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29 Cards in this Set

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1. Name the different groups and all the gram positive bugs associated with them (e.g. Group D Strep?) Why are they categorized this way?
Lancefield groups are categorized into Groups A through U on the basis of their C- carbohydrate, which is a polysaccharide in the cell walls of bacterias.
Group A: Sterptococcus pyogenes
Group B: Stretptococcus agalactiae
Group D: Stretptococcus bovis
2. What is the difference between alpha and beta (in terms of hemolysis)?
Alpha-hemolytic causes a chemical change in the hemoblobin of red cells in blood agar, resulting in the appearance of a greem pigment that forms a ring around the colony. Beta- hemolytic causes gross lysis of red blood cells, resulting in a clear ring around the colony.
3. List all the different formulations of amphotericin?
Amphotericin B deoxycholate (Fungizone, Amphocin)
Amphotericin B cholesteryl sulfate complex (Amphotec)
Amphoteri B Lipid Complex (Abelcet)
Amphotericin B lipsome (Ambisome)
4. What are the major side effects of amphotericin?
Endocrine metabolic: weight loss
GI: diarrhea, loss of appetite, N/V
Immunologic: complication of infusion, chills, fever, HA
Other: Malaise
5. Give the “general” coverage for the following: itraconazole,
All indicated for fungal infections
Itraconazole: Onychomycosis, Aspergillosis if refractory/intolerant to amphotericin B, blastomycosis, hostoplasmosiss
-Caution: CYP 3A4 inhibitor, QT prolongation, negative inotrope, must weigh risks and benefits in pts with HF
6. What bugs are covered mainly by penicillins?
Simple, non-resistant gram (+) and (-) bacteria, and bugs that have cell walls.
7. Are penicillins better with Strep or Staph?
Penicillins are the DOC for non-resistant Strep infections
8. What is the mg to unit ratio of PCN VK?
400,000 units: 250 mg
9. List the Antipseudomonal penicillins
a. Piperacillin
b. Ticarcillin
c. Mezlocillin
10. Do combination ‘cillin drugs cover B frag?
Yes, they cover anaerobes as well and the combination will enhance anaerobe stability
11. Does Unasyn and Augmentin have the same coverage?
Yes, Ampicillin (in Unasyn) and Amoxicillin (in Augment) have the same coverage
12. Does Zosyn cover Pseudomonas?
Yes, Zosyn is piperacillin and tazobactam. Piperacillin is the DOC for Pseudomonas
13. What is the cross-sensitivity between penicillin and cephalosporin?
Depending on which generation, there may be cross-sensitivity. It is important to monitor
14. What is the cross-sensitivity between cephalosporins and aztreonam?
None. Aztreonam is used for pcn/ceph allergies
15. What is the difference between coverage from 1st through 4th Cephalosporins?
1st: more gram (+) coverage and less gram (-) coverage
-->
4th : less gram (+) but more gram (-) coverage
16. What are the Cephamycins and what do they cover?
Cefuroxime
Cefaclor
17. Name the Antipseudomonal Cephs
Ceftazidime
Cefipime
18. What Ceph has carnitine deficiency and what causes it?
Cefditoren
Cause by inherited genetics or secondary to metabolic disorders
19. Do Cephs cover enterococcus?
no
20. Do Cephs cover Listeria?
No
21. Does Keflex cover H. flu?
No
22. Does Cefuroxime cover H. flu?
Usually effective clinically or >60% susceptible
23. Could we use fortaz and azactam together? Why or why not?
Ceftazidime and Aztreonam should not be used together because it would be considered polypharmacy since they have the same mechanism of actions and are both b-lactams
24. Which Quinolone is the best at covering gram negative bugs?
Ciprofloxacin
25. Which Quinolone(s) cover(s) pseudomonas the best?
Ciprofloxacin
Give the “general” coverage for the following: voriconazole,
Voriconazole: Invasive Aspergillosis, or Scedosporium, Fusifarium, Candidemia/ Candidiasis
-Caution: Anaphylactic reactions
Give the “general” coverage for the following:, Fluconazole,
Fluconazole: Vaginal candidiasis, oropharyngeal/esophageal and systemic candidiasis. Cryptococcal meningitis
Give the “general” coverage for the following: caspofungin,
Caspofungin: Invasive Aspergillosis, candidal infections, Emperic for neturopenia
-Caution: No approved indications for children
Give the “general” coverage for the following: ketoconazole (note- why would we use one over the other in terms of coverage)
Ketoconazole: Systemic fungal infections
-Caution: Hepatotoxicity