1
Q
common CNS/meningitis pathogens
A
s pneumo
n meningitidis
h influenzae
GBS (kids)
listeria (adults)
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2
Q
common URI pathogens
A
strep pyogenes
s pneumo
h influenzae
m cat
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3
Q
common lower resp tract infection pathogens
A
community: s pneumo, h inf, atypicals, enteric GNR
hospital: s aureus (MSSA, MRSA), pseud, acinetobacter baumannii, enteric GNR (including ESBL and MDR), s. pneumo
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4
Q
common endocarditis pathogens
A
s aureus/MRSA
s epidermidis
streptococci
enterococci
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5
Q
common SSTI pathogens
A
s aureus
s pyogenes
staph epidermidis
G+/- anaerobes, aerobes
GNR (in T2DM)
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6
Q
common UTI pathogens
A
e coli
proteus
klebsiella
staph saphrophyticus
enterococci
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7
Q
common bone/joint infection pathogens
A
s aureus
s epidermidis
streptococci
N. gonorrhoeae
GNR
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8
Q
what are the enteric gram - rods
A
proteus
e coli
klebsiella
enterobacter
serratia
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9
Q
G+ vs G-
A
G+ have a thick cell wall and stan dark purple on gram stain from crystal violet
G- have a thin cell wall and stain pink on gram stain from safranin counter stain
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10
Q
atypical pathogens and drugs that cover then
A
legionella
chlamydia
mycoplasma pnemoniae
mycobacterium
covered by TTC, macrolides, FQs and tigecycline
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11
Q
cultures show G+ cocci in clusters
what pathogen could this be
A
s aureus (MSSA or MRSA)
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12
Q
cultures show G- cocci
what pathogen could this be
A
neisseria spp.
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13
Q
cultures show G+ cocci in pairs
what pathogen could this be
A
strep pneumo
strep spp.
enterococcus (including VRE)
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14
Q
cultures show G+ spores
what pathogen could this be
A
anaerobes
peptostreptococcus
c diff
clostridium spp.
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15
Q
cultures show G- coccobacilli
what pathogen could this be
A
acineobacter baumannii
bordatella pertussis
moraxella cat.
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16
Q
cultures show G- rods (GNR)
what pathogen could this be
A
colonize gut = proteus mirabilis, e coli, klebsiella, serratia, enterobacter, citrobacter
curved or spiral GNR = h pylori, campylobacter spp, treponema spp.
do not colonize gut = pseud, h influenzae, providencia
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17
Q
what GNR do not colonize the gut
A
pseud, h influenzae, providencia
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18
Q
If a pathogen in + for ESBL, what does this mean and what are not treatment options? What are tx options?
A
pathogen has extended spectrum beta lactamases which makes all penicillins and most cephalosporins ineffective
tx options: carbapenems, ceftazidime/avibactam, ceftolozane/tazobactam
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19
Q
what are the commonly resistant bugs
A
SPEEAK
s aureus (MRSA)
pseug aeruginosa
e coli (ESBL, CRE)
e. faecalis, e. faccium (VRE)
acinetobacter baumannii
klebsiella (ESBL, CRE)
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20
Q
which abx has a BBW for c diff
A
clindamycin
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21
Q
which abx are hydrophilic and which are lipophilic? How does this affect the drug?
A
hydrophilic: B lactams, AGs, vanco, dapto, polymixins
inc hydrophilicity –> dec Vd –> renal elim and tox–> dec cell penetration and low F–> IV:PO not 1:1 and low activity against atypicals
lipophilic: TTC, macrolides, FQs, rifampin, linezolid
inc lipophilicity –> inc Vd –> inc cell penetration –> activity against atypicals and more 1:1 IV:PO ratios and hepatic elim
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22
Q
what does concentration dependent dosing mean? Which drugs use this?
A
goal is to have a high Cmax to inc killing while having a low trough to dec toxicity (large dose, long interval)
AGs, FQs, dapto
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23
Q
what does exposure-dependent dosing mean? Which drugs use this?
A
AUC:MIC is used to assess exposure over time in TDM
vanco, macrolides, TTC, polymixins
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24
Q
what does time>MIC dependent dosing mean? Which drugs use this?
A
goal is to maintain drug level>MIC for most of interval; uses
shorter dosing interval or extended/continuous dosing
B-lactams (penicillins, cephalosporins, carbapenems)
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25
Q
what are the natural penicillins and what do they cover
A
pen VK, Pen G
streptococcus
enterococcus
mouth flora
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26
Q
what are the anti-staph penicillins and what do they cover
A
naficillin, oxacillin, dicloxacillin
streptococcus
MSSA
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27
Q
which penicillins do not need renal dose adjustments
A
anti-staphs!
oxacillin, dicloxacillin and naficillin
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28
Q
what are the aminopenicillins and what do they cover
A
amox +- clav, amp +- sul
streptococcus
enterococcus
G- anaerobes in mouth flora
adding clavulanate or sulbactam extends coverage to
HNPEK
b frag (anaerobe)
MSSA
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29
Q
what is the extended spectrum penicillin? What does it cover?
A
covers same bugs as aminopenicillin/beta lactamase-i (streptococcus, enterococcus, G- mouth flora, HNPEK, MSSA, anaerobe b frag)
PLUS
pseudomonas and CAPES
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30
Q
what are the G- bacilli
A
CAPES
camphylobacter
acinetobacter
providencia
enterobacter
serratia
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31
Q
Pen VK is first line for __________
dosing?
A
pharyngitis (strep throat) and mild non-purulent SSTI without abscess
125-500mg Q6-12H on empty stomach
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32
Q
Penicillin G must be administered
A. IV
B. IM
C. PO
D. IV or IM
A
B. IM
Pen G has BBW for IV administration, only administer IM!
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33
Q
ampicillin and amp/sul are only compatible with ____
A
NS
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34
Q
amp/sul IV dosing
A
1.5-3g Q6h
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35
Q
what is the use of probenacid with penicillins
A
decreases penicillin renal excretion which is used as a mechanism in severe infections
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36
Q
pip/tazo dosing (IV) and infusion time
A
3.375mg IV Q6H or 4.5g IV Q6-8H
over 4 hours
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37
Q
penicillins increase/decrease bleed risk with warfarin?
methotrexate [ ] is increased/decreased by penicillins?
naficillin and dicloxicllin increase/decrease clot risk with warfarin?
A
penicillins dec clot factor production and pose a bleed risk
MTX [ ] increase with penicillins
naficillin and dicloxacillin dec warfarin efficacy and pose a clot risk
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38
Q
what are the contraindications to penicillins?
A
allergy
augmentin and unasyn with cholestatic jaundice or hepatic dysfunction with prev use
ER forms and augmentin 875mg if CrCl <30
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39
Q
amoxicillin/clav is a _____ ratio to decrease risk of ___________
A. 14:1 ; constipation
B. 14:1 ; diarrhea
C. 5:1 ; constipation
D. 5:1 ; diarrhea
A
B. 14:1 ; diarrhea
SMX/TMP is 5:1
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40
Q
which penicillin is a vesicant and is preferably administered in a central line?
A
naficillin
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41
Q
What should be monitored when a patient is on a penicillin
A
allergic reaction, LFTs, renal function, rash (SJS/TEN), hemolytic anemia (+coombs test), myelosuppression with prolonged use
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41
Q
what is the pneumonic for non-CAPES G- organisms
A
HNPEK
h. influenzae
neisseria
proteus
e coli
klebsiella
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42
Q
as cephalosporin generation increases, _____ coverage increases
A
gram negative
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43
Q
as cephalosporin generation increases, penicillin (PCN) cross reactivity ________________–
A
decreases
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44
Q
first generation cephalos
coverage
A
cephalexin
cefazolin
weak G-/PEK coverage
strep
staph
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45
Q
second generation cephalos
coverage
A
cefuroxime
- covers staph and resistant HNPEK
cefotetan and cefoxitin
- cover staph, resistant HNPEK and b frag!
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46
Q
what type of bacteria is b frag
A
G- anaerobe
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47
Q
3rd gen cephalos
coverage
A
ceftriaxone, cefotaxime, cefdinir
- cover resistant strep virdans, MSSA, G- anaerobes (including b frag)
ceftazidime
- NO G- COVERAGE, but covers pseud
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48
Q
4th gen cephalo
coverage
A
cefepime
- resistant strep virdans, MSSA
- HNPEK, CAPES, pseud
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49
Q
5th gen cephalo
coverage
A
ceftaroline
- G- anaerobes, MSSA
- MRSA
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50
Q
cefazolin
which generation
dosing
A
first
IV/IM 1-2g q8h
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51
Q
only cephalosporin without renal dose adjustments
A
CTX
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52
Q
cephalexin
which generation
dosing
A
first
250-500mg q6-12h
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53
Q
cefuroxime
which generation
dosing
A
second, group 1
PO/IV/IM 250-1500mg q8-12h
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54
Q
oral cephalosporins
A
cephalexin (1st)
cefuroxime (2nd)
cefdinir (3rd)
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55
Q
cefotetan
which generation
dosing
A
second - group 2
IV/IM 1-2g q12h
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56
Q
what is unique about cefotetan
A
has a unique side chain that increases bleed risk and risk of disulfiram reaction
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57
Q
cefoxitin
which generation
dosing
A
second - group 2
IV/IM 1-2g q6-8h
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58
Q
cefdinir
which generation
dosing
A
3rd - group 1
300mg q12h or 600mg qd
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59
Q
CTX
which generation
dosing
A
3rd - group 1
IV/IM 1-2g q12-24h
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60
Q
cefotaxime
which generation
dosing
A
3rd - group 1
IV/IM 1-2g q4-12h
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61
Q
ceftazidime
brand name
which generation
dosing
A
Tazicef
3rd - group 2
IV/IM 1-2g q8-12h
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62
Q
cefepime
which generation
dosing
A
4th
1-2g q8-12h
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63
Q
ceftaroline
which generation
dosing
A
5th
600mg q12h
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64
Q
CTX is contraindicated in
A
neonates (hyperbilirubinemia)
use with Ca-containing IV products
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65
Q
adverse effects of all cephalos
A
inc LFTs, seizure, AIN, hemolytic anemia, myelosuppression with long term use, SJS/TEN
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66
Q
If a patient is on an antacid, which cephalos are to be avoided
A
cefuroxime
cefpodoxime
cefdinir
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67
Q
cephalo monitoring
A
LFTs, renal function, CBC
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68
Q
cephalos with a beta lactamase - i (ceftazidime/avi, ceftolozane/tazo) cover which bugs
A
MDR GNR
69
Q
SATA
carbapenems do NOT cover
A. atypicals
B. anaerobes
C. MRSA
E. c. diff
F. G- ESBL
G. VRE
H. staph and strep
I. stenotrophom*onas
A
DO NOT COVER
atypicals, MRSA, c diff, VRE, stenotrophom*onas
(covers G+, G- (including ESBL), and anaerobes
70
Q
contraindications of carbapenems
A
pencillin allergy
71
Q
adverse effects of carbapenems
A
seizures, DRESS, inc LFTs
72
Q
ertapenem does not cover ______, _______ and _______ , but covers _________
A
does not cover pseudomonas, acinetobacter or enterococcus BUT
covers ESBL+ bugs
73
Q
all carbapenems are administered ____
A
IV
74
Q
meropenem
brand name
dosing
A
Vabomere
500-1000mg IV q8h
75
Q
ertapenem
brand name
dosing
administration
A
Ivanz
1g IV/IM qd
in NS only
76
Q
common uses of carbapenems
A
if combines w beta lactamase - i = used for CRE
polymicrobial diabetic foot infxn
empiric tx when suspecting ESBL+
resistant pseud, acinetobacter –> meropenem, not ertapenem
77
Q
carbapenems interact with ______ by decreasing its plasma concentrations
A
valproic acid
78
Q
what does aztreonam cover
brand name
dosing
A
gram negatives (HNPEK, CAPES, pseud
Azactam
500-2000mg IV q6-12 hours
CrCl < 30 –> dec dose
79
Q
what do aminoglycosides cover
A
gram negatives including pseud
80
Q
what are the benefits of extended / daily dosing of AGs
A
higher peaks, less accumulation and dec nephrotoxicity risk, dec cost, gives the kidneys a break, decreases likelihood of nephro and oto toxicities
81
Q
which ABX have a post-ABX effect? What does this mean?
A
AGs
AG bacteriocidal killing continues even when [ ] is below MIC
82
Q
How to determine which body weight to use when dosing AGs
A
if TBW<IBW –> use TBW
if TBW ~ IBW –> use either
if obese (TBW >120% of IBW –> use AdjBW
83
Q
AdjBW equation for AG calculations
A
AdjBW = IBW + 0.4(TBW-IBW)
84
Q
gentamicin and tobramycin dosing
when do we use the lower end of the range? higher end?
A
1-2.5mg/kg/dose
use lower end for G+ infections and higher for G- infections
85
Q
what are the renal dose adjustments for gentamicin and tobramycin
A
CrCl >/= 60 Q8h
CrCl 40-60 = Q12H
CrCl 20-40 = Q24H
CrCl <20 1x dose and adjust per level
86
Q
TDM for AGs tobramycin, gentamicin, amikacin
when to draw peak? trough?
what if its extended interval dosing?
A
peak trough
gent (G- synergy) 3-4 <1
gent (G-) 5-10 <2
tobra 5-10 <2
draw trough 30 min before 4th dose
draw trough 30 min after the 4th dose (30min infusion) is complete
if extended interval dosing, drawl level 6-14 hours after first infusion start, plot on Hartford nomogram and determine frequency from there
87
Q
amikacin dosing
A
5-7.5mg/kg/dose
88
Q
which are the respiratory fluoroquinolones? why?
A
levofloxacin and moxifloxacin since they have increased coverage of s pneumo and atypicals
89
Q
the fluoroquinolones ____________ and ____________ have increased coverage of _____________ and ______________
A
levofloxacin and ciprofloxacin
G- and anti-pseud
90
Q
moxifloxacin has increased coverage of _______ and _______
A. G- ; pseud
B. G+ ; anaerobes
C. G+ ; pseud
D. atypicals ; anaerobes
E. MRSA ; anaerobes
A
B. G+ ; anaerobes
91
Q
moxifloxacin can be used for UTI. T or F
A
false, does not concentrate in the urine
92
Q
BBW for all FQs
A
tendon rupture
peripheral neuropathy
CNS (seizure risk, tremor, paranoia, hallucnations, nightmares, inc ICP)
avoid in myasthenia gravis
93
Q
ciprofloxacin is CI with use of
A. metronidazole
B. warfarin
C. SMX/TMP
D. rifampin
E. tinidazole
A
E. tinidazole
94
Q
ciprofloxacin
dosing
renal adjustments?
A
PO: 250-500mg q12h
IV: 200-400 q8-12h
CrCl <50 q12h
CrCl<30 q18-24h
95
Q
levofloxacin
brand
dosing
renal adjustments
A
Levaquin
PO/IV 250-750mg QD
CrCl <50 Q48h or dec dose
96
Q
moxifloxacin
brand
dosing
renal adjustments
97
Q
Patient initiated on levofloxacin 750mg PO Q24H for pneumonia. What should be monitored?
A
QTc interval
potassium and mag to prevent prolonging QT and other cardiac events
BG
psych disturbances
tendons
antacid use
phosphate binder use
cations!!
98
Q
which FQ has the highest risk of QT prolongation?
A
moxfloxacin
99
Q
can a breast-feeding patient take a FQ
A
no, sorry charlie
100
Q
Patient on feeding tube is to initiate ciprofloxacin oral suspension at 250mg PO Q12H. How should this be given through the feeding tube?
A
wrong-o cannot do that. Suspension adheres to feeding tube womp womp.
use ciprofloxacin IR tabs, crush, and reconstitute in water.
101
Q
Patient BS is admitted to the hospital and a med rec is done by a superstar intern as follows (dosing not included bc not important in this case). While intern was doing med rec, patient was drinking coffee and enjoying the sunrise btw.
Patient is to be initiated on levofloxacin for CAP.
lisinopril
amlodipine
warfarin
glimepiride
insulin glargine
metformin
ibuprofen PRN
vitamin D
cincalcet
sevelamer
zocor
tums prn
protonix ER
rena-vite
which medications on the med list will the levofloxacin interact with? Anything else hint hint wink wink
A
warfarin (bleed risk)
glimepiride, insulin (hypoglycemia risk)
ibuprofen (increases FQ levels)
sevelamer (binds FQ)
protonix (absorption)
tums (binds FQ)
caffeine! (FQ will inc caffeine [ ])
102
Q
macrolides cover
A
atypicals and haemophilus infl.
103
Q
which macrolide requires renal dose adjustments? What is the threshold for adjustment?
A
clarithromycin, CrCl <30
104
Q
macrolides dosing
A
azithromycin
500mg po x1 day 1, then 250mg po daily day 2-5
or 500mg po daily x3d
clarithromycin
250-500mg po BID, adjust if CrCl <30
erythromycin
meh
105
Q
from azithro –> clarithro –> erythro what changes about drug solubilty? How does this affect dosing?
A
decreasing lipid solubility lowers Vd and plasma concentrations which leads to more frequent dosing
106
Q
SATA
macrolides azithro, clarithro and erythro are contraindicated in
A. hepatic dysfunction with prev use
B. use with tinidazole
C. use with Ca-containing IV products
D. neonates 2/2 hyperbilirubinemia
E. cholestatic jaundice with prev use
A
A and E
A. hepatic dysfunction with prev use
B. use with tinidazole - this is for ciprofloxacin
C. use with Ca-containing IV products - for CTX
D. neonates 2/2 hyperbilirubinemia - for CTX
E. cholestatic jaundice with prev use
107
Q
warnings for macrolides
A
QTc prolongation
hepatotox
myasthenia gravis exacerbation
clarithromycin in CAD
108
Q
what do tetracyclines cover
A
G+ (staph, strep, entero, propioni)
G - (h. flu, moraxella, atypicals)
other unique: rickettsiae, bacillus anthracis, triponemia, spirochetes)
VRE
doxy: also covers chlamydia, CAP, Lyme
109
Q
doxycycline dosing
with or without food
renal adjustments
IV:PO
A
100-200mg daily DIV qd-BID
take w food
no renal adjustments
1:1
110
Q
doxycycline CI in
A
<8yo, pregnancy, BF 2/2 suppressed bone growth and skeletal development; discolored teeth
111
Q
doxycycline should not be taken with
A. iron
B. calcium supplements
C. multivitamins
D. sucralfate
E. pepto bismol
F. warfarin
A
A-E
112
Q
patient on doxy going to florida for vacation. what should you warn them about
A
photosensitivity
113
Q
SMX/TMP
what does it cover
A
staph (MRSA, MSSA), HPEK (no N), enterobacter, shigella, salmonella, some OIs (PCP, toxo)
114
Q
SMX/TMP does NOT cover
A
atypicals, pseud, enterococci, anaerobes
115
Q
SMX/TMP has a _______ SMX/TMP ratio and doses need to be adjusted at a CrCl of _________. SMX/TMP is CI at a CrCl of ___________
A
5:1
<30
<15
116
Q
SMX/TMP dosing for
uncomplicated UTI
PCP ppx
PCP tx
A
1 DS tablet PO BID for uncomp UTI
1DS or 1 SS tab PO daily for PCP ppx
15-20mg/kg/d TMP DIV q6h for PCP tx
117
Q
a patient is starting SMX/TMP for PCP treatment. What should you warn the medical team about/monitoring?
A
blood dyscrasias, allergic reaction, hyperkalemia, dec BG, dec plts, crystalluria (stay hydrated)
118
Q
which defines the DDI between SMX/TMP and warfarin?
A. warfarin inhibits SMX/TMP metabolism via 2D6
B. SMX/TMP inhibits warfarin metabolism via 3A4
C. SMX/TMP inhibits warfarin metabolism via 2C19
D. warfarin inhibits SMX/TMP metabolism via 2E1
E. SMX/TMP inhibits warfarin metabolism via 2C9
A
E. SMX/TMP inhibits warfarin metabolism via 2C9
119
Q
what are examples of things that would increase the risk of hyperkalemia in a patient taking SMX/TMP?
A
concurrent ACE, ARB, MRA, NSAIDS, CYA, tacrolimus, canagliflozin, oral contraceptives
renal dysfunction
120
Q
what bugs does vanco cover? SATA
A. G+
B. MRSA
C. G- anaerobes
D. VRE+
E. strep
F. c diff
G. enterococci
H. MSSA
A
A. G+
B. MRSA
E. strep
F. c diff
G. enterococci
H. MSSA
121
Q
vanco dosing for systemic infection
which BW is it based on?
adjustments?
A
15-20 mg/kg q8-12h based on TBW
CrCl <50 -> q24h
CrCl <20 –> one time dose then adjust b/o level
122
Q
what are the therapeutic drug monitoring parameters for vanco?
which is preferred?
when do we draw which level(s)?
A
AUC:MIC 400-600
trough for UTI, skin infxn 10-15 mcg/mL
trough for MRSA 15-20mcg/mL
*draw trough 30 min before 4th or 5th dose
123
Q
nephrotoxins that are of concern with vanco use
A
NSAIDS, AGs, tacrolimus, amph B, loop diuretics, contrast dye, cyclosporine, polymixins
124
Q
what toxicities are of concern with vanco
A
nephro and oto toxicity
124
Q
ototoxic agents of concern with vanco use
A
cisplatin
AGs
loops
125
Q
vanco dosing for c diff
A
125mg PO QID x 10 days
no renal dosing
126
Q
to avoid an infusion reaction to vanco, the infusion should not exceed ______________
A
1 gram/ hour
127
Q
lipoglycopeptides
drugs
coverage
administration
A
televancin
oritavancin
dalbavancin
cover same as vanco
all IV!
128
Q
what are the black boxed warnings for televancin
A
fetal risk (need - preg test), CrCl </=50, nephrotoxicty
129
Q
oritavancin can be used for an osteomyelitis infection. T or F
A
false, does not penetrate bone
130
Q
should the medical team be concerned if a patients on televancin has an INR of 5.3
A
no, lipoglycopepetides falsely increase INR, aPTT and PT but do not inc bleed risk
131
Q
daptomycin #1 warning
A
RHABDOMYOLYSIS
RISK INC WITH STATINS
132
Q
should the medical team be concerned if a patients on daptomycin has an INR of 5.8
A
no, dapto falsely increase INR, aPTT and PT but do not inc bleed risk
133
Q
linezolid coverage and dosing
A
G+, MRSA and VRE
600mg Q12H
134
Q
adverse effects of linezolid
A
serotonin syndrome since it inhibits MAO, hypoglycemia, seizures, lactic acidosis, HTN
135
Q
linezolid should be avoided with ___________________
A
tyramine-containing foods
136
Q
clindamycin has a BBW for
A
c diff/colitis
137
Q
tigecycline has a BBW for
A
increased risk of death
138
Q
tigecycline should not be used in
SATA
A. bloodstream infections
B. pregnancy
C. lactation
D. <8yo
E. pseud, proteus, providencia (3 Ps)
A
A. bloodstream infections
D. <8yo
E. pseud, proteus, providencia (3 Ps)
139
Q
what does clinda cover
A
G+ (CA MRSA) and G+ anaerobes
140
Q
clindamycin dosing
A
po 150-450mg PO QID
iv 600-900mg TID
141
Q
clinda renal dose adjustments
A
tricky tricky, does not need to be renally adjusted
142
Q
metronidazole can be used for
A
gut infections (add on for anaerobes), b vag, trich, amebiasis, c diff (not first line)
143
Q
attending wants to add on metronidazole for an enteric (gut) infection
what is the dosing?
IV or PO?
A
500-750mg q8-12h
IV:PO 1:1!!!
144
Q
metronidazole, tinidazole and secnidazole BBW
A
possible carcinogenic
145
Q
metronidazole, tinidazole and secnidazole CI
A
use with et-OH, pregnancy, use with propylene glycol
146
Q
fidaxomicin
brand name
use
A
dificid
c diff
147
Q
nitrofurantoin
brand names and each dosing
renal adjustments?
A
macrobid: 100mg PO BID x5d
macrodantin: 50-100mg PO QID x3-7d
CI CrCl <60
148
Q
which ABX need to be refrigerated after reconstitution
A
amox/clav
Pen VK
ampcillin
cephalexin
vanco po
149
Q
DO NOT REFRIGERATE antibiotics
A
cefdinir
azithro
doxy
cipro
levofloxacin
clinda
linezolid
acyclovir
fluconazole
150
Q
ABX with DO NOT FREEZE warning
A
metronidazole
moxifloxacin
TMP/SMX
151
Q
ABX that do not require renal dose adjustments
A
CTX
moxifloxacin
clinda
doxy
azithro and erythro
metronidazole
linezolid
152
Q
ABX that need to be taken on an empty stomach
A
isoniazid
ampicillin
levofloxacin po soln
PenVK
rifampin
153
Q
ABX with a 1:1 IV:PO
A
-azoles
metronidazole
SMX/TMP
linezolid
doxycycline, minocycline, levoflox, moxiflox
154
Q
ABX that requier NS only
A
ampicillin
amp/sul
ertapenem
dapto cubicin RF
155
Q
ABX that can be in NS or LR
A
caspofungin
dapto cubicin
156
Q
ABX that can be in dextrose only
A
SMX/TMP
quinopristin/dalfo
Amph B
157
Q
what ABX cover MSSA
A
dicloxacillin, naficillin, oxacillin
3rd gens CTX, cefotaxime, cefdinir
4th gen cefepime
5th gen ceftaroline
amox/clav, amp/sul, pip/tazo
158
Q
what ABX cover MRSA
A
vanco
SMX/TMP (CA MRSA SSTI)
ceftaroline
linezolid
daptomycin (not in pneumonia)
doxycycline, minocycline (CA MRSA SSTI)
clinda (need D-test first) (CA MRSA SSTI)
159
Q
what ABx cover atypicals
A
TTC (doxy, minocycline)
macrolides (azithro and clarithro)
FQs
160
Q
what ABX cover HNPEK
(h infl, nesseria, proteus, e coli, klebsiella gram negatives)
A
amp/sul, amox/clav
pip/tazo
2nd gens cefuroxime, cefotetan, cefoxitin
3rd gens CTX, cefotaxime, cefdinir
4th gen cefepime
5th gen ceftaroline
carbapenems
aminoglycosides
FQs
SMX/TMP
161
Q
what ABX cover pseud
A
pip/tazo
3rd gen ceftazidime
4th gen cefepime
non-ertapenem carbapenems
ceftaz/avibactam
ceftolozane/tazobactam
levoflox and ciproflox
aztreonam
tobramycin
colistimethate, polymixin B
162
Q
what ABX cover CAPES
camphylobacter, acinetobacter, providencia, enterobacter, serratia
A
pip/tazo
4th gen cefepime
carbapenems
AGs
163
Q
what ABX cover ESBL+ GNRs
A
(ESBL is resistant to all penicillins and most cephalos)
carbapenems
ceftazidime/avi
caftolozane/tazo
164
Q
ABX that cover CRE
A
(carbapenem resistant Enterobacteriaceae)
ceftazidime/avi
meropenem/vaborbactam
impenem/cilastin/relebactam
colistimethate
polymixin B
165
Q
what ABX cover b frag (a G- anaerobe)
A
2nd gen cefotetan and cefoxitin
metronidazole
b-lactam and inhibitor (amox/clav, amp/sul, pip/tazo)
carbapenems
166
Q
what ABX cover c diff
A
vanco PO
fidaxomicin
metronidazole
167
Q
which ABX should be avoided in patients with myasthenia gravis
A
FQ (levoflox, ciproflox, moxiiflox)
macrolides (azithro, clarithro, erythro)
168
Q
which ABX lower the seizure threshold
A
penicillins
cephalosporins
carbapenems
FQ (BBW)
linezolid
169
Q
which ABX cause myelosuppression? what should be monitored?
A
penicillins
cephalos
carbapenems
linezolid
CBC (WBC, RBC etc.)
170
Q
which ABX have a warning for SJS/TEN
A
penicillins
cephalos
vanco
TTC
SMX/TMP
