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46 Cards in this Set

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  • Back
What is empiric therapy?
the initiation of treatment prior to determination of a firm diagnosis
What are things to consider when selecting an antibiotic?
ID of organism
Site of infection
Safety of agents
Status of patient
Which Abx are safe with pregnancy?
PCN
Cephs

Don't give:
AG
Macrolide
what is MIC?
minimum amount of antimicrobial agent needed to inhibit growth of bacteria
How much over the MIC do you want to go over to be effective?
2-4 times the MIC
would you use a cidal or static Abx with endocarditis?
Cidal
which 2 drugs require no modifications for renal pts?
Erythromycin
Chloramphenicol
Which drugs require Major reductions for renal pts?
AG
Vancomycin

Monitor peaks and troughs with these drugs
Which drugs do you avoid with renal pts?
TCN
Sulfonamides
Nitrofurantin
Which drugs require mild reductions for renal pts?
PCN
Cephs
Clindamycin
Rifampin
What causes resistance?
Mutation of bacteria
Overuse and inappropriate use of Abx
what is the major mode of bacterial resistance?
Beta-lactamase:

Penicillinase
Gram+/-
S.Aureus (40% is resistant)
If you see diplococci, what organism may that be?
Neisseria

Watch for meningitis in babies
Which drugs target the cell wall
PCN
Cephalosporins
Carbapenem
Monobactams
Which drugs target ribosomes(protein synthesis)
Macrolides
AG
Rifamfin

Chloramphenicol
Oxazolidinone
Streptogramin
Tetracycline
how do quinolones work?
By inhibiting DNA synthesis
List some Gram - Cocci
N.gonorrhea
N.meningitidis
M.catarrhalis
Name two protozoa
PCP
Toxoplasma gondi
Name the Atypical Bacteria
Chlamydia
Legionella
Mycoplasma Pneumonia
Mycobacterium TB
Mycobacterium (MAC)
Which drugs inhibit bacterial synthesis of folic acid?
Sulfonamides, they're bacteriostatic

Ex: Bactrim
what is the MOA of sulfonamides?
inhibit folic acid synthesis
when can you use Dapsone (a PABA antagonist)?
With HIV patients
With pts who cannot tolerate Bactrim
What are the adverse effects of sulfonamides?
SJS
Hemolytic anemia
Hypoglycemia(esp.IV)
Agranulocytosis(rare)
Kernicterus
Jaundice
What are the drug interactions of sulfonamides?
Warfarin- >INR(risk of bleed)
Oral hypoglycemic agents
NIDDM
What is the MOA of Trimethoprim?
Inhibits dyhydrofolate reductase
What is the adverse effects of Trimethoprim?
Folic acid deficiency; you should take supplements
What are some uses of Trimethoprim?
Meningococcal Meningitis(BBB)
Salmonella

Gram +/-
UTI
PCP
PCN allergic
PCN is only effective agains which organisms?
the ones that synthesize peptidoglycan cell walls
Which are the anti-staph PCNs?
the CONDM drugs
Which drugs are Extended spectrum, beta-lactamase inhibitor PCNs?
Augmentin- Amox/clauv acid
Unasyn- Amp/sulbactam
Which are the anti-pseudomonal PCNs?
MPCAT

Mezlocillin
Piperacillin
Carbecillin
Azlocillin
Ticarcillin

Most can have BLIs
What is the DOC for ghonorrhea?
Benzathine PCN G
or
Rocephin
which PCN is not good for liver patients?
Nafcillin: liver metabolized
Which of the CONDM drugs do you need to dose adjust?
Methicillin
which PCN causes bone marrow suppression?
Nafcillin
which PCN can cause interstitial nephritis?
All
What is a good agent to treat salmonella or shigella?

Also for prophylactic C-Section
Oral Ampicillin
What are the side effects of ampicillin?
Diarrhea (wipes out normal flora)
Which AG would you use with peperacillin to double cover
Tobramycin
which PCNs can give you hypokalemia?
Carbecillin and Ticarcillin
because they increase the Na load

Don't use with HTN patients
What are the side effects of PCNs?
N/V
Allergy: haptems
GI
SJS
Superinfections(C.diff)
Causes Bone marrow suppression, grey-baby syndrome, and is very toxic
Chloramphenicol
Which FQ is a broad spectrum with excellent anaeorobe coverage and crosses BBB
Trovafloxacin
which AG can be used for gut decontamination before surgery
Neomycin
Name the aminopenicillins/Extended spectrum
Ampicillin
Amoxicillin
Which aminopenicillin causes diarrhea
ampicillin