Therapeutics - AI

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  1. What bacteria types are common un the upper GI?
    G +
  2. What bacteria types are common in the mid-GI?
    Gram –
  3. What bacteria types are common in the lower GI?
  4. What are the common bacteria of Peritonitis?
    • E. coli
    • Streptococcus pneumonia
  5. How is Peritonitis diagnosed?
    Presence of ascites, bacteria in ascitic fluid
  6. What are the S/S of Spontaneous peritonitis?
    • fever & chills
    • abdominal pain, distention, vomiting
    • cloudy peritoneal fluid
    • shock
    • coma
    • Usually in chronic alcoholics with acites
  7. What is the treatment for Spontanteous peritonitis?
    • Fluid
    • empiric: 3rd generation cephalosporin (ceftriaxone, ceftazadime, cefotaxime) or cefepime
    • Add an anaerobic agent (clindamycin or metronidazole) if no response
    • Continue for 10-14 day
  8. What bacteria often bacterial etiology of Secondary peritonitis?
    • Usually Gram –
    • Lactobaccilli, streptococcus and oral anaerobes - peptostreptococcus, fusobacterium, bacteroides
    • biliary tract: E. coli, Klebsiella, enterococci
    • large bowel: anaerobes
  9. What are the S/S of Secondary Peritonitis?
    • fever
    • abdominal pain, nausea, vomiting
    • involuntary abdominal guarding
    • hypoactive bowel sounds
    • tense, rigid, board-like abdomen
    • tachycardia
    • diminished urine output
    • shock
  10. What is the treatment for Secondary bacterial peritonitis?
    • clindamycin or metronidazole + an antipseudomonal fluoroquinalone (ciprofloxacin) or aminoglycoside
    • or
    • any of the following alone:
    • imipenem/cilastin
    • piperacillin/tazobactam
    • ampicillin/sulbactam
    • meropenem
    • ertapenem
    • (All have G- and anerobic coverage)
    • Probably wanto to add Cipro to ertapenem and ampicillin/sulbactam to cover pseudomonas, as neither have that)
    • Add a quinolone for persistent infection
  11. Continuous Ambulatory Peritoneal Dialysis-Associated Peritonitis is usually what organism and what drug is usually used to treat it?
    • Staph or strep
    • Vanco
  12. What are the treatments available for Continuous Ambulatory Peritoneal Dialysis-Associated Peritonitis?
    • vancomycin if gram positive organisms
    • aminoglycosides or ciprofloxacin for gram negatives
    • either above may be give IV or intraperitoneal
    • Dosages significantly less than IV
    • Gentamicin or tobramycin 8 mg/L
    • Vancomycin 30 mg/L
  13. What are the potential bacterial etiologies of Continuous Ambulatory Peritoneal Dialysis-Associated Peritonitis?
    • coagulase negative staphylococci
    • Staphylococcus aureus (MRSA)
    • gram negatives
  14. What bacteria usually cause Cholecystitis and Cholangitis?
    • G + more common because higher up in GI tract, though G- still significant
    • Commonly:
    • E. coli,
    • Klebsiella spp.
    • Enterobacter
    • Proteus
    • Bacteroides
    • Clostridia
  15. What are the S/S of Acute Cholecystitis and Cholangitis?
    • fever, jaundice & abdominal pain (Charcot’s triad)
    • right upper quadrant pain
    • chills
    • nausea & vomiting
    • leukocytosis, hyperbilirubinemia, elevated liver enzymes
    • jaundice
  16. What are the treatment options for Cholecystitis and Cholangitis?
    • piperacillin/tazobactam or aminoglycoside + clindamycin or metronidazole
    • or ceftazadime or cefepime + metrondiazole or clindamycin
    • Carbapenem – imipenem/cilastin or meropenem or doripenem
    • surgery
    • fluids
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Therapeutics - AI
2014-10-26 15:37:33
Therapeutics AI
Therapeutics - AI
Therapeutics - AI
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