War of the Worlds (Antibiotics) Flashcards Preview

Buy the Farm (Pharmacology) > War of the Worlds (Antibiotics) > Flashcards

Flashcards in War of the Worlds (Antibiotics) Deck (31)
Loading flashcards...
1
Q

What pregnancy category is Bactrim?

A

C or D. ….I dunno… epocrates says D, but Sanford’s says C….

2
Q

What does it mean for a drug to be ‘bacteriostatic’?

A

A bacteriostatic agent or bacteriostat, abbreviated Bstatic, is a biological or chemical agent that stops bacteria from reproducing, while not necessarily harming them otherwise. Depending on their application, bacteriostatic antibiotics, disinfectants, antiseptics and preservatives can be distinguished. Upon removal of the bacteriostat, the bacteria usually start to grow again. This is in contrast to bactericides, which kill bacteria.

3
Q

With which antibiotics would you consider telling pts to discontinue alcohol use- for at least the time while on antibiotic therapy?

A

Flagyl, Bactrim, Tindamax, Isoniazid.

4
Q

A pt. with chronic A-fib who is anticoagulated with coumadin now has a UTI. Susceptibility to the offending agent calls for TMP/SMX as the best choice to treat. Although it is by no means your first choice- you reluctantly proceed with the therapy. What should you monitor closely, and why?

A

PT/INR. Giving TMP/SMX to a pt on warfarin is potentially dangerous. The drug interaction increases warfarin levels, resulting in a higher risk of bleeding.

5
Q

What kind of coverage can you expect from Bactrim? (i.e., which infections are typically susceptible to TMP/SMX)

A

TMP-Smx: Tree: (Respiratory tree) otitis media, sinusitis, bronchitis, pneumonia - that are a result of S pne or H flu. M- Mouth: Diarrhea from agents such as Shigella, Salmonella, and E.coli. P - Pee - UTIs, prostatitis, urethritis caused by enterics S - Syndrome (AIDS). Covers Pneumocystis carinii pneumonia (PCP). It is given to PREVENT PCP when CD4 counts drop below 200-250.

Other infections covered by Bactrim: Toxoplasma, Isospora.
Bactrim has NO anaerobic coverage!

6
Q

Pregnancy category for Vancomycin?

A

C

7
Q

Vancomycin: Oral Absorption %?

A

0 %

8
Q

A pt. of yours takes Lisinipril, and has just started a course of Bactrim. What should you monitor and why?

A

Potassium. Bactrim and ACE inhibitor combinations can act to increase K+ levels.

9
Q

A pt. of yours is on Phenytoin, and has now started a course of Bactrim. What should you monitor and why?

A

Phenytoin levels. Bactrim can act to increase Phenytoin levels.

10
Q

Ceftriaxone seems to be a good ‘go-to’ drug for many infections. But it is not a magic bullet. Name some infections for which Rocephin is NOT a good idea…

A

MRSA, Listeria, Enterococcus, B. fragilis, Pseudomonas aeruginosa
Is it just me, or are there some major players in this group?

11
Q

Rocephin: Pregnancy Category

A

B

12
Q

How much (what %) of Ceftriaxone is absorbed orally?

A

Trick question. Ceftriaxone is IV only.

13
Q

What is a ‘typical’ dose of Ceftriaxone?

A

1-2 gm IV q24h

14
Q

Does Rocephin achieve therapeutic levels in CSF?

A

Yes

15
Q

What black box warning is associated with Clindamycin?

A

C. difficile associated diarrhea

16
Q

Where is Clindamycin metabolized?

A

Liver. CYP450

17
Q

What (2) Black Box warnings are associated with Ciprofloxaxin?

A

Tendinitis/Tendon Rupture: Fluoroquinolones assoc. w/ incr. tendinitis/tendon rupture risk in all ages; risk further incr in pts >60 y.o., pts on corticosteroids, and pts w/ kidney/heart/lung transplant

Avoid in myasthenia gravis: fluoroquinolones may exacerbate muscle weakness in pts w/ m.g.

18
Q

Pregnancy category for Ciprofloxacin?

A

C

19
Q

What is the determination on Ciprofloxacin in a mother who is nursing?

A

Probably safe: Limited info in animals and/or humans demonstrates no/minimal risk of adverse effects to infant/breast milk production; caution advised

20
Q

A pt. is admitted with Strep pneumo meningitis, and has a severe allergy to penicillin. Name a drug that can be considered

A

Chloramphenicol

21
Q

Which antibiotic is associated with “Grey baby syndrome”?

A

Chloramphenicol

22
Q

What is the half life of Azithromycin?

A

68 hours

23
Q

What antibiotics should be avoided in pts with myasthenia gravis?

A

Fluoroquinolones, aminoglycosides, polymixins, macrolides (erythromycin, telithromycin)

24
Q

Vancomycin, normally bactericidal, is only bacteriostatic against which group of organisms?

A

Enterococcus

25
Q

How many classes of penicillins are there? Name them

A

4; Natural penicillins; Penicillinase-resistant penicillins; Aminopenicillins; Expanded spectrum/ Antipseudomonal penicillins

26
Q

Which are the ‘Natural Penicillins?’

A

PCN G; PCN V

27
Q

Which are the Penicillinase-resistant penicillins?

A

Oxacillin, Nafcillin, Methicillin

28
Q

Which are the Aminopenicillins?

A

Ampicillin, Amoxacillin

29
Q

Which are the Extended Spectrum penicillins?

A

Ticarcillin, Piperacillin

30
Q

What are the target enzymes of the penicillins?

A

penicillin binding proteins (PBPs)

31
Q

Name2 ORAL antibiotics that may be considered against Pseudomonas aeruginosa

A

Ciprofloxacin and Levofloxacin