Misc Questions

Question 1

Which drugs have an interaction with warfarin?

Answer 1

• metronidazole
• FQs
• TMP/SMX
• macrolides

Question 2

Which drugs are CI in pregnancy?

Answer 2

• FQs
• TCNs
• sulfa (TMP/SMX)

Question 3

What are the common intracellular pathogens?

Answer 3

• 3 types atypical pneumonia: Mycoplasma, Chlamydia, Legionella
• Mycobacterium
• Rickettsiae

Question 4

Which abx classes have activity against intracellular pathogens?

Answer 4

• FQs
• TCNs
• macrolides

Question 5

Which abx require adjusted dosing for renal dysfunction?

Answer 5

• penicillins (except nafcillin)
• most cephs (except ceftriaxone)
• vancomycin
• TMP/SMX
• aminogylcosides
• TCNs (except doxy and minocycline)
• FQs

Question 6

Describe vancomycin monitoring.

Answer 6

• peak trough levels
• obtain around 4th dose (both or trough only)
• 10-15 mcg/mL recommended
• peak is controversial so many hospitals only do trough

Question 7

Which abx class requires use of double coverage to treat Pseudomonas?

Answer 7

cephalosporins

Question 8

What drug is used in treatment of CF?

Answer 8

monobactams

Question 9

How is vancomycin administered and why?

Answer 9

• IV for systemic infections

- it is NOT absorbed via the GI tract

Question 10

What are some ways to prevent vancomycin resistance?

Answer 10

Discouraged use in:

• prophylaxis for infection of vascular catheters
• eradication of MRSA/CA-MRSA
• primary tx for C diff
• routine prophylaxis for VLBW infants
• routine prophylaxis for peritoneal dialysis

Question 11

What can be used to treat HCA-MRSA?

Answer 11

• *vancomycin DOC**
• TMP/SMX
• Linezolid
• Daptomycin
• Televancin
• Ceftaroline

Question 12

What can be used to treat CA-MRSA?

Answer 12

• mild to moderate: TMP/SMX, clindamycin, doxy

- severe: vancomycin

Question 13

What can be used to treat VRE?

Answer 13

• Linezolid
• Quinupristin/Dalfopristin
• Daptomycin

Question 14

What drug interactions must be avoided with FQ use?

Answer 14

• chelation (decreased absorption) with metal cations eg antacids, iron salts (take 2 hrs before or after)
• theophylline (cipro)
• warfarin
• any meds that prolong QT interval (moxifloxacin)

Question 15

What drugs can get to the CSF?

Answer 15

• TMP/SMX

- metronidazole

Question 16

What are aminoglycosides used in combination with and why?

Answer 16

• beta lactams
• beta lactams affect bacterial cell wall
• weaker cell wall allows AGs to get in and affect protein synthesis

Question 17

Which abx act on the 30S ribosome?

Answer 17

• aminoglycosides

- tetracyclines

Question 18

Which abx act on the 50S ribosome?

Answer 18

• macrolides

- clindamycin

Question 19

Which abx can be used to treat P. acnes?

Answer 19

-TCNs –> doxycycline

Question 20

What is important to remember about erythromycin absorption?

Answer 20

• destroyed by gastric acid

- food decreases absorption

Question 21

Which drugs may cause QT prolongation and must be administered carefully?

Answer 21

-macrolides and FQs

Question 22

Which abx has C. diff as a potential adverse effect?

Answer 22

-clindamycin

Question 23

What drug has a bad interaction w/ EtOH and what happens?

Answer 23

• metronidazole
• get a build up of acetaldehyde
• causes nausea and flushing
• no EtOH during tx or 3 days after

Question 24

What is the chief avoidable cause of illness and death in the US?

Answer 24

smoking/tobacco use

Question 25

What is the most common infectious cause of death in the US?

Answer 25

community acquired pneumonia

Question 26

What are the top 2 nosocomial infections in the US?

Answer 26

1. UTI | 2. HAP

Question 27

What 2 drugs are used to treat Enterococcus?

Answer 27

IV ampicillin and gentamicin

Question 28

Which macrolide has the highest bioavailability?

Answer 28

clarithromycin

Question 29

What are three respiratory FQs?

Answer 29

Levofloxacin Moxifloxacin Gemifloxacin

Question 30

What is the dosage for an oral prednisone burst for COPD exacerbation?

Answer 30

40 mg PO qday x5 days

Question 31

What are the options for H. pylori treatment?

Answer 31

amoxicillin TCN clarithromycin metronidazole

Question 32

What is used to treat Trichomoniasis?

Answer 32

metronidazole

Question 33

Which abx require pharmacokinetic monitoring? Why?

Answer 33

vancomycin and AGs | due to ototoxicity and nephrotoxicity side effects

Question 34

What is the FQ of choice for Pseudomonas?

Answer 34

cipro

Question 35

Which macrolide has the most significant drug interactions?

Answer 35

erythromycin

Question 36

Which macrolide has the fewest significant drug interactions?

Answer 36

azithromycin

Question 37

Common Cervicitis/Proctitis/Urethritis Pathogens

Answer 37

Neisseria and Chlamydia

Question 38

In asthma treatment, what are thrush, dysphonia and coughing side effects of?

Answer 38

Inhaled Corticosteroids

Question 39

What are the 4th generation cephalosporins?

Answer 39

Cefipime | Ceftaroline

Question 40

What asthma intervention prevents inflammation but does not treat it?

Answer 40

Leukotriene modifiers (Singulair/Montelukast)

Question 41

What treatment can be used for nighttime asthma sxs or with prolonged exercise?

Answer 41

LAB2A

Question 42

What is the treatment for atypical pneumonia?

Answer 42

``` resp FQs (eg moxifloxacin) macrolides doxycycline ```

Question 43

What disease is caused by Rickettsiae?

Answer 43

Rocky Mtn Spotted Fever

Question 44

What drug has good Gm+ and anaerobe coverage?

Answer 44

Clindamycin

Question 45

For a decreased asthma response to PRN SABA, what is the treatment?

Answer 45

prednisone burst 3-10 days

Question 46

Red Neck Syndrome is a side effect of what drug?

Answer 46

Vancomycin

Question 47

Which cephalosporin has activity against MRSA?

Answer 47

Ceftaroline

Question 48

What is indicated in Tx and Px of influenza A and B?

Answer 48

Oseltamivir and Zanamivir

Question 49

Which cephalosporins has pseudomonas activity?

Answer 49

Ceftazidime, Cefipime

Question 50

Which drug is most likely to cause seizures?

Answer 50

Imipenem

Question 51

Which antibiotic has no absorption when given orally? What is the only indication for giving this drug orally?

Answer 51

- vancomycin | - c diff if it is unresponsive to metronidazole

Question 52

What is essential therapy for persistent asthma?

Answer 52

ICS and PRN SAB2A

Question 53

What agent is used to treat Chlamydia (STI)?

Answer 53

azithromycin or doxy