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Antimicrobial Therapy
Test 3 Sem 2
39
Medical
Graduate
02/16/2011

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Cards

Term
formula for creatine clearance?
Definition
(140-age/serum Cr x 72) x 0.85 in females x IBW
Term
what are the 5 considerations for antimicrobial therapy?
Definition
1) the organism and it's drug susceptibility
2) type of infection
3) Host factors
4) Antimicrobial agents (route, dose, etc)
5) public health considerations
Term
if immunosupressed what should be the approach to antibiotic therapy?
Definition
broader spectrum
Term
Which drugs are directly toxic to the kidneys? (3)
Definition
1) aminoglycosides
2) polymyxins
3) amphotericin B
Term
What can chloramphenicol cause?
Definition
bone marrow supression - aplastic anemia
Term
ototoxicity is caused by what drug?
auditory neurotoxicity is caused by what drug?
Definition
ototoxicity - aminoglycosides
auditory neurotoxicity - vancomycin
Term
Which two antibiotics can cause seizures?
Definition
penicillins in large doses
ofloxacin
Term
peripheral neuropathy can be caused by what 2 meds?
Definition
trimethoprim or isoniazid
Term
What drugs cause liver toxicity?
Definition
TB meds
Tetracyclines - fatty liver
High doese B-lactam - hepatitis/choestasis
Term
Which two classes cause prolonged QT syndrome and V tach?
Definition
Erythromycin and macrolides
Term
Pencillins work how and what is the most common side effects?
Definition
work by impairing cell wall synthesis

SE-hypersensitivity and GI rxns
Term
What is a penicllinase-resistant penicillin?
Definition
nafcillin, dicloxacillin
Term
What are some penicillinase-susceptible broad-spectrum 2nd generation penicillins?
Definition
Ampicillin and amoxicillin
Term
3rd generation extended spectrum carboxpenicillins?
Definition
ticarcillin
Term
extended spectrum acylaminopencillins - 4th generation
Definition
mezlocillin, piperacillin, and azlocillin

*increased anerobe susceptibility - B. fragilis
Term
What is a B-lactamase inhibitor combo that is effective for upper/lower respiratory infections, UTIs, and Human/animal bites?
Definition
Amoxicillin-clavulanic acid - Augmentin
Term
Which B-lactamase combo is good for GYN and intra-abdominal infections?
Definition
Ampicillin-sulbactam
Term
cephalosporins are what type of antibiotics and how do they work?
Definition
B-lactam antibiotics, they inhibit bacterial cell wall synthesis
Term
cephalosporins and surgical prophylaxis?
Definition
use 1st generation accept for colorectal and abdominal operations - use 3rd generation (cefoxitin, cefotetan, or cefmetazole))
Term
Meningitis and Gonorrhea should be treated with what cephalosporin?
Definition
3rd generation ceftriaxone
Term
MOA of carbapenems and examples
Definition
MOA-bactericidal and inhibit cell wall synthesis - covers gram negative and positive

Imipenem, Ertapenem, meropenem
Term
aztreonam is effective against what?
Definition
A monobactam that is effective against aerobic gram negative bacteria

* does not cross react w/other penicllin/b-lactams
Term
What is the most common reaction with B-lactams
Definition
hypersensitivity - rash, fever
Term
1) Aminoglycosides work how?
2) effective against what?
3) what do they penetrate?
4) Example?
Definition
1) 30S ribosomal subunitof bacteria
2) gram-negative bacilli
3) synovial fluid and ascitic
4) Gentamicin
Term
What is spectrum of tetracyclines and what is the feared SE?
Definition
broad spectrum (gram negative and positive), permanent discoloration of teeth
Term
Tigecycline a glycycycline is effective against what and used for what?
Definition
effective against gram neg, gram pos, and anaerobic infections.

Used for complicated abdominal and skin infections
Term
Which macrolide is an effective alternative to penicillins and is active against legionella, mycoplasm, and chylamida?
Definition
Erythromycin - gram pos
Term
which macrolide has the same spectrum as erythromycin but w/less SE?
Definition
clarithromycin
Term
Which macrolide has a prolonged duration in tissue of 4-7 days?
Definition
azithromycin
Term
Which AB has good anerobic coverage for GI tract/genital tract infections?
Definition
Clindamycin - also good for aspiration pneumonia
Term
What is a complication of clindamycin?
Definition
pseudomembranous colitis
Term
What is the main reason chloramphenicol is rarely used?
Definition
occurences of aplastic anemia
Term
Which drugs are effective against vancomycin-resistant enterococci?
Definition
chloramphenicol, Streptogramins, and linezolid is the drug of choice
Term
What AB is bacteriocidal against gram pos. bacteria and is the drug of choice for MRSA?
Definition
vancomycin
Term
trimethorprim sulfamethoxazole is the drug of choice for what?
Definition
prevention/treatment of P. jiroveci pneumonia and nocardiosis

*also AOM in children and uncomplicated UTIs
Term
What drug is used to treat pseudomembranous colitis caused by C. diff?
Definition
Metronidazole
Term
Quinolones are effective against what?
Definition
most enteric gram-negative bacilli
Term
What is the drug of choice against B. anthracis?
Definition
ciprofloxacin
Term
Nitrofurantin should only be used for what?
Definition
treatment/prevention of uncomplicated UTIs
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