infectious disease midterm

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infectious disease midterm
2011-02-06 14:36:22
infectious disease aminoglycosides

therapy iv exam 1 infectious disease
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  1. what are primary options for HA MRSA
    • vancomycin
    • quinupristin/dalfopristen
    • linezolid
    • datpomycin
    • tigecycline
    • telavancin
  2. what are primary options for CA MRSA
    • clindamycin
    • tmp/smx
    • minocycline/doxycycline
  3. what are current vanco tdm
    15-20 mg/L trough. no peak recmmendation
  4. what are breakpoints for vanco with s aureus
    • susceptible <=2
    • intermediate 4-8mg/L
    • resistant >=16 mg/L
  5. what kinda killer is vanco
    concentration independent killer
  6. what is the best way to therapeutically monitor vancomycin
    • troughs are the most accurate and practical method for moitoring efficacy
    • troughs should be maintained >10mg/L (15-20 for complicated)
    • monitoring trough serum concntrations to reduce nephrotxicity--best suited for agfressive dosing (troughs 15-20mg/L)
    • all patients receiving prolonged therapy should have at least one steady state trough concentration (>4th dose)
  7. what are three types of antifungal agents
    • inhibitors of fungal cell membranes -- ampotericin B, azole, nystatin
    • DNA inhibiotrs--flucytosine
    • inhibitoris of cell wall biosynthesis--echinocandins
  8. what is moa, dosing, and adverse reactions of amphotericin B
    • binds sterols in fungal cell membrane, change in membrane permeability, cell leakeage, death
    • drug of choie for many infections including in pregnancy
    • ifusion related reactions--include fevere, chills, nvh thrombophlebities myalgias, arthroalgias. can avoid with premedicating with antihistamine thrombophlebitis can be avoided by slwoing infusion rate
    • nephrotoxicity--avoid with preinfusing 500mlNS
    • eletrolyte imbalances--esp k, ca, mg
    • leukocytosis
  9. what is moa, dose adjustments, and adverse reactions of flucytosine
    • converted to five flurouracil in fungal cells,
    • never use alone0--inreased resistance
    • adjust in renal dysfunction
    • adverse reactions--bone marrow suppression, hepatotoxicity, renal dysfunction, nvd, enterocolitis