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23 Cards in this Set
- Front
- Back
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what are the risk factors for righ sided IE
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CVC
IVDA chronic hemodialysis |
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pts with what risk factors are at high risk for IE
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prosthetic device
congenital heart malfunctions shunts previous IE |
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what are non cardiac RF for IE
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CVC
chronic hemodialysis IVDA diabetes melitus |
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what is the most common cause of native IE
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strep
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what is the most common pathogenic cause of IVDA and CVC related IE
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staph
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in prosthetic valve IE
<1 year what is the bug >1 year what is the bug |
<1 year bug is staph
>1 year bug is strep |
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what tools are used to diagnose IE
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blood cultures - 2 samples taken within 24-48 hours period
echocardiography - trasnthoracic (less invasive do this first) and transesophageal (90% sensitive) |
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what is the most important determinant of treatment success in infective endocarditis
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antibiotic therapy
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what are factors that decrease the efficacy of antibiotic therapy
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high inoculum
bacteria encased inside vegetation quiescent vegetation |
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when is the duration of therapy in iE measured
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from last positive blood culture
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if patient has a Native valve MIC < 0.1 what drugs do you use to treat
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Pen G 12-18 MU/24hrs 4 weeks
Ceftriaxone 2g/24hrs 4 weeks or Pen G 12-18MU/24hrs 2 weeks Ceftriaxone 2g/24hrs 2 weeks plus gentamicin 3mg/kg/24hrs 2 weeks or vancomycin 30mg/kg/24hrs 4 weeks |
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if a patient has a Native valve MIC > 0.1 whta drugs do you use to treat
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Pen G 24 MU/24hrs 4 weeks
Ceftriaxone 2g/24hrs 4 weeks plus gentamicin 3mg/kg/24hrs 2 weeks vancomycin 30mg/kg/24hrs 4 weeks |
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if a patient has Prosthetic valves what drugs can you use to treat
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Pen G 24 MU/24 hrs 6 weeks
Ceftiaxone 2g/24hrs 6 weeks w/ or w/o gentamicin 3mg/kg/24hrs 2 weeks depending on MIC or vancomycin 30mg/kg/24hrs 4 weeks |
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if pt has Entercococcus susceptible to PCN, vancomycin, and gent what is the treatment regimen
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Amp/Sulb 12g/24hrs 4-6 weeks
or Pen G 18-30 MU/24hrs 4-6 weeks plus gentamicin 3mg/kg/24hrs 4-6 weeks or vancomycin 30mg/kg/24hrs 6 weeks plus gentamicin 3mg/kg/24hrs 6 weeks |
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if pt has Enterococcus resistant to PCN, vancomycin, and gent what is the treatment regimen
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Daptomycin 6mg/kg/24hrs >8 weeks
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if pt has Staph with prosthetic device what is the treatment
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Nafcillin/Oxacillin 12g/24hrs >6 weeks
Rifampin 900mg/24hrs >6 weeks gentamicin 3mg/kg/24hrs 2 weeks or vancomycin 30mg/kg/24hrs >6 weeks rifampin 900mg/24hrs > 6 weeks gentamicin 3mg/kg/24hrs 2 weeks |
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if pt has Staph and Righ sided endocardiditis and is IVDA
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nafcillin/oxacillin 12g/24hrs 2 weeks
gentamicin 3mg/kg/24hrs 2 weeks vancomycin 30mg/kg/24hrs 6 weeks |
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if pt infected by HACEK organism what is the treatment
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ceftriaxone 2g/24hrs 4 weeks
ampicillin/sulbactam 12g/24hrs 4 weeks ciprofloxacin 800mg or 1g IV 4 weeks |
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what patients are contraindicated for outpatient therapy
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congestive hear failure
cardiac rhythm disturbances (AV block) persistent bacteremia lack of reliable IV access |
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what are the drug monitoring toxicities for B-lactams, aminoglycosides, vancomycin, rifampin, daptomycin, and in general
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B lactam - seizures
aminoglycosides - oto and nephrotoxicity vancomycin - red man syndrome, nephrotoxicity rifamping - CYP450 inducer and discoloration of body fluids damptomycin - increased CPK, myalgias in general - secondary catheter related bacteremia |
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when would you use prophylaxis in dental surgery
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all dental procedures that involve:
manipulation of gingival tissues or periapical region of teeth perforation of oral mucosa |
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when would you not use prophylaxis in dental surgery
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dental radiographs
placement,removaol or adjustment of orthodontia shedding of deciduous teeth bleeding from trauma to lips/oral mucosa |
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what drug is used for prophylaxis in dental procedures
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amoxicillin 2g adults 50mg/kg children
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