E1: DR. WOOD'S HINTS :D (copy)

which beta lactams cover pseudomonas

Piperacillin/Tazobactam (Zosyn)
Ceftazidime
Cefepime
Aztreonam
Imipenem, Meropenem, Doripenem

can't be given in the first 30 days of life

Ceftriaxone (Rocephin)

used instead of Rocephin for neonates

cefotaxime

does NOT need renal adjustment

Ceftriaxone (Rocephin)

PCN that needs renal monitoring

Piperacillin

needs therapeutic drug monitoring

Vanco & aminoglycosides

contraindicated in seizures

Imipenem

can cross CSF

Cephalosporins

Beta lactamase inhibitors cover for...

anaerobes

what should u do if pt has Red Man Syndrome

decrease the dose of vanco (check troughs!)

what is another option if carbapenems or pipercillin aren't working?

tigecycline

if you double cover for something make sure it's 2 different MOAs

don't use 2 beta lactams to cover for pseudo

(can use cefipime and ciprofloxacin for ex)

*he specifically said DO NOT pick piperocillin + imipenem or piperocillin + cefipime

worried about pt getting aspiration pneumonia (anaerobes get introduced to lungs) what could u use?

clinda

(covers MRSA & anaerobes - unique coverage!)

clinda is good to use for..

- skin
- TSS

what is special about moxifloxacin

metabolized in the liver so it won’t treat UTIs

overuse (resistance) is high in which abx

FQs!

FQ adverse effects

- GI motility
- QTc interval
- tendinitis
- chelates w cations

do macrolides cause a QT prolongation?

YES

QT prolong is caused by....

blockage of K channels

what covers VRE??

linezolid (zyvox) & dapto

DAPTO DOESNT COVER _______

PNEUMONIA

pt was on vanco for MRSA pneumonia, come back and its VRSA, what would u do next?

NOT dapto

(zyvox would be good option)

monitor for ______ with dapto due to myotoxicity

CPK

tetracycline ADRs

- don't give <8yrs (yellow teeth)
- don't give 2nd & 3rd trimester (suppresses bone growth)
- chelates with cations
- photosensitivity

monitor renal function with the trouphs for ________

aminoglycosides

_______ causes c diff

clinda

______ can be used to treat immunocomp people

sulfa

sulfa ADRs

- SJS (skin sloughs off)
- warfrin = ↑ INR = ↑ bleeding time

azoles inhibit

CYP3A4

______ sucks

amphotericin

(nystatin is great)

________ and _______ treat nail infections which have long treatment times, which have an inc treatment failure due to patient compliance

allyamines and griseofulvin

most common azol

fluconazole (vaginal & yeast infxns)

why is it easy for voriconazole to cause toxicity?

it has an IV vehicle (cyclodexterin)

which azols have a long QT interval

posaconazole & ketoconazole

_____ treats worms

antihelminth

fluoroquinolones inhibit _______

DNA gyrase (bacteriocidal!)

how does sulfa inhibit DNA synth

inhibits folic acid

all protein inhibitors are bacteriostatic EXCEPT

aminoglycosides & dapto (bacteriocidal)

He doesn't care that we know if the proteins are 30s vs 50s just that they're proteins

:p

what does vanco cover?

MRSA & c.diff

duhhhhhh

Fungals: MOA of cell membrane inhibitors

decrease ergosterol

Fungals: MOA of cell wall inhibitors

inhibits d-glucan synthesis

Fungals: MOA of cell division inhibitors

inhibits dermatophytes

Fungals: MOA of nucleic acid inhibitors

inhibits thymidylate

Antihelmiths: MOA of benzimadoles

inhibits glucose uptake -> kill parasite

** for all the MOA's know each category and the abx in them!

for ex - he'll prob give us caspofungin and ask for it's MOA (d-glucan synthesis!)

_______ distorts hyphae

Tolnafate

drugs for AOM

1st - amoxicillin

2nd - aug

allergic to PCN - azith or cefdinir or rocephin

kid diagnosed with AOM and had amoxicillin, 3 days later they're still complaining of pain. what do you give?

cefdinir! (or aug)

pt presenting with history of asthma and develop a thrush infection, what would you rx to treat it?

nystatin

can you use valacyclovir via IV?

no! its a pro-drug, have to take PO