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NAPLEX RxPrep 2023 > Infectious Disease 1: Background & Antibiotics By Drug Class > Flashcards

Infectious Disease 1: Background & Antibiotics By Drug Class Flashcards

1
Q

What is the definition for a Transmissible Disease?

How is it spread? What is it also referred to as?

A

Person to Person
“Communicable”
“Contagious”

RxPrep p 336

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2
Q

What are 3 primary factors that impact ID treatment decisions?

A
  1. Bug (pathogen)
  2. Drug (antibiotic)
  3. Patient (host)

*must be considered together - these are not separate entities

RxPrep p 336

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3
Q

What are key infection characteristics?

Antibiotic Selection

A
  1. Infection site
  2. Infection severity
  3. Community- or Hospital-acquired

*presence determined by signs & symptoms

RxPrep p 337

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4
Q

What are key antibiotic characteristics?

Antibiotic Selection

A
  1. Spectrum of Activity
  2. Penetration Ability to Infxn Site

lipophilic drugs ~ better tissue pentration

RxPrep p 337

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5
Q

What are key patient characteristics?

Antibiotic Selection

A
  1. Age & Body Weight
  2. Renal & Hepatic Functions
  3. Allergies & Comorbidities

RxPrep p 337

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6
Q

CNS / Meningitis

Common Bacterial Pathogens for Select Sites of Infection

A
  1. Neiserria meningitidis (GN cocci)
  2. Strep pneumo (GP diplococci) & H. influenzae (GN rods)
  3. Listeria (GP rods), Group B Strep, & E. Coli (enteric GN rods)

Group 3 pathogens occur in younger & older patients

RxPrep p 337

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7
Q

Mouth

Common Bacterial Pathogens for Select Sites of Infection

A
  1. Peptostreptococcus mouth flora (GP anaerobes, spores)
  2. Prevotella & B. fragilis (GNR anaerobes)
  3. Strep viridans

RxPrep p 337

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8
Q

Upper Respiratory

Common Bacterial Pathogens for Select Sites of Infection

A
  1. Strep pyogenes (GP diplococci)
  2. Strep pneumo & H. influenzae (GN rod)
  3. M. catarrhalis (GN coccobacilli)

RxPrep p 337

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9
Q

Heart / Endocarditis

Common Bacterial Pathogens for Select Sites of Infection

A
  1. MSSA & MRSA (GP clusters)
  2. Streptococci & Entercocci (GP diplococci)

RxPrep p 337

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10
Q

Skin / Soft Tissue

Common Bacterial Pathogens for Select Sites of Infection

A
  1. MSSA & MRSA (GP clusters)
  2. Strep pyogenes (GP dipolocci)
  3. Pasteurella multocida (GNR)

Pasteurella in Diabetes ~ think diabetic foot Infections!

RxPrep p 337

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11
Q

Intra-Abdominal

Common Bacterial Pathogens for Select Sites of Infection

A
  1. Enteric GNR (PEK, Citrobacter, Enterobacter, Serratia)
  2. B. fragilis (GNR anaerobes)
  3. Streptococci & Enterococci (GP diplococci)
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12
Q

Bone / Joint

Common Bacterial Pathogens for Select Sites of Infection

A
  1. MSSA / MRSA (GP clusters)
  2. Streptococci (GP diplococci)
  3. Neisseria gonorrhoeae (GN cocci)

RxPrep p 337

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13
Q

Urinary Tract

Common Bacterial Pathogens for Select Sites of Infection

A
  1. E. Coli, Proteus, Klebsiella (PEK, enteric GNR)
  2. Staph saprophyticus (GP cluster) & Enterococci (GP diplococci)

RxPrep p 339

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14
Q

Lower Respiratory (Community)

Common Bacterial Pathogens for Select Sites of Infection

A
  1. Atypicals (Legionella, Mycoplasma, Chlamydophilia)
  2. Strep pneumo (GP diplococci) & H. influenzae (GN rods)

Alcohol Use Disorder? Enteric GNRs may show up

RxPrep p 337

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15
Q

Lower Respiratory (Hospital)

Common Bacterial Pathogens for Select Sites of Infection

A
  1. MSSA & MRSA (GP clusters)
  2. Pseudomonas (GN rods)
  3. Enteric GNRs (PEK, Citro- / Enterobacter, Serratia; ESBLs, MRDOs)
  4. Strep pneumo (GP diplococci) & Acinetobacter (GN coccobacilli)

Proteus, E. Coli, Klebsiella

RxPrep p 337

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16
Q

What are characteristics and organisms for Gram + stains?

Gram Stain for Select Bacterial Organisms - Color & Shape

A
  1. Positive = Purple!
  2. Cocci clusters - Staph
  3. Diplococci (pairs) - Strep & Enterococcus
  4. Bacilli rods - Listeria & Corynebacterium
  5. Anaerobes - Peptostrepto & C. diff

Thick cell walls

RxPrep p 338

17
Q

What are characteristics and organisms for Gram - stains?

Gram Stain for Select Bacterial Organisms - Color & Shape

A
  1. Pink color!
  2. Cocci - Neisseria
  3. Coccobacilli - BAM ~Acinetobacter, B. pertussis, M. catarrhalis
  4. Anaerobes - BP ~ B. fragilis, Prevotella
  5. Enteric Rods - PEK, CES ~ PEK, Citrobacter, Enterobacter, Serratia
  6. Non-Enteric Rods - PH ~ Psuedomonas, H. influenzae
  7. Spiral Rods - THC ~H. pylori, Campylobacter, Treponema

Thin cell walls absorb safranin counterstain

RxPrep p 338

18
Q

What are characteristics and organisms for Atypical stains?

Gram Stain for Select Bacterial Organisms - Color & Shape

A
  1. No stain!
  2. Chlamydia, Legionella, Mycoplasma, Mycobacterium

No cell walls

RxPrep p 338

19
Q

What is the definition of Synergy?

Antibiotic Treatment

A

The effect of 2 antibiotics have an effect greater than the sum of the individual drugs

Aminoglycosides + Beta-Lactams for gram(+) infective endocarditis

RxPrep p 340

20
Q

What are key monitoring parameters for antibiotic treatment response?

Assessment of Treatment

A
  1. Fever trend
  2. WBC trend
  3. Reduction in infxn signs & symptoms

O2 saturation, mental status, pain/inflammation, negative repeat culture

RxPrep p 340

21
Q

Intrinsic Resistance

Common Mechanisms of Antibiotic Resistance

A

Natural resistance

Vancomycin cannot treat E. Coli because it can’t penetrate the cell wall

RxPrep p 341

22
Q

Selection Pressure

Common Mechanisms of Antibiotic Resistance

A

Antibiotics kill susceptible bacteria & leave resistant strains behind to multiply

Vancomycin kill Enterococci, leading to VRE strains

RxPrep p 341

23
Q

Acquired Resistance

Common Mechanisms of Antibiotic Resistance

A
  1. DNA resistant genes transferred between species
  2. DNA resistant genes picked up from dead bacterial fragments

RxPrep p 341

24
Q

Enzyme Inactivation
What are some major bacterial resistant enzymes? What are some antibiotics used to treat such organisms?

Common Mechanisms of Antibiotic Resistance

A
  1. Bacterial enzymes break down drug - beta-lactamase
  2. Beta-lactamase inhibitors (BLI): clavulanate, sulbactam, tazobactam, avibactam
  3. ESBLs: treated w/ carbapenems or newer cephalosporin/BLI
  4. Carbapenem-resistant Enterobacter (CRE): MDROs that create carbapenemase; treated w/ polymyxins or Avycaz

CRE MDROs: E. Coli, Klebsiella

RxPrep p 341

25
Q

What are Common Resistant Pathogens?

“Kill Each and Every Strong Pathogen”

A
  1. Klebsiella (ESBL, CRE)
  2. E. Coli (ESBL, CRE)
  3. Acinetobacter
  4. Enterococcus faecalis/faecium (VRE)
  5. Staph aureus (MRSA)
  6. Pseudomonas

Gram (+): Enterococcus, Staph

26
Q

All antibiotics have a risk warning for what? What antibiotics have the highest risk for this?

A
  1. C. diff Infection (CDI)
  2. Symptoms: loose stools, cramping, & pseudomembranous colitis (colectomy, fatal)
  3. Clindamycin! broad penicillins & cephalosporins, quinolones, carbapenems

RxPrep p 341

27
Q
A

NAPLEX RxPrep 2023 (5 decks)

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