Therapeutics - Infectious disease 1

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kyleannkelsey
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283524
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Therapeutics - Infectious disease 1
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2014-09-21 13:31:18
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Therapeutics Infectious disease
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Therapeutics - Infectious disease
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  1. What is the MIC?
    • Minimum inhibitory concentration
    • The amount of drug that will inhibit the growth of an organism
  2. What is the MBC?
    • Minimum bactericidal concentration
    • Amount of drug that will kill an organism
  3. What are the classes of Beta lactams?
    • Penicillins
    • Cephalosporins
    • Carbepenems
    • Monobactams
  4. Mechanisms of resistance for organisms is often the same within a ___________.
    Class
  5. A high or low MIC indicates that the organism is susceptible to that drug?
    Low
  6. Would you use PCN against a staph infection?
    No
  7. Would you use PCN against a strep infection?
    Yes
  8. Describe the coverage of PCN as was shown on the chart in class:
    • Good: Streptococcus, S. pneumoniae
    • Poor: H. influenza, Staph, E. faecalis, E. faecium, Peptostreptococcus, anaerobes
    • No: gram negative, except H. influenza
  9. What is the general coverage of PCNs (not chart)?
    • Streptococcal infections including: Streptococcus pyogenes (Group A), Streptococcus pneumoniae (PCN sensitive), Group B streptococcus
    • Trepomena pallidum (syphilis)
    • Neisseria meningitidis
    • Peptostreptococcus infections (anaerobic infections - above the diaphragm) (MOUTH)
  10. What is the IV preparation for PCN?
    Pen G
  11. What is the Oral preparation or PCN?
    Pen VK
  12. How is PCN eliminated?
    Renally
  13. 250 mg of PCN is equivalent to how many units?
    400,000 units = 250 mg
  14. What is the T1/2 of PCN in ESRD?
    8-20
  15. What is the Normal IV dose of PCN?
    0.5-4 mU Q4hrs
  16. What is the Normal dose of PCN?
    250-500 mg QID
  17. What is the peak level for PCN G?
    25-63 ug/mL (2 Mu IV)
  18. What are the peak levels for PCN VK?
    5-6 ug/mL (500 mg)
  19. What is the T1/2 of PCN in a patient with uncompromised renal function?
    0.5 hours
  20. Allergy to PCN is mediated by what antibody?
    IgE
  21. With long term use of PCNs, what AE can occur?
    • Neutropenia
    • Thrombocytopenia
    • Interstitial nephritis
    • Eosinophilia
    • Drug fever
  22. If you do not adjust the PCN dose for renal insufficiency, what preventable AE do your risk?
    Seizures
  23. What is the most important kinetic/dynamic parameter in evaluating the efficacy of PCN?
    Time above MIC
  24. When a patient is on a PCN and develops diarrhea, at what point should you suggest they see their physician?
    >4-6 stools/day for >1 week
  25. What is TEN?
    • Toxic epidermal necrosis
    • A form of anaphylaxis
  26. What coverage (from the charts shown in class) does ampicillin have?
    • G+ bugs, some minimal G- coverage
    • Group A strep
    • S. pneumonia
    • E. faecalis
    • Peptostreptococcus
    • G-: H. influenza, N. gonorrhea
  27. Do Aminopenicillins cover Staph?
    No
  28. How does Ampicillin’s coverage of E. faecalis compare to PCN G/VK?
    4x better than PCN G/VK
  29. What are the dosage forms/route of administration available for aminopenicillins?
    • Ampicillin = IV or oral
    • Amoxacillin = oral
  30. Which aminopenicillin has better oral availability?
    Amoxicillin – better bioavailability (80%) vs. ampicillin (50%)
  31. How are aminopenicillins eliminated?
    Renally
  32. Which aminopenicillin has a SR formulation?
    Amoxacillin
  33. What are the normal doses for Aminopenicillins?
    • Ampicillin: 250-500 Q6h PO, or 50-200 mg/kg IV/day
    • Amoxicillin 250-1000 mg TID
  34. What is the half-life for ampicillin?
    • 1 hour in normal kidney function
    • 7-20 hours in renal insufficiency
  35. What are the peak levels for Aminopenicillins?
    • Ampicillin: 120 ug/mL (2 grams IV)
    • Amoxicillin: 5.5-7.5 ug/mL (500 mg PO)
  36. What are the aminopenicillins used for (not from the chart)?
    • Ampicillin: Streptococci, Enterococci, Listeria meningitis
    • Amoxicillin: Anthrax (in pregnancy), Pharyngotonsillitis, H. pylori, Otitis media infection – 1st episode
  37. Ampicillin is the drug of choice for what type of infections?
    Enterococcal
  38. What are the penicillinase resistant penicillins?
    • Nafcillin
    • oxacillin
    • dicloxacillin
    • cloxacillin
  39. What are the IV penicillinase resistant penicillins?
    • Nafcillin
    • oxacillin

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