NAPLEx > Micro-background I > Flashcards

Micro-background I Flashcards

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1
Q

Common resistant pathogens
Kill Each And Every Strong Pathogen

A

Klebsiella pneumoniae (ESBL, CRE)
Escherichia coli (ESBL, CRE)
Acinetobacter baumannii
Enterococcus faecalis, enterococcus faecium (VRE)
Staphylococcus aureus (MRSA)
Pseudomonas aeruginosa

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2
Q

Penicillin V Potassium

A

tablet and suspension
- Penicillin (natural penicillin)

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3
Q

Penicillin G Aqueous

A

pfizerpen- injection
- Penicillin (natural penicillin)

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4
Q

Penicillin G Benzathine

A

Bicillin L-A
-not for IV use, can cause cardio-respiratory arrest and death
- Penicillin (natural penicillin)

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5
Q

Penicillin G Benzathine + penicillin G procaine

A

Bicillin C-R
- Penicillin (natural penicillin)

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6
Q

Dicloxacillin

A

Capsule
- Penicillin (antistaphylococcal penicillin)
- antistaphyloccal:
— preferred for MSSA soft tissue, bone and joint, endocarditis and bloodstream infections
— and no renal dose adjustment

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7
Q

Nafcillin

A

injection
- nafcillin is vesicant- admin through centeral line- if extravasation occurs, use cold packs and hyaluronidase injection
- Penicillin (antistaphylococcal penicillin)

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8
Q

Oxacillin

A

injection
- Penicillin (antistaphylococcal penicillin)

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9
Q

Amoxicillin

A

tablet, capsule, chewable!, suspension
- Penicillin (aminopenicillins penicillin)

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10
Q

amoxicillin/clavulanate

A

Augmentin, Augmentin ES 600
-tablet, chewable!, suspension
- use 14:1 ration to decrease diarrhea caused by clavulanate
- Penicillin (aminopenicillins penicillin)

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11
Q

Ampicillin

A

injection!, capsule, suspension
- ampicillin PO is rarely used due to poor bioavailability (only preferred when switching to PO from IV ampicillin)
- Penicillin (aminopenicillins penicillin)

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12
Q

Ampicillin/sulbactam

A

Unasyn- injection
- IV ampicillin and ampicillin/sulbactam must be diluted in NS only
- Penicillin (aminopenicillins penicillin)

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13
Q

Piperacillin/tazobactam

A

zosyn- injection
-contains 65mg NA per 1 gram of piperacillin
- 0.375grams/3grams of piper/tazo respectively, dosing…
- Penicillin (Extended- Spectrum penicillin)

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14
Q

cefazolin

A

IV/IM 1-2 grams q8h
- 1st generation cephalosporins

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15
Q

cephalexin

A

keflex PO
- 1st generation cephalosporins

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16
Q

cefadroxil

A

PO 1-2 gram q12-24h
- 1st generation cephalosporins

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17
Q

cefuroxime

A

Zinacef
PO/IV/IM
- 2nd generation cephalosporins

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18
Q

cefotetan

A

cefotan- IV/IM
- contains side chain- can increase risk of bleed and disulfiram-like reaction with alcohol
- 2nd generation cephalosporins

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19
Q

cefaclor

A
  • 2nd generation cephalosporins
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20
Q

cefoxitin

A
  • 2nd generation cephalosporins
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21
Q

cefprozil

A
  • 2nd generation cephalosporins
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22
Q

cefdinir

A

omnicef, PO
- 3rd generation cephalosporins

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23
Q

ceftriaxone

A

Rocephin
- IV/IM
- avoid in neonates, causes hyperbilirubinemic
- avoid use with calcium-containing IV products in neonates <28 days old, forms insoluble precipitates
- no renal dose adjustment, CNS penetration at high dose
- 3rd generation cephalosporins

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24
Q

cefotaxime

A

IV/IM
- neonates better…
- 3rd generation cephalosporins

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25
cefditoren
PO - 3rd generation cephalosporins
26
cefixime
suprax available chewable tablets! PO - 3rd generation cephalosporins
27
cefpodoxime
PO - 3rd generation cephalosporins
28
ceftibuten
PO- on empty stomach 400mg daily - 3rd generation cephalosporins
29
ceftazidime
Fortaz, tazicef IV/IM - 3rd generation cephalosporins
30
Cefepime
IV/IM - 4th generation cephalosporins
31
ceftaroline fosamil
Teflaro IV - 5th generation cephalosporins
32
ceftazidime/avibactam
avycaz IV activity against some carbapenem-resistant enterobacteriaceae (CRE) - cephalosporin combinations
33
ceftolozane/tazobactam
Zerbaxa - cephalosporin combinations
34
cefiderocol
fetroja IV - siderophore cephalosporin
35
Doripenem
Injection IV - carbapenems
36
Imipenem/cilastatin
primaxin I.V. - carbapenems
37
Imipenem/cilastatin/relebactam
Recarbrio Injection IV - carbapenems
38
Meropenem
IV 500-1,000 mg q8h - carbapenems
39
meropenem/ vaborbactam
vabomere injection IV, 4 grams q8h, each dose infused over 3 hours - carbapenems
40
ertapenem
Invanz - stable in NS only - no coverage of pseudomonas, acinetobacter, or enterococcus - carbapenems
41
Aztreonam
azactam cayston- inhaled for cystic fibrosis IV CrCl <30 dose adjusment requred - aztreonam - avoid in penicillin allergy
42
gentamicin
IV, IM, Ophthalmic topical - aminoglycosides
43
tobramycin
IV, IM, ophthalmic, inhaled tobramycin inhalation for CF (Tobi, Tobi Podhaler, Bethkis, Kitabis Pak) - aminoglycosides
44
Amikacin
IV, IM - aminoglycosides
45
Streptomycin
IM - aminoglycosides
46
Plazomicin
Zemdril IV for complicated UTI only - aminoglycosides
47
Ciprofloxacin
Cipro, Cilaxan eye drops, cetraxal, and Otiprio ear drops tablet, suspension, injection, ointment, ophtalmic, otic - quinolones
48
ciprofloxacin + dexamethasone
ciprodex - quinolones
49
ciprofloxacin + fluocinolone
Otovel - quinolones
50
ciprofloxacin + hydrocortisone
Cipro HC - quinolones
51
levofloxacin
levaquin tablet, solution, injection, ophthalmic - quinolones
52
moxifloxacin
Avelox, Moxeza, and Vegamox eye drops tablet, injection, ophtalmic - quinolones
53
Delafloxacin
Baxdela tablet, injection - quinolones
54
Gatifloxacin
Zymaxid eye drops - quinolones
55
Gemifloxacin
tablets - quinolones
56
Ofloxacin
Ocuflox eye drops tablet, ophthalmic, otic - quinolones
57
Azithromycin
Zithromax, Z-Pak, Zithromax Tri-Pak, AzaSite eye drops tablet, suspension, injection, ophthalmic better gram negative activity than erythromycin can be used for traveler's diarrhea - macrolides
58
Clarithromycin
tablet, ER tablet, suspension better gram -positive activity - macrolides
59
erythromycin
E.E.S, Ery-tab, Erythrocin, EryPed, Ery and Erygel topical E.E.S= erythromycin ethylsuccinate - macrolides
60
Doxycycline
Vibramycin, Doryx, Oracea, Acticlate, others - no renal dose required - tetracyclines
61
Minocycline
Minocin, Solodyn, CoreMino, Minolira, Ximino - associated with drug induced lupus - tetracyclines
62
Eravacycline
Xerava injection - tetracyclines
63
Omadacycline
Nuzyra tablet, injection - tetracyclines
64
Sarecycline
Seysara tablet - tetracyclines
65
Tetracycline
capsule - tetracycline
66
Sulfamethoxazole/Trimethoprim
Bactrim, Bactrim DS, Sulfatrim Pediatric - single strength 400/80 - double strength 800/160 all product 5:1 ratio - avoided in pt with G6PD deficiency - suolfonamides
67
Vancomycin
Vancocin, Firvanq oral solution first line for moderate to severe MRSA if MIC >=2 consider alternative
68
telavancin
vibativ approved for SSTI (soft tissue infections, hospital acquired and ventilator associated pneumonia - Lipoglycopeptides
69
Oritavancin
Orbactive approved for SSTI (soft tissue infections) - Lipoglycopeptides
70
Dalbavancin
Dalvance approved for SSTI (soft tissue infections - Lipoglycopeptides
71
Daptomycin
cubicin and cubicin RF do not use to tx pneumonia (inactivated in the lungs by surfactants) - daptomycin - cyclic lipopeptide
72
Linezolid
zyvox is a MAO inhibitor - oxazolidinones
73
tedizolid
sivextro is a MOA inhibitor - oxazolidinones
74
quinupristin/ dalofpristin
synercid injection dilute in D5W only
75
Tigecyclin
tygacil injection derivative of minocycline boxed warning- increased risk of death, use only when alternative tx are not suitable
76
Colistimethate
Coly-Mycin M - Polymyxins
77
Polymyxin B
injection prodrug- hydrolyzed to colistin 1mg=10,000units of polymyxin B - Polymyxins
78
Chloramphenicol
injection rarely used due to adverse effects
79
Clindamycin
Cleocin injection, capsule, suspension topical formulation: Cleocin-T, clindagel, clindacin ETZ, clindacin Pac, Clindacin- P, evoclin, foam, gel, lotion, kit, solution, swab clindesse, cleocin vaginal cream and suppository common uses: purulent and non-purulent skin infections, beta-lactam alternative for dental abscess, surgery prophylaxis and infective endocarditis prophylaxis -lincosamide antibiotic
80
Metronidazole
Flagyl tablet capsule, injection topical: MetroCream, Merolotion, Metrogel, Noritate, Rosadan Vaginal: Nuvessa, Vandazole - metronidazole and related drugs
81
Tinidazole
tablet like metronidazole, alcohol should not be used with or after 3 days of med d/c due to disulfiram-like reaction - metronidazole and related drugs
82
Secnidazole
solosec granule packet approved only for bacterial vaginosis - metronidazole and related drugs
83
lefamulin
xenlata tablet, injection - first in class pleuromutilin, inhibits bacterial protein synthesis
84
fidaxomicin
dificid tablet, suspension used for C. difficile infection -inhibits RNA polymerase
85
rifaximin
xifaxan think of traveler's diarrhea - DNA/RNA inhibitor - not effective for systemic infections of label use for c. diff (second recurrence) tx- hepatic encephalopathy - inhibits bacterial RNA synthesis
86
fosfomycin
monurol - inhibits bacterial wall synthesis by inactivating the enzyme pyruval transferase. - packet granules- 3mg per packet
87
Nitrofurantoin
macrobid, macrodantin capsule and suspension - uncomplicated UTI - avoid crcl <60ml/min SE= brown urine discoloration macroBID= given BID - bacterial cell wall inhibitor
88
mupirocin
bactroban - topical decolonization
89
Methylcillin- sensitive staphylococcus aureus (MSSA)
**- Dicloxacillin, nafcillin, oxacillin - Cefazolin, cephalexin (and other 1st and 2nd generation cephalosporins) ** - Amoxicillin/clavulanate, ampicillin/sulbactam - doxycycline, minocyclin - SMX/TMP
90
Community- associated methicillin-resistant staphylococcus aureus (CA-MRSA) skin & soft tissue infection (SSTIs)
**- SMX/TMP - Doxycycline, minocycline - clindamycin - linezolid**
91
Severe SSTIs requiring IV treatment or hospitalization (cover MRSA and Streptococci)
**- Vanco (if MIC>=2 consider alternative - Linezolid, tedizolid - daptomycin - ceftaroline** - telavancin - oritavancin - dalbavancin - quinupristin/dalfopristin - tigecyclin
92
Nosocomial MRSA
**- Vanco (if MIC>=2 consider alternative - linezolid - daptomycin (not in pneumonia)** - telavancin
93
VRE (E. faecalis)
**- Pen G or ampicillin - Linezolid - Daptomycin** - Tigecycline - **Cystitis** only: nitrofurantoin, Fosfomycin, doxycycline
94
Acineobacter baummanni
**- carbapenems (except ertapenem) **- ampicillin/sulbactam - minocycline - tigecycline - quinolones - SMX/TMP - amikacin - colistimethate, polymyxin B
95
VRE (E. Faecium)
**- Daptomycin - Linezolid** - Quinupristin/Dalfopristin - Tigecycline - Cystitis only: nitrofurantoin, fosfomycin, doxycycline
96
Extended-spectrum beta-lactamase producing gram-negative rods (ESBL GNR) - E.coli, K.pneumoniae, P. mirabills
**- carbapenems - ceftazidime/avibactam - ceftolozane/tazobactam** - aminoglycosides - cystitis only: fosfomycin
97
HPNEK
**- beta-lactam/beta-lactamase inhibitor **- Amoxicillin (if beta-lactamase negative) - Cephalosporins (except 1st generation) - Carbapenems - SMX/TMP - aminoglycosides - Quinolones
98
Carbapenem-resistant gram-negative rods (CRE)
**- ceftazidime/avibactam - colistimethate, polymyxin B** - Meropenem/vaborbactam - Imipenem/cilastatin/ relebactam
99
Atypical organisms
**- azithromycin, clarithromycin - doxycycline, minocycline - quinolones**
100
Bacteroides fragilis
**- metronidazole - beta-lactam/beta-lactamase inhibitor - cefotetan, cefoxitin - carbapenems** - tigecycline - other (reduced activity): moxifloxacin
101
C. Diff
**- oral vanco - fidaxomicin ** - metronidazole
102
Pseudomonas aeruginosa
**- Piperacillin/tazobactam - Cefepime - Ceftazidime - Ceftazidime/avibactam - ceftolozane/tazobactam - carbapenems (except ertapenem) - cipro, levo - aztreonam - aminoglycosides - colistimethate, polymyxin B**
103
Refrigeration after reconstitution required
**Penicillin VK Ampicillin, Amoxicillin/Clavulanate, ** Cephalexin, Cefadroxil, Cefpodoxime, Cefprozil, Cefuroxime, Cefaclor, Ceftibuten, Vanco Oral, Valganciclovir
104
Refrigeration recommended
amoxicillin- improves taste
105
Do not refrigerate
**cefdinir**, azithro, clarithromycin (bitter taste, thickens/gels), doxycycline, cipro, levofloaxcin, clindamycin (thickens, may crystallize), Linezolid sulfamethoxazole/trimethprim acyclovir fluconazole pasoconazole virconazole nystatin
106
storage requirements: IV antibiotics do not refrigerate
**metronidazole moxifloxacin sulfamethoxazole/trimethoprim** acyclovir- (refrigeration causes crystallization)
107
Take with/without food
most antibiotics can be taken with food to decrease GI upset except: take on empty stomach- - ampicillin oral capsules and suspension - ceftibuten suspension - levofloxacin oral solution - penicillin VK - rifampin - isoniazid - itraconazole solution - voriconazole take within one hour of finishing meal- amoxicillin ER
108
IV to oral 1:1
levofloxacin, moxifloxacin doxycycline, minocycline linezolid, tedizolid metronidazole sulfamethoxazole/trimethoprim fluconazole, isavuconazonium, posaconazole, voriconazole
109
light protection during admin
**doxycycline micafungin** pentamidine
110
compatible with dextrose only diluent compatibility
**quinopristine/dalfopristin sulfamethoxazole/trimethoprim amphotericine b** dalbavancin, oritavancin pentamidine
111
compatible with saline only diluent compatibility
**ampicillin ampicillin/sulbactam ertapenem daptomycin (cubicin RF)**
112
compatible with NS/LR only diluent compatibility
**caspofungin daptomycin (cubicin)**
113
what are atypical organisms
**chlamydia ssp, legionella spp., mycoplasma pneumoniae, mycobacterium tuberculosis**
114
tetracyclines and quinolones have in common
**avoid multivitamins**- separated for divalent cations
115
Escherichia coli- pyelonephritis
most common cause of pyelonephritis healthy pt. empiric therapy while waiting on culture results go for - fluoroquinolone (cipro or levo) for 5-7 days or - SMX/TMP for 7-10 days
116
empiric tx for accute cystitis, most likely pathogen is E. Coli
bactrim, nitrofurantoin, or fosfomycin if bactrim was used 2 months ago, avoid reuse...
117
prophylaxis of Pneumoncystis Pneumonia
SMX/TMP!
118
kissing virus
epstein-barr virus
119
prego and HIV
zidovudine to prevent HIV transmission to infant - NRTI
120
interfere with coagulation assays
dapto, ortivancin, telavancin
121
no renal dose adjustment
antistaphylococcal penicillins ceftriaxone clinda doxy macrolides (only azithro and erythromycin metronidazole moxifloxacin linezolid
122
key features of nitrofurantoin
- review prego use - avoid in renal <60 ml/min - MacroBID= BID - macrodantin= QID - counseling: take with food to avoid nausea and cramping - can discolor urine to brown
123
bactrim and warfarin
INR increases, use alternative when possible
124
key features of tetracycline
doxy and minocycline- CA- MRSA skin infections and acne doxy= 1st line tx for lyme disease and rocky mt spotted fever, CAP, COPD exacerbations, VRE UTI, chlamydia Do not use in prego, breastfeeding or children <8 years old
125
key features of macrolides
all macro: CAP, and alternative to beta-lactam for strep throat clarithromycin and erythromycin are strong cyp 3A4 inhibitors, lova and simva are contraindicated
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