DOC
What is the drug of choice for MRSA?
IV Vancomycin
Why do you want to avoid bactrim in pregnancy?
neural tube defects - 1st trimester
Kernicterus - 3rd trimester
What are the main adverse effects of bactrim?
Photosensitivity and SJS
others:
GI, dose-dependent bone marrow suppression, anemia, crystalluria, ATN
Which medications are protein synthesis inhibitors?
Clindamycin, Tedizolid, Linezolid
What is the only clinical use for nitrofurantoin and max amount of days it can be used? what are main bacteria it covers? (3)
UTI and never more than 7 days
coverage:
good - e. coli, staph sap., enterococcus
(other) modest - klebsiella, citrobacter, proteus
What is drug of choice for trichomonas vaginalis?
Metronidazole
When is nitrofurantoin contraindicated and why?
Pregnancy in patients at term (38-42 weeks), and neonates- induce hemolytic anemia
Pts with renal function decline: CrCl < 30
What are main adverse effects of tedizolid/linezolid?
Myelosuppression
other: anemia, neuropathy
What medication is time dependent?
Bactrim
Other: beta lactams
Which two medications cover anaerobes?
Clindamycin, metronidazole
What is the drug of choice for gonorrhea?
Ceftriaxone
Which medications are safe in pregnancy? (3)
Clindamycin, metronidazole, vancomycin
What medication causes "red-man" syndrome and how do you fix it?
rapid infusion, slow infusion
not allergy related
Which medications are bacteriostatic? (3)
Clindamycin, linezolid, tedizolid
other: macrolides, tetracyclines
Which medication is the only one that has coverage for Haemophilus and Moraxella?
Bactrim
What is the drug of choice for enterococcus in a patient with a true penicillin allergy?
IV Vancomycin
Why should you use caution when treating an obese patient with vancomycin?
Accumulation of drug
What is common adverse effect for metronidazole?
Metallic taste
other: GI
Which medications are concentration dependent?
Nitrofurantoin, daptomcyin
How can vancomycin be used to treat C. diff? Why does it have to be that way? What does vancomycin cover normally?
C. diff - when given orally, not absorbed via the gut
gram positive! staphylococcus, streptococcus, enterococcus
What 4 things is Bactrim the DOC for?
PCP, toxoplasma gondii, nocardia, stenotrophomonas maltophilia
What are the only four medications that don't require renal adjustments?
Tedizolid, linezolid, clindamycin, metronidazole
What are the two severe adverse effects associated with clindamycin?
SJS and C. diff
Which medications are cell wall synthesis inhibitor AND cell membrane depolarization?
Telavancin, oritavancin, dalbavancin
Which medications cover gram positive? (MSSA, MRSA, streptococcus pyogenes, penumoniae, enterococcus)
Vancomycin, daptomycin, televancin, dalbavancin, oritavancin, linezolid, tedizolid
Bactrim - DOES NOT COVER enterococcus
Clindamycin - doesnt cover enterococcus requires too high of doses basically untreatable