Viro exam 1

Question 1

Gram + aerobic organism associated with:

Answer 1

-Skin and soft tissue infections
-Community acquired pneumonia
-Catheter related bacteremia

Question 2

Gram + aerobic bacteria that have cluster shape staphylococcus if coagulate positive

Answer 2

Staphyloccus aureus

Question 3

Gram + aerobic bacteria that have cluster shape staphylococcus
Coagulase -

Answer 3

Staphylococcus epidermis

Question 4

MRSA

Answer 4

Methicillin resistant to staphyloccoccus and wont work

Question 5

ORSA

Answer 5

Oxacillin resistant to staphyloccoccus and wont work

Question 6

MSSA

Answer 6

Methiccilin sensitive to staphyloccucus will work

Question 7

OSSA

Answer 7

oxacillin sensitive to staphyloccoccus will work

Question 8

Gram + aerobic bacteria with bacilli shape are:

Answer 8

Streptococcus–>Streptococcus pneumonie (S.pneumonie) –> A hemolytic
Streptococcus pyrogen (S.pyrogen)–> B-hemolytic

and enterococcus sp –> Group D streptococci–> Y hemolytic

Question 9

Diferentiation of gram + aeorobic bacteria with bacilli shape are based on

Answer 9

hemolysis test and penicillin resistant s.pneumoniae

Question 10

Differentiation of enterococcus 2 major types

Answer 10

-They behave differently to antibiotics
E.faecalis
E.Faecium
problem is Vancomycin Resistant Enterococcus (VRE)

Question 11

Other Gram +

Answer 11

Listeria meningitis (Rod)
Coynebacterium spp (bacilli)

Question 12

Gram + anaerobes cocci

Answer 12

Peptococcus and Peptostreptococcus
-They are in the mouth and if aspirate pneumonia contents is a problem

Question 13

Gram + anaerobes baccili

Answer 13

Clostridiodides difficile–>C.deff –> in the GIT causes GI problems
Clostridium Sp. –> in the GIT

Question 14

Gram + bacterias in the skin

Answer 14

Staphylococcus sp.–> Gram + aerobic cluster –> If + coag test is staphylococcus aureus . –> if - coag test staphylococcus epidermis

Streptococcus sp.–> Gram + aerobic chains or pairs form–> S.pneumonia and S.pyrogen (strep throat)

Question 15

Gram + bacterias in the oropharynx
in mouth, upper respt tract or lower

Answer 15

Gram + aerobic: Streptococcus sp–> Streptococcus pyrogen and Streptococcus pneumonia
Gram + anerobic cocci–> peptococcus and peptostreptococcus

Question 16

Gram + bacterias in the GIT:

Answer 16

Gram + aerobic with chain or paris –> Enterococcus: E.Faecalis, E.Faecium

Gram + anaerobic baccili–> Clostridioides difficile (C.deff.) and Clostridium sp

Question 17

Gram (-) aerobic bacterias are associated with

Answer 17

Urinary tract infections
Intra-abdominal and gastrointestinal tract infections
Bacteremia–> infection of blood
Nosocomal pneumonia–> hospital acquired pneumonia

Question 18

Gram (-) aerobic cocci bacteria

Answer 18

Neisseria species–> N.meningitis and N.gonorrhoeae

Moraxella catarrhalis–> Respiratory pathogens

Question 19

Gram (-) aerobic baccili lactose fermentating

Answer 19

Enterobacteriales:
E.Coli
Enterobacter
Klebsiella
Citrobacter
-They are in the GIT and urinary tract –> So they cause urinary tract infections

Question 20

Gram (-) aerobic baccili non fermentating

Answer 20

Proteus
Salmonella
Shingella
Pseudomonas

Question 21

Other Gram (-) aerobe that is in the oropharynx is:

Answer 21

Hemophilus influenzae

Question 22

Gram (-) anaerobe:
Where does is located?

Answer 22

Bacteroides fagilis group
In the GIT

Question 23

What Gram (-) bacterias are in the skin?

Answer 23

pseudomonas
Acinetobacter sp

Question 24

What are the gram (-) aerobic bacterias in the oropharynx?

Answer 24

H.influenzae
N.meningitis

Question 25

What are gram (-) aerobic bacilli bacterias that are positive lactose fermentating found in the GIT?

Answer 25

Enterobacteriales: E.coli Klebsiella Citrobacter, Serratia

Question 26

What are the gram (-) aerobic bacili lactose fermentating bacterias in the urinary tract?

Answer 26

Enterobacterias E.coli Klebsiella Citrobacter, Serratia

Question 27

What are the atypical organism>

Answer 27

Mycoplasma pneumoniae--> Walking pneumoniae Chlamydia pneumoniae Ligionella pneumonie

Question 28

What is Penicillin G? When should it be use? Coverage against what bacterias? Does it requires Dose adjustment?

Answer 28

IV or IM is natural penicillin -Can use it for emergency situations also -Gram + -->Streptococcus (S.pneumonia, S.pyrogen), Enterococcus (E.faecalis), Mouth anaerobes (Peptocpoccus, pepsistreptococcus), N.meningitis, syphilis, Pasteurella Multocida dog or cat bite -Yes renal and heart failure ptd

Question 29

What is Penicillin G Procaine? When should it be use? Coverage against what bacterias? Does it requires Dose adjustment?

Answer 29

-Only IM -Natural penicillin Coverage against: Gram + --> Only Streptococcus (S.pneumonia, S.pyrogen), Enterococcus (E.facalis, E.faceium) in the GIT, Mouth anarobes peptococcus, pepstreptococcus, n.meningitis, syphilis, pasteurella multocida - dog/cat bite Yes--> For renal dysfuction pt and for heart failure pt

Question 30

What is Penicillin G Benzathine? When should it be use? Coverage against what bacterias? Does it requires Dose adjustment?

Answer 30

Natural penicillin Only IM x 1 dose Coverage against Gram + = Streptococcus S.pneumonia, S.pyrogen, Enterococcus (E.faecalis, E.Faecium), mouth anaerobes Peptococcus, pepstreptococccus. Syphilis, N.meningitis, pasteurella multocida Yes: Renal dysfunction and heart failure pts

Question 31

What is Nafcillin? When should it be use? Coverage against what bacterias? Does it requires Dose adjustment? ## Footnote u-

Answer 31

Nafcillin (Unipen) is a penicillinase resistant penicillin also known as antistaphyloccus -Inhibits bacteria cell wall synthesis and the bulky group prevent destruction from B-lactamase -Use IV for skin and soft tissue infections -Coverage against Gram + --> Staphylococcus S.aureus (Coug+) S.epidermis (coag -) BUT NO MRSA , Streptococcus (S.pyrogen, S.pneumonia) -No dose adjustment is metabolize by the liver -May elevate liver enzymes --> Pontential risk for hepatitis -Avoid extravasation --> fluid leaks from IV line into interstitial -DDI with warfarin -Do not administer in same IV line of Aminoglycosides

Question 32

What is Oxacillin? When should it be use? Coverage against what bacterias? Does it requires Dose adjustment? ## Footnote B-

Answer 32

Oxacillin (bactocilli) IV Is a penicillinase resistant penicillin Also refered as antistaphylococcus -Use for skin and soft tissue infections -Inhibits bacteria cell wall synthesis prevent transpeptidase from linking Glycine + alanine -The bulky group prevent destruction by B-lactamase Coverage against Gram + = Staphylococcus coug + S.aureus Coug - S.epidermis, Streptococcus -No dose adjustment needed because is metabolize by the livers -Can increase liver enzymes--> Potential risk for hepatitis -Do not administer in the same IV line with aminoglycosides

Question 33

What is Dicloxacillin? When should it be use? Coverage against what bacterias? Does it requires Dose adjustment? ## Footnote d-

Answer 33

Dicloxacillin (Dynapen) only PO Is a penicillinase resistant penicillin antibiotic also known as ANTISTAPH Use for skin and soft tissue infections Coverage against Gram + --> Staphylococcus if coug + S.aureus if coag - S.epidermis no MRSA -Does not require renal dose adjustment -Need to give 1-2 hrs after meal -Can increase LFT --> potential risk for hepatitis -DDi--> Warfarin --> Dicloxacilin (Dynapen) will enhance metabolism of warfarin and decrease the effects of warfarin

Question 34

What is Ampicillin? When should it be use? Coverage against what bacterias? Does it requires Dose adjustment? What are the DDI? What are some AE?

Answer 34

Ampicillin is a amino-penicillin IV or PO QID -Is use for upper respiratory tract infections: otitis media, sinus, bronchitis. Can also be use for neserria and enterococcal infections (intraabdominal infections) -It has coverage against: Gram + --> Streptococcus S.pneumonia, Enterococcus E.Faecalis, E.Faecium and may be use for VRE Gram +mouth anaerobes --> Peptococcus, peptostreptococcus Gram (-)--> Enterobacteriales --> E.coli and proteus if lactose fermentating -Hemophilus influenzae Dose adjustment: Yes requires dose adjustment for renal Only dilute ampicillin IV and ampicillin/sulbactam in NS Do not administer together in same IV line DDi: Allopurinol--> Can cause rash if take ampicillin + allopurinol Warfarin--> It will decrease the effects of warfarin --> Increases risk of bleeding because increases the INR AE: -Nausea -Skin rahs because of allergie to penicillin -Problem increase bacteria resistance

Question 35

What is Amoxicillin? When should it be use? Coverage against what bacterias? Does it requires Dose adjustment? What are the DDI? What are some AE?

Answer 35

Amoxicillin (Amoxil, trimox)--> is aminopenicillins -Is primarily use for upper respiratory tract infections : otitis media, sinus, bronchitis Coverage against: Gram (+) : --> Streptococcus--> S.pneumonia --> Enterococcus --> E.faecalis Mouth anaerobes--> peptococcus, pepsistreptococcus Gram (-): -Enterobacteriales--> E.coli (lactose fermentating), proteous -H.Influenzae -neseria meningitis , listeria meningitis Dose: 500-875mg BID Dose adjustment: -For renal and if the CrCl <30 DONT USE IT DDi: Allopurinol--> Increase risk of rash Warfarin--> Decreases effects of warfarin so increase INR increases risk of bleeding AE: -Nausea -Diarrhea -Allergic rxn to the amino group

Question 36

What is Piperacillin IV? When should it be use? Coverage against what bacterias? Does it requires Dose adjustment? What are the DDI? What are some AE? | Pip-

Answer 36

Piperacillin IV (Pipracil) is a extended spectrum penicillin -Use for Gram (-) infections such as UTI, pneumonia, pseudomonas -Coverage against: Gram (+) -Streptococcus --> S.pneumonia -Enterococcus -E. faecalis -Mouth anaerobes --> Peptococcus, pepsistreptococcus -Gut anaerobes --> C.diff Gram (-): -Enterobacteriales--> E.coli (lactose fermentating), klebisella, Enterobacter, serratia -Pseudomonas aeroginosa -H.influenzae Dose: -Not require dose adjustment -Piperacillin (pipracil) has high levels of Na+ 65mg Na+/gram or 1.85 MEQ Na+ /gram so need to monitor Na+ levels in pt -Can also give with aminoglycosides and fluoroquinolones but do not give the aminoglycoside in the same IV line AE: -Thrombophletis -Injection site rxn -Can cause renal toxicity if administer with vancomycin

Question 37

What is Amoxicillin/Clavunate? When should it be use? Coverage against what bacterias? Does it requires Dose adjustment? What are the DDI? What are some AE?

Answer 37

Amoxicillin/Clavunate -Augmentin XR , augmentin -Is a penicillin + b-lactamase inhibitor a suicide -The suicide will cause hydrolyisis bind to the b-lactamase attack it twice irriversible and prevents the hydrolysis of penicillin -THe suicide can increase the antimicrobial activity of the penicillin but on their own no antimicrobial activity -Coverage against: Gram (+): -Staphylococcus aureus coag + --> MSSA Gram - -Enterobacteriales --> Lactose fermentating E.coli, klebsiella, proteus Pseudomonas Moraxella catarrhalis H.influenzae Anaerobes in the GIT --> bacteroides fragilis Renal dose adjustment and avoid givingg 875mg if CrCl <30 Ratio is 2:1, 4:1, 7:1 AE: -N/V -Anemia -Seizure, coma--> at high doses -Allergic rxn

Question 38

What is Ampicillin/Sulbactam? When should it be use? Coverage against what bacterias? Does it requires Dose adjustment? What are the DDI? What are some AE? | una-

Answer 38

Ampicillin/Sulbactam (Unasyn) IV -Is use primarly for upper and lower respiratory tract infections and for Intra-abdominal infections Coverage against: Gram (+)--> Staphylococcus areus (Coag +) and MSSA and Enterococcus Gram (-): Enterobacteriales baccili lactose fermentating--> E.coli, klebisella, proteus Moraxella catarhalis --> Resp pathogen H.Influenza Pseudomonas Gram (-) anaerobic--> Bacteroides fragilis in GIT No dose adjustment DDI: -Warfarin AE: -Nausea -Vomiting -Diarrhea -Hemolytic anemia and plalet dysfunction -Interstitial nephritis -Seizure / coma --> High doses -Skin rash allergic rxn

Question 39

What is Piperacillin/Tazobactam? When should it be use? Coverage against what bacterias? Does it requires Dose adjustment? What are the DDI? What are some AE? | Zo

Answer 39

Piperacillin/Tazobactam (Zosyn) IV -Is use for Upper / lower respiratory tract infections and for intraabdominal infections Coverage against: Gram (+)--> Staphylococcus aereus (coag +) , MSSA and enterococci Gram (-): Enterobacteriales lactose fermentating--> E.coli, klebesilla, proteus H. Influenzae Morazella catarrhs pseudomonas Gram (-) anerobes--> Bacteroides Dose adjustment: Yes for renal if CrCl <40ml/min AE: -N,V, diarrhea -Skin rxn -Hemolytic anemia -Seizure, coma

Question 40

What is Cefazolin and what gen? When should it be use? Coverage against what bacterias? thinck SPEcK What are some AE? | An-, Ke-

Answer 40

Cefazolin (Ancef, Kefzol) IV 1st gen cephalosporine -Is a bacteriocidal inhibit bacteria cell wall synthesis -Use for Gram + skin infections and for surgical prophylaxis Coverage against: SPEcK Gram (+)--> Staphylococcus S.aureus, S.epidermis . Streptococcus S.pneumonia, S.pyrogen Gram (-) Proteus --> non lactose ferm E.coli--> lactose ferm Klebisella --> lactose ferm AE: -Thrombophlebitis -Hypersensitive rxn -Injectiin site rxn -Cross sensistive with penicillin osea si pt fue allergico a penicillin there is 5% also that is allergic to 1st gen cephalosporin -Eosonophilia -Thrombocytopenia

Question 41

What is Cephalexin and what gen? When should it be use? Coverage against what bacterias? thinck SPEcK What are some AE? ## Footnote K-

Answer 41

Cephalexin (Keflec) PO 1st gen cephalosporins -Is bacteriacidal inhibits bacteria cell wall synthesis -Use it for Gram + skin infections Coverage against: SPEcK Gram (+)--> Staphylococcus S.auereus coag + , S.epidermis coag - Streptococcus S,pneumonia, S.pyrogen Gram (-): Proteus --> non lactose ferm E.coli--> lactose ferm klebisella --> lactose ferm AE: -N,V, diarrheaa -Possible C.diff -Hypersensitive rxn -Thrombocytopenia -Eosonophilia -Cross reactivity--> pt is allergic to penicillin there is 5% que tambien also allergic to 1st gen cephalosporins

Question 42

What is Cefadroxil and what gen? When should it be use? Coverage against what bacterias? thinck SPEcK What are some AE? | Dar-

Answer 42

Cefadroxil (Daricef) PO 1st gen cephalosporin MOA: Bacteriocidal inhibit bacteria cell wall synthesis -Use it for Gram + skin infections -Coverage against SPEcK Gram (+)--> Staphylococcus S.aureus (coag+) S.epidermis (Coag-). Streptococcus S.pneumonia, S.pyrogen Gram (-): Proteus, E.coli, Klebisella AE: -N,V, D, c.Diff -Hypersensitive rxn -Eosinophilia -Thrombocytopenia -Cross reactivity with penicillin can be 5% chance that is also allergic to cepha 1st gen

Question 43

What is Cefuroxime and what gen? When should it be use? Coverage against what bacterias? thinck HNM-SPEcK What are some AE? | Kefu-, Zina-

Answer 43

Cefuroxime (Kefurox, Zinacef) IV 2nd Generation group A -Use primarly for upper and lower respiratory tract infections Coverage against: Gram (+) Streptococcus--> S.pyrogen, S.pneumonia Gram (-): cocci H.Influenzae N.meningitis Moxarella catarrhs--> resp Gram (-) baccili Proteaus E.coli Klebesella AE: -Thrombophlebitis -Hypersensitive rxn -Cross-reactivity with penicillins --> osea si ot es allergic a penicillin there is 5% that also a cefuroxime (Kefurox, zinacef)

Question 44

What is Cefonocid and what gen? When should it be use? Coverage against what bacterias? thinck HNM-SPEcK What are some AE? | mon-

Answer 44

Cefonocid (Monocid) 2nd generation Cephalosporin Group A only IV -Use it for Upper-lower respiratory tract infections -Coverage: HNM-SPEcK Gram (+)= Streptococcus S.pneumonia, S.pyrogen Gram (-): cocci H.influenzae N.meningitis Moxarella catarrhs--> resp pathogen Gram (-) baccili: Proteus--> non lactose E.coli--> lactose Klebisella--> lactose AE: Thrombophlebitis Eosonophilia Thrombocytopenia -Cross reactivity if pt is allergic to penicillins

Question 45

What is Cefuroxime axetil and what gen? When should it be use? Coverage against what bacterias? thinck HNM-SPEcK What are some AE? | cef-

Answer 45

Cefuroxime axetil (Ceftin) PO 2nd generation cephalosporin group A -Use for upper and lower respiratory trac infections Coverage: HNM-SPEcK Gram (+)--> Streptococcus S.pneumonia, S.pyrogen Gram (-) cocci: H.influenzae Moxarella catarrhs--. resp pathogen N. Meningitis gram (-) baccili: Proteus--> non lactose E.coli--> lactose Klebisella--> lactose AE: -Eosonophilia -Thrombocytopenia -Hyper sensitive rxn -N,V,D -C.diff -cross reaction si es tambien penicillin allergic

Question 45

What is Cefaclor and what gen? When should it be use? Coverage against what bacterias? thinck HNM-SPEcK What are some AE? | cec-

Answer 45

Cefaclor (Ceclor, Ceclor CD) PO 2nd gen cephalosporine group A -Use for upper and lower respiratory tract infections Coverage: HNM-SPEcK Gram (+)--> Streptococcus S.pneumonia, S.pyrogen Gram (-) cocci: H.influenzae N.meningitis Moxarella catarrs--> resp pathogen Gram (-) baccili: Proteus E.coli Klebesilla AE: -Thrombocytopenia -Eosonophilia -N,V,D -C.diff -Hypersensitive rxn -Cross -reactivity with penicilllin if also allergic 5% chance also allergic to 2n gen

Question 46

What is Cefprozil and what gen? When should it be use? Coverage against what bacterias? thinck HNM-SPEcK What are some AE? | Cefz-

Answer 46

Cefprozil (cefzil) PO 2n generation cephalosporines group A HNM-SPEcK -Use for upper and lower respiratory tract infections Coverage against HNM-SPEcK Gram (+) --> Streptococcus --> S.pneumonia, S.pyrogen Gram (-) cocci: H.influenzae N.meningitis Moxarella catarrs--> resp pathogen Gram (-) baccili: Proteaus--> non lactose E.coli--> lactose Klebesilla--> lactose AE: -Eosonophilia -Thrombocytopenia -N,V,D -C.diff -Hypersensitive rxn -Cross reactivity with penicillin --> si es alergico no le des 2nd gen

Question 47

What is Cefoxitin and what gen? When should it be use? Coverage against what bacterias? thinck SPEcK-BF What are some AE? | mefox-

Answer 47

Cefoxitin (Mefoxin) only IV and is 2nd gen cephalosporine group B cephamycin subgroup -Use for aerobi and anerobic bacteria infections --> intraabdominal and pelvic infections Coverage against SPEcK-BF Gram (+) --> Streptococcus --> S.pneumonia, S.pyrogen Gram - baccili Proteus--> non lactose E.Coli--> lactose Kebisella--> lactose Gram (-) anerobe: Bacteriodes fragilis AE: -Thromobophebilitis -Eosonophilia -Thrombocytopenia -Hypersensitive rxn -Cross reactivtiy

Question 48

What is Cefotetan and what gen? When should it be use? Coverage against what bacterias? thinck SPEcK-BF What are some AE?

Answer 48

Cefotetan (Cefotan) IV 2nd generation Cephalosporine group B cephamycin subgroup -Use for aerobic/anaerobic infections--> intrabdominal and pelvic infections Coverage against SPEcK -BF Gram (+) cocci--> Streptococci S.pneumonia, S.pyrogen Gram (-) bacili: -Proteus--> non lactose E.coli--> lactose Klebisella--> lactose Gram (-) anaerobe: -Bacteriodes fragilis AE: -n-methyl-5-thiotetrazole (MTT) --> Disulfiram like rxns increase aceta aldehyde --> hangover symptoms and bleeding because inhibit pro-thrombin synthesis -Thrombophlebitis -Eosonophilia -Thrombocytopenia

Question 49

What are the 2nd generation cephalosporins that have MTT I MET a MAN with a PERfect TAN

Answer 49

Cefotetan Cemetazole Cefomandole Cefoperazole

Question 50

What is Cefotaxime and what gen? When should it be use? Coverage against what bacterias? What are some AE? | clar-

Answer 50

Cefotaxime (Claforan) IV 3rd generation cephalosporin -Use for severe gram (-) infections like UTI, intraabdominal infections, pelvic infection and for pneumonia Coverage against: -Looses some Gram (+) coverage -More gram (-) coverage due to the aminothiazole ring that allows to enter to the gram (-) periplasmic space Gram (-) cocci: N.meningitis, moxarella catarrhs Gram (-) baccili: Enterobacteriales E.coli, klebesilla AE: -Thromboplebitis -Eosonophilia -Thrombocytopenia

Question 51

What is Ceftriaxone and what gen? When should it be use? Coverage against what bacterias? What are some AE? | Roce-

Answer 51

Ceftriaxone (Rocephin) IV 3rd generation cephalosporine Use for severe gram (-) infections like UTI, intraabdominal, pelvic infections -It can penetrate the CSF and treat n.meningitis -Can also treat lyme disease and gnorrhea -IV q24h Coverage against: looses Gram (+) but can treat streptococcal pneumonia Gram (-): Cocci--> n.meningitis Baccili--> Enterobacteriales E.coli, klebisella AE: -Increase liver transaminase ---> Can cause cholestasis (gall stone) because is not renally excreted DDI: Do not administer ceftriaxone (rocephin) with IV calcium, ringer solution, parental nutrition Because it will form Ceftriaxone+ Calcium complex and centriaxone wont work

Question 52

What is Ceftazidine and what gen? When should it be use? Coverage against what bacterias? What are some AE? | For-

Answer 52

Ceftazidine (Fortaz) IV 3rd gen cephalosporine -Use for gram (-) infections like: UTI, intraadominal and pelvic infections -Can also treat pnemonia from gram + Coverage against: Looses some Gram (+)--> streptococci Gram (-)--> Psedomonas Gram (-) enterobacteriales --> E.coli, klebisella AE: -Hypersensitive rxn -Thrombophlebitis -Thrombocytopenia -Eosonophilia

Question 53

What is Ceftazidine -Avibactam and what gen? When should it be use? Coverage against what bacterias? What are some AE?

Answer 53

Ceftazidine-Alvibactam (Avicaz) third gen cepha For Gram (-) Complicated uti, intraabdominal and pelvic infections , severe nosocomial pneumonia And has activity againse ESBL (Extended Spectrum Beta-lactamase) like E.coli, klebisella

Question 54

What is Cefpodoxime proxetil and what gen? When should it be use? Coverage against what bacterias? What are some AE? What are DDi? | Van-

Answer 54

Cefpodoxime proxetil (Vantin) 3rd gen cephalosporine Dose is PO BID -Give with food to enhace absorbtion -Use it for severe Gram (-) infections like UTI, nosocomal pnemonia, intraabdominal and pelvic infection -Looses some Gram (+) coverage Moree Gram - coverage Gram (-) Enterobacteriales --> E.coli, klebesella AE: Eosonophilia -N,V,D -Thrombocytopenia DDI: Antiacids, Calcium, magnisium, H2 blockers--> because they decrease absorption of vantin

Question 55

What is Cefdinir and what gen? When should it be use? Coverage against what bacterias? What are some AE?

Answer 55

Cefidinir (Omnicef) PO Once a day 3rd gen cephalosporine -Use for severe gram (-) infections: UTI, nosocomal pneumonia, intraabdominal, pelvic infections -Looses gram + More gram - Enterobacteriales--> E.coli, klebesilla AE: -N,V,D -Thrombocytopenia -Eosonophelia

Question 56

What is Ceftolozane-tazobactam and what gen? When should it be use? Coverage against what bacterias? What are some AE? | Zer-

Answer 56

Ceftolozane-tazobactam (Zerbaxa) gen 3 or 4 cephalosporin -For complicated gram (-) infections: Complicated UTI x7days, complicated intraabdominal infections 7-14 days and give along with metronidazole, ventilator associated pnemomia Coverage against: Gram (-)--> E.coli, klebesella Gram (-)--> Pseudomonas Expanded spectrum beta lactamase (ESBL) or multidrug resistance pathogens

Question 57

What is Cefepime and what gen? When should it be use? Coverage against what bacterias? Dose adjustment? What are some AE? | Max-

Answer 57

Cefepime (Maxipime) IV 1 g PO q 12h is 4th gen cephalosporine -Use for severe infections septic shock Coverage against: Gram (+)--> Streptococcus S.pneumonia like Ceftriaxone (Roceptin) Gram (-) --> Pseudomonas like Ceftazidine (Forzaz) Gram (-) --> Enterobacteriales E.coli, klebisella Dose: -Renal dose adjustment -Also even if CrCl<60ml/min need to adjust dose because it can cause seizure -Renal dose adjustment for elderly and compromise renal function

Question 58

What is Ceftaroline fosamil and what gen? When should it be use? Coverage against what bacterias? Dose adjustment? What are some AE?

Answer 58

Ceftaroline Fosamil (Teflaro) IV BID Gen 5 cephalosrporine -Use for: MRSA, community acquired pneumonia, bacteremia, skin infections Coverage against: GRAM (+)--> Streptococcus Gram (+) --> Staphylococcus aureus and MRSA Gram (-): H.influenzae Enterobacteriales--> E.coli, klebisella Dose adjustment: Renal dose and if CrCl <50ml/min

Question 59

What is Aztreonam IV? When should it be use? Coverage against what bacterias? Dose? What are some AE? | azac-

Answer 59

Aztreonam IV (Azactam) Is a monobactam Use for Gram (-) infections : UTI, bacteremia, intraabdominal pelvic infections Coverage: Gram (-) baccili lactose ferm--> Enterobacteriales E.coli, Klebisella Gram (-) baccili non lactose ferm--> pseudomonas Gram (-) H.influenza Dose: no cross reactivity with penicillin allergic pt IV Inhalation for cystic fibrosis pt AE: -Rash -Diarrhe -Local rxn

Question 60

What is Imipenem-Cilastin? When should it be use? Coverage against what bacterias? Dose adjustment? What are some AE? DDI | prima-

Answer 60

Imipenem-cilastin (Primaxin) is a carbapenem -Ihibits bacteria cell wall synthesis -Is use for severe life threating polymicrobial infections and infections due to pseudomonas and ESBL (ex. pt has E.coli + Septic) Coverage against: Gram (-) Staphylococcus but NO MRSA Streptococcus --> S.pneumonia, S.pyrogen Enterococcus--> Only E.faecalis Mouth anaerobes--> Pepstreptococcus, Peptococcus Gram (-): Gram (-) baccil i--> Enterobacterialis E.coli, Klebesilla -Pseudomonas Gram (-) cocci: N.meningitis, N.gonorrhea Moraxella catarrhs AlsonH.influenzae Gram (-) anaerobic--> Bacteriodes flagelli Renal dose adjustment AE: -Seizure --> risk factors are: renal dysfunction, high dose, CNS lession, history of seizure -Allergy rash, drug fever --> Can give if pt is allergic to penicillin -N, V -Phlebitis DDI: -Avoid giving it if the pt is taking Valproic acid (T-type ca2+ blocker, NMDA blocker, GABA T inhibitor) becase it will change the ADME and the pt will suffer from seizure

Question 61

What is Meropenem? When should it be use? Coverage against what bacterias? Dose adjustment? What are some AE? DDI

Answer 61

Meropenem (Merem) IV is a Carbapenem Inhibits bacteria cell wall synthesis -Use for N.meningitis Coverage: Has More coverage against gram (-) and less for gram (+) Gram (-): Gram (-) cocci--> N.meningitis, N. gonorrhea, moraxella catarrhs Gram (-) baccili: Enterobacteriales--> E.coli lactose ferm, Klebisella lactose ferm Non lactose ferm--> pseudomonas Renal dose adjustment AE: -Drug fever -Rash -Phlebetis -Less risk of seizure DDI: -Avoid giving it to pt that is on valproic acid (depakote, depakene) valproic acid will block T-type Ca2+ in the post synaptic neuron, also inhibits GABA transaminase so prevent metabolism of GABA, also blocks NMDA receptors and is use for convulsion So if you give meropenem to the pt taking Valproic acid it will cause seizure in the pt

Question 62

What is Ertapenem ? When should it be use? Coverage against what bacterias? Dose adjustment? What are some AE? DDI | inv-

Answer 62

Ertapenem (Invaz) IV once daily is a carbapenem and will inhibit synthesis of bacteria cell wall -For severe life threating polymicrobial infections Coverage against: Gram (+) Staphylococcus --> S.aureus, S.epidermis NO MRSA Streptococcus--> S.pnemonia, S.pyrogen Enterococcus--> E.faecalis Mouth anaerobes--> peptococcus, pepstreptococcos Gram (-) Cocci -N.meningitis, Moraxella catarrhs Baccili Lactose ferm--> enterobacteriales E,coli, klebisella but NO Pseudomonas for Ertapenem (Invaz) -H.influenzae -Gram (-) anaerobes--> bacteriodes fagelli Dose adjustmet for renal AE: -Skin rxn -Drug fever -N,V, D -Phlebitis --> infusion rxn DDI: -Valproic acid (T-type Ca2+ channel blocker in the post synaptic, GABA T inhibitor, NMDA antagonist) and ertapenem (invaz) will disrupt the ADME of valproate and causes seizure to the pt taking valproate

Question 63

What is gentamicin and tobramycin? How is bacteriacidal? Coverage against? AE? TANGS do NOT kill ANAEROBES Dosing? Peak and trough

Answer 63

Gentamicin will bind to the 30s ribosomal unit to the subunit A and will cause a mismatch of the AA so the protein that is going to code it wont work -Is for UTI, burns, psudomonas, skin infections, nosocomal pnemonia and endocarditis infections Coverage against: Mostly Gram (-): Baccili--> E.coli (lactose), Kebesilla (lactose), Pseudomonas (non lactose) Cocci--> N.meningitis, Moraxella catarrhs , H.influenzae Gram (+) ---> Staphylococcus--> S.areus, S.epidermis no MRSA Gram (+) --> Streptococcus S.pnemonia, S.pyrogen Gram (+) ---> Enterococcus --> endocarditis use also b-lactam but not in the same IV line AE: Nephrotoxicity --> reversible, the risk factors are: elderly, duration of dose, unstable renal function Ototoxicity--> irriversible due to damage to the 8 cranial nerve causes vestibular disturbance and auditory loss Teratogen Dosing: Need CrCl = (140-age) x BW / 72 x SCr (0.85 if female) IBW= 50kg Peak --> 30 min after 4th dose 3-4mcg/mL Trough--> 30min before 4th dose <1mcg/mL

Question 64

What is amikacin? How is bacteriacidal? Coverage against? AE? TANGS do NOT kill ANAEROBES Dosing? Peak and trough

Answer 64

Binds to the 30s ribosomal to the A subunit and insert the wrong amino acid and causes a misreading --> the protein that is produce is useless is a bacteriocidal IS FOR MULTIDRUG RESISTANCE TB and fro ESBL Klebesilla Gram (-): Baccili lactose--> E.coli, ESBL Klebisella Baccili non lactose--> PSEUDOMONAS Gram (+): Streptococccus--> S.pneumonia , S.pyrogen Enterococcus--> Endocarditis AE: Nephrotoxicity Otoxicity Teratogenic Dosing base on CrCl, BW Traditional Peak--> 30min after 4th dose 15-30mcg/ml Trought--> 30min before 4th dose <10mcg/dl Once a day 15mg/kg/d base on CDK --> Above the MIC and on PAE--> below the MIC

Question 65

Televancin | Vibac-

Answer 65

Improved vancomycins Gram + MRSA also and also for hospital acquired pneumonia and ventilator associated pneumonia | Vibactiv

Question 66

What is Linezolid? When should it be use? Coverage against what bacterias? Dose adjustment? What are some AE? DDILinezolid | Zy

Answer 66

Oxazolidone class Is bacteriostatic For Gram + complicated skin and skin structure infections, nosocomial pnemonia and VRE Coverage: Gram + Staphylococcus --> S.aureus coag +, S. epidermis Coag- and MRSA Streptococcus--> S.pnemonia, S.pyrogen Enterococcus--> E.faecalis and VRE No dose adjustment IV / PO AE: -Myelosupression: Anemia, leukopenia, thrombocytopenia -HA -Peripheral neuropathy -N/V/ diarrhea DDI: -SSRI, SNRI, MAOi, TCA, amphetamines, tyramine food --> increase risk of serotonin syndrome | Zyvox

Question 67

What is Tedizolid? When should it be use? Coverage against what bacterias? Dose adjustment? What are some AE? DDI | S

Answer 67

Oxazolidine class Bacteriostatic Coverage against GRAM + Staphylococcus--> S. aureus coag +, S.epidermis, MRSA , MSSA Streptococcus--> S.pneumonia, S.pyrogen Enterococcus--> E.faecalis No dose adjustment is IV or PO and once daily AE: -Much lower neutropenia DDI: SNRI, SSRI, amphetamines, tyramine cheese, --> increase risk of Serotonin syndrome | Sivextro

Question 68

What is Quinupristin/Dafopristin 30:70? When should it be use? Coverage against what bacterias? Dose adjustment? What are some AE? DDI | sy

Answer 68

Bacteriostatic member of streptogramins -Should be use for severe life threating skin reactions, bacteremia, VRE, Coverage against GRAM + -Staphylococcus--> S.aureus (Coag+), S.epidermis (Coag-), MRSA -Streptococcus--> S.pyrogen, S.pneumonia, -Enterococcus--> E.faecium, VRE Dose: -Is hepatic metabolize so yes renal dose adjustment -IV and need to dilute in D5W and sterile water AE: -Inflammation injection site rxn -Athralgia -Myalgia -HA -N/V, Diarrhea -Piritus --> increase bilirubin -Cost $$$ DDI: -Is a 3A4 inhibitor --> so avoid statins, benzos, carbazepine, amlodipine, nifedipine, apixaban, rivoroxaban | Synercid

Question 69

What is Daptomycin? When should it be use? Coverage against what bacterias? Dose adjustment? What are some AE? DDI | Cubi

Answer 69

-Daptomycin (Cubicin) is from the lipopeptides antibiotics -Use for complicated skin infections, skin structure infections, Staph.Aureus bacteremia, Right sided endocarditis Coverage: Braod Gram + Staphylococcus--> S.aureus (Coag+), S.epidermis (Coag-), MRSA Streptococcus--> S.pyrogen, S.pnemonia. Penicillin resistant strep.pnemonia Enterococcus--> E.faecalis Dose adjustment: Yes is 80% renally excreted -Need dose adjustment if CrCl <30 AE: -Injection site rxn -Neuropathy -Increase transaminase -Myopathy, increase CK levels if combine with statins DDI: -Is highly protein bound so DDI with other drugs that are highly protein bound | Cubicin

Question 70

What is Clindamycin IV PO? When should it be use? Coverage against what bacterias? think + and anaerobes Dose adjustment? What are some AE? DDI | Cleo

Answer 70

Is a lincomycin related antibiotic class Alternative for antistaph penicillins (Naficilin(unipen), Oxacillin (Bactoci), Dixocillin (Dynapen) and 1st gen cepha fa-pha SPEcK Cefazolin (Ancef, Kecof IV), Cephalexin (Keflex PO), Cefadroxil (Duricef PO) -Topically can treat rosacea and acne -Can treat aspiration pneumonia -Can use with other gram - coverage agents for polymicrobial infections Coverage think Gram + and anaerobes is bacteriostatic -Staphylococcus--> S.epidermis, S.aureus and community acquired MRSA -Streptococcus--> S.pneumonia, S.pyrogen Mouth anaerobe: Peptostreptococcus Gut anaerobes: Bacteriodes fragilis -Hepatic metabolize no need renal dose adjustment AE: -Diarrhea--> can lead to C.diff -Hypersensitive rxn -Bitter taste | Cleocin

Question 71

What is Metronidazole IV/PO? When should it be use? Coverage against what bacterias? think anarobes Dose adjustment? What are some AE? DDI | Fla

Answer 71

Think Anaerobes is bacteriocidal -Is use for C.diff -Can be use topically for acne -Can also be use for crohns and vaginitis -Can also be use for in combo for polymicrobial infections Coverage: Mouth anaerobes --> peptococcus some mild coverage Gut anaerobes mainly--> Bacteroides fragilis, C.diff Miscelleneus--> helicobacter pylori, giardia lambia, trichomonas vaginalis No dose adjustment is hepatic metabolize AE: -Metallic taste --> counsel pt you chew gum -GI upset -Dry mouth -CNS--> peripheral neuropathy, seizure, encephalopathy -Dilsufram rection--> so avoid alcohol DDI: Metronidazole (Flagyl) is a CYP 3A4 and 2C9 inhibitor --> so avoid warfarin because metronidazole (flagyl) will inhibit the metabolims of warfarin and the warfarin concentration in the blood will increase and increase the risk of toxicity and increase INR | Flagyl

Question 72

What is tetracycline PO? When should it be use? Coverage against what bacterias? think respiratory pathogens and sexual transmitted Dose adjustment? What are some AE? DDI

Answer 72

Bacteriostatic Use for atypical pneumonia, sexually transmitted chlamydia, UTI, skin and soft tissue infections Coverage: Think respiratory pathogens Gram + Streptococcus --> S.pneumonia Staphylococcus--> S.aureus, S.epidermis and community acquired MRSA gram - H.influenzae Miscellaneus Atypical: Mycoplasma pneumonia, chlamydia pneumonia, legionella pneumonia chlamydia trichomatis Lyme disease No dose adjustment --> has a shorter T1/2 and renally excreted AE: Photosensitive --> pt should wear sunscreen Tooth discoloration and bone deposition--> avoid in pregnatn and kids Gi disturbance DDI: separate 2hrs from Ca2+, mg2+, antacids, milk, cholestyramine, colestipol --> chelation rxn

Question 73

What is Minocycline IV/Po? When should it be use? Coverage against what bacterias? think respiratory pathogens and sexual transmistted Dose adjustment? What are some AE? DDI | m

Answer 73

-Bacteristatic -For atypical pneumonia, sexually transmitted chlamidia, UTI, skin and soft tissue infection Coverage againts: Think Respt pathogens Gram + Streptococcus--> S.pneumonia Staphylococcus--> S.aureus, S.epidermis and Community acquired MRSA Gram - H.influenza miscelleneous: Atypical: Mycoplasma pneumonia, chlamydia pneumonia, legionella pneumonia -Chlamydia trichomatis -Lyme disease No dose adjustment AE: -Photosensitive--> need to wear sunscreen -Tooth discoloration and bone deposition--> CI kids and pregnat -Gi disturbance DDI: Mg2+ , Ca2+, Fe, milk, antacids, cholestyramine, colestipol--> chelation rxn so need to separate 2hrs before or 2hrs after | Minocin

Question 74

What is Doxycycline (IV/PO)? When should it be use? Coverage against what bacterias? think respiratory pathogens and sexual transmitted Dose adjustment? What are some AE? DDI | vibra

Answer 74

Bacteriostatic -Use for atypical pneumonia, chlamydia, UTI, skin and soft tissue infections Coverage: Gram + Streptococcus --> S.pneumonia Staphylococcus--> S.aureus and S.epidermis and community acquired MRSA Gram - H.influenzae Miscellenous: Atypical: Mycoplasma pneumonia, chlamidia pneumonia, ligonella pneumonia Chlamydia trichomatis Lyme disease No dose adjustment --> Has a longer half life and in less renally excreted AE: Photosensitive--> need sunscreen Tooth discoloration and bone deposition--> CI kids and pregnant Gi disturbance DDI: -Mg, Ca,Fe, milk, antiacids, cholestyramine, colestipol--> chelation rxn so separate 2hrs | Vibramycin

Question 75

What is Tigecycline IV? When should it be use? broad spectrum gram+ , gram - and anerobic Coverage against what bacterias? Dose adjustment? What are some AE? DDI | Tiga

Answer 75

-Bacteriostatic -For complicated skin/skin structure and intraabdominal infections Coverage: Gram + Staphylococcus --> S.aureus, S.epidermis, MRSA Streptococcus--> S.pneumonia, Spyroned, Penicillin Resistant Streptococcus Enterococcus--> E.faecalis, E.faecium andd VSE Anaerobes: Mouth anaerobes: peptostreptococcus Gut anaerobes--> Bacteriodes fragilis, C.diff Dose adjustment: -Is billiary/fecal elimination--> dose adjustment if severe hepatic impairment AE: -Photosensitive --> wear sunscreen -Tooth discoloration -N/V/D DDI: -Mg, Ca, Fe, milk, antiacids, cholestyramine, colestipol --Chelation rxn so need to separate dose by 2hrs before or 2hrs after | Tigacil

Question 76

What is Sulfamethoxazole-Trimethoprim? When should it be use? Think Respiratory tract, GIT, and urinary tract Coverage against what bacterias? Dose adjustment? What are some AE? DDI | B and S

Answer 76

Is bacteriostatic -Use for UTI, Skin and structure infections, respiratory tract infections, PCP HIV, travelers diarrhe Coverage: Gram + Streptococcus S.pneumonia Community acquired MRSA Gram - Enterobacteriales --L> E.coli H.influenzae Moxella catarrhs Miscelleneous Gi pathogens --> Shigella, salmonella Listeria monocytogenesis Stenetrophomans maltophilia Pneumocytosis Juvenili (PCJ) Dose adjustment: Yes renall dose adjustment Is liver metabolize and renal excreted AE: Photosenstive Bone marrow supression--> drop WBC, hemolytic anemia Hypersenstive rxn--> rash, Steven johnson syndrome Crystalluria Hyperkalemai DDI: Bactrim is a 2C9 inhibitor --> so inhibits metabolism of warfarin so increases INR and increases concentration of warfarin in the serum Dose Single dose -->TM 80mg Sulfa 400mg Double strentg --> TM 160mg Sulfa 800mg | Bactrim, Septra

Question 77

What is Erythromycin? When should it be use? Coverage against what bacterias? Think respiratory pathogens and HIV Dose adjustment? What are some AE? DDI

Answer 77

Erythromycin IV/PO Is a macrolide antibiotic --> Bacteriostatic Think Respiratory pathogens and HIV -Use for respiratory pathogens, MAC (Mycobacterium avium complex) in HIV, gram + infections Coverage: Gram + Streptococcus--> S.pneumonia but increasing resistance Staphylococcus--> S.aureus, S.epidermis NO MRSA Gram - Respiratory pathogens --> H.influenzae, Moxella catarrhs Miscellenous Atypical: Mycoplasmic pneumonia, chlamidia pneumonia, legionella pneumonia, chlamydia trachomatis HIV pathogens: Mycobacterium avium complex (MAC) Dose: -No renal dose adjustment -If give IV can be irritative to the blood vessels -If give PO: E-base will be destroyed by gastric acid contents E-formulation need to be taken without food to enhance absorption Bus EES or delayed release formulation--> is not affected by food AE: GI: N,V, diarrhea CNS: Seizure, hearing impairment, tinitus--> is reversible QT prolongation --> can cause arrythmia Increase LFT --> can lead to cholestasis jaudince DDI: -Erythromycin is a 3A4 inhibitor so avoid giving 3A4 substrates: Warfarin, statins, benzos, cyclosporine, carbazepine It will increase the serum concentration of warfarin --> increases its effect increase INR increase risk of bleeding Drugs that prolong QT--> methadone, cyclobenzaprine (TCA), antipsychs

Question 78

What is Azithromycin? When should it be use? Think respiratory pathogens and HIV Coverage against what bacterias? Dose adjustment? What are some AE? DDI

Answer 78

Is bacteriostatic think Respiratory pathogen and HIV Coverage: Gram + -Streptococcus --> S.pneumonia, S.pyrogen -Staphylococcus--> S.aureus Coag +, S.epidermis coag- NO MRSA Gram - Respiratory pathogens--> Moxella catarrhs, H.influenzae Miscellenous: Atypical pathoges: Mycoplasma pneumonia, chlamydia pneumonia, legionella pneumonia, chlamydia trachomatitis HIV: Mycobacterium Avium Complex (MAC), Toxoplasmosis clyptosporidium Dose: no renal dose Zpack: Day 1 take 2 tablets (total 500mg) from day 2-5 take 1 tablet Tri pack: Take 1 tablet 500mg for 3 days AE: -GI: N,V,D -CNS: Seizure, hearing impairment, tinitus--> reversible -Prolong Qt--> increase risk of arrythmia -Increase LFT--> increase risk of cholestasis -IV injection site rxn DDI: -Antacids because it will decrease the absorption of azythromycin | Zithromax, Zpack, Tripack

Question 79

What is Clarithromycin PO? When should it be use? Think respiratory pathogens and HIV Coverage against what bacterias? Dose adjustment? What are some AE? DDI | Biax

Answer 79

Clarithromycin PO (Biaxin) is bacteriostatic Use for: MAC --> Mycobacterium Avium Complex in HIV along with ethambutol and rifabutin H.pylori Coverage: Gram + Streptococcus chains and pairs--> S.pneumonia Staphylococcus clusters--> S.aureus coag+, S.epidermis coag- NO MRSA Gram - Respiratory pathogens: H.influenza, Moxella catarrhs Atypical: Mycoplasmic pneumonia Chlamydia pneumonia Legionella pneumonia Chlamydia trachomatis HIV pathogens: MAC--> Mycobacterium avium complex Toxoplasmosis cryptosporidium H.pylori No dose adjustment required AE: -GI: N, V, diarrhea CNS: seizure, hearing loss, tinnitus--> reversible -QT prolongation --> can cause arrythmia -Increase LFT --> increase risk of cholestasis DDI: Clarithromycin (Biaxin) is a 3A4 and 2C9 inhibitor --> so it will inhibit metabolism of Warfarin --> so increase warfarin concentration in blood so increase the effects of warfarin and increases INR and increases risk of bleeding. Also inhibit metabolism of benzos, carbamazepine, cyclosporine, statins DDI with other drugs that prolonged the QT: Methadone, cyclobenzaprine (Flexeril, Amrix), antipsych | Biaxin

Question 80

What is Cirpofloxacin IV/PO? When should it be use? Coverage against what bacterias? Dose adjustment? What are some AE? DDI

Answer 80

Is bacteriocidal MOA: inhibits DNA gyrase and topiosimerase IV Use for UTI, respiratory pathogens Coverage: More Gram - Pseudomonas Enterobacteriales: E.coli lactose ferm, Klebesella, Proteus Respiratory pathogens: H.influenza, Moxella catarrhs Some Gram + Staphylococcus --> No MRSA Streptococcus--> S.pneumonia, S.pyrogen Need renall dose adjustment AE: GI: N, V, diarrhea and taste perverssion Neurotoxicity: HA, dizziness, seizure, worsening myasthenia gravis, peripheral neuropathy, confusion, psychiatric issues Allergies--> skin rash Photosensitive Musculoskeletal---> Tendon rupture --> increase risk in elderly, renal dysfunction pt and pt on corticosteroids QT prolongation Hypoglycemia Increase LFT CI: -Pregnant pt -Elderly pt DDI Ciprofloxacin is a 1A2 inhibitor so it will incrase the levels of caffeine therefore causing increase nervousness and excitation -QT prolongation drugs like: Cyclobenzaprine, methadone, haldol, risperidone, Class 1A antiarrythmic: Procainamide, Disopyramide, Class 3 antiarrythmic: Sotalol, Ibutillide, Dofetilide, amiodarone, dronedarone -It can increase concentration of warfarin by: Inhibiting metabolism of warfarin, disrupt normal GI flora so no vitamin K synthesis, displace warfarin from protein binding -Need to separate dose when taking Ca, Mg, multivatimes, K, Fe, milk, yogurt | Cipro

Question 81

What is Levofloxacin IV/PO 250-500mg daily and for complicated 750mg daily? When should it be use? Think broad spectrum emphasize on gram - Coverage against what bacterias? Dose adjustment? What are some AE? DDI

Answer 81

Quinolone is bacteriocidal MOA: inhibit bacteria DNA synthesis and replication by inhibiting DNA gyrase and topoisomerase IV Use for respiratory tract infections and UTI Coverage: Gram + Streptococcus --> s.pneumonia, s.pyrogen Staphylococcus--> S.aureus, S.epidermis NO MRSA Enterococcus Gram - Enterobacteriales--> E.coli Pseudomonas Respiratory pathogen: Moxella catarrhs, h.influenza Atypical: Mycoplasmac pneumonia, chlamydia pneumonia, limogella pneumonia Yes renal dose adjustment AE: GI: N, V, diarrhea, taste perversion Neurotoxicity: Seizure, psychiatric, confusion, dizziness, worsening myasthenia gravis, periphery neuropathy, HA Photosensitivity Tendon rupture--> increase risk in elderly, renal dysfunction and if using corticosteroids Hypoglycemia Increase LFT Prolong QT DDI: -Need to separate dose when taking Fe, Ca, Mg, Zn, Al,sulcrafate, multivit, milk, cheese -NSAID --> increase CNS activation -Class 1 antiarrthmic-_> disopyrimidine, procainamide -Class 3 antiarrthmic--> ilbutillide, dofetillide, sotalol, amiodarone, dronedarone -QT prolong drugs: methadone, cyclobenzaprine, risperidone (risperdal), haldol Increase concentration of warfarin by: -Inhibiting metabolism -Disrupting normal GI flora so no vitamin K -Displacement from PPB | Ofloxacin

Question 82

What is Moxifloxacin IV/PO daily? When should it be use? Think broadspectrum some gram - but also anaerobes Coverage against what bacterias? Dose adjustment? What are some AE? DDI | Ave

Answer 82

Is a quinolone Bacteriocidal--> it will inhibit DNA gyrase and Topoisomerase IV so inhibit bacteria DNA synthesis and replication -Use for respiratory tract infections and UTI Coverage: Gram + Streptococcus--> S.pneumonia, S.pyrogen Staphylococcus--> S.aureus, S.epidermis NO MRSA Enterococcus Gram - Enterobacteriales--> E.coli Respiratory pathogens--> H.influenzae, Moxella catarrhs Anaerobic: Mouth anerobes--> Peptostreptococcus Gut anaerobes--> C.diff, Bacteriodes fragelli Atypical pathogens: Mycoplasmic pneumonia, Chlamydia pneumonia, limogella pneumonia -Is hepatic excreted so no need renal dose adjustment -Can take it with or without food AE: GI: N,V,D, taste perversion Neurotoxicity: Seizure, dizziness, HA, confusion, peripheral neuropathy, worsening of myasthenia gravis, psychiatric Tendon rupture--> increase risk in elderly and in renal dysfunction pt and pt on corticosteroids\ Photosensitive Hypoglycemia Prolong QT--> increase risk if pt has low Mg or K, cardiac conditions, on other meds that prolong QT Increase LFT Ci: -Avoid in pregnancy and elderly pt DDI: -Need to separate dose when taking Ca, Mg, Fe, Zn, Al, milk, sulcrafate, yogurt -NSAID --> Increase CNS activation -Class 1 antiarrythmic--> procainamide, disopyrimide Class 3 antiarrthmic--> ilbutillide, dofetillide, sotalol, amiodarone, dronedarone Other drugs that prolong qt--> cyclobenzaprine, haldol, methadone Warfarin: -It will increase the levels of warfarin because: Inhibits metabolism Disrupt GI flora so no Vitamin K Displacement from PPB | Avelox

Question 83

What is Delafloxacin ? When should it be use? Think broad spectrum emphasis on gram - Coverage against what bacterias? Dose adjustment? What are some AE? DDI | Baxi

Answer 83

Quinolone Bacteriocidal Use it for skin and skin structure infections Coverage against Gram + Staphylococcus --> Yes MRSA, S.aureus, Se.epideris Streptococcus--> S.pneumonia, S.pyrogen Enterococci Gram - Enterobacteriales--> E.coli Pseudomonas Resp pathogens--> H.influenzae, moxella catarrhs Atypical: Chlamydia pneumonia, mycoplasmic pneumonia, limogella pneumonia Yes renal dose adjustment -Has good bioavailabily -Has difference in IV and PO dosing AE: AE: GI: N,V,D, taste perversion Neurotoxicity: Seizure, dizziness, HA, confusion, peripheral neuropathy, worsening of myasthenia gravis, psychiatric Tendon rupture--> increase risk in elderly and in renal dysfunction pt and pt on corticosteroids\ Photosensitive Hypoglycemia Prolong QT--> increase risk if pt has low Mg or K, cardiac conditions, on other meds that prolong QT Increase LFT Ci: -Avoid in pregnancy and elderly pt DDI: -Need to separate dose when taking Ca, Mg, Fe, Zn, Al, milk, sulcrafate, yogurt -NSAID --> Increase CNS activation -Class 1 antiarrythmic--> procainamide, disopyrimide Class 3 antiarrthmic--> ilbutillide, dofetillide, sotalol, amiodarone, dronedarone Other drugs that prolong qt--> cyclobenzaprine, haldol, methadone Warfarin: -It will increase the levels of warfarin because: Inhibits metabolism Disrupt GI flora so no Vitamin K Displacement from PPB | Baxidella