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64 Cards in this Set
- Front
- Back
what is the definition of an abx?
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substsances produced by other psecies which prevent the growth of other microorganisms
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what are some things to consider when choosing an abx?
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reaches the target
binds to the target interferes with fxnl capacity of target reaches appro concentration maintains adequate contact time avoids toxicity to the host |
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what are some reasons for treatment failure
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wrong dose
factors like abscess or foreign body at site of infec poor delivery immunocompromised host superinfection inappropriate PD/PK |
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antimicrobial activity depends on what 2 thigns
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drug concentration and duration of exposure
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cell walls are made up of ____________ and are joined by _________
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peptidoglycan
glycosidic bonds and peptide cross bridges |
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what is the MOA of b- lactams?
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it binds the transpeptidase which typically joins the monomers. in doing so, peptide cross links don't occur and causes a weak cell wall and lyses
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beta lactams are highly selective with low toxicity T OR F
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true
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natural PCN are usu good for what organisms?
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g+
some g- anaerobes |
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which natural PCN is given IM and what is given IV and PO?
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IM = aq procaine PCN G, benzathine PCN G
IV= aq crystalline PCN G po = PCN V |
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Which is used for endocarditis? syphylllis? strep throat?
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IV= endocarditis
IM= syphyllis PO= strep throat |
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why is PCN G given IV or IM?
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it is unstable in stomach acid
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what is the drug inactivation that can occur?
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b-lactamase can open up the b-lactam ring.
altered target site so abx can't bind |
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what are some anti staph PCN
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nafcillin
oxacillin dicloxacillin |
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what does anti staph PCN NOT protect against?
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enterococci
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which ones are IV and which ones are PO?
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IV= nafcillin and oxacillin
PO= dicloxacillin |
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which ones need renal adjustment and which need hepatic adjustment?
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renal = dicloxacillin
hepatic= nafcillin |
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what is antistaph pcn used to treat?
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cellulitis, osteomyelitis, bacteremia, endocarditis
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what aminoPCN is used for otitis media and endocarditis prophylaxis?
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amoxicillin
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what route is amoxicillin administered?
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PO
excreted renally so you need renal adjustment |
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which is for listeria meningitis and enterococcus?
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ampicillin (IV)
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what is added as an adjunct to amoxicillins and ampicillins to increase their coverage of organisms?
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b lactamase inhibitors
clavulanic acid sulbactam tazobactam |
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what are the 2 combos with b lactamase inhibitors + aminopcn?
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ampicillin+ sulbactam (PO)
amoxicillin + clavulanic acid (IV) |
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what do you give when you're switching from Unasyn (IV)
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you give amoxicillin + clavulanic acid (augmentin) po
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what are the combo drugs used for?
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HEENT, bacetermia, cellulitis, osteomyelitis, pneumonia
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what are some antipseudomonal PCNs?
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piperacillin
ticarcillin |
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what are the combos of antipseudomonals?
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pip + tazobactam = zosyn (IV)
tic + clavulanic acid = timentin (IV) |
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what are some SE of antipseudomonals?
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allergy, rash, pancytopenia, hepatotoxicity
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what do anti pseudomonal pcns cover?
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pseudomonas, anaerobes, g+, lesser g-, NOT atypicals
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what is a highly potent broad spectrum abx against g + g- anaerobes enterococcus and has the acronym DIME
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doripenem
imipenem meropenem ertapenem |
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which is th eonly one not given IV?
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eratpenem (IM)
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which one is always given with cilastin?
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imipenem
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what is the point of cilastin?
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it inhibits dihydropeptidase I (enzyme that destroys the drug)
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what are some thigns that carbapenems protect against
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intra-ab infec
bacteremia soft tissue infection bone/joint infection nosocomial pnuemonia |
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which one of the carbapenems is a niche drugs and what is it used for?
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ertapenem, specifically for cSSSI, intraab infections and for outpatient therapy
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T OR F: carbapenems, because they work so well, should be used as a first line tx
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false
they should always be reserved for last line therapy |
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what is another niche medicine good against pseudomonas and for pts with b lactam allergy
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azitreonam
IV/IM |
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what are some SE with azitreonam
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hepatotoxicity
hypersensitivity rxn |
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what do cephalosporins NOT protect against EVER?
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enterococci
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T OR F : a 4th generation cephalosporin is the best tx for a g+ bacteria
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FALSE
4th generation has the least potency against g+ it has the best against g- though |
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how are cephalosporins different than PCN?
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2 r groups and a 6 membered ring
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what are some major SE of cephalosporins?
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allergies, hepatoxicity, sludging of gall bladder with ceftriaxone,
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what is the drug to give when switching from IV cefazolin?
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PO cephalexin
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what is a first gen cephalosporin only good for?
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g+
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what is a 1st gen ceph used for?
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puncture wound, cellulitis, cystitis, sx prophylaxis
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what are the 2nd generation cephs and what are they used for?
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cefoxitin
cefotetan" cefuroxime used for HNM PEK h flu, n meningitis, m catarrhalis, proteus, e coli, kleb |
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which ones are IV and which ones are PO
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cefturoxime is the only IV and PO, all others are IV
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what are 2nd gen cephs good for?
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anaerobe AND gram- coverage
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what are 2nd gen used for in treatment settings?
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pulm, HEENT, infections
decreases otitis media, pnuemonia, pharyngitis, tonsillitis, bronchitis |
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for a 3rd gen cep, which one has biliary excretion?
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ceftriaxone
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which 3rd gen is used to switch from IV cefotaximeor ceftriaxone?
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PO cefpodoxime
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which one is similar to 4th gen? why?
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ceftazidime because it has pseudomonas coverage
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what do 4th gen cephs protect against?
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acinetobacter and pseudomonas
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when do you use 4th gens?
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when there are resistant infections
bacteremia, pneumonia, febrile neutropenia, intraab infection, meninigitis IV only |
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this drug is used for g+ pts with b lactam allergy and can also be used for MRSA infections. does NOT protect against VRE enterococcus
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vancomycin
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T or F, vancomycin is preferred over b lactams
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false. vanco is inferior to b lactams
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PO vanco is used only for what org?
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c. difficile
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vanco is used via IV in all sites except where?
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GI
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what are some major se of vanco?
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ototoxcity
nephrotoxicity red man syndrome |
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what do you give for HA MRSA if all the other drugs are failing and it irreversibly binds to membranes and causes an efflux of k+, destroying the [] gradient
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daptomycin
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daptomycin is good only against what type of bacteria?
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g+
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how is daptomycin administered?
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iv only, adjust dose for renally impaired pts
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what lab tests do you have to check for weekly if you're on dapto?
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cpk elevations.
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what disease is daptomycin NEVER used for?
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pneumonia
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what disease does daptomycin protect against that vancomycin does NOT?
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VRE
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