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46 Cards in this Set
- Front
- Back
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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
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Aztreonam
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What are three most important characteristics of pneumonia
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Productive cough
Fever Chest x ray - lobar consolidation |
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Has an abrupt onset with RESOLUTION OF SYMPTOMS WITH THERAPY WITHIN 2-3 WEEKS
What type of sinusitis |
ACUTE
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Has PERSISTENT PURULENT NASAL DISCHARGE despite therapy but no permanent mucosal damage
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SUBACUTE
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- 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
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MOST COMMON bacterial pathogens isolated from sinus aspirates
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S PNEUMONIAE most predominant
H INFLUENZAE MORAXELLA CATARRHALIS |
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Which bug causes atypical sinusitis
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Moraxella catarrhalis
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Some medical conditions that can increase risk for sinusitis
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Cystic fibrosis
Asthma Immunosuppression Allergic rhinitis |
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_ may increase the risk of bacterial sinusitis during cold because of decreased mucociliary clearance
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Smoking
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Hallmark of persistent sinusitis
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Dull ache or pressure across midface or headache
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All three types of sinusitis may exacerbate _
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Asthma or otitis media
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_ sinuses most frequently involved in acute rhinosinusitis followed by _ sinuses
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Maxillary
Frontal |
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Antibiotics are recommended for all types of sinusitis - most commonly used
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Penicillins
Cephalosporins Macrolides Fluoroquinolones |
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Most common adverse effect of penicillins
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Hypersensitivity
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Which immunoglobulin involved in anaphylactic shock caused by penicillin
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IgE
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MOA penicillins
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Beta lactam antibiotics - inhibit cell wall synthesis
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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
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Amoxicillin
TMP-SMX |
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Antibiotic therapy of acute sinusitis - both are inexpensive and GOOD INITIAL DRUGS OF CHOICE
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Amoxicillin and TMP SMX
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_ not effective against H influenzae and M catarrhalis due to moderate and high levels of resistance in treatment of acute sinusitis
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Amoxicillin
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_ is less effective against S pneumoniae in treatment of acute sinusitis
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TMP SMX
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Drugs of choice for resistant pathogens due to enzyme production in treatment of acute sinusitis
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Amoxicillin - clavulanate - AUGMENTIN
Loracarbef - LORABID Cefuroxime - axetil (CEFTIN) Macrolides |
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Sinusitis caused by PENICILLIN RESISTANT S PNEUMONIAE can be treated with _
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High dose amoxicillin
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Sinusitis in patients not responding to traditional therapy may be due to _
Treatment? |
Chlamydiae pneumoniae
Tetracycline Clarithromycin Azithromycin |
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Which macrolide has longest T 1/2
Why |
Azithromycin
Largest volume of distribution - 2000 L |
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Main side effects of clarithromycin
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GI + metallic taste
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MOA of tetracycline
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Inhibition of 30S subunit
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MOA of clarithromycin
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Inhibition of 50S subunit
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Which macrolide is used in treatment of H pylori
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Clarithromycin
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What is the treatment for chronic sinusitis
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Longer course of therapy using broad spectrum of antibiotics - amoxicillin clavulanate, 2nd generation cephalosporins, macrolides etc
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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 |
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Which drug causes pseudomembranous colitis
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Clindamycin
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Therapy with TMP-SMX has been associated with what side effects
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Rash including STEVENS JOHNSON SYNDROME
Crystalluria Photosensitivity |
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Amoxicillin clavulanate has been associated with what side effect
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GI complains + diarrhea
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Which antibiotics cause hypersensitivity reactions such as hives, laryngeal edema and anaphylactic shock and pose an immediate threat and warrant medical attention
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Penicillins
Cephalosporins Sulfonamide antibiotics |
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Most frequently reported side effects of macrolides
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GI complains such as nausea, vomitting and diarrhea
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Bacterial causes of pharyngitis
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Mycoplasma pneumonia
Chlamydia pneumonia Neisseria gonorrhea - rare Corynebacterium diphtheriae - in unimmunized patients |
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Most important pathogen to identify in pharyngiits
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Group A beta hemolytic strep - S pyogenes
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Who usually gets strep throat
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School aged children
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Strawberry tongue + rash - diagnosis
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Scarlet fever
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Estolate form of erythromycin should never be given to pregnant women - why
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Causes cholestatic jaundice
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Drug of choice in patients whose treatment for strep pharyngitis fails
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Amoxicillin clavulanate
Clindamycin Combination of penicillin with rifampin |
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Can rifampin be used for treatment of Myco Leprae
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NO - DAPSONE
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For individuals who are chronic carriers of group A strep what drug should be given
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Penicillin G
Erythromycin - if allergic to penicillin |
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Antibiotics NOT indicated for treatment fo GABHS pharyngitis
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Tetracyclines
TMP SMX Sulfonamides Chloramphenicol |
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Most common pathogens in COPD
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H influenzae
Strep Pneumoniae Moraxella catarrhalis |
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Choice of antibiotics in COPD
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TMP SMX
Doxycycline Clindamycin |
