Therapeutics - Infectious disease 3

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Therapeutics - Infectious disease 3
2014-09-21 13:31:47
Therapeutics Infectious disease

Therapeutics - Infectious disease
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  1. What are the Oral penicillinase resistant penicillins?
    • dicloxacillin
    • cloxacillin
  2. According to the charts, what is thespectrum for penicillinase resistant penicillins (Nafcillin)?
    • MSSA
    • Peptostreptococcus
    • Group A strep
    • S. pneumonia
  3. What microbes are outside of the spectrum of activity for Nafcillin/penicillinase resistant penicillins?
    • Gram – (including H. influenza)
    • MRSA
    • E. faecalis/faecium
  4. Penicillinase resistant penicillins (Nafcillin/oxacillin/dicloxacillin/cloxacillin) are the drug of choice for what bug?
  5. What is the normal dose for Penicillinase resistant penicillins (Nafcillin/oxacillin/dicloxacillin/cloxacillin)?
    • 1-2 grams IV Q4H
    • 250-500 mg PO Q6H
  6. How is Nafcillin eliminated?
  7. What is the half-life for Nafcillin/Dicloxacillin (Penicillinase resistant penicillins)?
    0.5 hours
  8. What level of proteinbinding is exhibited by Nafcillin/Dicloxacillin (Penicillinase resistant penicillins)?
  9. What arethe peack levels for Nafcillin/Dicloxacillin (Penicillinase resistant penicillins)?
    • 50-80 ug/mL for 1 gram IV
    • 10-15 ug/mL for 500 mg PO
  10. What are the side effects for Nafcillin/Dicloxacillin (Penicillinase resistant penicillins)?
    • Neutropenia and Thrombocytopenia in treatments > 3 weeks
    • Interstitial nephritis
  11. What should you monitor for when giving Nafcillin/Dicloxacillin (Penicillinase resistant penicillins)?
    • CBCs and WBCs for Neutropenia/thrombocytopenia when giving for a long duration (3-6 weeks)
    • BMP (basic metabolic profile) and a rise in SCr for Interstitial nephritis
  12. What is Unasyn?
    Ampicillin and sulbactam
  13. What is Augmentin?
    Amoxicillin and clavulanic acid
  14. Sulbactam and clavulanic acid are what type of molecules?
    Suicide inhibitors
  15. What type of coverage do Unasyn have (chart)?
    • Group A strep
    • S. pneumonia
    • Peptostreptococcus
    • E. faecalis
    • Some E. faecium
    • Gram -: H. influ, N. gonorrheae, B. fragilis some Klebsiela
  16. Is Unasyn active against MSSA?
    • No
    • Ampicillin has no activity against Staph
  17. Unasyn is IV or PO?
  18. Augmentin is IV or PO?
  19. What is Unasyn or Augmentin the drug of choice for?
    • Pet bites
    • Abdominal wounds
    • Anything where anaerobes might be the infecting agent
  20. What is a normal dose of Unasyn?
    1.5-3 grams IV Q6H
  21. What is the normal dose of Augmentin?
    • 500/125-875/125 mg PO Q8-12H
    • XL dose: 1000/62.5 2 tabs BID
  22. What is the half-life of Unasyn?
    • Ampicillin:
    • Normal renal activity: 1.3 hours
    • Renal insufficiency: 5-20 hours
    • Sulbactam:
    • Normal renal activity: 1.7 hours
    • Renal insufficiency: 20 hours
  23. How is Unasyn eliminated?
  24. What is Zosyn?
    Piperacillin and Tazobactam
  25. What is the main use of Zosyn (piperacillin/tazobactam)?
    Drug of choice for intra-abdominal infections/wounds and anaerobic infections
  26. Zosyn (piperacillin/tazobactam) has what coverage (chart)?
    • Group A strep
    • S. pneumonia
    • E. faecalis
    • Peptostreptococcus
    • Gram – rods: N. gonorrhoeae
    • E. coli
    • B. fragilis
  27. By what route of administration is Zosyn (piperacillin/tazobactam) available?
    IV onlu
  28. How is Zosyn (piperacillin/tazobactam) eliminated?
  29. What is the T1/2 for Zosyn (piperacillin/tazobactam)?
    • Piperacillin:
    • Normal renal function: 1 hour
    • Renally insufficient: 1 hour
    • Tazobactam:
    • Normal renal function: 3-5 hours
    • Renally insufficient: 3 hours
  30. What is the normal dose of Zosyn (piperacillin/tazobactam)?
    • 3.375 grams IV TID
    • Infuse over 4 hours
    • 4.5 grams IV TID for empiric pseudomonas
  31. Which antibiotic is the only available monobactam?
    Aztreonam (Azactam)
  32. What is Aztreonam (Azactam) used for in general (G+ or G-)?
    Gram negative infections only
  33. What does Aztreonam (Azactam) have no activity against?
    All G+
  34. What is the spectrum according to the charts for Aztreonam?
    • Fairly good against nosocomial G- rods:
    • H flu, N. gonorrhoeae, E. coli, K. pneumonia, S. marcescenes
    • Pseudomonas , though not often used for that indication
  35. What type sof G- infectionsis Aztreonam used for?
    • Cystic fibrosis
    • Pseudomonas infection
    • PCN allergic patients (who had anaphylaxis to PCNs)
  36. What is the dose of Aztreonam?
    1-2 grams Q6-8H IV