Renal- Renal Infxs and Antibiotics Flashcards Preview

Pharmacology & Drugs > Renal- Renal Infxs and Antibiotics > Flashcards

Flashcards in Renal- Renal Infxs and Antibiotics Deck (64):
1

What is the typical presentation of cystitis

-Young, nonpregnant female

2

What is the pathogenesis of UPEC

-Biofilm like intracellular Bacterial communities
-Type 1 pili, antigen 43, Curli

3

In the case of a complicated severe pyelonephritis, what drug can be used

Beta lactam + beta lacamase inhibitor or a carbapenem

4

What is the treatment for acute proliferative glomerulitis

*Aka post streptococcal glomerulonephritis
-Loop diuretic, antihypertiesive, dialysis
-Antibiotics

5

In the case of a complicated mild pyelonephritis, what drug can be used

Ceftriaxone, Ciprofloxacin, levofloxacin, or aztreonam

6

How is imipenem metabolized

By dihydropeptidase in the kidney

7

Which common causing complicated UTI are good inhibitors of the class A beta lactamases

E. Coli and Klebsiella

8

What are the adverse effects in the use of Fluoroquinolones

Tendinitis and tendon rupture
Peripheral neuropathy
CNS effects

9

During complicated UTI, was is usually the pathogenesis occurring

Inflammatory response in the bladder due to neutrophils, along with fibrinogen accumulation in the case of catheters

10

What is the most common clinical presentation of complicated UTI and what is the most common cause

Severe dysuria, with 70-80% being due to indwelling catheters

11

Complicated UTI is normally occurring in which conditions

-Compromised urinary tract or host defenses (such as catheters, urinary obstructions, renal failure, etc.)

12

What drug is given in the cause of cystitis with resistance

Ertapenem (except ineffective against P. Aeruginosa

13

What are the clinical symptoms of pyelonephritis

-Unilateral back or flank pain with a fever

14

Which bacteria are very vulnerable to clindamycin

*Anaerobes
-strep, staphyl and pneumococci

15

What are the contraindications for nitrofurantoin

-Antagonizes nalidixic acid (synthetic quinolone antibiotic)
-Not to be used in patients G6PDH deficiency

16

Which bacteria should not be treated with nitrofurantoin

P aeruginosa and Proteus are resistant

17

What are the fluoroquinolones used to treat pyelonephritis

Ciprofloxacin or levofloxacin

18

What is the pathogenesis of P. Aeruginosa

-Microcolony formation by changing hydrophobicity of the surface
-Lectins, rhamnolipids

19

What is an adverse effect of using clindamycin for treatment

C. Difficile induced diarrhea and colitis

20

Which of the first line beta lactams is not given with a beta lactamase inhibitor

Cefepime

21

What are the drugs used in the treatment of complicated pyelonephritis that are classified as beta lactamase inhibitors

-Tazobactam
-Avibactam

22

What is the pathogenesis of P. Mirabilis

-Produces urease
-Calcium crystals and magnesium phosphate precipitates
-Crystaline biofilms

23

Which drug 3rd line drug should not be used to treat cystitis

-Moxifloxacin

24

What is the treatment of a prostatitis

TMP-SMZ, Ciprofloxacin, levofloxacin

25

What are Fluoroquinolones commonly used in cystitis

-Ciprofloxacin
-Levofloxacin
-Oflaxacin

26

What is the pathogenesis of E. Faecalis

Fibrinogen

27

Which drugs should not be used to empirically treat uncomplicated cystitis

Ampicillin and amoxicillin

28

What can be used to treat a complicated pyelonephritis in a pt with beta lactam allergy

Aztreonam

29

What are the adverse effects with nitrofurantoin

-Anorexia, nausea, vomiting

30

Which drug should be given to treat a complicated cystitis caused by gram positive cocci on gram stain

*Suggests enterococcus UTI (E.faecalis, faecium)
Ampicillin or amoxicillin
Phenazopyridine

31

What is the second line for treatment of cystitis

-Oral beta lactams

32

Which bacteria are targeted by fosfomycin

Gram positive and negative bacteria

33

What are the pharmokenetics of nitrofurantoin

Metabolized and excreted by kidneys very quickly, so there is no systemic antibacterial effect

34

What are the agents used for first line of treatment for cystitis

Nitrofurantoin
Fosfomycin
Trimethoprim-sufamethoxazole (TMP-SMX)

35

Which drug will cause urine to change orange or red

Phenazopyridine

36

Which bacteria are not affected by aztreonam

Gram positive or anaerobes

37

Can fosfomycin be used in pregnancy

Yes

38

Majority of cases of a prostatitis is caused by which pathogen

E. Coli

39

What are the adverse effects of fosfomycin

Limited headaches

40

What are the pharmokenetics of fosfomycin

Oral form with 40% bioavailability

41

What is the mechanism of action for fosfomycin

-Cell wall synthesis inhibitor by blocking enolpyruvate transferase Via binding to the cysteine residue of the active site

42

What are the symptoms of cystitis

-Dysuria, urinary frequency and urgency
-Nocturia, hesitancy, suprapubic discomfort, gross hematuria

43

Which bacteria are affected by aminoglycosides

Aerobic gram negative with P.aeruginosa

44

When is the second line of treatment for pyelonephritis used

When pt has Fluoroquinolone hypersensitivity or resistance

45

What are the oral beta lactams used in the treatment

-Amoxicillin (aminopenicillin)
-Cefpodoxime (3rd gen)
-Cefdinir (3rd gen)
-Cefadroxil (1st gen)

46

When is aztreonam used in the treatment of pyelonephritis

When patients can not handle the other treatment drugs

47

What is a common characteristic of bacteria causing a complicated UTI

More likely to be resistant to commonly used oral agents used in the treatment of uncomplicated UTI

48

When are fluoroquinolones used in the treatment of pyelonephritis

Severe cases or where there is resistance

49

What are the adverse effects of aminoglycosides

-CN VII toxicity with vertigo and hearing loss
-Renal toxicity
-NM blockage

50

What are the aminoglycosides used in the treatment of pyelonephritis

Gentamicin or tobramycin

51

Which common causing complicated UTI are good inhibitors of the class C beta lactamases

-Enterobacter spp.
-P. aeruginosa

52

When should nitrofurantoin and fosfomycin not be given

If there is suspicion of early pyelonephritis because does not have the adequate renal tissue levels

53

What are the symptoms and clinical presentation of a case of asymptomatic bacteriuria (ASB)

No symptoms and will only present with bacteria in the urine

54

What is the mechanism of action for nitrofurantoin

Bacterial reductases converts nitrofurantoin into highly reactive intermediate that targets bacterial machinery and DNA/RNA

55

What are the second line of treatments for pyelonephritis

-TMP-SMX
-Oral beta lactams
-aztreonam

56

What is the most common cause of UTI

UPEC or uropathogenic E.Coli

57

How are dori-,mero-, and Erta- metabolized

Not by dihydropeptidase

58

What are the bacterial that can cause complicated UTI

-E. Coli
-K. Pneumonia
-Enterobacter spp.
-P. Aeruginosa

59

What are the first line treatment for pyelonephritis

-Fluoroquinolones and aminoglycosides

60

In the case of a complicated cystitis, what drug can be used

Ciprofloxacin or levofloxicin

61

What are the uncomplicated UTI

Acute cystitis or pyelonephritis (usually in a nonpregnant outpatient women without an atomic abnormalities)

62

What is the mechanism of action for aminoglycosides

Irreversible protein synthesis inhibator on 30S
Interference with the initiation complex
Misreading of mRNA

63

What is the third line for treatment of cystitis

Fluoroquinolones

64

Which bacteria are targeted with Nitrofurantoin

Gram positive and negative