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35 Cards in this Set

  • Front
  • Back
List the major drug-drug interactions with Zyvox and describe them?
Adrenergic agents
Myelosuppressive medications
Serotonergic agents
Tramadol – could lead to seizures
Quinipristin and Dalfopristin – what is the brand name and dose?
E. Faecium 7.5mg/kg/dose q8h
. Do Quinipristin and Dalfopristin cover E. faecium or E. faecalis or
Only E. Faecium
. How are Quinipristin and Dalfopristin metabolized?
Active metabolites via nonenzymatic reactions
Give the coverage of chloramphenicol?
H. Flu
Neisseria meningitidis
Active against vancomycin resistant enterococci
56. List the “cautions” for chloramphenicol and describe them
Serious and Fatal blood dyscrasias after both short term and prolonged
Use caution in patiensynthesis and inhibiting fungal cell membrane formation
Does Chloramphenicol cover MRSA, VRE
a) MRSA (N)
b) VRE (Yes)
Coverage of Vancomycin
a) Anaerobes
i) Bacteroides fragilis
ii) Clostridium (including C. diff)
b) G+
i) Strep Groups A, B, C, G
ii) Strep pneumo (pneumococcus)
iii) Enterococcus (faecium and faecalis)
iv) Staph (MSSA, MRSA, CA-MRSA, epidermidis)
v) Colostridium jeikeium
vi) Listeria monocytogenes
59) Does Vanco Cover N. meningitis
a) Yes it does, but there are better drugs with more activity, such as Rocephin.
What dose Cidal Mean?
a) This means that the drug “kills” the bacteria
What does static mean?
a) Drugs that are static, usually stop protein synthesis. They do not have an effect on the organisms that are already mature, just prevent more organisms from being made so that the body’s natural immunities can kill those organisms present.
62) What does MIC mean?
a) MIC = Mnimum Inhibitory Concentration?
i) The MIC90 is a lab test to determin the minimum concentration of drug needed to kill 90% of the culture. The MIC90. Usually drug levels are targeted 4-5x the MIC or higher, in order to assure that they are high enough in vivo to kill the organism.
63) How do you calculate ANC? Why would you calculate ANC?
a) ANC = WBC * (% Segs + % Bands)
b) ANC is a test neutropenia. We can test to see if the patient is a candidate for G-CSF therapy, especially in oncology / transplant patients.
64) What is the difference between a lymphocyte and a monocyte
c) Lymphocyte:
i) Lymphocytes activate the complement system as well as stimulating an immune response through MHCI complexes.
ii) Monocytes are responsible for “scavenging” and engulfing (phagocytosis) to get rid of cells or antigents or other parts that need to be destroyed
65) What is ESR
e) Erythrosedemtation rate is a non specific marker of inflammation
66) What is the difference between a seg and a band?
Seg = PNM = Neutrophil (mature)
Band = an immature beutrophil that shows up in blood. Can be a sign of a serious infection, indicating tha thte bone marrow is overwhelmed and “pumping out” Neutrophils too fast
67) Why do we do Bone Scans
To test of osteomyelitis (infection of the bone)
68) why do we do gram stains
Fast, cheap way to narrow and direct our Abx therapy specific for a patient with a specific disease.
Coag +
S. aureus
Coag (-)
S. epi, saprophyticus
70) Make a table of cidal. Vs. static
CIDAL: PCN, CEPHS, AG, FQ’S, Nitrofurans, VANCO, Monobactams, Metronidazole, Co-Trimoxazole
STATIC: TCN’S, SMP/TMP, Chloramphenicol, Licosamides, Macrolides.
) List anaerobic, what does it mean, how to kill them:
LIST: ACTINOMYCES, b FRAG, p. MELANINGENICA, C diff, Other Clostridia,
Mean: lives with out O2
Kill: almost everything coveres PEPTOSTREPTO. Rest: we can use PCN’s , CARBAPENEMS are great (Meropenem), some FQ/Cephs, CLINDA and CHLORAMPHENICOL, LINEZOLID, SYNERCID, METRONIDAZOLE
All the Abx that cover the BBB
Amp, Naf, Pen G, Pip, Ticarcillin, Many Cephs (except Cefazolin)
Chloramphenicol, SMX/TMP (minimal)
Cipro, Levo, Metronidazole, Vanco
(Don’t cross BBB)
Clindamycin, AminoGlyc (usually) Cefazolin,
can vanco be delivered to the brain
Yes, 3-5mL of concentrated, sterile Vanco is sometimes given
) % of flagyl that’s gets to CSF
nL: 16-43%
Inflamed Meninges: 100%
Does Invanz (Ertapenem) cover Pseudomonas?
List one advantage of Ertapenem
Less C. diff due to its specific spectrum
list major side effects of
Isoniazid, rifampin Ethambutol streptomycin
Isoniazid (Hepatotoxicity)
Rifampin (Hepatotoxicitiy, Blood dyscrasias)
Ethambutol (Psych Δ and Vision Δ)
Streptomycin (Nephrotoxicity)
What causes C. diff
Kill normal flora and C. diff overgrows
) List major bugs of endocarditis
(Staph and Strep – 80%)
Major s/sx of pneumonia
Dyspnea, cough, fever, tachycardia, tachypnea, chest pain, sputum, fatigue, confusion (elderly), exacerbation of underlying disease, falls (elderly)
) What is D.O.T
Major bugs in cellulitis
Group A Strep, sometimes Grop B
S. aureus, and CA-MRSA is becoming a concern
difference between Pyelonephritis and Cystitis:
Pyelonephritis: Inflammation of the kidney and its pelvis caused by bacterial infection
Cystitis: Inflammation of the urinary bladder and ureters