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46 Cards in this Set

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Has strong activity against susceptible gram negative bacteria including Pseudomonas aeruginosa. IT HAS NO USEFUL ACTIVITY AGAINST GRAM POSITIVE BACTERIA OR ANAEROBES. It is known to be effective against wide range of bacteria including Citrobacter, Enterobacter, E coli, Haemophilus, Klebsiella, Proteus and Serratia
Aztreonam
What are three most important characteristics of pneumonia
Productive cough

Fever

Chest x ray - lobar consolidation
Has an abrupt onset with RESOLUTION OF SYMPTOMS WITH THERAPY WITHIN 2-3 WEEKS

What type of sinusitis
ACUTE
Has PERSISTENT PURULENT NASAL DISCHARGE despite therapy but no permanent mucosal damage
SUBACUTE
- Occurs with episodes OF PROLONGED INFLAMMATION and or repeated or inadequately treated acute infections

- Symptoms persist for longer than 3 months depsite appropriate therapy

- Permanent damage to mucosa

What type of sinusitis
CHRONIC
MOST COMMON bacterial pathogens isolated from sinus aspirates
S PNEUMONIAE most predominant

H INFLUENZAE

MORAXELLA CATARRHALIS
Which bug causes atypical sinusitis
Moraxella catarrhalis
Some medical conditions that can increase risk for sinusitis
Cystic fibrosis

Asthma

Immunosuppression

Allergic rhinitis
_ may increase the risk of bacterial sinusitis during cold because of decreased mucociliary clearance
Smoking
Hallmark of persistent sinusitis
Dull ache or pressure across midface or headache
All three types of sinusitis may exacerbate _
Asthma or otitis media
_ sinuses most frequently involved in acute rhinosinusitis followed by _ sinuses
Maxillary

Frontal
Antibiotics are recommended for all types of sinusitis - most commonly used
Penicillins

Cephalosporins

Macrolides

Fluoroquinolones
Most common adverse effect of penicillins
Hypersensitivity
Which immunoglobulin involved in anaphylactic shock caused by penicillin
IgE
MOA penicillins
Beta lactam antibiotics - inhibit cell wall synthesis
In areas that have LOW INCIDENCE OF RESISTANCE due to beta lactamase producing strains of H influenzae and M catarrhalis patients may be initially treated with _ . On the other hand _ is effective against beta lactamase producing organisms
Amoxicillin

TMP-SMX
Antibiotic therapy of acute sinusitis - both are inexpensive and GOOD INITIAL DRUGS OF CHOICE
Amoxicillin and TMP SMX
_ not effective against H influenzae and M catarrhalis due to moderate and high levels of resistance in treatment of acute sinusitis
Amoxicillin
_ is less effective against S pneumoniae in treatment of acute sinusitis
TMP SMX
Drugs of choice for resistant pathogens due to enzyme production in treatment of acute sinusitis
Amoxicillin - clavulanate - AUGMENTIN

Loracarbef - LORABID

Cefuroxime - axetil (CEFTIN)

Macrolides
Sinusitis caused by PENICILLIN RESISTANT S PNEUMONIAE can be treated with _
High dose amoxicillin
Sinusitis in patients not responding to traditional therapy may be due to _

Treatment?
Chlamydiae pneumoniae

Tetracycline

Clarithromycin

Azithromycin
Which macrolide has longest T 1/2

Why
Azithromycin

Largest volume of distribution - 2000 L
Main side effects of clarithromycin
GI + metallic taste
MOA of tetracycline
Inhibition of 30S subunit
MOA of clarithromycin
Inhibition of 50S subunit
Which macrolide is used in treatment of H pylori
Clarithromycin
What is the treatment for chronic sinusitis
Longer course of therapy using broad spectrum of antibiotics - amoxicillin clavulanate, 2nd generation cephalosporins, macrolides etc
Acute exacerbation of chronic sinusitis is most likely caused by _

Treatment
Gram negative and gram positive anaerobic bacteria

Clindamycin
Dicloxacillin/metronidazole
Cefuroxime/metronidazole
Clarithromycin
Fluoroquinolones
Which drug causes pseudomembranous colitis
Clindamycin
Therapy with TMP-SMX has been associated with what side effects
Rash including STEVENS JOHNSON SYNDROME

Crystalluria

Photosensitivity
Amoxicillin clavulanate has been associated with what side effect
GI complains + diarrhea
Which antibiotics cause hypersensitivity reactions such as hives, laryngeal edema and anaphylactic shock and pose an immediate threat and warrant medical attention
Penicillins

Cephalosporins

Sulfonamide antibiotics
Most frequently reported side effects of macrolides
GI complains such as nausea, vomitting and diarrhea
Bacterial causes of pharyngitis
Mycoplasma pneumonia

Chlamydia pneumonia

Neisseria gonorrhea - rare

Corynebacterium diphtheriae - in unimmunized patients
Most important pathogen to identify in pharyngiits
Group A beta hemolytic strep - S pyogenes
Who usually gets strep throat
School aged children
Strawberry tongue + rash - diagnosis
Scarlet fever
Estolate form of erythromycin should never be given to pregnant women - why
Causes cholestatic jaundice
Drug of choice in patients whose treatment for strep pharyngitis fails
Amoxicillin clavulanate

Clindamycin

Combination of penicillin with rifampin
Can rifampin be used for treatment of Myco Leprae
NO - DAPSONE
For individuals who are chronic carriers of group A strep what drug should be given
Penicillin G

Erythromycin - if allergic to penicillin
Antibiotics NOT indicated for treatment fo GABHS pharyngitis
Tetracyclines

TMP SMX

Sulfonamides

Chloramphenicol
Most common pathogens in COPD
H influenzae

Strep Pneumoniae

Moraxella catarrhalis
Choice of antibiotics in COPD
TMP SMX

Doxycycline

Clindamycin