Infections

Question 1

What is the spectrum of activity of natural PCNs?

Answer 1

Gram +

Question 2

True of False:

Very little resistance has occurred to natural PCNs.

Answer 2

False

Question 3

What class of drugs is used to treat MSSA? (Methicillin-sensitive Staph aureus)

Answer 3

Pencillin-resistant penicillins or anti-staphyloccal penicillins

Question 4

Name the most commonly used anti-staph PCNs.

Answer 4

Methicillin

Nafcillin

Question 5

What is the spectrum of coverage for aminopenicillins?

Answer 5

Gram + and Gram -

Question 6

Name the most common aminopenicillin that is used IV.

Answer 6

Unasyn.

Question 7

Why are beta-lactamase inhibitors sometimes added to aminopenicillins?

Answer 7

They protect the penicillins from inactivation by beta-lactamases.

Question 8

Are anti-pseudomonal penicillins used more in the outpatient or inpatient setting?

Answer 8

Inpatient (ex: Zosyn)

Question 9

What is the spectrum of coverage for anti-pseudomonal penicillins?

Answer 9

Gram + and -

Question 10

What is the main adverse effects of beta-lactams?

Answer 10

GI (specifically diarrhea)

Question 11

GI side effects of beta-lactams: do they increase or decrease with broader spectrum coverage?

Answer 11

The broader the coverage, the more likely the GI side effects.

Question 12

What is the spectrum of coverage for each generation of cephalosporins?

Answer 12

1st: +
2nd: + and -
3rd: -
4th: + and -
5th: + and -

Question 13

What are the most common first generation cephalosporins?

Answer 13

Keflex (cephalexin) and Ancef (cefazolin)

Question 14

What setting are third generation cephalosporins mostly used in?

Answer 14

Inpatient

Question 15

What are the two most commonly used IV preparations of 3rd generation cephalosporins?

Answer 15

Ceftriaxone (Rocephin)

Ceftazidime (Fortaz)

Question 16

Which cephalosporin has good CNS penetration, making it a good choice in meningitis treatment?

Answer 16

Ceftriaxone (Rocephin)

Question 17

What is the 4th generation cephalosporin?

Describe it’s spectrum of coverage and uses.

Answer 17

cefepime (Maxipime)
Gram + and -
IV
febrile neutropenia, peritonitis, HCAP

Question 18

What is the 5th generation of cephalosporins unique coverage?

Answer 18

MRSA, but not psuedomonas

Question 19

What is the primary adverse effect of cephalosporins?

Answer 19

GI upset

Question 20

What do we generally see the carbapenems reserved for?

Answer 20

“Heavy hitters.”

Resistant infections.

Question 21

What is the spectrum of coverage for carbapenems?

Answer 21

Broad

Question 22

If a patient has a PCN allergy, is it safe to prescribe a cephalosporin?

Answer 22

Generally, yes.

Question 23

True or false:

Judicious use of fluoroquinolones had led to resistance.

Answer 23

True

Question 24

Which second generation fluoroquinolone has good pseudomonas coverage?

Answer 24

Ciprofloxacin

Question 25

What are the two most common uses for levofloxacin?

Answer 25

UTI | URI

Question 26

Which two fluoroquinolones are "respiratory"?

Answer 26

Levofloxacin | Moxifloxacin

Question 27

What is the boxed warning for fluoroquinolones?

Answer 27

Tendon rupture.

Question 28

What CNS adverse effects of fluoroquinolones are more prominent in the elderly?

Answer 28

Headache, dizziness, drowsiness

Question 29

What setting are aminoglycosides generally used in?

Answer 29

Inpatient

Question 30

What spectrum are aminoglycoside agents used for?

Answer 30

Gram -

Question 31

Pharmacokinetic monitoring of aminoglycosides is used for what toxicities for peaks and troughs?

Answer 31

Peak: Efficacy and Ototoxicity Troughs: Nephrotoxicity

Question 32

Macrolides are commonly used for:

Answer 32

URI | H. Pylori

Question 33

Erythromycin is no longer generally used to treat infection, but rather used for:

Answer 33

prokinetic properties in GI (diabetic gastroparesis)

Question 34

What cardiac side effect of macrolides requires close monitoring?

Answer 34

QT prolongation

Question 35

What type of bacteria is clindamycin most well-known for treating?

Answer 35

Anaerobic

Question 36

What complication of clindamycin is most common?

Answer 36

C-diff

Question 37

What is the mechanism of action of clindamycin?

Answer 37

Protein synthesis inhibitor

Question 38

What is the spectrum of coverage for tetracyclines?

Answer 38

Broad

Question 39

Why should tetracyclines be taken on an empty stomach?

Answer 39

They bind with cations.

Question 40

Why are tetracyclines contraindicated in those under 8 years of age and in pregnancy/lactation?

Answer 40

Permanent yellow-brown staining of teeth.

Question 41

True of false: | Vancomycin has good oral absorption.

Answer 41

False

Question 42

What is oral vanco usually used for?

Answer 42

Cdiff

Question 43

For Vanco, what are the peaks and troughs used for?

Answer 43

Peaks: toxicity (oto/nephro) Troughs: Efficacy

Question 44

Besides oto/nephro toxicity, what is the other common side effect of vanco?

Answer 44

"Red man" or "Red neck" Syndrome | Histamine release causing a flushed look

Question 45

What is the most common sulfonamide drug used?

Answer 45

trimethoprim/sulfamethoxazole (Bactrim)

Question 46

What is the mechanism of action of sulfonamides?

Answer 46

Inhibit bacterial growth by blocking folic acid synthesis.

Question 47

For patients with sulfa allergy, what are some drugs/drug classes to use caution with?

Answer 47

Loop diuretics, thiazides, sulfonylureas, sumatriptan, topiramate.

Question 48

What is a drug very commonly used to treat UTI?

Answer 48

Nitrofurantoin

Question 49

What toxicity is known to Nitrofurantoin?

Answer 49

Neuropathy and lung toxicity

Question 50

What drug can be used as one time dose for UTI?

Answer 50

Fosfomycin

Question 51

Does flagyl have anaerobic coverage?

Answer 51

Yes

Question 52

Why shouldn't patients on Flagyl drink alcohol?

Answer 52

Disulfiram-like reaction.

Question 53

What two medications are used in latent TB treatment?

Answer 53

Rifampin | Isoniazid

Question 54

What is a known adverse effect of Rifampin?

Answer 54

Red secretions

Question 55

What is side effects of Isoniazid?

Answer 55

Isolated nerve problems