PANCE: Antibiotics-Exam questions and Answers

Inhibit cell wall production - ANSWER Β-lactams (PCN, cephalosporin, carbapenems) Monobactams Glycopeptides (vancomycin) Inhibit protein synthesis via 50S ribosome - ANSWER Macrolides, lincosamides Inhibit protei ...

Inhibit cell wall production - ANSWER Β-lactams (PCN, cephalosporin, carbapenems) Monobactams Glycopeptides (vancomycin) Inhibit protein synthesis via 50S ribosome - ANSWER Macrolides, lincosamides Inhibit protein synthesis via 30S ribosome - ANSWER Aminoglycosides, tetracyclines Inhibit DNA synthesis via topoisomerase inhibition - ANSWER Fluoroquinolones Alter bacterial DNA - ANSWER Metronidazole Inhibit folic acid synthesis - ANSWER TMP-SMZ Bactericidal Abx - ANSWER β-lactams Fluoroquinolones Glycopeptides Aminoglycosides Metronidazole Bacteriostatic - ANSWER Tetracyclines Macrolides Sulfonamides Time dependent killing - ANSWER β-lactams Concentration dependent killing - ANSWER Aminoglycosides, fluoroquinolones Hepatic excretion - ANSWER Ceftriaxone, Macrolides, metronidazole Ototoxic - ANSWER Aminoglycosides (gentamicin >>vancomycin) Minocycline (transient) Nephrotoxic - ANSWER Amphotericin B >> Gentamycin >> β-lactams (nafcillin) > Vancomycin Disulfiram-like Rxn - ANSWER Metronidazole (NO EtOH!!!) N/V/D, flushing, tachycardia, HA Red-man Syndrome - ANSWER Vancomycin Red-Lobster Syndrome - ANSWER Rifampin (due to red dye) Discolored teeth - ANSWER Tetracyclines (doxy, mino, tetra) NO PG or children < 8yo Loss of red/green vision - ANSWER Ethambutol Yellow babies - ANSWER Sulfonamides No 3rd trimester or neonates Cause hyperkalemia - ANSWER Trimethoprim (careful with Bactrim + ACE or ARB) Cause HypOkalemia - ANSWER Penicillins (esp Nafcillin) Associated with C. diff - ANSWER Amoxicillin, cephalosporins (esp cephalexin), clindamycin EBV + Abx = maculopapular, nonpruritic rash - ANSWER Any aminopenicillin (esp ampicillin) PG Category B - ANSWER Β-lactams, clindamycin, erythromycin, azithromycin, oral vancomycin, Metronidazole (not 1st trimester fetotoxic) PG Category C - ANSWER Clarithromycin, fluoroquinolones, TMP-SMZ, IV vancomycin PG Category D - ANSWER Aminoglycosides, tetracyclines PCN allergy - ANSWER Penicillins, cephalosporins, carbapenems Oral Gold standard for MSSA - ANSWER Dicloxacillin (cephalexin is silver standard) Oral Tx for MRSA - ANSWER Linezolid (Minocycline/doxycycline > TMP-SMX) TX for VRE - ANSWER Linezolid, oral or parenteral (VRE = vancomycin resistant enterococcus) Oral Tx for Pseudomonas - ANSWER Ciprofloxacin & levofloxacin Oral Gold Standard for Anaerobes - ANSWER Metronidazole or amoxicillin/clavulanate Silver = clindamycin Parenteral MSSA gold standard - ANSWER Nafcillin > cefazolin > vancomycin Parenteral gold standard for MRSA - ANSWER Vancomycin Parenteral Tx for anaerobes - ANSWER Β-lactam/ Β-lactamase inhibitor (piperacillin/tazobactum), carbapenems, metronidazole Tx: Strep Pharyngitis; cellulitis; syphilis - ANSWER PCN G or PCN VK Tx: skin & soft tissue infection, esp if suspect S. aureus - ANSWER Nafcillin (IV) or dicloxacillin PO Tx: URTIs, dental prophylaxis, Lyme Dz - ANSWER Ampicillin IV or Amoxicillin PO Tx: Animal/Human bite, Amoxicillin failure URTI, recurrent strep pharyngitis, SSTIs, dental infection - ANSWER Ampicillin/sulbactam IV or amoxicillin/clavulanate (Augmentin PO) Tx: CAP, meningitis, gonorrhea - ANSWER Ceftriaxone (+azithromycin for CAP) Tx: URTI, outpatient CAP, non-gonococcal urethritis/cervicitis, tick borne Dz - ANSWER Doxycycline, Tetracycline, minocycline, Tx: URTI, CAP in/outpatient, - ANSWER Clarithromycin, azithromycin Tx: peptic ulcer dz/ H. pylori - ANSWER Clarithromycin SE: arthropathy, tendinopathy, CNS toxic, photosensitivity, QT prolongation - ANSWER Fluoroquinolones (CI < 18 yo) Tx: upper & lower UTI, enteric infection, traveler's diarrhea - ANSWER Ciprofloxacin or levofloxacin (fluoroquinolone) Inhibits CYP2C9 - ANSWER TMP-SMZ (CYP2C9 breaks down Warfarin) Tx: PCP - ANSWER TMP-SMZ Fluconazole Tx: BV, C. diff, giardiasis, trichomoniasis - ANSWER Metronidazole 1st line Antimycobacterials - ANSWER Isoniazid (INH) Rifampin (RIF) Pyrazinamide (PZA) Ethambutol (ETH) Tx: CMV - ANSWER Ganciclovir Tx: oropharyngeal candidiasis - ANSWER Nystatin Tx: Skin fungal infection, topical - ANSWER Clotrimazole Tx: Vaginal fungal infection, topical - ANSWER Miconazole Tx: fungal infection, systemic Tx - ANSWER Fluconazole Tx: onychomycosis - ANSWER Terbinafine (hepatotoxic, order LFTs) TOC Bordetella pertussis - ANSWER