Id Questions 51-88

Front 1

List the major drug-drug interactions with Zyvox and describe them?

Back 1

Adrenergic agents
Myelosuppressive medications
Serotonergic agents
Tramadol – could lead to seizures

Front 2

Quinipristin and Dalfopristin – what is the brand name and dose?

Back 2

Synercid
E. Faecium 7.5mg/kg/dose q8h

Front 3

. Do Quinipristin and Dalfopristin cover E. faecium or E. faecalis or
both?

Back 3

Only E. Faecium

Front 4

. How are Quinipristin and Dalfopristin metabolized?

Back 4

Active metabolites via nonenzymatic reactions

Front 5

Give the coverage of chloramphenicol?

Back 5

Bacteroids
H. Flu
Neisseria meningitidis
Salmonella
Rickettsia
Active against vancomycin resistant enterococci

Front 6

56. List the “cautions” for chloramphenicol and describe them

Back 6

Serious and Fatal blood dyscrasias after both short term and prolonged
therapy
Use caution in patiensynthesis and inhibiting fungal cell membrane formation

Front 7

Does Chloramphenicol cover MRSA, VRE

Back 7

a) MRSA (N)
b) VRE (Yes)

Front 8

Coverage of Vancomycin

Back 8

a) Anaerobes
i) Bacteroides fragilis
ii) Clostridium (including C. diff)
b) G+
i) Strep Groups A, B, C, G
ii) Strep pneumo (pneumococcus)
iii) Enterococcus (faecium and faecalis)
iv) Staph (MSSA, MRSA, CA-MRSA, epidermidis)
v) Colostridium jeikeium
vi) Listeria monocytogenes

Front 9

59) Does Vanco Cover N. meningitis

Back 9

a) Yes it does, but there are better drugs with more activity, such as Rocephin.

Front 10

What dose Cidal Mean?

Back 10

a) This means that the drug “kills” the bacteria

Front 11

What does static mean?

Back 11

a) Drugs that are static, usually stop protein synthesis. They do not have an effect on the organisms that are already mature, just prevent more organisms from being made so that the body’s natural immunities can kill those organisms present.

Front 12

62) What does MIC mean?

Back 12

a) MIC = Mnimum Inhibitory Concentration?
i) The MIC90 is a lab test to determin the minimum concentration of drug needed to kill 90% of the culture. The MIC90. Usually drug levels are targeted 4-5x the MIC or higher, in order to assure that they are high enough in vivo to kill the organism.

Front 13

63) How do you calculate ANC? Why would you calculate ANC?

Back 13

a) ANC = WBC * (% Segs + % Bands)
b) ANC is a test neutropenia. We can test to see if the patient is a candidate for G-CSF therapy, especially in oncology / transplant patients.

Front 14

64) What is the difference between a lymphocyte and a monocyte

Back 14

c) Lymphocyte:
i) Lymphocytes activate the complement system as well as stimulating an immune response through MHCI complexes.
ii) Monocytes are responsible for “scavenging” and engulfing (phagocytosis) to get rid of cells or antigents or other parts that need to be destroyed

Front 15

65) What is ESR

Back 15

e) Erythrosedemtation rate is a non specific marker of inflammation

Front 16

66) What is the difference between a seg and a band?

Back 16

Seg = PNM = Neutrophil (mature)
Band = an immature beutrophil that shows up in blood. Can be a sign of a serious infection, indicating tha thte bone marrow is overwhelmed and “pumping out” Neutrophils too fast

Front 17

67) Why do we do Bone Scans

Back 17

To test of osteomyelitis (infection of the bone)

Front 18

68) why do we do gram stains

Back 18

Fast, cheap way to narrow and direct our Abx therapy specific for a patient with a specific disease.

Front 19

Coag +

Back 19

S. aureus

Front 20

Coag (-)

Back 20

S. epi, saprophyticus

Front 21

70) Make a table of cidal. Vs. static

Back 21

CIDAL: PCN, CEPHS, AG, FQ’S, Nitrofurans, VANCO, Monobactams, Metronidazole, Co-Trimoxazole
STATIC: TCN’S, SMP/TMP, Chloramphenicol, Licosamides, Macrolides.

Front 22

) List anaerobic, what does it mean, how to kill them:

Back 22

LIST: ACTINOMYCES, b FRAG, p. MELANINGENICA, C diff, Other Clostridia,
Peptostreptococcus
Mean: lives with out O2
Kill: almost everything coveres PEPTOSTREPTO. Rest: we can use PCN’s , CARBAPENEMS are great (Meropenem), some FQ/Cephs, CLINDA and CHLORAMPHENICOL, LINEZOLID, SYNERCID, METRONIDAZOLE

Front 23

All the Abx that cover the BBB

Back 23

Amp, Naf, Pen G, Pip, Ticarcillin, Many Cephs (except Cefazolin)
Chloramphenicol, SMX/TMP (minimal)
Cipro, Levo, Metronidazole, Vanco

Front 24

(Don’t cross BBB)

Back 24

Clindamycin, AminoGlyc (usually) Cefazolin,

Front 25

can vanco be delivered to the brain

Back 25

Yes, 3-5mL of concentrated, sterile Vanco is sometimes given

Front 26

) % of flagyl that’s gets to CSF

Back 26

nL: 16-43%
Inflamed Meninges: 100%

Front 27

Does Invanz (Ertapenem) cover Pseudomonas?

Back 27

No.

Front 28

List one advantage of Ertapenem

Back 28

Less C. diff due to its specific spectrum

Front 29

list major side effects of
Isoniazid, rifampin Ethambutol streptomycin

Back 29

Isoniazid (Hepatotoxicity)
Rifampin (Hepatotoxicitiy, Blood dyscrasias)
Ethambutol (Psych Δ and Vision Δ)
Streptomycin (Nephrotoxicity)

Front 30

What causes C. diff

Back 30

Kill normal flora and C. diff overgrows

Front 31

) List major bugs of endocarditis

Back 31

(Staph and Strep – 80%)

Front 32

Major s/sx of pneumonia

Back 32

Dyspnea, cough, fever, tachycardia, tachypnea, chest pain, sputum, fatigue, confusion (elderly), exacerbation of underlying disease, falls (elderly)

Front 33

) What is D.O.T

Back 33

DIRECLY OBSERVED THERAPY

Front 34

Major bugs in cellulitis

Back 34

Group A Strep, sometimes Grop B
S. aureus, and CA-MRSA is becoming a concern

Front 35

difference between Pyelonephritis and Cystitis:

Back 35

Pyelonephritis: Inflammation of the kidney and its pelvis caused by bacterial infection
Cystitis: Inflammation of the urinary bladder and ureters