Therapeutics - Infectious disease 7

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kyleannkelsey
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283697
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Therapeutics - Infectious disease 7
Updated:
2014-09-21 13:32:26
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Therapeutics Infectious disease
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Therapeutics - Infectious disease
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  1. Which flouroquinolones are PO?
    • Ciprofloxacin (Cipro)
    • Levofloxacin (Levaquin)
    • Moxifloxacin (Avelox)
    • Gemifloxacin (Factive)
    • Norfloxacin (Noroxin)
    • All
  2. Which Flouroquinolones are IV?
    • Ciprofloxacin (Cipro)
    • Levofloxacin (Levaquin)
    • Moxifloxacin (Avelox)
  3. What is the spectrum of Ciprofloxacin?
    • Good coverage for all gram – and atypicals
    • Ok for acinitobacter and B. fragilis
    • Ok, G + coverage but not great (MSSA, MRSA and peptostrepto = 8, Coagulase negative staph = 16)
  4. What is the spectrum of Levofloxacin?
    • Good coverage for all gram – and atypicals
    • Ok for acinitobacter and B. fragilis
    • Ok, G + coverage but not great (Not really enterococcus; MSSA, MRSA and peptostrepto = 8, Coagulase negative staph = 16)
  5. How do ciprofloxacin and Levofloxacin compare in terms of coverage?
    • Levo has less enterococci coverage
    • Levo has better MRSA and MSSA
  6. Do Flouroquinolones have good or bad bioavailability?
    Good both IV and PO
  7. What are the main uses for Flouroquinolones?
    • Pneumonia
    • GI organisms
    • Atypical respiratory organisms
    • Gm negative osteomyelitis
    • UTI
    • Pseudomonas infx
    • Intra-abdominal infx
  8. What are the peak levels for Cipro?
    • PO: 4.6 ug/mL with 400 mg IV
    • IV: 3.6 ug/mL with 750 mg PO
  9. What are the peak levels for Levofloxacin?
    • PO: 6.4 ug/mL with 500 mg IV
    • IV: 5.7 ug/mL with 500 mg PO
  10. What is the half-life of Ciprofloxacin (Quinolone)?
    • 4 hours
    • 9 hours in renal insufficiency
  11. What is the half-life of Levofloxacin (Quinolone)?
    • 7 hours
    • 76 hours in renal insufficiency
  12. What class drugs provided the first oral therapy for osteomyelitis, eliminating the need for hospitalization?
    Quinolones
  13. What counseling pearls should you pass on to a patient receiving tetracyclines?
    • Avoid trivalent cations
    • N/V/D
    • May feel like you drank too much coffee
    • Avoid sun exposure
  14. What should you monitor for when giving Quinolines?
    • Trivalent Cations w/ PO version
    • Cipro = hepatic excretion, watch for DDIs with warfarin, theophylline, cyclosporine
    • Dose adjust for renal insufficiency
    • QT prologation (avoid patients on amiodarone)
    • Ci in pregnancy, children
    • Tendon rutptreAvoid in myasthenia gravis
    • Phototoxicity
    • Hypo or Hyper glycemia
  15. If you are taking a PO quinolone, when should you take your multivitamin?
    2 hours before or after the quinolone
  16. Vancomycin has what coverage (chart)?
    • Gram positive only
    • Good for all G +, though reported to not be good for MSSA
  17. Ho must you give Vanco for C. diff?
    PO
  18. Whata re the main uses for Vancomycin?
    • MRSA
    • C. diff
    • G + infections in PCN allergic patients
  19. What is the dose for Vancomycin?
    15 mg/kg IV Q12H in normal renal function
  20. What is the most important factor for PK/PD?
    AUC/MIC
  21. What I sthe peak conc. for Vancomycin?
    45-50 ug/mL
  22. What is the trough level for Vancomycin?
    10-20 ug/mL
  23. What is the half-life for vancomycin?
    • 6 hours
    • Renal insufficiency: >200 hours
  24. What is the brnad name for Telavancin?
    Vibativ
  25. What is the spectrum for Televancin?
    • Primarily G +: Goof fore everything including C. diff
    • No G – activity
  26. By what route is Telavancin (Vibativ) given?
    IV only
  27. What is Televancin (Vebativ) CI in?
    • Pregnancy
    • Requires a negative pregnancy test before commencement
  28. What are the SE for Televancin (Vibativ)?
    • QT prologation
    • Taste disturbances
    • N/V
    • Elevated SCr
    • Foamy urine
  29. What are the major uses for Televancin (Vibativ)?
    • Skin/skin structure infections, including:
    • MRSA, Enterococcus and Streptococcal infections
  30. What is a normal dose for Televancin (Vibativ)?
    10 mg/kg over 1 hour
  31. What is the coverage for Daptomycin (Cubicin)?
    • Only G +
    • Used for MRSA
    • Good for all G +, OK for enterococci
    • No G -

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