocycline and levofloxacin  C. Avelox and amoxicillin  D. Bactrim and Zithromax  E. Biaxin and Zyvox
Minocycline and levofloxacin ## Footnote Tetracyclines and quinolones should be separated from divalent cations (e.g., calcium, iron, magnesium, zinc) as they may inhibit absorption through chelation.
30
Which of the following statements is correct in regard to ceftriaxone?  A. It is considered a broad-spectrum antimicrobial agent with activity against Pseudomonas.  B. It is cleared unchanged by the kidney and requires dose adjustments in renal impairment.  C. It is a drug of choice for spontaneous bacterial peritonitis.  D. It should be avoided in patients who are pregnant.  E. It can be used with calcium containing IV products in neonates
It is a drug of choice for spontaneous bacterial peritonitis.
31
Which of the following medications is/are associated with seizures and/or decreasing the seizure threshold? (Select ALL that apply.) A. Imipenem/Cilastatin B. Ciprofloxacin C. Cefuroxime D. Penicillin G E. Azithromycin
Imipenem/Cilastatin Ciprofloxacin Cefuroxime Penicillin G ## Footnote Ciprofloxacin and the other quinolones decrease the seizure threshold. Beta-lactams have been associated with seizures, especially if the drug accumulates (e.g., longer courses, renal failure).
32
HW is a 71-year-old male who has been in the intensive care unit for several weeks and is now being treated for pneumonia, with a lower respiratory culture positive for Pseudomonas aeruginosa. His weight is 225 pounds and height is 6'0". His current serum creatinine is 2.4 mg/dL. Based on the culture sensitivities, the medical team decides to start tobramycin at 2.5 mg/kg. They ask the pharmacist to write the order and administer the first dose at 8:00 AM. Which dose of tobramycin should be administered at 8:00 AM?  A. 560 mg  B. 410 mg  C. 340 mg  D. 220 mg  E. 100 mg
220 mg ## Footnote Aminoglycosides are dosed using adjusted body weight for obese patients. 2.5 mg/kg x 87.47 kg = 218.68 mg; round to 220 mg. 
33
Which quinolone antibiotic is preferred for treatment of MRSA skin and soft tissue infections?  A. Delafloxacin  B. Ciprofloxacin  C. Levofloxacin  D. Moxifloxacin  E. Gemifloxacin
Delafloxacin | Brand: Baxdela ## Footnote Delafloxacin has activity against MRSA and is indicated for skin and soft tissue infections. Other quinolones should be avoided due to higher rates of resistance.
34
MT should be counseled to take the Levaquin 2 hours before or 2 hours after which medication?  A. Zinc  B. Simvastatin  C. Warfarin  D. Aspirin  E. Hydrochlorothiazide
Zinc ## Footnote Quinolones should not be given with zinc or other divalent cations, due to decreased absorption with chelation.
35
Preferred Initial ART Regimens in Most Tx-Naive Adults
Biktarvy Triumeq Dovato Tivicay + Truvada Tivicay + Descovy | Do not use if CrCl < 30 ## Footnote All contain an integrase inhibitor w/ a high barrier to resistance
36
Dovato
Dolutegravir + lamivudine
37
# Dovato Criteria for use
VL < 500,000 No HBV No resistance to either component | Dolutegravir + lamivudine
38
Emtriva | Generic
emtricitabine
39
Complete HIV Antiretroviral Regimens
Base (Choose 1) NRTI (2 in most cases)
40
# Complete HIV Antiretroviral Regimens Base
INSTi (eg, raltegravir) OR Boosted PI (eg, darunavir/ritonavir) OR NNRTI (eg, doravirine)
41
# Complete HIV Antiretroviral Regimens NRTI Backbone
Abacavir or Tenofovir PLUS Emtricitabine or lamivudine
42
# ART in Pregnancy Already on ART
May continue pre-pregnancy ART regimen in most cases
43
# ART in Pregnancy New starts
3 components recommended: Dolutegravir or boosted darunavir, **PLUS** Dual NRTI backbone (eg, emtricitabine/tenofovir)
44
# ART in Pregnancy Perinatal transmission PPx
Maternal administration of IV zidovudine prior to delivery Neonatal administration of ART (exact regimen & duration dependent on risk)
45
Immune Reconstitution Inflammatory Syndrome (IRIS)
Worsening of an underlying condition after ART initiation & as the CD4 count begins to recover ## Footnote Can be known or previously unidentified condition More likely when ART initited at low CD4 counts
46
# Immune Reconstitution Inflammatory Syndrome (IRIS) Key points
Continue ART Treat underlying condition (eg, opportunistic infection) Provide supportive care (eg, fluids, antipyretics)
47
Which of the following statements is correct regarding piperacillin/tazobactam?  A. Tazobactam is added to inhibit beta-lactamase activity.  B. The brand name is Zofran.  C. It exhibits concentration-dependent killing.  D. The dosing is 0.375 grams/3 grams of piperacillin/tazobactam respectively.  E. It is available as an oral suspension and intravenous formulation.
Tazobactam is added to inhibit beta-lactamase activity. ## Footnote Piperacillin/tazobactam (Zosyn) is available IV only and exhibits time-dependent killing. Tazobactam is a beta-lactamase inhibitor that expands its spectrum of activity to include anaerobes and more resistant organisms. The correct dosing formulation is 3 g/0.375 g of piperacillin/tazobactam, respectively.
48
Common Resistant Pathogens | Mnemonic
Kill Each And Every Strong Pathogen **K**lebsiella pneumoniae (ESBL, CRE) **E**. coli (ESBL, CRE) **A**cinetobacter baumannii **E**nterococcus facecalis & faecium (VRE) **S**taphylococcus aureus **P**seeudomonas aeruginosa
49
A prescription for generic minocycline is filled. Which of the following statements regarding minocycline are correct? (Select ALL that apply.) A. This medication has been associated with drug-induced lupus. B. Take on an empty stomach 1 hour before or 2 hours after meals. C. This medication may increase the risk of sunburn. D. This medication should be separated when given with antacids. E. This medication does not interact with other medications.
This medication has been associated with drug-induced lupus. This medication may increase the risk of sunburn. This medication should be separated when given with antacids. ## Footnote Minocycline should not be used in children younger than 8 years old or in patients who are pregnant due to the risk of tooth discoloration, bone growth retardation and reduced skeletal development. Phosphate binders like fosrenol also decrease minocycline absorption.
50
# Tetracyclines Drugs
**Doxycyline** (**Vibramycin**) **Minocycline** (**Minocin, Solodyn**) Eravacycline (Xerava) Omadacycline (Nuzyra) Sarecycline (Seysara) **Tetracycline**
51
# Tetracyclines Coverage
Gram (+): Staph, Strep, Entero, Propionibacterium Gram (-): including respiratory flora (Haemophilus, Moraxella, **atypicals**) Other: Rickettsiae, Bacillus antracis, Treponema pallidum & other spirochetes)
52
# Tetracyclines Doxycycline Coverage
Respiratory tract infections (e.g., **CAP**) **Tickborne/rickettsial diseases** Spirochetes Sexually transmitted infections (e.g., **chlamydia**)
53
# Tetracyclines Common Uses
CA-MRSA skin infections Acne ## Footnote Minocycline is preferred for acne
54
# Tetracyclines Doxycycline Common Uses
First line for * Tickborne illnesses (Lyme disease, Rocky Mountain Spotted Fever) * Chlamydia Treatment option for * CAP, * COPD exacerbations, * Bacterial sinusitis (if antibiotic indicated), * VRE UTI
55
# Tetracyclines Tetracycline Common Uses
H. pylori Tx regimens
56
# Tetracyclines Warnings
Avoid in Children < 8 y/o (supresses bone growth & discolors teeth) & Pregnancy & breastfeeding Causes Photosensitivity
57
# Tetracyclines Intxn
Inhibit absorption Antacids & other polyvalent cations (eg, Mg, Al, PO4, Ca, Fe, Zinc) Multivitamins Sucrafate Bismuth Subsalicylate Bild Acid Renins
58
# Tetracyclines IV:PO
1:1 | Doxycyline, minocycline
59
Which antibiotic induces drug induced lupus erythematosus (DILE)?
**Minocycline** (**Minocin, Solodyn**)
60
# Which are Hydrophilic Agents
Beta-Lactams Aminoglycosides Glycopeptides Daptomycin Polymyxins
61
Hydrophilic Agents | Proporties
Small Vd Renal elimination Low intracellular concentrations Increased clearance in sepsis Poor-moderate bioavailability
62
# Which are Lipophilic Agents
Quinolones Macrolides Rifampin Linezolid Tetracycline Chloramphenicol
63
Lipophilic Agents | Properties
Large Vd Hepatic metabolism Achieve intracellular concentrations Clearance changed minimally in sepsis Excellent bioavailability
64
Recommended Initial HIV ART for most pts
INSTI plus 2 NRTIs: Bictegravir/tenofovir alafenamide/emtricitabine (Biktarvy) Dolutegravir/abacavir2/lamivudine (Triumeq) Dolutegravir (Tivicay) plus: * Emtricitabine/tenofovir alafenamide (Descovy) * Emtricitabine/tenofovir disoproxil fumarate (Truvada) INSTI plus 1 NRTI: Dolutegravir/lamivudine (Dovato) ## Footnote Do not use INSTI + 1 NRTI if pretreatment HIV RNA > 500,000 copies/mL, there is known hepatitis B coinfection, or HIV genotyping is not available.
65
Clindamycin Brand
Cleocin Topical: Clocin-T, Clindagel
66
Clindamycin Coverage
Staph (including CA-MRSA), Strep & Anaerobes
67
Clindamycin Renal
No dose adjustment
68
D-test
Induction test on Saureus susceptible to clindamycin but resistant to erythromycin **Flattened zone** indicates clindamycin resistance (don't use)
69
Clindamycin Box Warning
C. diff
70
Metronidazole Coverage
Anaerobes & Protozoal
71
Metronidazole IV:PO
1:1
72
Metronidazole CI
Pregnancy Alcohol (disulfiram rxn)
73
Metronidazole SE
Metalic Taste
74
Metronidazole Drug Intxn
↑ INR w/ warfarin
75
# Which antibiotics are Cmax:MIC (concentration-dependent)
Aminoglycosides Quinolones Daptomycin
76
# Which antibiotics are AUC:MIC
Vancomycin Macrolides Tetracyclines Polymyxins ## Footnote Technically also concentration dependent but AUC is not usually measure in practice
77
# Which antibiotics are Time > MIC (time-dependent)
Beta-lactams
78
# OTC HIV testing Brand
OraQuick In-Home HIV Test ## Footnote Other might be available but might require labs
79
# OTC HIV testing Sample & timing
Oral fluid sample to detect the presence of HIV antibodies Perform ≥ 3 months from exposure to avoid false negative
80
# OTC HIV testing Testing procedure
Swab upper & lower gums with test stick Insert test stick into tube containing testing solution After 20 minutes, read the results: * One line indicates a positive control (ie, valid test) * Two lines indicates a positive HIV result Positive results require follow-up laboratory confirmation for diagnosis
81
Aminoglycoside Boxed Warning
Nephrotoxicity Ototoxicity Neuromuscular blockage
82
Maraviroc (Selzentry)
CCR5 Antagonist Hepatotoxicity (boxed warning) Hypersensitivity reactions (including SJS/TEN) Orthostatic hypotension (in patients with renal impairment) Tropism test required prior to starting CYP3A4 substrate
83
Fostemsavir (Rukobia)
Attachment Inhibitor Must maintain effective HBV treatment if coinfected Can ↑ SCr (especially if underlying renal disease) Is a substrate of CYP3A4: check for drug interactions!
84
Ibalizumab-uiyk (Trogarzo)
Post-Attachment Inhibitor IV injection Infusion-related reactions (observe for 1 hour after 1st infusion) Other side effects: diarrhea, dizziness, nausea, rash
85
Enfuvirtide (Fuzeon)
Fusion Inhibitor SC injection Risk of bacterial pneumonia, hypersensitivity reactions Injection site reactions: pain, erythema, nodules & cysts, ecchymosis Other side effects: nausea, diarrhea, fatigue
86
Lenacapavir (Sunlenca)
Initial: PO loading dose then Then SC injections Q6 months Safety & Monitoring * Contraindicated with strong CYP3A4 inducers * Injection site reactions: erythema, induration, nodule, pain, swelling
87
DOC for Acinetobacter
Meropenem
88
# Vancomycin Target AUC/MIC ratio for serious MRSA infections
400-600
89
An antibiogram is: (Select ALL that apply.) A. Another name for a culture and susceptibility report B. A collection of culture and susceptibility reports over a period of time C. Used to select empiric therapy D. Used to help establish local resistance trends E. Provides information on the MIC of specific bacteria
A collection of culture and susceptibility reports over a period of time Used to select empiric therapy Used to help establish local resistance trends ## Footnote The culture and susceptibility report is for a single patient specimen and provides MIC information. The antibiogram is a collection of C & S reports over a period of time (typically 1 year) that provides the percent of isolates that are susceptible. It is used to help select therapy before the susceptibility report is available and to establish local guidelines (based on local resistance patterns).
90
Metronidazole is likely to be useful in which of the following infections? (Select ALL that apply.) A. Urinary tract infection B. Bacterial vaginosis C. Trichomoniasis D. Community-acquired pneumonia E. Peritonitis after a perforated colon
Bacterial vaginosis Community-acquired pneumonia Peritonitis after a perforated colon ## Footnote Metronidazole is an agent with anaerobic activity (including B. fragilis) and antiprotozoal activity. Community-acquired pneumonia and urinary tract infections do not typically involve these pathogens.
91
BT is a 28-year-old female with a 2-day history of increased **urinary frequency and burning with urination**.  She has **suprapubic tenderness but no flank pain**.  Her vital signs are normal.  A urinalysis is positive for white blood cells, leukocyte esterase, and nitrites, and a urine culture is pending.  BT has a history of **Escherichia coli urinary tract infections**, the **last of which was treated 2 months ago with sulfamethoxazole/trimethoprim**.  She has **no known drug allergies**.  Which antibiotic is the best choice to empirically treat the infection while awaiting culture results?  A. Amoxicillin  B. Bactrim DS  C. Fosfomycin  D. Metronidazole  E. Zithromax
Fosfomycin ## Footnote The first-line empiric treatment for acute cystitis (a lower urinary tract infection) is nitrofurantoin, fosfomycin, or sulfamethoxazole/trimethoprim.  An antibiotic that has not been used within the past 3 months should be selected.
92
# Acute cystitis Microbiology
Escherichia coli (most common) Other gram-negative pathogens (eg, Proteus spp., Klebsiella spp.) Staphylococcus saprophyticus
93
# Acute cystitis Clinical features
Dysuria Increased urinary frequency and/or urgency Suprapubic tenderness
94
# Acute cystitis Diagnosis
Urinalysis with pyuria (WBC > 10 cells/mm3), bacteria & positive leukocyte esterase and/or nitrites Urine culture for organism identification & susceptibility
95
TM is a 42-year-old male who has been started on clarithromycin for treatment of pneumonia. Which of the following medications does not pose a drug interaction with the antibiotic treatment?  A. Amiodarone  B. Methadone  C. Simvastatin  D. Sucralfate  E. Voriconazole
Sucralfate ## Footnote Clarithromycin (as well as erythromycin) is a strong CYP3A4 inhibitor and is contraindicated with simvastatin (and lovastatin) and can cause increased concentrations of methadone and voriconazole. Macrolides are associated with QT interval prolongation, which would be additive with amiodarone, methadone and voriconazole. Macrolides do not have chelation issues with sucralfate.
96
A 23-year-old sexually active male visits his primary care physician concerned about multiple soft, nonpainful, mildly pruritic, skin-colored papules that have developed on the shaft of his penis.  He is diagnosed with genital warts.  What treatment is recommended?  A. Clindamycin PO  B. Imiquimod cream  C. Metronidazole gel  D. Mupirocin ointment  E. Tinidazole PO
Imiquimod cream ## Footnote Human papillomavirus is a sexually transmitted disease that causes anogenital warts.  Imiquimod cream is an immune activator that can help resolve the appearance of the warts.
97
# Genital warts Etiology
Sexual transmission of HPV strains 6 & 11
98
# Genital warts Clinical features
Single or multiple pink or skin-colored lesions Lesions range from smooth, flattened papules to cauliflower-like growths
99
# Genital warts Treatment
Common patient-applied therapies: * Imiquimod cream (immune activator) * Podofilox solution or gel (causes wart necrosis) Provider-administered: cryotherapy, surgical removal
100
# Genital warts Prevention
Vaccination: HPV-9 (Gardasil 9) recommended for age 9–26 Barrier contraception

NAPLEX Review UWorld (17 decks)

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