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75 Cards in this Set
- Front
- Back
Fluoroquinolones MOA
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inhibit DNA replication in bacterial cell wall (DNA gyrase inhibitors)
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fluoroquinolones routes of admin
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PO, IV, topical
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FQ coverage
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gram +, gram - very limtited anaerobe coverage (Avelox)
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excretion of FQ
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renal
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FQ meds
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Norfloxacin (Noroxin) UTI only
Ciprofloxacin (Cipro)good bone penetration; 45% pseudo. resistance Ofloxacin (Floxin) Enoxacin (Penetrex) UTI, STD Levofloxacin (Levaquin) HAP 65% pseudo. sens. Moxifloxacin (Avelox) some anaerobic coverage |
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FQ contraindications
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pregnancy
pediatrics pts on meds known to cause QT seg prolongation |
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FQ SE
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n/v/d, CNS effects, phototoxicity, liver toxicity, connective tissue problems, QT segment elongation
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FQ great "switch" drug secondary to __________ when taken po
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approx 100% bioavailability
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Vancomycin MOA
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inhitibs wall synthesis
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Vancomycin coverage
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Must have MRSA if using on pt with staph
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Vancomycin routes of admin
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IV or oral (no absorption) is acutally topical to GI lumen
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Vancomycin SE
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"red man", ototoxicity, ?nephrotoxicity (pt also on aminoglycoside)
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when should peak and trough levels be check when using Vanco?
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never, unless renal dysfxn or endocarditis
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excretion of Vanco
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renal, but not dialyzed
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Daptomycin (Cubicin) MOA
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unique mechanism; binds to bacterial cell wall causing rapid depolarization of membrane potential (decrease replication)
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Daptomycin coverage
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gram +, MRSA and ?VRE
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daptomycin is alternative to ______
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vancomycin
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Linezolid (Zyvox) MOA
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unique mechanism; binds to 50s ribosomal subunit, prevens translation
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Linezolid coverage
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gram +, MRSA, VRE
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Linezolid routes of admin
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IV and PO both give 100% bioavailability
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Metronidazole (Flagyl) coverage
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anaerobes and some parasites
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Metronidazole routes of admin
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PO, IV, topical
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Metronidazole SE
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GI (nausea, metalic taste), peripheral neuropathy (prolonged use), disulfiram-like rxn (etoh, perfume/cologne)
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antifungal agents
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amphotericin B, Fluconazole (difulcan, Miconazole (Monistat), Flucytosine (Ancobon), Ketoconazole (Nizoral), Itraconazole (Sporanox), Clotrimazole (Myclelex), Echinocandins, Boriconazole(Defend)
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1st line non albicans tx
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amphotericin B
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1st line candida albican tx
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Fluconazole (tx only c. albicans)
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topical cream suppository
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Miconazole, Flucytosine, Ketoconazole
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tx for c. albicans and aspergilas
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Itraconazole and Boriconazole
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Flucytosine coverage
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non albicans
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Echinocandins coverage
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candida albicans, c. glabrata, c tropicalis
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Best anitfungal around
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Amphotericin B (ampho "terrible")
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Amphotericin B admin
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IV, irrigational, topical, liposomal preparations
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dosing of Amphotericin B
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1/2 mg/kg Q D also hydrocortisone to decrease SE
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Amphotericin B SE
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electrolyte imbalance (decrease Mg, K), renal toxicity, hepatotoxicity
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other antifungals
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Nystatin (Mycostatin)-topical for thrush
Terbinafine (Lamisil)-cream or po for onychomycosis |
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Urinary Antispetics
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Ntrofurantoin (Macrodantin) negative SE in pregnancy
Nalidixic acid (Negram) indwelling catheters Methenamine mandelate (Mandelamine) breaks down formaldihyde ototoxicity |
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Pentamidine coverage
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anitprotozan
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Pentamidine admin
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IV (tx only)or inhalation (only for prophylaxis)
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Pentamidine SE
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hyper and hypoglycemia-FSBS QD
electrolyte disturbance-dec K renal dysfxn-BUN and creatinine |
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Antiviral agents for Herpes
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acyclovir (Zovirax), Famcylovir (Famvir), Velacyclovir (Valtrex) PO and IV, don't use topical unless liver dysfxn and must have tx
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Antivirals for CMV
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Gancylcovir (Cytovene), Valgancyclovir (Valcyte) IV, PO, intraocular
Foscarnet (Foscavir) Cidofovir (Vistide) tx with IV then oral for life |
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antivirals for tx of influenza
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Amantadine (symmetrel), Rimantadine (Flumadil), Zanamavir (Relenza)-inhaled, Oseltamivir (Tamiflu)-oral
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concentration-dependent killing exhibited by
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FQ and aminoglycosides
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Concentration-dependend killiing defined as
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rate and extent of bacterial killing maximized at high concentrations (doses)
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usually occurs when drug concentration is ____ the MIC
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10 times
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MIC is
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minimum inhibitory concentration
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Time-dependent killing defined as
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killing activity depends on the time drug concentration remains above MIC
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time-dependent killing exhibited by
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beta-lactams, vancomycin, clindamycin, and ees
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dosing stratey for Time dependent killing
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maximize time above MIC
(should be above MIC 50%) |
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bacteriology of community acquired respiratory infxn
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s. pneumoniae, h. influenzae, k. pneumoniae, m. catarrhalis, mycoplasma, legionella, TB
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bacgteriolgoy of nosocomial acquired resp. infxn
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s. aurea, p. aeruginosa, enerobacger cloacae, fusobacterium species, peptococcus, legionella
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tx comm. acquired resp. infx
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PCN, Amox, 2nd gen. ceph., macrolides, FQ
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tx nosocomial resp. infx
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pipercillin/tazobactam, ticaricillin/clavulanic acid, 3rd gen. ceph, add aminoglycoside, FQ, macrolide
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CNS infxns:
neonates infants/childrens children/young adults |
s. pnuemonia, e. coli, listeria
h. flu, s. pneumonia, n. meningiditis s. pneumo, n. meningiditis |
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CNS infxns:
adults elderly |
s. pneumo, n. meningiditis
s. pneumo, n. meningiditis, e. coli, klebsiella, listeria |
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CNS infxns:
neurosurgery closed head trauma open head trauma |
s. aureus, s. epidermiditis, gram -
s.pneumo, h. flu look at environ (sewage ditch vs concrete) |
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CNS tx:
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must penetrate CNS
cephalosporins PCN |
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Bacteriology of endocarditis
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s. viridans, s. epidermidis, entercoccus, c. albicans
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tx endocarditis
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PCN, vancomycin, add aminoglycoside, long duration
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prophylaxis of endocarditis
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dental/oral procedure: amox 3g 1 hr prior, 1.5 g 6 hr later
GI/GU procedure: ampicillin, amox, gentamicin |
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bacteriology of skin and ST infxn
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Cellulitis: strep and staph
add DM pseudomonas and anaerobes |
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Tx skin and ST infxn
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cefzolin, macrolides, amp/sulbactam or ticarcillin/cavulanic acid
FQ with metronidazole |
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GI infxn tx
travellers diarrhea psuedomembranous colitis h. pylori |
pepto-bismol, TMP/SMX, doxy, FQ
oral metronidazole adn vanco amox, clarithromycin, tcn, metronidazole plus PPI |
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bacteriology of intra-abdominal infx
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gram +: enterococcus
gram -: e.coli, enterobacter cloacae, acineobacter anaerobes: bacteroides |
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tx intra-abdominal infx
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2nd and 3rd gen. ceph
extended spectrum pcn metronidazole imipenem-cilastatin |
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bacteriology of UTI
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e.coli, enterococcus, klebsiella, proteus
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tx UTI
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sulfa, trimethoprim, 1st gen ceph, nitrofurantoin, FQ
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bacteriology of STD
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syphyllis, gonorrhea, chlamydia, gential herpes, trichomoniasis
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tx STD
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syphillis:pcn, spectinomycin
Gonorrhea:3rd gen ceph, ofloxacin, enoxacin, cipro chlamydia:doxy, ees,FQ,azith Gent herpe: acyclovir, famcyclovir trich: metronidazole |
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bacteriology of osteomylitis
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hematogenous:staph, gram neg
adjacent infx:staph, gram neg, anaerobes vascular insuff:staph, g -, anaerobes |
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tx osteomylitis
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bone penetration, IV, oral therapy (cipro)
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azithryomicin doesn't cover
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septicemia
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cipro doesn't cover
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strep
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nosocomial infxn tx
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need broad spectrum and somthing to cover gram - (aspiration)
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ventilation associated pneumonia caused by
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pseudomonas aeruginosa
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