PANCE Antibiotics Review Exam Graded A

which class of abx is known for causing permanent SNHL? - ANSWER aminoglycosides (esp. gentamicin) which antibiotic can cause transient (not permanent) vestibular dysfunction (SNHL)? - ANSWER minocycline which antimicrobial is the most nephrotoxic? - ANSWER amphotericin B which class of abx can cause acute tubular necrosis (ATN)? - ANSWER aminoglycosides (esp. gentamicin) which antibiotic is known for causing a disulfuram-like reaction? - ANSWER metronidazole (drinking a beer on the metro (subway)) which antibiotic causes Red Man Syndrome? - ANSWER Vancomycin (Van the Red Man) which abx causes Red Lobster Syndrome? - ANSWER rifampin (Rifampin the Red lobster) which class of abx causes teeth discoloration and is contraindicated in children <8yo? - ANSWER tetracylines which class of abx causes Yellow Babies by displacing bilirubin? - ANSWER sulfonamides (Bactrim/Septra) which abx is most commonly associated with C. Diff? - ANSWER clindamycin which abx is associated with a diffuse, maculopapular, nonurticarial rash when given to someone with EBV? - ANSWER ampicillin metronidazole is pregnancy category B, except when? - ANSWER first trimester...fetotoxic which class of abx are associated with tendon ruptures, esp Achilles tendon? - ANSWER flouroquinolones which class of abx are very similar to penicillins with regard to mechanism of action and allergic reactions? - ANSWER cephalosporins if someone gets a rash from penicillin, you wouldn't give them a penicillin, but you could potentially give what class? - ANSWER cephalosporin if someone has an anaphylactic reaction to PCN, you wouldn't give a PCN or what other class? - ANSWER cephalosporin what is the MOA of PCN? - ANSWER inhibits cell wall synthesis what are the 2 main organisms treated with PCN in primary care? - ANSWER s. pyogenes (group A strep) and t. pallidum (syphilis) what are the anti-staph penicillins? - ANSWER nafcillin (IV) and dicloxacillin (PO) Naf rhymes with staph. He had a staph infxn on his DICk which oral antibiotic would you use for a skin abscess in which s. aureus is the suspected organism? - ANSWER dicloxacillin which abx would you use to treat Lyme Disease in a child under 8 y/o? - ANSWER amoxicillin which abx would you use for endocarditis prophylaxis prior to a dental procedure? - ANSWER amoxicillin which abx would you use as prophylaxis or to treat an animal or human bite? - ANSWER amoxicillin/clavulanate (augmentin) if you treated a sinus infection or otitis media with amoxicillin and the patient did not get better, which abx would you use next? - ANSWER amoxicillin/clavulanate (augmentin) what is the MOA of cephalosporins? - ANSWER inhibit cell wall synthesis what are the most common 1st generation cephalosporins? - ANSWER cefazolin (IV) and cephalexin (PO) which antibiotic would you use for perioperative prophylaxis? - ANSWER cefazolin (ancef) which generation are the "respiratory" cephalosporins? - ANSWER 2nd generation what are the 2nd generation "respiratory" cephalosporins? - ANSWER cefuroxime what are the oral 3rd generation cephalosporins? - ANSWER cefpodoxime (vantin) and cefdinir (omnicef) what are the 2nd generation cephalosporins typically used for? - ANSWER URTIs and soft tissue infections what are the oral 3rd gen cephalosporins used for? - ANSWER URTIs and soft tissue infections (similar indications as 2nd gen) As generations of abx increase what happens to coverage? - ANSWER you lose gram pos coverage and gain gram neg coverage what is the parenteral/injectable 3rd gen cephalosporin? - ANSWER ceftriaxone what is the DOC for gonorrhea? - ANSWER ceftriaxone which cephalosporin is used for meningitis? - ANSWER ceftriaxone what are the 4th generation cephalosporins? - ANSWER ceftazidime and cefepime what is the 5th generation cephalosporin? - ANSWER ceftaroline what is the only cephalosporin with MRSA coverage? - ANSWER ceftaroline what can be done to limit the risk of Red Man Syndrome when giving vancomycin? - ANSWER infuse over 60 minutes what is the treatment for mild c. diff? - ANSWER metronidazole what is the treatment of mod-severe c. diff? - ANSWER vancomycin what is the MOA of tetracyclines? - ANSWER inhibits the 30S bacterial ribosome what is the DOC for tick-borne diseases in children over 8 y/o? - ANSWER Doxycycline What is the MOA of macrolide abx? - ANSWER inhibits the 50S bacterial ribosome what is a major consideration when prescribing a macrolide? - ANSWER QTc prolongation what are the macrolide abx? - ANSWER azithromycin, clarithromycin, erythromycin what is the MOA of lincosamide abx? - ANSWER inhibits the 50S bacterial ribosome what is the lincosamide abx? - ANSWER Clindamycin when would you use clindamycin for strep throat or a skin/soft tissue infection? - ANSWER serious PCN allergy what is the MOA of the aminoglycoside abx class? - ANSWER inhibits the 30S bacterial ribosome what are the major ADRs of aminoglycosides? - ANSWER ototoxicity and nephrotoxicity what are the aminoglycoside abx? - ANSWER gentamicin and tobramycin what antibiotic would you use to treat chlamydia (non-gonoccocal urethritis/cervicitis)? - ANSWER azithromycin what is the MOA of the flouroquinolones? - ANSWER inhibit bacterial DNA topoisomerases what 2 drug interactions should you be careful of with flouroquinolones? - ANSWER QTc prolongers and multivalent cation drugs (decreased absorption) what are the major SE of flouroquinolones? - ANSWER arthropathy and tendonopathy flouroquinolones are contraindicated in what population? - ANSWER kids under 18 what is the non-respiratory flouroquinolone? - ANSWER ciprofloxacin what is the main use of ciprofloxacin? - ANSWER abdominopelvic infections what are the respiratory flouroquinolones? - ANSWER levofloxacin and moxifloxacin what is the main use for respiratory flouroquinolones? - ANSWER upper and lower URIs what is the MOA of trimethoprim & sulfamethoxazole? - ANSWER inhibits folate synthesis be careful of Bactrim/septra in people taking what medication? - ANSWER warfarin (get an INR) patients with sulfa allergies should not get what abx? - ANSWER trimethoprim/sulfamethoxazole what is the treatment of PCP pneumonia? - ANSWER trimethoprim/sulfamethoxazole which abx can cause hemolytic anemia in G6PD deficient patients? - ANSWER trimethoprim/sulfamethoxazole what is the MOA of nitroimidazole abx? - ANSWER DNA damage what is the nitroimidazole abx? - ANSWER metronidazole what are the major ADRs of metronidazole? - ANSWER metallic taste at high doses, disulfiram-like reactions, fetotoxic in first trimester (cat B after that) what is a good abx for anaerobic infections below the diaphragm? - ANSWER metronidazole What is the treatment for bacterial vaginosis? - ANSWER metronidazole what is the treatment for trichomoniasis? - ANSWER metronidazole what is the treatment for giardiasis? - ANSWER metronidazole what is the treatment for mild C. Diff infections? - ANSWER metronidazole what are the drugs used to treat active TB? - ANSWER Rifampin, Isoniazid, Pyrazinamide, Ethambutol (RIPE) which drug can turn bodily fluids orange/red? - ANSWER rifampin which drug can cause red-green color blindness? and what is the actual cause of the blindness? - ANSWER ethambutol; optic neuritis what is the DOC for latent TB? how long do pts take it? - ANSWER Isoniazid; 9 months what are the anti-herpetic antivirals? - ANSWER acyclovir, valacyclovir, famciclovir what 2 drugs are used only for influenza A prophylaxis and treatment? - ANSWER Amantadine and Rimantadine what 2 drugs are used for influenza A and B prophylaxis and treatment? - ANSWER Oseltamivir and Zanamavir anti-flu drugs are only useful if taken within how long? - ANSWER 48 hours the anti-influenza medication Zanamavir is associated with what side effect? - ANSWER bronchospasm which antifungal is used for deep fungal infections (Cryptococcus, blastomycosis, etc)? - ANSWER amphotericin B which antifungal medication would you give a child with oral candidiasis (thrush)? - ANSWER nystatin S&S (swish and swallow) which antifungal medication would you give an adult with oral candidiasis? - ANSWER fluconazole which antifungal medication is used to treat vaginal or esophageal candidiasis? - ANSWER fluconazole what is a topical anti-fungal commonly used to treat vaginal candida infections? - ANSWER miconazole (monistat) what is the generic name for Lamisil? - ANSWER terbinafine terbinafine is typically used to treat what? - ANSWER onychomycosis and cutaneous dermatophyte infections when prescribing oral terbinafine, what labs would you order and when? - ANSWER terbinafine is hepatotoxic. order baseline LFTs and then periodically while taking the med what is the gold standard oral anti-MSSA drug? - ANSWER dicloxacillin what is the silver standard (2nd line) oral anti-MSSA drug? - ANSWER cephalexin (Keflex) what are the 2 most common anti-pseudomonal abx? - ANSWER ciprofloxacin and levofloxacin what 2 drugs are considered the gold standard anti-aerobic abx? - ANSWER metronidazole or augmentin what is the silver standard (2nd line) anti-aerobic abx? - ANSWER clindamycin what is the gold standard IV anti-MSSA abx? - ANSWER nafcillin (naf rhymes with staph) what is the silver standard (2nd line) IV anti-MSSA abx? - ANSWER cefazolin (ancef); which is a 1st gen cephalosporin and is used in perioperative prophylaxis what is the bronze standard (3rd line) IV anti-MSSA abx? - ANSWER vancomycin what are the 3 best oral abx for MRSA infections? - ANSWER linezolid (Zyvox), Doxy, TMP-SMX what is the gold standard IV MRSA drug? - ANSWER vancomycin