What Ron says we need to know....

Question 1

When is it indicated to use more than one prophylactic antibiotic in surgury?

Answer 1

If the case lasts more than 4 hours

Question 2

If you have a high MIC do you need more or less drug to kill the organism?

Answer 2

High MIC = More drug needed

Question 3

Infections that require empiric anaerobe coverage

Answer 3

Dental
Aspiration Pneumonia
Intra-abdominal
PID
Gas gangrene
Diabetic foot ulcers

Question 4

What drugs empirically cover anaerobes?

Answer 4

Carbapenams
Clindamycin (Cleocin)
Moxyfloxacin (Avolex)
Metronidiazole (flagyl)
Pip/Tazo (Zosyn)
Amp/Sulb (Unasyn)

Question 5

What infections need empiric pseudomonas coverage?

Answer 5

NOSOCOMIAL - PNA, UTI, Meningitis
Severe diabetic foot ulcer
Puncture would through shoe
Burns

Question 6

What drugs empirically treat pseudomonas?

Answer 6

Levoquin (Levafloxacin)
Pip/Tazo (Zosyn)
Carbapenams - NOT ERTAPENAM
Cefepime (Maxipime)
Cipro
Ceftazadime (Fortx)

Question 7

What infections need empirically treated for MRSA?

Answer 7

Prulent cellulitis
Post opp wounds
Nosocomial PNA and Meningitis

Question 8

What drugs empirically treat MRSA?

Answer 8

Doxycyclin
Clindamycin
Bactrim
Linezolid
Vancomycin

Question 9

What types of infection need to be empirically treated for enterococcus?

Answer 9

Intrabdominal/bilary infections
UTI
CLABSI

Question 10

What drugs empirically treat enterococcus?

Answer 10

Amox/Clauv (Augmentin) 
Amp/Sulb (Unasyn)
Pip/Tazo (Zosyn)
Vancomycin
Daptomycin
Cipro
Levaquin
Linezolid
Nitrofurantoin - UTI

and PNC lol

Question 11

What is the MOA for beta-lactams?

Answer 11

bactericidal

Question 12

What organisms are not covered by cephalosporins?

Answer 12

CEPHALOSPORINS HAVE NOT ENTEROCOCCAL COVERAGE

Most anaerobes

Question 13

What are the first generation cephalosporins(2) and when should they be used?

Answer 13

Cefazolin (Ancef)
Cephalexin (Keflex)

Used for MSSA, strep

Sx prophylaxis, non-purulent skin infections

Question 14

What are the 2nd (3) generation cephalosporins and when should they be used?

Answer 14

3rd generation cephalosporins:
ceFOXitin (Mefoxitin)
ceFUR-OXime (Ceftin)
ceFAClor (Ceclor)

Gram negative and some anaerobes
Used for surgical prophylaxis and URI

Question 15

What are the third generation (3) cephalosporins and when should they be used?

Answer 15

3rd Generation cephalosporins:
cefTRIAXone - Rocephin
cefeTAZidime -Fortaz
cefDINIR -Omnicef

empiric UTI, PNA, Meningitis

Question 16

What is the one 4th generation cephalosporin that we need to know and what is it indicated for?

Answer 16

Cefepime

+, - and PSUEDOMONAS

Question 17

What is the one 5th generation drug we need to know and what is it indicated for

Answer 17

Ceftaroline - Teflaro

ONLY CEPH THAT COVERS MRSA

Question 18

What is special about coverage with carbapenams and what is a CI/ADR?

Answer 18

Carbapenams have the broadest coverage +, -, ESBL and anaerobes

increased SZ risk

Question 19

What is the monobactam drug and what microorganisms does it cover?

Answer 19

Monobactam = aztreonam

Covers ONLY GRAM (pseudomonas)

Question 20

What are the commonly used fluroquinolones?

Answer 20

Levofloxacin - Levaquin
Moxyfloxacin
Cipro

Question 21

What organisms are covered by fluroqunolones?

Answer 21

Atypicals - mycoplasma

Question 22

When can fluroquinolones such as Levofloxacin and CIprofloxacin be used as monotherapy?

Answer 22

Complicated UTI
Prostatitis
CAP

Question 23

What is the BBW for fluroquinolones?

Answer 23

Tendone rupture, myasthenia gravis pts, C. DIFF

Question 24

What are the macrolides? (3)

Answer 24

Erythromycin
Azythromycin- Zithromax
Clarithromycin- Biaxin

Question 25

What drug can be used for MAC?

Answer 25

Clarithromycin - Biaxin (in CLAR skies BI(axin)RDS fly)

Question 26

When are macrolides used?

Answer 26

DOC for atypical such as chlamidia, mycoplasma and legionella atypicals and empiric PNA

Question 27

What are ADR with macrolides?

Answer 27

QT prolongation, increased LFT, potentiates warfarin

Question 28

What are the commonly used aminioglycosides? When are they most commonly used?

Answer 28

Gentamycin Tobramycin Used for endocarditis and nosocomial infections

Question 29

What is the MOA for aminoglycosides?

Answer 29

bactericidal, concentration dependent killing and a post antibiotic effect

Question 30

What are toxicities associated with ahminoglycosides and how are they limited?

Answer 30

oto and nepho toxicity Limited by monitoring peak and trough levels

Question 31

What tetracyclines are most commonly used?

Answer 31

Minocycline - Minocin Doxycyclin - Adoxa Tetracyclin-`

Question 32

When should tetracyclines be used?

Answer 32

``` For unusual such as Lyme disease, rickettsiae, tularemia Doxy covers MRSA COPD CAP Acne ``` NOT IN UTI

Question 33

What are the ADR with tetracyclines?

Answer 33

Teeth staining | photosensitivity

Question 34

When should bactrim be used?

Answer 34

MRSA uncomplicated UTI PCP prophylaxis

Question 35

What are the serious drug reactions associated with bactrim?

Answer 35

hyperK SJS potentiates warfarin

Question 36

What microbes are covered with clindamycin?

Answer 36

anaerobes ABOVE DIAPRAGM | MRSA - do not use if resistant to emycin

Question 37

What are ADRs with clindamycin?

Answer 37

C DIFF

Question 38

What microbes are covered my metronidazole/flagyl?

Answer 38

anaerobes below diaphragm protozoans C-DIFF

Question 39

What are the ARDS associated with metronidazole?

Answer 39

Metallic taste Neuropathy Warfarin interaction Rxn with EtOH

Question 40

What organisms are covered by nitrofurantoin and when is nitrofurantoin used?

Answer 40

nitrofurantoin - gram negatives UNCOMPLICATED UTI

Question 41

When is linezolid used? Ci?

Answer 41

MRSA/VRE do not use with SSRIs or Myelosuppresed patients

Question 42

When is daptomycin used? CI?

Answer 42

MRSA/VRE can't use for lung infections something about muscle damage lol