Antiinfective therapy

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Antiinfective therapy
2012-04-15 16:00:04

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  1. Narrow spectrum antibiotics are good against what?
    Gram positive bacteria
  2. What meds should not be prescribed to children under the age of 8 years
    The tetracyclines (to include doxycycline)
  3. ___________ are contraindicated in all persons under the age of eighteen. This class of antibiotics can weaken tendons and predispose an individual to tendon rupture.
  4. _________work by inhibiting the bacterium’s ability to synthesize folate (folic acid), another essential nutrient necessary to maintain life.
    Sulfa drugs
  5. ________ is your antiseptic “drug of choice” (DOC). It is supplied in a myriad of forms (pads, swabs, bottled solutions and cleansers, etc.).
  6. ____________ should never be used on open wounds (as with alcohol). This is because when it’s concentrated enough to kill bacteria, it’s also concentrated enough to kill living tissue. (And dead tissue is not something you want to leave in a wound.)
    Hydrogen peroxide
  7. __________________ is a preferred substance for handwashing prior to medical procedures and in-between patients.
    Chlorhexidine gluconate
  8. ______________ refers to a basic chemical ring structure found in some antibiotic families such as the penicillins, cephalosporins, carbapenems and monobactams.
    “Beta lactam”
  9. Cautions for beta lactams
    Oral contraceptives, superinfection, Diarrhea
  10. ____________ is the preferred oral penicillin. It is more acid stable in the gut than oral penicillin G.
    Penicillin V
  11. __________________ is a long acting (1 - 4 weeks) preparation useful in the treatment of strep pharyngitis and the DOC (drug of choice) for syphilis.
    Benzathine penicillin
  12. Examples of Penicillinase resitance PCN
    This class of penicillins is not, however, effective against MRSA (methicillin-resistant staph aureus). Nafcillin is administered IM or IV. Oxacillin, Cloxacillin and Dicloxacillin are oral drugs. methicillin
  13. Aminopenicillins
    Ampicillin, amoxicillin, amoxicillin/clavunaic acid (DOC for animal bites)
  14. DOC for animal bites?
  15. Also known as “anti-pseudomonal” penicillins. These penicillins are expensive and for parenteral use against serious gram-negative infections, to include infections caused by Pseudomonas species.
    Extended spectrum PCN


  16. Individuals who are allergic to the penicillins may also exhibit hypersensitivity to the _________
    cephalosporins (around 10%).
  17. Cephalosprins are also known as what?
    How do they work?
    • Beta lactams,
    • inhibiting cell wall formation (bacterialcidal)
  18. The generations of cephalospirins (third), as they go up, what coverage decreases.
    • Increased gram negative
    • decreased gram positive
  19. what is SPEcK?
    • Strep/staph
    • Proteus Milaribilus
    • Eschericia Coli
    • Kleibsiella Pneumonai
  20. What is a common 1st generation cephalosporin and its coverage/applications?
    Cephazolin (ancef)- Good tissue and bone penetration, no BBB penetration, good anti staph and pre-op (non war wound).
  21. A common second generation cephalosporin, applications and coverage?
    • Heaomophilus influenza
    • Enterobacter
    • Neisseria
    • SPEcK

    Cefoxitin (IV) (good anerobic coverage), Cefuroxime
  22. What are some characteristics of 3rd generation cephalosporins??

    Common medications?
    Broad spectrum, poor anaerobic, penetrates BBB

    • Ceftriaxone
    • Cefotaxime

    GOOD SPEC OPS antibiotic
  23. What third generation cephalosporin is good for pseudomonas?
    ceftazidime, excellent gram (-)
  24. What are the most commonly used 1G cephalosporins by SPEC OPS
    cefazolin, cephalexin
  25. What are the most common SPEC OPS 2G cephalosporins
    cefoxitin, cefuroxime
  26. _____________, is recommended by 2011 TCCC guidelines for all open combat wounds in patients who cannot take oral medications (e.g., shock, unconsciousness). It has the advantage of once daily dosing and can be administered IM or IV.
    Ertapenam (Invanz), a carbapenem
  27. What are synthetic PCNs with broad spectrum including anerobes and inhibit cell wall synthesis?
    Carbapenems and monobactams
  28. Vancomycin characteristics?
    MRSA, C. dificile, NO GRAM NEG, nephro and ototoxicity, red man syndrom (histamine release)
  29. The SOF medic must consider this superinfection in anyone presenting with significant diarrhea following prior antibiotic therapy. (What bacteria)
    Clostridium Dificile
  30. What medication inhibits protein synthesis, has good anaerobic coverage and is synthesized in the liver and excreted through urine. Gram POS, no Gram NEG

    Used topically for acne and intravaginally for BV

    May cause C. Diff overgrowth
  31. What do you treat pseudomembranous collitis with?
    Vancomycin, metronidazole (flagyl)
  32. What types of ABX are structurally different from PCNs and good with Atypical bacteria (clamydia, legionairres)
  33. Cautions for erythromycin
    estolate-avoid in adults, may cause choleocystatic jaundice, abd cramping, nausea, vomiting.
  34. What are some improved macrolides with less GI side effects, used to treat chlamydia, broader spectrum of activity?
    • Azithromycin (clap)
    • Clarithromycin
  35. This is a new class of ABX that must be used for patients 18+ and are used for pneumonia, bacterial sinusitis, acute exacerbations of chronic bronchitis, and must be contraindicated for patients with myasthenia gravis.
    • Telithromycin (ketex)
  36. What Tetracycline can be given to patients with renal comprimise?
    Doxycycline (only hepatic processiing)
  37. What class inhibits protein synthesis, metabolized in the liver, excreted hepatically and renally, broad spectrum, some BBB coverage
    Tetracyclines (Doxy, Tetracycine, minocycine)
  38. What are some adverse effects of tetracyclines?
    Increased photosensitivity, GI upset, vertigo (minocycline), permanent teeth darkening in PEDs (do not give under 8)
  39. Tetracycline uses?
    • Anthrax (doxy per CDC)
    • Acne,
    • Clap,
    • Cholera
    • Lyme
    • Malaria prophylaxis
  40. What type of ABX has high ototoxicity and is not for SOF use? and renotoxicity
    Aminoglycosides (streptomycin, gentamycin, neomycin, all the cins, amikacin.
  41. What ABX causes grey baby syndrome, tetarogenic and DOC for typhoid fever. Causes bone marrow suppresion.
  42. What inhibits the production of folic acid used by bacteria?
  43. Coverage for sulfanomides
    Gram POS, Fair Gram NEG, No anearobic, may be used in infants over 6 months, crosses placenta and breast milk
  44. Uses for Sulfonamides
    EENT, UTI, GI, URI, Prostate infections,
  45. Adverse effects for sulfamidines
    • Photosensitivity
    • Preceipitation in acidic urine
    • Anemias
    • Displaces drugs like warfarin, diabetes drugs, digoxins, thiazides
  46. What is a good drug for meningitis prophylaxis? Has good CSF penetration.
    Rifampin (orange urins and tears)
  47. Natrufurantoin (macrobid) good for what?
    UTIs (does not reach antibacterial levels until in the urinary system)
  48. What anti funger is for seriousl fungal infections
    Amphotericin B
  49. What are some common azole antifungals?
    Ketoconazole, Fluconazole.
  50. Common antivirals for flu
    Zanamavir and Oseltavir