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Flashcards in Introduction To Abx Deck (53):
1

Penicillins are used to treat which bugs? (5)

Strep pyogenes: GAS, erysipelas, glomerulonephritis, pharyngitis
Strep viridans: found in mouth, causes endocarditis
Oral anaerobes: but less efficient than Clindamycin
Syphillis
Leptospirosis: kidney and liver disease
[P.VALS]

2

Ampicillin and amoxicillin both cover the same organisms than penicillin plus ...

E.Coli: they can be used for UTI in pregnancy as they are safe for the foetus

3

Penicillin exists in 3 forms

Penicillin G: IV
Penicillin VK: oral
Benzothine: long acting IM used for syphillis

4

Which gram negative bacterias are covered by amoxicillin?

H.Influenza
E.coli
Listeria
Proteus
Salmonella
[HELPS]

5

Amoxicillin is the best initial tx for (6)

Otitis media
Dental infection, endocarditis prophylaxis
Lyme limited to 7th CN, rash, joint
UTI in pregnancy
Listeria
Enterococci

6

Oxacillin, cloxacillin, nafcillin, dicloxacillin can be used for tx of

Skin infections: cellulitis (bc it is staph)
Endocarditis, meningitis and bacteremia from staph
Osteo and septic arthritis when proven sensitive
NOT against MRSA or enterococcus

7

Piperacillin and Ticacillin cover which organisms?

Gram neg bacilli (E.coli and proteus)
Enterobacteriae
Pseudomonas

8

Piperacillin and Ticacillin are the best therapy for (6)

Cholecystitis
Ascending cholangitis
Pyelonephritis
Bacteremia
Hospital acquired or ventilator assoc. pneumo
Neutropenia (absolute neutrophil count

9

Piperacillin, ticacillin, azlocillin, mezlocillin are generally combined with?

A beta-lactamase inhibitor such as taxobactam or clavulonic acid

10

Taxobactam and clavulonic acid add .... coverage to piperacillin and ticacillin

Staph

11

Cross reaction between penicillin and cephalosporins is

3-5%

12

Can you use cephalosporin in a penicillin allergic patient?

If pt only has a rash: yes
If anaphylaxis: no beta lactams

13

Which organisms are covered by any class of cephalosporins?

Group A, B and C strep
Strep viridans
E.coli
Klebsiella
Proteus

14

Which organisms are resistant to all forms of cephalosporins? (3)

Listeria
MRSA
Enterococcus

15

Name 4 first generation cephalosporins

Cefazolin, cephalexin, cephradrine, cefadroxyl

16

First generation cephalosporins are used to treat

Staph (methicillin sensitive)
Strep (but not enterococcus)
Some gram neg like E.coli but not pseudomonas
Osteomyelitis, septic arthritis, endocarditis, cellulitis

17

Name 6 second generation cephalosporins

Cefotetan, cefoxitin, cefaclor, cefprozil, cefuroxime, loracarbef

18

Second generation cephalosporins cover

Cover the same organisms than first generation (staph and strep if methicillin sensitive) but a little more anaerobes (specially cefotetan and cefoxitin) and gram neg bacilli

19

Cefotetan and cefoxitin (2nd generation cephalosporins) are the best initial therapy for .... But increase risk of ... and ...

PID combined with doxy
Bleedind and disulfiram like reaction with alcohol

20

Cefotetan and cefoxitin should not be taken with... ; why?

Alcohol
Disulfiram like reaction

21

Cefuroxime, loracarbef, cefprozil, cefaclor (2nd gen cephalosporins) are used for which conditions?

Respiratory infections (NOT PNEUMO)
bronchitis, otitis media, sinusitis

22

Name three third generations cephalosporins

Ceftriaxone, cefotaxime, ceftazidime

23

Ceftriaxone (3rd generation ceph)is first line tx for (5)

Pneumococcus, including partially insensitive organisms: meningitis, CAP (combine with macrolide), gonorrhea, lyme involving heart or brain

24

In whom ceftriaxone should be avoided?

Neonates, anaphylaxis to penicillin

25

Cefotaxime (3rd generation ceph) is better than ceftriaxone in which population?
In which disease?
Has better ... Coverage

Impaired hepatic metabolism (cefotaxime does not require metabolism by liver): Neonates
Spontaneous bacterial peritonitis
Pseudomonal

26

Cefepime (4th gen ceph) has better ... Coverage than third generation and is used for...

Staph
Used for : neutropenia and fever, ventilator associated pneumonia

27

What cephalosporin covers MRSA?

Ceftaroline

28

Carbapenems cover

Gram negative bacilli
Anaerobes
Staph and strep
Neutropenia and fever
Pseudomonas (except ertapenem)

29

Ertapenem is different than other carabapenems because

It does not cover pseudomonas

30

Axtreonam is used exclusively for

Gram negative bacilli, like E.coli, enterobacter, citrobacter, pseudomonas

31

Can you use aztreonam in a penicillin allergic patient?

Yes, there is no cross reaction

32

Name 4 fluoroquinolones

Ciprofloxacon
Gemifloxavin
Levofloxacin
Moxifloxacin

33

Fluoroquinolones are first line treatment for...

CAP: including penicillin resistant pneumococcus (except cipro!)
Gram negative bacilli including pseudomonas

34

Ciprofloxacin is number one drug for

Cystitis and pyelonephritis

35

Mocifloxacin is used for
It is the only quinolone covering

Lungs infections, diverticulitis and GI infections (no need to be combined with metronidazole)

It covers anaerobes

36

Quinolones adverse effects

Bone growth abnormalities in children and pregnant woman (do not use them in kids and preg)
Tendonitis and achilles tendon rupture

37

Gentamicin, tobramycin, amikacin (aminoglycosides) cover

Gram negative bacilli (bowel, urine, bacteremia): e.coli, enterobacter, citrobacter, pseudomonas, morganella, ceressia
+ synergistic with beta lactams for enterococci and staph

38

Aminoglycoside are synergistic with ... For ... And ... Infections

Beta lactams
Enterococci and staph

39

Aminoglycoside no not cover

Anaerobes: they need oxygen to work

40

Aminoglycoside side effects

Nephrotoxic : acute tubular necrosis
Ototoxic

41

Doxycycline is a drug of choice for

Chlamydia
Lyme disease rash, joint, 7th CN palsy
MRSA of the skin
Rickettsia (rocky mountain spotted fever)
Syphillis primary and secondary but ONLY if allergic to penicillin
Borrelia (lyme), ehrlichia (also tick borne) and mycoplasma

42

Adverse effects of doxy

Tooth discoloration (children)
Fanconi syndrome (type II RTA proximal)
Photosensitivity
Esophagitis (sit and drink a lot of water)

43

TMP/SMX is used for

Cystitis (3d if uncomplicated)
Pneumocystis pneumonia tx and prophylaxis
MRSA of skin and soft tissue (not heart and brain!)

44

TMP/SMX S.E

rash (sulfa drug)
Hemolysis, specially in G6PD deficiency
Bone marrow suppression (folate antagonist)

45

Nitrofurantoin is used for

Cystitis in pregnancy

46

Amoxicillin clavulonate
Ticacillin/clavulonate
Add what coverage?

Staph, covers only sensitive staph though

47

Best initial tx for sensitive staph or strep?

Oxacillin, cloxacillin, nafcillin, dicloxacillin
(Ox and naf IV)
1st gen cephalo
Fluoroquinolones
Macrolides (axithromycin, claithro, erythro): less efficacy than ox or cephalo and erythro is more toxic

48

Methicillin resistant staph first line tx?

Vancomycin
Linezolid (careful, reversible BM tox)
Daptomycin (NOT for lung)
Tigecycline (does not cover pseudomonas)
Ceftaroline

49

S.E of linezolid?

Reversible bone marrow toxicity (platelets!)

50

Tx for minor MRSA infections of the skin (not for blood, brain or heart)

TMP/SMX
Clindamycin
Doxycycline

51

Tx for anaerobes infections

Oral (above diaphragm) : penicillin (G, VK, ampi, amoxi), clindamycin
Under diaphragm: metronidazole (safe in pregnancy)
Piperacillin, carbapenems, second gen ceph also cover anaerobes

52

Diseases caused and tx for gram neg bacilli (e.coli, enterobacter, pseudomonas, klebsiella, proteus, citrobacter)

Bowel (peritonitis, diverticulitis)
Urinary tract (pyelonephritis)
Cholecystitis or cholangitis

Quinolones, aminoglycosides, carbapenems, piperacillin, tocacillin, aztreonam, cephalosporins (not pseudomonas in first gen)

53

Name beta lactams group of drugs (4)

Penicillins
Cephalosporins
Carbapenems
Aztreonams