Term
| Bactrim (Trimethoprim) is indicated for what conditions? |
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Definition
1. UTI's (can be given alone)
TMP/SMZ Combo:
2. Pneumocystis jiroveci pneumonia
3. Shigellosis
4. Systemic salmonella infections
5. UTIs
6. Prostatitis
7. Traveler's D
8. Non-TB mycobacterial infxns
9. Staph aureus (including MSSA and MRSA)
10. Respiratory tract pathogens (haemophilus, moraxella catarrhalis, k. pneumoniae) |
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Term
| What are the adverse effects of Bactrim (Trimethoprim)? |
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Definition
1. Megaloblastic anemia, leukopenia, granulocytopenia
2. N/V, drug fever, vasculitis, renal damage and CNS disturbances
3. AIDS pts have MORE rxns: fever, rash, leukopenia, D, elevated LFTs, hyperkalemia, hyponatremia |
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Term
What is the 1st line tx for pneumocystis jiroveci?
2nd line? |
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Definition
1st line- TMP-SMZ (Trimethoprim with Sulfas)
2nd line- Clindamycin in combo with Primaquine or Dapsone for pts with HIV |
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Term
| What do fluroquinolones do? |
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Definition
| Block bacterial DNA synthesis. |
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Term
| Name a 1st generation fluroquinolone? |
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Definition
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Term
| What are 2nd generation fluroquinolones? |
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Definition
1. Ciprofloxacin
2. Norfloxacin
3. Ofloxacin |
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Term
| What are 3rd generation fluroquinolones? |
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Definition
1. Gatifloxacin (tequin) (Zymar)- clinical use: conjunctivitis
2. Levofloxacin
3. Moxifloxacin |
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Term
| What are 4th generation fluroquinolones? |
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Definition
1. Gemifloxacin
2. Trovafloxacin |
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Term
| What is Cipro the DOC for? What are the clinical uses for Cipro? |
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Definition
DOC for: Anthrax
Clinical Uses:
1. UTIs
2. Bacterial D caused by Shigella, Salmonella, E coli and Campylobacter
3. Infxns of soft tissue, bone, joint and intra-abdominal
4. Gonnococcal, Clamydial or cervicitis infxns
5. TB
6. URI/LRI |
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Term
| What are the MC SE of fluroquinolones (Cipro)? |
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Definition
N/V/D- They are usually WELL tolerated.
Also, RARE SE include: H/A, dizzy, insomnia, skin rash and abnormal LFTs |
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Term
| Can fluroquinolones (Cipro) cause QT Prolongation? What pts should these drugs be avoided in? |
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Definition
Yes they CAN cause QT Prolongation. Should be avoided in pts with:
1. QT interval prolongation
2. Pts taking Class IA antiarrythmics: Quinidine or procainamide
3 Taking Class III antiarrythmics: Sotalol, Ibutilide, Amiodarone
4. Taking erythromycin or TCAs |
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Term
| Can fluroquinolones such as Cipro cause hyper/hypoglycemia? Tendonitis? Can they be used in Prego? |
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Definition
Yes, can cause hypo/hyper glycemia.
Yes, can cause tendonitis and tendon rupture.
No, cannot be used in prego (lacking significant safety data) |
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Term
| Why should fluroquinolones be avoided in pts <18 yo? When conditions are they indicated for in children? |
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Definition
They are typically not used in <18 yo pts bc they can cause damage to growing cartilage, causing a reversible arthropathy.
There is a growing consensus that it CAN be used in children for infections assoc with cystic fibrosis. |
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Term
| Are they any organisms resistant to Cipro? What type of organisms is Cirpo most active against? |
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Definition
| MRSA resistance. Cipro is most active against gram - bacteria, esp P. aeruginosa. |
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Term
| Levofloxacin has superior activity against what type of organisms? |
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Definition
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Term
| What are the3 beta lactamase inhibitors? |
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Definition
1. Augmentin (Amoxicillin + Clavulanic acid)
2. Sulbactam (Ampicillin + Sulbactam)
3. Zosyn (Piperacillin + Tazobactam) |
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Term
| What is Sulbactam used for? |
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Definition
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Term
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Definition
1. Appendicitis
2. Peritonitis
3. PID
4. Endometriosis (postpartum)
5. Community acquired/nosocomial pneumonia |
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Term
| What is the MOA for Beta Lactamase Inhibitors? |
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Definition
1. Protect hydrolyzed PCM from inactivation by beta-lactamses
2. Very weak antibacterial action
3. Potent inhibitors of many beta-lactamases and therefore extend the spectrum of the penicillin
4. Dose adjustments for renal insufficiency are made based on the penicillin component. |
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