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Infectious Disease EXAM 2 - Bergman
Infectious Disease EXAM 2 - Bergman
59
Pharmacology
Graduate
01/16/2011

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Term
penicillins are the #1 cause of allergic reactions
hematologic (lowering the blood count)
neurologic, seizures
Definition
ADRs of penicillin
Term
efficacy, safety, and cost
Definition
what categories should be used to evaluate antimicrobial therapy?
Term
cefazolin IV and cephalexin PO
gram positives: MSSA and beta hemolytic strep
gram negatives: Proteus, E. coli, Klebsiella (PEcK)
Definition
spectrum of activity of first generation cephalosporins
Term
Cefuroxime IV or PO
gram positives: alpha hemolytic strep
gram negatives: Haemophilus, Neisseria, Proteus, E. coli, Klebiella (PEcK)
Definition
spectrum of activity of second generation cephalosporins
Term
Cefotetan and Cefoxitin IV
gram negatives: Haemophilus, Neisseria, Proteus, E. coli, Klebsiella (PEcK)
anaerobes
Definition
spectrum of activity of cephamycins
Term
Ceftriaxone and Cefotaxime
gram positives: alpha hemolytic strep
Definition
spectrum of activity of third generation cephalosporins
Term
Pseudomonas
Definition
spectrum of activity of ceftazidime
Term
Ceftriaxone is approximately 50% eliminated via the biliary tract and therefore no dosage adjustment is needed for renal insufficiency
Definition
are renal dosage adjustments needed for Ceftriaxone?
Term
Cefepime IV
gram positives: alpha hemolytic strep
gram negatives: Haemophilus, Enterobacter, Neisseria, Proteus, E. coli, Klebsiella (HENPEcK) and Citrobacter, Acinetobacter, Morganella, Providencia, Serratia (CAMPS) and pseudomonas
Definition
spectrum of activity of fourth generation cephalosporins
Term
allergic reactions
hematologic
neurologic
disulfiram like reaction
Definition
ADRs of cephalosporins
Term
inhibits dehydropeptidase I of the renal brush border
coadministered with carbapenems
Definition
MOA of Cilastatin
Term
diarrhea - high risk of C. difficile b/c of broad spectrum
allergic reactions
seizures
Definition
ADRs of carbapenems
Term
aztreonam is weakly immunogenic
Definition
ADRs of aztreonam
Term
gram negative bacilli
can be used in combination to treat staph, enterococci and certain mycobacteria
Definition
spectrum of activity of aminoglycosides
Term
renally
Definition
how are aminoglycosides eliminated?
Term
gentamicin
Definition
which aminoglycoside can be used synergistically to treat enterococci?
Term
tobramycin
Definition
which aminoglycoside has greater activity against Pseudomonas aeruginosa?
Term
improves peak to MIC ratio and maximizes concentration dependent bactericidal activity
takes advantage of post antibiotic effect (stun the bacteria so they can't grow anymore)
gives kidneys time to recover so possibly less nephrotoxicity
less potential for resistance
lower cost of supplies and nursing time
Definition
advantages of once daily dosing for aminoglycosides
Term
MAJOR: nephrotoxicity, ototoxicity (vestibular and auditory), neuromuscular blockade
Definition
ADRs of aminoglycosides
Term
urinary tract pathogens: Enterobacteriaceae
staphylococcus aureus including MRSA
Definition
spectrum of activity of sulfamethoxazole/trimethoprim
Term
CA-MRSA skin and soft tissue infections
urinary tract infections
Definition
therapeutic uses of sulfamethoxazole/trimethoprim
Term
renally
Definition
how is sulfamethoxazole/trimethoprim eliminated?
Term
hypersensitivity reactions
renal: can crystallize and cause stones if not hydrated, counsel patient to take with water, contraindicated in renal failure
hematologic - bone marrow suppression common at high doses
Definition
ADRs of sulfamethoxazole/trimethoprim
Term
gram positive aerobes
atypicals
Definition
spectrum of activity of tetracyclines
Term
respiratory infections
sexually transmitted diseases
skin infections
Definition
main indications of tetracyclines
Term
photosensitivity
discoloration of developing teeth
esophageal ulceration
Definition
ADRs of tetracyclines
Term
MRSA, VRE, PRSP (S. pneumoniae)
enterics
respiratory gram negatives
anaerobes
atypicals
bacteria NOT susceptible: Pseudomonas and Proteus
Definition
spectrum of activity of tigecycline
Term
Nausea and vomiting
Definition
ADRs of Tigecycline
Term
decrease maintenance dose in LIVER failure
Definition
when should there be a dose decrease for Tigecycline?
Term
active, but resistance is developing
S. pneumoniae
respiratory gram negatives
atypicals
Definition
spectrum of activity of macrolides
Term
nausea
abdominal pain, worst with erythromycin
metallic taste, clarithromycin
Definition
ADRs of macrolides
Term
Erythromycin
Clarithromycin
Definition
which macrolides utilize the hepatic chromosome P-450 enzyme system, primarily 3A4?
Term
FDA advisory on use due to HEPATIC FAILURE
Definition
why is telithromycin rarely used?
Term
hepatotoxicity
Definition
ADR of Telithromycin
Term
Enterobacteriaceae
Pseudomonas aeruginosa atypicals
no longer active against gram positives
Definition
spectrum of activity of ciprofloxacin IV or PO
Term
Streptococci
Enterobacteriaceae
Pseudomonas aeruginosa, high dose 750 mg/day only
atypicals
Definition
spectrum of activity of Levofloxacin
Term
Streptococci
Enterobacteriaceae
some anaerobes
atypicals
not for urinary tract infections
Definition
spectrum of activity of Moxifloxacin
Term
C. difficile diarrhea
CNS effects
arthropathy
tendonitis/tendon rupture
QT interval prolongation CAUTION WITH OTHER MEDS THAT PROLONG QT
Definition
ADRs of quinolones
Term
multivalent metal cations (Ca, Mg, Fe)
Definition
quinolone drug interactions
Term
anaerobes
aerobic gram positive bacteria
Definition
spectrum of activity of Clindamycin
Term
GI upset
diarrhea
C. difficile pseudomembranous colitis
Definition
ADRs of clindamycin
Term
anaerobes
Definition
spectrum of activity of Metronidazole
Term
CNS effects
GI upset
Metallic taste
disulfram like reaction
Definition
ADRs of metronidazole
Term
aplastic anemia (irreversible)
bone marrow suppression (reversible)
gray baby syndrome (primarily neonates)
Definition
ADRs of Chloramphenicol
Term
aerobic gram positive
not orally absorbed
Definition
spectrum of activity of Vancomycin
Term
nephrotoxicity
drug fever
infusion related side effects (red man syndrome)
Definition
ADRs of vancomycin
Term
metabolized to several active metabolites
Definition
metabolism of quinupristin/dalfopristin
Term
aerobic gram positive cocci
Enterococcus faecium (VRE) but not E. faecalis
Staphylococcus aureus, including MRSA
Definition
spectrum of activity of quinupristin/dalfopristin
Term
severe pain and inflammation at infusion site
arthralgia/myalgia
Definition
ADRs of quinupristin/dalfopristin
Term
non-renal
Definition
elimination of Linezolid
Term
aerobic gram positive cocci
MRSA
Streptococcus pneumoniae
VRE (E. faecium)
Definition
spectrum of activity of linezolid
Term
thrombocytopenia
Definition
ADR of linezolid
Term
mono amine oxidase inhibition may lead to serotonin syndrome with SSRIs
Definition
drug interaction of linezolid
Term
pneumonia, lung penetration is good
Definition
therapeutic uses of linezolid
Term
inactivated by pulmonary surfactant
eliminated in the kidneys
Definition
distribution and elimination of daptomycin
Term
aerobic gram positive cocci
MRSA
VRE
Definition
spectrum of activity of daptomycin
Term
myopathy - damages muscle cells b/c the drug cannot distinguish between bacterial cell membranes and human cell membranes
Definition
ADR of daptomycin
Term
nephrotoxicity
birth defects
Definition
ADRs of telavancin
Term
infection of Clostridium difficile (anaerobic Gram + cocci) to LOCALLY treat in the GI tract
but the drug IS NOT ABSORBED ORALLY
Definition
when is the only time vancomycin is given orally?
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