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CH - 22 ID 1 > Study Tip Gal > Flashcards

Study Tip Gal Flashcards

1
Q

CLASS EFFECTS All penicillins should be avoided in patients with a beta-lactam allergy

A

Exceptions: treatment of syphilis during pregnancy (all patients) and in HIV patients with poor compliance/follow-up desensitize and treat with penicillin G benzathine

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2
Q

All penicillins increase risk of seizure if accumulation occurs

A

e.g., failure to dose adjust in renal dysfunction

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3
Q

A first-line treatment for strep throat and mild nonpurulent skin infections (no abscess)

A

Penicillin VK

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4
Q

First-line treatment for acute otitis media

pediatric dose: 80 - 90 mg/kg/day

A

Amoxicillin

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5
Q

Drug of choice for infective endocarditis prophylaxis before dental procedures (2 grams PO x 1, 30 - 60 minutes before procedure)

A

Amoxicillin

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6
Q

First-line treatment for acute otitis media (pediatric dose:

90 mg/kg/day) and for sinus infections (if antibiotics indicated)

A

Amoxiciilin/ClavuianatefAugmentin)

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7
Q

Drug of choice for syphilis (2.4 million units IM x 1)

Not for IV use: can cause death

A

Penicillin G Benzathine (Bicillin L-A)

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8
Q

Only penicillin active against Pseudomonas

A

Piperacillin/Tazobactatn (Zosyn)

Extended infusions (4 hours) can be used to maximize Time > MIC

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9
Q

OUTPATIENT (ORAL)

Common uses: skin infections (MSSA), strep throat

A

1st Generation: Cephalexin (Keflex)

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10
Q

OUTPATIENT (ORAL)
Common uses: acute otitis media, community-acquired
pneumonia (CAP), sinus infection (if antibiotics indicated)

A

2nd Generation: Cefuroxime

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11
Q

OUTPATIENT (ORAL)
Common uses: community-acquired
pneumonia (CAP), sinus infection
(if antibiotics indicated)

A

3rd Generation: Cefdinir

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12
Q

Common use: surgical prophylaxis

A

1st Generation: Cefazoiin

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13
Q

Anaerobic coverage (B. fragilis)

A

2nd Generation: Cefotetan and Cefoxitin

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14
Q

Common use: surgical prophylaxis (colorectal procedures)

A

2nd Generation: Cefotetan and Cefoxitin

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15
Q

Can cause a disulfiram-like reaction with alcohol ingestion

A

2nd Generation: Cefotetan

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16
Q

Active against Pseudomonas

A

Ceftazidime (3rd Generation) and Cefepime (4th Generation)

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17
Q

Common uses: CAP, meningitis, spontaneous bacterial

peritonitis, pyelonephritis

A

3rd Generation: Ceftriaxone and Cefotaxime

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18
Q

Has no renal dose adjustment

Do not use in neonates (age 0 -28 days)

A

3rd Generation: Ceftriaxone

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19
Q

Only beta-lactam active against MRSA

A

Ceftaroiine

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20
Q

Common uses: CAP, skin and soft tissue infections

A

Ceftaroiine

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21
Q

Used for MDR Gram-negative organisms (including Pseudomonas)

A

Ceftolozane/Tazobactam and Ceftazidime/Avibactam

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22
Q

CEPHALOSPORINS CLASS EFFECTS

A

Risk of seizures if accumulation occurs

23
Q

CARBAPENEMS Class effects

A 
All active against ESBL-producing organisms
and Pseudomonas (except ertapenem)

Do not use with penicillin allergy

24
Q

Carbapenems are very broad-spectrum antibiotics

A

Reserved for MDR Gram-negative infections

25
Q

Seizure risk (with higher doses, failure to dose adjust in renal dysfunction, or use of imipenem/cilastatin)

A

CARBAPENEMS Class effects

26
Q

Remember what CARBAPENEMS do not cover

A 
Atypicals, 
VRE, 
MRSA, 
C. difficile, 
Stenotrophomonas
27
Q

ErtAPenem does not cover PEA:

A

Pseudomonas
Enterococcus
Acinetobacter

28
Q

Polymicrobial infections (e.g., severe diabetic foot infection)

Empiric therapy when resistant organisms suspected

ESBL-positive infections

Resistant Pseudomonas or Acinetobacter
infections

A

Carbapenems

Resistant Pseudomonas or Acinetobacter
infections (except ertapenem)

29
Q

Carbapenem dosage form

A

All are IV only. Ertapenem must be

diluted In normal saline.

30
Q

Aminoglycosides kill Gram-negative pathogens

fast,

A

are synergistic with betalactams for someGram-positive organisms, and have low resistance and drug cost.

31
Q

Aminoglycosides demonstrate concentrationdependent

activity and have a post-antibiotic effect

A

(the bacterial killing continues after the serum level drops below the MIC).

32
Q

Have notable toxicities that require monitoring: renal damage and ototoxicity, which may be irreversible (hearing loss/tinnitus/ balance problems).

A

Aminoglycosides

33
Q

Aminoglycoside smart idea

A

Take advantage of the concentration-dependent kinetics -> give larger doses less frequently -> this gives the kidneys time to recover between doses.

34
Q

Common uses of fluoroquinolones

A

Can vary by agent: pneumonias, UTIs, intraabdominal

infections, travelers’ diarrhea

35
Q

Respiratory Quinolones

A

Levofloxacin
moxifloxacin
gemifloxacin

Reliable S. pneumoniae activity (in pneumonia)

36
Q

Antipseudomonai Quinolones

A

Ciprofloxacin, levofloxacin

Used for Pseudomonas infections (including pneumonia)

37
Q

Only quinolone that is not renally adjusted (do not use for UTIs)

A

Moxifloxacin

38
Q

Flouroquinolone with IVtoPO Ratio 1:1

A

Levofloxacin and moxifloxacin

39
Q

Flouroquinolone Profile Review Tips

A

■ Caution with CVD, decreased K /Mg and with other QT-prolonging drugs (e.g., azole antifungals, antipsychotics, methadone, macrolides)
■ Avoid in patients with a seizure history or if using seizure drugs
■ Avoid in children

40
Q

Flouroquinolone Counseling

A

■ Avoid sun exposure, separate from cations, monitor blood glucose (in diabetes)
■ Watch for tendon rupture, neuropathy, CNS or psychiatric side effects

41
Q

CAP, and as an alternative to a beta-lactam for strep throat

A

All macrolides:
Erythromycin
Clarithromycin
Azithromycin

42
Q

COPD exacerbations, chlamydia (as monotherapy), gonorrhea (in combination therapy), prophylaxis for Mycobacterium Avium Complex, severe travelers’ diarrhea (including dysentery, diarrhea with bloody stools)

A

Azithromycin:

43
Q

Increased gastric motility and is used for gastroparesis

A

Erythromycin

44
Q

Macrolide profile review tips

A

QT Prolongation
■ Caution with CVD, decreased K/Mg and other QT-prolonging drugs (e.g., azole antifungals, antipsychotics, methadone, quinolones)

45
Q

Drug Interactions

■ Clarithromycin and erythromycin

A

are strong CYP3A4 inhibitors; lovastatin and simvastatin are contraindicated (increased risk of muscle toxicity)

46
Q

Common Uses Doxycycline and minocycline:

A

CA-MRSA skin Infections, acne

47
Q

first-line treatment for Lyme disease. Rocky Mountain Spotted Fever (tickborne illnesses), CAP, COPD exacerbations, sinusitis (if antibiotic indicated), VRE UTI, chlamydia (as monotherapy), gonorrhea (in combination therapy)

A

Doxycycline

48
Q

All tetracyclines

A

Do not use in pregnancy, breastfeeding or children < 8 years old

49
Q

Common Uses for sulfamethoxazole

A

CA-MRSA skin infections, UTI, Pneumocystis

pneumonia (PCP)

50
Q

5:1 Ratio of SMX/TMP (Dose Based on TMP)

A

■ Single strength (SS) tablet contains 80 mg TMP

■ Double strength (DS) tablet contains 160 mg TMP usual dose is one tablet BID

51
Q

SMX/TMP drug interactions

A

INR increased when used with warfarin. Use alternative antibiotic when possible.

52
Q

Drug of choice for

uncomplicated UTI

A

NITROFURANTOIN

Contraindicated when CrCI < 60 mL/min

53
Q

NO RENAL DOSE ADJUSTMENT

REQUIRED

A 
Antistaphylococcal penicillins (e.g., dicloxacillin, nafcillin)
Ceftriaxone
Clindamycin
Doxycycline
Macrolides (azithromycin and erythromycin only)
Metronidazole
Moxifloxacin
Linezolid

CH - 22 ID 1 (15 decks)

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