Infxntopharm.txt

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Author:
nsmallwood
ID:
125389
Filename:
Infxntopharm.txt
Updated:
2011-12-31 12:02:02
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absite
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Description:
infection through pharmacology
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  1. MC organism involved in endocarditis
    strep sanguinous
  2. enterococcus is resistent to all
    cephalosporins
  3. mutation of VRE to vanc is attributed to
    mutation in cell wall binding protein
  4. what are two families of gram positive rods
    clostridium and corynebacterium
  5. what type of organism is h pylori
    gnr
  6. mc colonizer of indwelling catheters
    pseudomonas
  7. best tx for acinetobacter
    carbapenems
  8. gram neg cocci
    • neisseria
    • moraxella
  9. time frame for calling and infxn nosocomial
    after 48 hrs post admission and up to 30 days after d/c
  10. comorbidity RFs for SSI
    • advanced age
    • COPD
    • renal failure
    • liver failure
    • dm
    • malnutrition
    • immunosupp
    • obesity
  11. SSI incidence with type of wound
    • Clean 2%
    • clean contam 4%
    • contam 8%
    • dirty or gross contam 30%
  12. ssi within 48hrs of surgery
    • colon leak or
    • virulent organism
  13. mc infxn causing death in surgical pt
    nosocomial pna
  14. amount of organism present in BAL to dx PNA
    > 104
  15. mc class of organism in VAP
    GNRs
  16. tx of VAP
    vanc + 3rd ceph/fluoro/antipseud pcn
  17. chemical pneuomitis from aspiration of gastric acid secretion
    mendelsons syndrome
  18. tx of CAP
    3rd gen ceph or fluoroquinolone +/- clinda or flagyl
  19. mc organisms in line infxns
    • staph epi
    • staph aureus
    • enterococcus
    • yeast
    • GNR
  20. rfs for clostridium myonecrosis
    • farming accidents
    • CA
    • delay in tx
  21. gray dish water fluid from wound
    clostridium
  22. tx of splenic abscess
    splenectomy
  23. tx of lung abscess
    abx
  24. recurrence rate with c diff
    15%
  25. colonoscopic findings in c diff
    • pmns in mucoasa and submucosa
    • yellow plaques and ring like lesions
  26. dx c diff
    • ELISA for toxin A or B (can repeat if neg and suscipion is high)
    • stool cytotoxin assay is gold standard but takes longer
  27. indications to treat for fungi
    • + blood cultures
    • cultures from 2 or more sites
    • 1 site if sever infxn
    • endophthalmitis
    • prolonged abx with no improvement
    • febrile neutropenia
  28. PNA with chest pain and hemoptysis
    aspergillus
  29. febrile neutropenic pt with new lung nodules
    aspergillus
  30. fumgal infxn with pulmonary and skin
    blastomycin
  31. tortuous abscesses
    actinomyces
  32. may be the only sx in SBP
    hepatic encephalopathy
  33. dx SBP
    • wbcs> 500
    • PMNs >250
    • positive cxs
  34. organisms in SBP
    • MC E. coli
    • step pneumo
    • klebsiella
  35. tx of SBP
    3rd gen ceph
  36. who needs prophylactic abxs for sbp
    • previous sbp
    • bleeding esophageal varices
  37. mc organism in peritoneal dialysis catheter
    staph aureus
  38. TIG only given to
    contaminated wounds in pts who lack appropriate immunization
  39. tx of tetanus infxn
    • flagyl + TIG
    • Mg
    • diazepam
  40. tx to prevent Hep B transmission to fetus
    HBIG and vaccine
  41. drugs for tx of Hep B and who gets treated
    • INf alpha + Entecavir
    • HepB and increased LFTs or fulminant hepatitis
  42. tx of hep c
    inf alpha and Ribavirin
  43. mc side effect in heart therapy
    pancreatitis
  44. MC infxn requiring laparotomy in HIV/AIDS
    cmv colitis
  45. mc focal brain lesion in HIV
    • toxoplasmosis
    • can tx with bactrim
  46. used for prophylactic tx in AIDS
    bactrim or Pentamidine
  47. MC organism in nosocomial pna
    • staph
    • mc class GNRs
  48. inhibits 30s
    • tetracyclines
    • aminoglycosides
    • linezolid
  49. inhibits 50s
    • macrolides
    • clindamycin
    • chloramphenicol
    • synercid
  50. moa of flagyl
    produces o2 radicals breaking up DNA
  51. moa of daptomycin
    membrane depolarizer resulting in decrease synthesis of DNA/RNA
  52. abx that are bacteriostatic
    • chloramphenicol
    • tetracycline
    • clindamycin
    • macrolides
    • bactrim
  53. mc method of abx resistance
    transfer of plasmids
  54. mc mechanism for gent resistance
    decrease uptake
  55. mc mechanism for fluoroquinolones resistance
    modified DNA gyrase
  56. mc mech of res for flagyl
    plasmid/gene for nitroreductase
  57. res seen in MRSA is from
    mutation in cell wall binding protein
  58. MDR pseudomonas
    acquired mutations in efflux pumps
  59. have inducible ampC beta lactamase
    • serratia
    • enterobacter
  60. MDR klebsiella
    beta lactamase plasmids
  61. mdr serratia
    beta lactamase plasmids
  62. mdr enterobacter
    • beta lasctamase
    • carbapenemase
  63. carbapenems are not effective for
    • MRSA
    • enterococcus
    • Proteus
    • Pseudomonas
  64. cephalosporin that can produce Coombs + test
    1st gen- cefazolin, cephalexin
  65. all generations of cephalosporins are not effective agains
    enterococcus
  66. s/e of vanc
    • HTN
    • Redmans
    • nephro/oto
  67. s/e of zyvox
    • low plts
    • rare mitochondrial inh leading to lactic acidosis
  68. daptomycin treats what bacteria
    • MRSA
    • VRE
    • Corynebacterium
    • NO PNA
  69. monobactams effective for
    • pseudomonas
    • accinetobacter
    • serratia
  70. abx combined with statins can cause peripheral neuropathy
    macrolides
  71. abx that can prolong QT
    macrolide
  72. active metabolite of flagyl
    ferredoxin
  73. s/e of flagyl
    • disulfiram like rxn
    • peripheral neuropathy
  74. abx effective for enterococcus
    • amp/amox
    • gent + amp
    • Timentin/Zosyn
    • vanc
  75. moa of ampho
    creates channels with ergosterol in membrane
  76. s/e of ampho
    • renal (nephrogenic DI)
    • hypotension
    • fever
    • increase LFTs
  77. moa of anidulafungin
    inh synthesis of cell wall glucan
  78. moa of voriconazole
    inh P450 oxidase dependent synthesis of ergosterol
  79. moa of fluconazole
    inh p450 and sterol C 14 alph demethylation
  80. moa of ant TB drugs
    • INH- mycolic acids
    • Rifampin- rna polymerase
    • Pyrazinamide- inh arabinogalactan synth
    • ethambutol- inh fatty acid synthesis
    • streptomycin- 30s
  81. anti TB with retrobulbar neuritis
    ethambutol
  82. total length of treatment of TB
    9-12 months
  83. volume of distribution =
    amt of drug in body / amt of drug in plasma
  84. phase I
    • non synthetic
    • requires mixed function oxidases
    • i.e NADPH and O2
  85. Phase II
    conjugation with glucuronic acid or sulfates
  86. inducers of P 450
    • barbiturates
    • phenytoin
    • theophylline
    • coumadin
  87. mox of probenecid
    inh renal reabsorption of uric acid
  88. moa of niacin
    blocks fat breakdown resulting in decrease fatty acids, dec LDL, increase HDL
  89. moa of fibrates
    increase lipoprotein lipase
  90. good for decreasing TAGs
    gemfibrozil
  91. when used in conjuction with statins can increase myopathies and rhabdo
    fibrates
  92. increase HDL
    Fibrates, Niacin
  93. tx of beta blocker overdose
    glucagon
  94. s/e of amiodarone
    • inh p450
    • pulmonary fibrosis
    • thyroid dysf
    • increase LFTs
  95. best single agent used to decrease mortality from CHF or after MI
    ACE
  96. helps prevent increase renal dysfunction in pts with DM and or HTN
    ACE
  97. endothelin receptor antagonist used in pulm HTN
    • bosentan
    • ambrisentan
  98. moa of loop diuretics
    N/K/2Cl transporter
  99. moa thiazides
    inh Na/Cl transporter
  100. first line drug for DM II
    metformin
  101. moa of rosiglitazone
    decrease insulin resistance by up regulation of PPAR
  102. only agent to improve survival in pts with severe COPD
    home O2
  103. besides a ppi what else can be used in pts who chronically use NSAIDS
    Misoprostol
  104. s/e of tramadol
    szs especially when combined with SSRIs
  105. moa of gabapentin
    CNS calcium channel blocker
  106. what is needed before placing someone on infliximab
    PPD
  107. s/e of Remicade
    • infxn
    • abscess
    • serum sickness
    • allergic rxns
    • PML
    • Lymphoma
  108. s/e of gadolinium
    • acute renal dysfunction
    • nephrogenic systemic fibrosis
  109. antidote for wilsons
    penicillamine
  110. antidote for lead poisoning
    dimercaptosuccinic acid

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