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Top 100 Drugs (Brand-Generic) > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Gram + cocci

A

Streptococcus

Staphy

Enterococcus

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2
Q

Gram + Rods

A
  • Diphtheriae
  • Listeria
  • Anthrax
  • Clostridium species*
  • = anaerobic
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3
Q

Gram - Cocci

A
  • Neisseriae

- Moraxella

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4
Q

Gram - Rods

A
  • e. Coli
  • Psuedomonas
  • Haemophilus Influenzae
  • Helicobacter Pylori
  • Shigella; Salmonella
  • Campylobacter
  • Bacteroides. Fragilis
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5
Q

Altabax

A

Retapamulin

Cream/ointment used for

  • Impetigo!!**

MSSA only!!

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6
Q

How to treat MRSA colinization

A

Bactoban Nasal single use tubes

Hibiclens soap sln

 - (4% Chlorhexidine)
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7
Q

MRSA DOC (PO/IV)

A

PO outpatient ABX:

  • Bactrim
  • Doxycycline
  • Clindamycin
  • Linezolid (Zyvox), Tedizolid (Sivextro)
    Delafloxacin (Baxdela);
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8
Q

MRSA IV ONLY

A

Daptomycin (cubicin)

Cedtaroline (Teflaro)

Quinupristin/ Dalfoprostin (Synercid)

Tigecycline (Tygacil)

Dalbavancin (Dalvance)

Ortivancin (Orbactiv)

TELAVANCIN (Vibativ)

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9
Q

ABX for Pseudomonas aeruginose

A

Anti-pseudomonal PCN’s:

 - Ticarcillin + Clav(Timentin)
 - Piperacillin + Tazobactam (Zosyn)

Anti-Pseudomonal CEPH’s:

 - Cedtazidine(Fortaz)
 - Cefepime (Maxipime)
 - Cedtazidime + Avibactam (avycaz) 
 - Ceftolozane + tazobactam (Zerbaxa) MDR

Carbapenems (NOT ERTAPENEM)

Fluoroquinolones (Cipro/ Levaquin)

Aminoglycosides: (Not as single agent)

Monobactam: Aztreonam (Gram - ONLY)

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10
Q

H. Pylori Triple Therapy

A

PO BID x 14 days

1) Clarithromycin 500mg BID
2) Amox 1g BID
3) PPI (BID)

Note: FOR PATIENTS W/ no HISTORY OF MACROLIDE RESISTANCE!!!

Note: If PCN allergy use Flagyl instead

Prevpac: combination package for 14 days:

Amox + Clarithromycin + Lansoprazole (Prevpac)

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11
Q

H. Pylori

Bismuth Quadruple therapy (10-14d)

A

1) Bismuth
2) Metronidazole
3) Tetracycline
4) PPI

Note: pts w/ risk factors for MACROLIDE RESIStance

Pylera: combo of Bismuth, Flagyl, Tetracycline
3 CAPS QID after meals and at HS x 10d

Concomitant Therapy:

  - Triple Therapy + Metronidazole

Clarithromycin + Amox + Metronidazole + PPI

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12
Q

Infective Endocarditis

A
  • STREP
  • STAPHY
  • Enterococcus

Emp Tx:

- pref: Vanco IV +/- gram(-) coverage
- alt: Oxacillin/Nafcillin + Gentamicin - **Pathogen specific therapy for 4-6 WEEKS**
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13
Q

Infective CARDITIS dental ppx

A

Done in certain CARDIAC patients prior to dental procedures

  • AMOX 2g PO 30-60 min prior to procedure

If PCN allergy:

1) Clindamycin 600mg PO
2) Azithromycin 500mg PO
3) Clarithromycin 500mg PO

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14
Q

Cellulitis/ Erysipelas/ Abscess

A

Superficial: STAPH AND STREP

-Cellulitis: Mostly STREP and MSSA

  DOC: Keflex

Abscess: 50% MRSA

 DOC: Bactrim, doxycycline/ Clindamycin —————————————————————— Diabetic skin infections: POLYMICROBIAL
  • Gram(+), Gram(-), and anaerobes

#Deep: Also cover Gram(-) and Anaerobes
——————————————————————
Animal/ Human bites:

  • Tx: Augmentin, Tdap
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15
Q

Intra-Abdominal Infections

  • Usually post surgery
A

B. Frag: Gram(-) Rod
E. Coli: gram (-) Rod
Enterococci: gram(+) cocci
Peudomonas: gram(-)

Empiric Tx:
———————
1)single agent:Ertapenem, Zosyn, Timentin

2)combos: Levaquin/ Cipro + Metronidazole

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16
Q

Acute Gastroenteritis

A

Diarrhea, abd pain, n/v, maybe fever

Majority: VIRAL, Rotavirus in children and Norovirus in children

Tx: supp care and volume/ electrolyte replacement
————————————

Bacterial causes: Salmonella, Shigella, Campylobacter, e.coli,

Tx: levaQuin, Rifaximin, Azithromycin

Giardia: Treat w/ METRONIDAZOLE

C.diff: flagyl or oral vanco

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17
Q

Diverticulosis/itis

A

Osis: high fiber diet

Diverticulitis: Infection of bulging pouches in colon wall

Tx: E.coli and b.frag

 - Cipro + Metro
 - Bactrim + Metro
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18
Q

Osteomyelitis

A
  • STAPH aureus
  • Aerobic bacilli (Pseudomonas)

Tx: Outpatient IV Abx therapy via PIC line 6 weeks

- Zosyn(Pip-taz)
- unasyn(amp-sulbactam)

If PCN allergy: cipro/levQuin + metro or Clinda

Id MRSA: Vanco/ Daptomycin

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19
Q

UTI/PYELONEPHRITIS

A

Bugs: PEKEPS (Proteus, E.colo, Klebsiella, Enterococci, Pseudomonas, Staph saprophyticus)
——————————————
Tx: Acute cystitis
- Bactrim, Nitrofurantoin, Fosfomycin

Pyelonephritis
- Bactrim, URINARY FQ(cipro/ levaquin)

-MOXIFLOXACIN- AVELOX NOT USED FOR UTI- doesnt concentrate in URINE/Kidneys

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20
Q

Prostatitis

A

Urinary FQ for 28-30 days

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21
Q

Community acquired pneumonia

CAP

A

Bugs: Pneumococcus, Mycoplasma, Legionell, Haemophilus, Klebsiella, Pseudomonas, MRSA

OUT-PATIENT:
- Low rate (<25%) of macrolide RESIST
(MACROLIDE OR DOXYCYCLINE)

-High rate (>25%) of Macrolide resist: DOXY

Comorbid conditions, recent ABX, or ^ rate of local Doxy RESIST:
- Beta-Lactam PLUS MACROLIDE OR DOXY

 - Resp Quinolone (Levo, moxi, gemi)
    **NOT CIPRO** ———————————————————

Adult Inpatient Non-ICU:

  • IV beta-lactam + Macrolide OR
  • IV Resp FQ

Adult inpatient ICU:
- IV Beta-Lactam + Macrolide or FQ
- IV FQ + aztreonam
—————————————————————

If susp of MRSA: vanco, Linezolid, Clindamycin

If susp Gram(-) bacilli
- RECENT HOSPITILIZATIONS, CYSTIC FIBROSIS, ALCOHOLICS, COPD

  • TREAT w/ ANTIPSEUDOMONAL BETA-lactamb+ RESP FQ!!
    ——————————————————
    PEDIATRIC CAP:
  • Outpatient: ^ dose of Amox, cefdinir, Clinda, macrolide
  • Inpatient:Ampicillin, PCN G, Ceftriaxone, Cefotaxime
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22
Q

Meningitis

A

Bugs: Pneumococcus, Neisseria, H.influ

Empiric tx: Ceftriaxone + Vanco

Close contact: Vaccine and Abx ppx
——————————————-

Neonatal Meningitis: Exposure to E.coli and GBS during BIRTH. 3rd most common cause is LISTERIA!!

Empiric tx(Nosocomial) 
    - amp+ gent
Empiric Tx(Community)
    - amp+ gent
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23
Q

Chlamydia

A

Tx:

  • Doxyycline 100mg BID X 7 days
  • Azithromycin(preferred) 1 g x 1 dose
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24
Q

Gonorrhea

A
  • Ceftriaxone 250mg IM x1

PLUS

  • Azithromycin 1g x 1

NOTE: **If allergy to cephs, Then Azithromycin 2g PLUS Gentamicin or gemifloxacin

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25
Q

Syphillis

A
  • Benzathine PCN G IM
    2. 4 MILLION UNITS X 1-2

If PCN allergy: THEN DOXY for 14-28 DAYS

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26
Q

Genital Herpes

A

Supression

- Valacyclovir (Valtrex) 500mg po QD
- Acyclovir (Zovirax) 400mg po BID
- Famciclovir (Famvir) 250mg po BID
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27
Q

Trichimonas

A
  • Single 2 g dose of either
    • METRONIDAZOLE
    • TINIDAZOLE(TindaMAX)
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28
Q

Human papillomavirus (HPV)

Warts/ Cervical CA

A
  • Vaccinations, Cyrotherapy, Liquid Nitrogen,

- Trichloroacetic acid, Imiquimod(Aldara), podofilox

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29
Q

Scabies (MiTES)

A

Severe Itching that is usually WORST at night,

SCRATCH can cause Impetigo

Tx: Topical PERMETHRIN (Elimite)CREAM

   ORAL ivermectin (Stromectol) (off-label)

   TOPICAL SULFUR
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30
Q

Pinworm

-Enterobius vermicularis

A

Anal itching
(Scotch tape and paddle test)
COMMON IN CHILDREN

Tx:
——-
- Treat WHOLE FAMILY
- Mebendazole(Emverm) single tablet 100mg x1
- Albendazole(Albenza) 400mg x1
- Oral pyrantel Pamoate (REESE Pinworm med) OTC

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31
Q

Common Bugs

Otitis Media

A
  • Pneumococcus,
  • H.influenzae
  • Moraxella
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32
Q

common BUGS

Meningitis in NEWBORN

A

GBS

E.Coli

Listeria

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33
Q

Common BUGS

MENINGITIS IN INFANTS/CHILDREN

A

*Pneumococcus

Neisseria

H.Influ, type b

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34
Q

Common BUGS

MENINGITIS IN ADULTS

A

*Pneumococcus

Neisseria

Haemophilus. Influ

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35
Q

COMMON BUGS

MENINGITIS IN ADOLESCENTS

A
  • Neisseria

Pneumococcus

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36
Q

UTI (COMMON BUGS)

A

*E.coli

PEKEPS(proteus, E.coli, Klebsiella, Enterococci, Pseudomonas, staph. Saprophyticus)

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37
Q

Endocarditis (COMMON BUGS)

A
  • staph aureus

Strep viridans

Enterococcus

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38
Q

Cellulitis (COMMON BUGS)

A

*staph aureus(MRSA;MSSA),

Strep, Type A

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39
Q

Cystic Fibrosis (COMMON BUGS)

A

Pseudomonas, Haemophilus

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40
Q

Infected diaper RASH

A

Candida albicans

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41
Q

Penicillin

A

MOA: Inhibit cell wall

Forms: VK; GK; Benzathine (IM)

Spectrum: Strep, Peptostrep, Treponema

Treats: DOC(syphillus), dental ppx, pharyngitis,

Kinetics: KIDNEY (Watch for RENAL) fx**

Pregnancy category B (GENERALLY safe in PREGNANCY)

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42
Q

Bicillin L-A

A

Benzathine Penicillin

Treats: Group A strep: 1.2 million U x 1
RF: 1.2 million U IM QMONTH
SYPHILLUS: 2.4 MU IM x1 dose

             - Tertiary syphillis: IM qW x3 doses
  • NOT given IV
  • LAST 2-4 weeks
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43
Q

Bicillin C-R

A

Procaine penicillin + benzathine penicillin

Caution: NOT EQ TO BICILLIN LA

Treats: Scarlet fever, skin/soft tissue, Group A strep

2.4 Million Units IM x 1 dose

Caution: NOT USED FOR SYPHILLUS

            *NOT GIVEN IV*
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44
Q

Penicillin G

A

IV FORMULATION!!

Treats: 
———————————————
1) Pneumococcal Pneumonia
2) Meningitis
3) Neurosyphilis
4) Anthrax (Bioterrorism)

8-24 million U/d IV divided 4-6 hours

Decrease dose by 1/2 if CrCl< 10

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45
Q

Pen-Vee K; Veetids

A

Penicillin V

ORAL FORMULATION

250-500mg PO qid EMPTY STOMACHE

SOLUTION IS stable in refrigerator for 14 days

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46
Q

Pre-Pen

A

Benzylpenicilloyl polylysine

-skin testing for allergic patients:

1 drop in needle scratch; then 0.01-0.02ml intradermally if no reaction

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47
Q

Penicillinase Resistant PCN’s

A

COND

Cloxacillin (not avail)

Oxacillin: HEPATOTOXIC: if dose > 12 QD: LFT

NAFCILLIN: MSSA: 1-2g IV q4-6h
(NO ADJUSTMENT IN RENAL IMPAIRMENT)

Dicloxacillin - Empty stomache

METHICILLIN: Not avail
——————————————————
Note: THESE DRUGS ARE USED FOR STAPH AUREUS ONLY. MSSA BUT NOT MRSA.

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48
Q

Ampicillin

A

Aminipenicillin

Spectrum: strep, enterococci, LiSTERiA

Form: IV/PO (EMPTY STOMACHE)

SE: RASH, Diarrhea

DOC for ENTEROCOCCUS

Suspension stability

  - 7 days at room temp
  - 14 days in refrigerator

Decrease dose if CrVl < 10

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49
Q

Amoxicillin

MoxaTag (ER, 775mg QD)

A

AminoPCN

Dose: 250-500mg q8H or 500-875 po Q12

Forms: TABS IR/ER: Oral SUSP/ Infant Drops (stable for 14 days room temp & refrigerator)

Indications: OTITIS MEDIA( 1st Line) - 90mg/kg/d**

                 **Dental ppx (2G 1 hour prior) **

REMEMBER THE DOSAGES. TOP 100 drug

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50
Q

Beta-lactam combo’s

Spectrum of coverage

A

Zosyn (pip-taz) IV

Unasyn (Ampicillin/sulbactam) IV

Augmentin (Amox/ clavulanate) PO/SUSP ORAL

Zosyn/ Timentin are anti-pseudomonal
————————————————————-

By adding B-lactamase we gain BACK activity

  • staph aureus
  • Enterococcus
  • Streptococcus
  • B.frag
  • H.influ
  • M. Cat

**Pseudomonas (Zosyn/ Timentin ONLY)

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51
Q

Unasyn

A

AminoPCN + Beta-Lactamase Inhibitor

Amp/Sulbactam

Forms: IV/IM ONLY

DOSE: 1.5-3.0 g q6H

Most stable: NORMAL SALINE

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52
Q

Augmentin (amox+clav)

A

Forms: tabs BID
CHEWABLE/ SUSP BID

AUGMENTIN ES: 600mg susp. BID W/ Food
AUGMENTIN XR: 1000mg amox + 62.5mg claV BID W/ FOOD

  - contraindicated w/ crcl < 30ml/min - REFRIGERATE SUSP
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53
Q

Zosyn

A

Piperacillin/tazobactam

  • Dose adjust in RENAL iMPAIRment

COVERS PSEUDOMONAS

DOSE ADJUST IN RENAL iMPAiRMENT

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54
Q

Adverse EFFECTS of PCN and METABOLITES

A

HYPERSENSITIVITY

CNS: SEIZURES

GI TOXICITY: Diarrhea

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55
Q

Which bugs are cephalosporins NOT effective w?

A

1) anaerobes
2) Enterococci
3) MRSA
4) ListeriA

(MEAL)

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56
Q

First GEN CEPHS

GENERAL INFO

A

Spectrum: Gram(+) and PEK organisms(Proteu, E.coli, Klebsiella)

  • ALL pregnancy CATEGORY B and RENAL
  • USUALLY FIRST LINE FOR SURGICAL PPX!
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57
Q

Keflex

A

Cephalexin

1st GEN

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58
Q

Ancef

A

Cefazolin (1st GEN)

Forms: IV/IM Q6-8h;DOC for surgical PPX

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59
Q

Duricef

A

Cefadroxil

1st GEN ceph

Forms: PO/suspension

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60
Q

Second generation CEPHS

Spectrum of ACTIVITY!!

A

2nd GEN are a 2nd line for OTITIS MEDIA(AMOX IS 1st LINE)

Greater activity against gram (-) organisms HENPEKS
———————————-

H. Influ

ENterobacter

neisseria

E.coli

Klebsiella

Strep pneumoniae

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61
Q

Cefaclor

A

2nd GEN

FORMS: PO

Not used as much

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62
Q

Cefzil

A

2nd GEN

FORM: PO ONLY

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63
Q

CEFTIN; ZiNACEF

VERY COMMON

A

CEFURIXIME

FORMS: IM/IV/PO

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64
Q

Mefoxin

A

Cefoxitin

2nd GEN

FORM: IV ONLY

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65
Q

Cefotetan

A

2nd GEN CEF

FORMS: IM/IM

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66
Q

Which 2nd gen CEPHS do have activity against anaerobes (b. Fragilis)

A

1) Cefoxitin
2) cefotetan

(CAN BE USED FOR INTRAABDOMINAL SURG)

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67
Q

Which CEPHS cover pseudomonas?

A
  • Ceftazidime (Fortaz) 3rd gen
  • Cefepime (4th gen)
  • ceftolozane/tazobactam (Zerbaxa) (5th gen)
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68
Q

3rd GEN ORALS

PO DRUGS ONLY

A 
Omnicef (Cefdinir) - PO
**COMES IN SUSP AND YOU DO NOT REFRIGERATE**
**DONT COMBINE WITH MULTIVIT OR ANTACIDS
—————————————————
SPECTRACEF (cefditoren)
**CONTRAINDICATED WITH MILK/PROTEIN ALLERGY**
—————————————————
Suprax (cefixime)
-CoverGe against N.gonorrhea
———————————————-
Vantin (cefpodoxime)

Cedax (Cefibutin)

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69
Q

3rd GEN CEPHS (Parenteral)

A

*Ceftazidime (Fortaz;Tazicef
IM/IV, Antipseudomonal

Ceftaz/avibactam (Avycaz)
TYPICALLY FOR MORE RESISTANT Enterobacteriaceae, Klebsiella, Pseudomonas, BUT NOT USED FOR ACINETIBACTER

IV- Over 2H for conplicated abdominal inf and UTi

Cefotaxime (Claforan): IM/IV

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70
Q

Rocephin

KNOW VERY WELL (COMMON)

A

Ceftriaxone

Form: IM/IV ONLY

Treats: 1) Meningitis and ENDOcarditis
(2g IV Q12)

         2) Goborrhea: Ceftriaxone 250mg IM + 
                                  Azithromycin 1g

NO RENAL ADJUSTMENTS

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71
Q

Maxipime

A

Cefepime (4th GEN)

Anti-pseudomonal covers gram-/+

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72
Q

Fifth GEN CEPHS

A

Teflaro (Ceftaroline) - IV

CEFTOLOZANE/Tazobactam (ZERBAXA) - IV

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73
Q

Teflaro

A

Ceftaroline (5th GEN)

Forms- IV ONLY

Treats: CAP (but not for MRSA PNA)
SSTI (MRSA APPROVAL IS FOR SKIN INFECTIONS ONLY

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74
Q

Zerbaxa

A

Ceftolozane/ tazo

5th GEN

IV ONLY

TREATS: IntraAbdominal Infections w/ FLAGYL

            COMPLICATED UTI*

RENALLY DOSE ADJUST

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75
Q

Carbapenems

Spectrum and GENERAL INFO

A

SOA: Gram(+) EXCEPT MRSA
GRAM (-) and Anaerobes

  • ALL cover Pseudomonas, acinetoBACTER, Enterococcus EXCEPT ERTAPENEM
  • Useful for intraabdominal infections and DOC for pancreatitis

Vabomere(Meropenem + vaborbactM)
Complited UTI/puelonephritis

TECHNICALLY DO NOT GIVE WITH PENICILLIN ALLERGY

Cause SUPER-INFECTUONS: Fungus!!

DOSE DEP SEIZURE (ESPECIALLY W/ Primixin)
——————————————————
DI: Decrease VALPROIC ACID LEVELS AND CAN CAUSE SEIZURE IN PATIENTS WHO HAVE SEIZURES

^ Increase seizures w/ ganciclovir

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76
Q

Azactam

A

Aztreonam (MonoBActaM)

Aerobic gram(-) ONLY, w/ Pseudomonas

Treats: UTi (IM,IV): 500mg to 1g q8-12H

         SEVERE SYSTEMIC UNFECTIONS

         CYSTIC FIBROSIS

ADVERSE EVENTS: SKIN RASH

  • Used if nephrotoxicity from AG
  • USED FOR PENICILLIN ALLERGY*
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77
Q

VancOmyciN

A

MOA: InhibITS CELL WALL phospholipids

Spectrum: MRSA; ALL GRAM(+), PCN/ceph allergic patientz

AR: OTOTOXICITY, NEPHROTOXICITY, RED-MAN SYNDROME

Peak 20-30 mcg/l

TROUGH: 10-20 mcg/ml

HIGHER TROUGHS OF 15-20 are RECOMMENDED FOR: Bacteremia, Endocarditis, Osteomyelitis, Meningitis, HAP PNA CAUSED BY S.aureus

Trough: USUALLY DRAW WHEN STEADY-STATE HAS BEEN REACHED USUALLY BEFORE THE 4th DOSE

2nd line agent for: c.diff oral form (REALLY THIS IS FIRST LINE NOW!!!)

Maint dose: 15-20mg/kg given over ATLEAST 1 hour

REDMAN SYNDROME W/ rapid IV infusion

Crcl > 50 Q8-12

20-49 QD

< 20, depends on serum levels

C.diff: 125mg PO QID x10 days

78
Q

AmiNOglycosides

A

GENTAMYCIN/TOBRAMYcin, NEOMYcin, and Amikacin!!

Coverage: Pseudomonas and gram(-)

SE: NEPHROTOXICITY
OTOTOXICITY
- Neuromuscular BLOCK

  • POST AB EFFECT
  • Conc DEP killing

Gentamicin/Tobramycin

       - Peak 5-10, Trough <2
—————————————-
Amikacin 
        -peak 20-30, trough <5
—————————————-
Trough: drawn immediately after next dose 30 min prior

Prak: 15-20 min after IV Infusion or 90 mins after an IM injection

79
Q

Cortisporin

A

Neomycin/ polymyxin B, Hydrocortisone

80
Q

Cubicin

A

Daptomycin w/ NORMAL SALINE

FORM: IV ONCE DAILY

TREATS: complicated SKIN, not used in PNA.

Unlabled use: VRE!!!

MOA; Binds to cell membrane and cause depolarization. CIDAL.

Gram(+) ONLY; NEVER IN THE LUNGS!!

RENAL

SE: Neuropathy/ Myopathy

PREGANCY CAT B

Dont use for PNA

81
Q

What alternatives can you use for GRAM(+) for Cubicin

A

Zyvox (Linezolid)

Synercid

82
Q

FLOUROQUINOLONES (FQ)

General INFO

A

MOA: DNA GYRASE

SPECTRUM: gram(-); ATYPICALS

Treat: CAP; UTI; STD’s

Caution: AVOID IN CHILDREN AND PREGNANCY (Can cause arthropathy; cartilage erosion)

Counseling pts: SEPERATE ANTACIDS, Vitamins, Didanosine (quinALONE)

NOT FOR CHILDREN < 18YO

DRUG INT: ^ THEOPHYLLINE; ^Warfarin

83
Q

FQ SIDE EFFECTS:

A

CNS: (HA, Dizziness, seizures)

CRYSTALLURIA: Nephrotoxicity (DRINK FLUID!!!)

PHOTOSENSITIVITY

QT prolongation(moxi-Avelox)

TENDON RUPTURE especially if on CORTICOSTEROID: BBW!!

PSEUDomembranous COLITIS

PERIPHERAL NEUROPATHY/ exacerbate MUSCLE WEAKNESS

ASSOCIATED W/ HYPO: HYPERGLYCEMIA

84
Q

2nd GEN FQ’s

A

CiPRO

OFLOXACIN (Ocuflox; eye/ear/ PO tabs)

Cover: UTI’s/ PSEUDOMONAS/ Gram(-)/ SSTi/ Osteomyelitis

CAUTION: $$$$NEVER USE 2nd gen for PNEUMONIA, NEVER USE CIPRO FOR PNA!!!$$$$

85
Q

3rd GEN CEPH’s

A

Levofloxacin(LEVAQUIN)

Covers: MSSA, Gram(-), & atypicals: C. Pneumoniae and M,Pneumoniae

Respiratory tract (PNA)/ SSTI/ UTi

Note: LEVAQUIN IS PROBABLY MOST BROARD SPECTRUM AND CAN BE USED AGAINST UTI AND PNA$$

86
Q

Fourth GEN CEPH’s

A

Gatifloxacin, Moxifloxacin

Coverage: Anaerobic bacteria

(Dont use MOXIFLOXACIN: AVELOX AGAINST UTI

87
Q

Baxdela

A

Delafloxacin

Forms: PO/IV

MRSA/ strep/ e.coli/ klebsiella, Enterobacter, Pseudomonas

88
Q

Cipro/ cipro XR/ ProQuin XR

A

Ciprofloxacin

Dose: 250-500 q12H

Forms: ciproDEX (otic)(Cipro/dexamethasone)
Otolevel (cipro/fluocinolone)
Ciloxan (ophthalmic; EYE)

IV is 80% of ORAL

Reduce dose in RENAL IMPAIRMENT

DI: Inhibits cyp1A2 - caffeine/theophylline/ warfarin/ hypoglycemia w/ glyburide

  • 2h before or 6h AFTER ANTACIDS/ Ca+ products/ viramins

OATP Inhibitors: Orange juice, apple juice, green tea DECREASE LEVELS OF CIPRO!!

  • DO NOT GIVE ORAL SUSP THROUGH A FEEDING TUBE!!
89
Q

Levaquin

A

Levofloxacin (3rd GEN)

Forms: IV/PO/ORAL Solution

750mg QD for CAP
500mg Qd for 7DAYS

PROSTATITIS: use for 28 DAYS

^ INR, monitor SUGARS with SULFONYL UREAS

90
Q

Zymaxid

A

Gatifloxacin

Ophthalmic 0.5% soln

4th GEN

91
Q

Factiva

A

GEMIFLOXACIN

PO TABLETS

4th GEN

Chronic bronchitis
Community acquired pneumonia

  • D/C if pts get a RASH
92
Q

Avelox

Vigamox- Eyes

Moxeza- Eyes

A

Moxifloxacin

4th GEN CEF.

NEVER GIVE FOR UTi!!!

Form: 400mg PO/IV

ADMIN: INFUSE OVER 1 HOUR (Like Vanco)

CONTRAINDICATED W/ Ziprasidone (GEONDON)

AVOID IN HEPATIC FAILURE!!

Safe in renal impairment????

93
Q

Besivance

A

Besifloxacin

0.6% ophthalmic (SUSPENSION)

Make sure to SHAKE BEFORE USING

94
Q

Baxdela

A

Delafloxacin

Treats: SSTI(MRSA), PseudomoNAS, gram(-)

Dose: IV/PO

NOT RECOMMENDED IN ESRD <15

95
Q

HOW TO TREAT UTI!???

A

Uncomplicated cystitis (UTI)

- BACTRIM
- Nitrofurantoin (Macrobid)
- Fosfomycin (Monurol)

If need quinolone, suggest CIPRO, Levaquin is too broad unless PYELONEPHRITIS

Advise physician to not use Moxiflox/gemifloxacin as it does NOT REACH THE URINE
———————————————-
1st Line for Pyelonephritis: CiPRO, Levaquin/ Bactrim

96
Q

Biaxin; Biaxin XL

A

Clarithromycin

Treats: Group A strep, sinusitis, CAP, MAC 250-500mg BID

P450 INHiBiTOR
——————————-
Renal 
           Decrease by 50% for 30-60ml
           Decrease by 75% for < 50ml

Counseling: Take Biaxin XL w/ food

Forms: *DO NOT REFRIGERATE SUSPENSION**

97
Q

zMax; ZithroMAX

A

Azithromycin

Forms: Tabs: 250, 500, 600
Suspension 100;200/5mL - EMPTY STOM.
Z-pack # six 250mg tablets x5 days
Tri-Pack # THREE 500mg tabs

         Zmax: XR oral SUSP. 2 GRAMS 60mL single dose BOTTLE. Store at ROOM TEMP. MUST USE W/I 12 HRS) - EMPTY STOMACHE
            - IV 500mg over 1 HOUR
———————————————————-
Caution:  - IV site rxn.
                - HEARING LOSS
                - QT prolongation
                - DOES NOT INHIBIT P450
                - DONT TAKE W/ antacids
                - OBSERVE patient for GI upset; if vomit after 1 hour, no need to redose.
98
Q

Dificid

A

Fidaxomicin

MOA: Inhibit RNA synthesis by inhibiting RNA polymerase.

Dose: 200mg bid x10

SE: nausEa/vomiting

Pregnancy CATEGORY B

99
Q

Tetracyclines

A

MOA: Binds to 30S sub-unit of RiBOSOME

SPECTRUM: gram(+), gram(-), ATYPICALS!!

Also can use foR SYPILLIS IF PCN ALLERGY!!

100
Q

VibraMYCiN, Adoxa, Acticlat, Doryx, Oracea

A

DoxyCYCLiNE

  • IV/PO

TREATS: CAP, Bronchitis, Lyme Disease,Rosacea, PID,

  • Doryx MPC (Delayed Release)
  • OK TO GIVE IN RENAL IMPAIRMENT!!
101
Q

Minocin, Dynacin, Solodyn, Ximino

A

Minocycline

  • 200mg IV/PO first dose then 100mg BID

Hepatotoxic, LUPUS

Treats: Acne, PROSTHETIC JOINT INFECTXN.

102
Q

Sumycin

A

Tetracycline

Treats: chronic bronchitis
ACUTE EXACERBATION
PUD

DOSAGE: 250-500mg PO QID ON EMPTY STOM.
250-500mg PO BID for ACNE vulgaris

103
Q

Tetracycline

COUNSELING POINTS:

A

Doxy/ Minocycline: May give w/ food to decrease GI upset. GIVE W/ FULL glass of WATER!

Doxy: Have pat. SIT UPRIGHT FOR 30 minutes.

Oracea(Doxycycline): low dose doxy which has ANTI-IMFLAMMATORY RESPONSE.

Solodyn(Minocycline): for mod/severe ACNE
(LESS DIZZINESS because XR)

Ximino(Minocycline) - ER caps
(FOR IMFLAMMATORY, ACNE)
————————————————
- PHOTOSENSITIVITY
- INTERACT W/ milk/ antacids,

-DECREASE EFFECTS OF COC; ^ INR w/ Warfarin
————————————————-
-children < 8yo
- Pregnancy: TEETH STAINING
- RENAL patients should not be treated with any tetracycline besides DOXY.

104
Q

Chloramphenicol

A

MOA: Binds to 50s ribosomal SUBUNIT.

BROAD SPECTRUM:

Gram(+), Gram(-), anaerobes

SE: 1) Hemolytic anemi

  2) BINE MARROW SUPP
  3) Leukemia
  4) **GRAY BABY SYNDROME**
105
Q

Cleocin

A

Clindamycin

MOA: Inhibits 50S RIBOSOME

SPECTRUM: gram(+); ANAEROBES
(NO GRAM(-) AT ALL)

Forms: caps; solution

SE: #1 cause of C.DIFF
PSEUDOMEMBRANOUS COLITIS: REPORT SEVERE DIARRHEA

106
Q

Linocin

A

Lincomycin(similar to CLINDA)

SERIOUS GRAM(+)

  • DO NOT USE IN CLINDAMYCIN HYPERSENT
  • DO NOT USE W/ ERYTHROMYCIN DUE TO ANTAGONISTIC EFFECT
107
Q

Flagyl

A

Metronidazole

MOA: disrupts bacterial DNA syntheSIS

SPECTRUM: ANAEROBES (DOC: c.diff/ b. Frag)

Contraindicated in 1st TRiMESTER - then PREGNANCY CATEGORY B

SE: Disulfiram reaction (Avoid alcohol)

   1) Darkens URine
   2) Metallic Taste, GI upset
   3) Neuro: Seizures/ Peripheral/ optic neuropathy

DI: ^ INR w/ Warfarin

  • Flagyl is a CYP2C19 Inhibitor thus ^ WARFARIN
  • if a patient is on it for BACTERIAL vaginosis recommend vaginal CLINDAMYCIN
    ———————————————-
    Dosage forms: - IV
    May be Refrigerated; redissolve if
    Crystals form using WATER
    DILUTE W/ NS
  • Tabs TID
  • Caps TID
  • ER: 750mg QD (EMPTY STOMACHE)
108
Q

Macrobid; MacroDantin; Furadantin (Susp)

A

NitrofuranToin

Spectrum: ALL UTi gram (-) except for PSEUDOMONAS & Proteus

DOSE- Furadantin, Macrodantin: 50-100mg Q6H W FOOD

  • Macrobid: 100mg po BID w/ FOOD X7d
    ———————————————————
    Caution—>
  • Dont use if crCL < 60ml
  • Pregnancy > 38 weeks
  • DO NOT use jn infant < 1 month
  • Discoloration of urine (BROWN)
  • Heoatic rxns, Peripheral neuropathy; pulm tox!
109
Q

Monurol

A

Fosfomycin

-Simple uncomplicated UTi

  • One 3 gram packet, single dose
  • Dissolve in 1/2 cup of water
  • Metoclopramide decreases urinary excretion
  • Single dose is less effective than cipro/ bactrim
110
Q

Oxazolidinones, are which ABX and what is this MOA?

A

MOA: Inhibit the 50S. Ribosome subunit and Gram (+) ONLY!!

Linezolid (Zyvox) oral/ IV : BID

TEDIZOLID (Sivextro) - oral/ IV: QD

111
Q

Zyvox

A

LineZOLID

MOA: Inhibits translation PROCESS

SPECTRUM: VRE/MRSA/GRAM(+)

Dose: 600mg PO BID

FORMS: tabs, susp, IV(D5W)
———————————————-
- Thromocytopenia

  • MAO INHIBITOR (interacts w/ serotonergic agents and TYRAMINE food/ 3 MONTHS OF TREATMENT

RENALLY CLEARED: NO ADJUSTMENT NEEDED

PREGANCY CATEGORY C

112
Q

Sivextro

A

Tedizolid

GRAM(+), skin infections, MES, strep, and ENTEROCOCCUS FAECALIS

DOSE: 200mg QD IV OR ORAL

NO DOSE ADJUSMENTS Needed in HEPATIC/ RENAL

CAUTION: MyeloSUPP
* NOT RECOMMENDED IF ANC < 1000

  • MAOI

COMMON SE: n/v/ diarrhea/ dizziness

113
Q

Synercid

A

Quinupristine/ Dalfopristin

IV ONLY

GRAM(+) ONLY

SPECTRUM: VRE/ MRSA

SE: Venous irritation, Arthalgia/ Myalgia

CYP3A4 inhibitor

  • COVERS E. Faecium ONLY
114
Q

Tygacil

A

Tigecycline

MOA: works on 30S RIBOSOME Inhibits protein synthesis

BROAD SPECTRUM ACTIVITY

GRAM(+) pathogens, SSTI, intraABDOMINAL, but NOT FOR CAP CAUSED BY MRSA, VRE; faecium/faecalis

Gram(-) pathogens

Anaerobic

INCREASE RISK OF DEATH BBW
————————————————
Similar ti TETRACYCLINES thus has similar SE

  • N/V: Photosensitivity: Pancreatitis

Cautions: Pregnancy CAT
DO NOT GIVE LESS THAN 8 yrs OLD
DECREASE EFFICACY OF OCP
MONITOR INR

115
Q

Lipoglycopeptides

VERY SIMILAR TO VANCO

A

Vibativ : Telavancin (QD)

Dalvance: Dalbavancin (WEEKLY)

Orbactiv: Ortavancin (Single Dose)

Spectrum: GRAM(+)

MOA: Inhibit CELL WALL SYNTHESIS

116
Q

Vibativ

A
  • TelavAncin (LIKE VAnco)

Complicated SSTI (MSSA/MRSA)

  • Qt prolongation
  • Nephrotoxicity
  • TASTE DIST/ Foamy URINE!!**
    ————————————————
  • IV QD w/ no monitoring
    ————————————————

Dose adjustments < 50

  • CrCL of 30-50 is 7.5mg/kg every 24h
  • CrCl 10-30: 10mg/kg every 48h

OVER 69 minutes because of RED-MAN syndrome

117
Q

Dalvance

A

Dalbivancin

VERY LONG HALF LIFE

D5W

Infuse over 30 minutes.

GIVE ONE DOSE WEEKLY

118
Q

Orbactiv

A

OritaVANCIN

SINGLE DOSE OVER 3 HOURS

D5W ONLY!!

LONG T1/2 10 days

ONLY GOOD FOR 6 HOURS AT ROOM TEMP!!!

Contraindicated: USE OF IV HEPARIN for 120 hours after ORBACTIV; falsely ELEVATED aPTT test for 120 hours.

  • Orbactiv my increase risk of BLEEDING w/ Warfarin.
119
Q

Treatment of MRSA - IV

A
  • Vanco
  • Daptomycin
  • Linezolid
  • Tedizolid
  • Ceftaroline
  • Telavancin
  • Dalbavancin
  • OritaVancin
120
Q

TREATMENT OF MRSA- PO

A
  • Clindamycin
  • Bactrim
  • Doxycyline
  • Minocycline
  • Linezolid/ Tedizolid
121
Q

Which drugs TREAT VRE

A
  • Linezolid (WORKS BOTH)
  • Daptomycin
  • Tigecycline
  • synecid (faecium only)
  • Tedizolid/ TelVancin/ Oritavancin( Faecalis)
122
Q

BacTRIM/ SepTRA/Sulfatrim/

Cotrimoxazole

A

Trimethoprim-Sulfamethoxazole

Trimethoprim MOA: Inhibit bacterial dihydrofolATE. SULFONAMIDE IS FOR SYNERGY

SE: BONE MARROW SUPRESSION
- Anemia, Leukopenia, Thrombocytopenia- GIVE FOLIC ACID TO REVERSE

  • HYPERKALEMIA
  • RASH**/ crystalURIA
  • PHOTOSENSITIVITY W THE RASH

Renal CL
USE 50% of dose for crcl 15-30

  • DONT USE IF CrCL< 15

PREGANCY CATEGORY C
—————————————-
Spectrum: gram(-), PCP, MRSA

Clinical use: UTI/ PCP/ MRSA

DI: -Warfarin
- Rifampin

Counseling pts: SULFA ALLERGY
REPORT RASH(AVOID SUN)
DRINK A LOT OF WATER
————————————————
Contraindicated in MEGALOBLASTIC ANEMIA
PREGNANT PATIENTS AND NURSING MOTHERS and can cause kernicturs

Infants< 2 months

  • Hepatic damage or severe renal insufficiency
123
Q

Bactrim dosing

A

400(s)-80; DS 800-160mg (5-1) RATIO

  • Store away from heat, moisture, Light

UTI: 800-160mg q12

    - Uncomplicated UTI: 3-5 days
    - complicated 7-10 days: pyelo 10-14 days

PCP: 15/20 mg/kg TMP every 24 HOURS
PCP PPX: 1 DS Qd

MRSA: 1DS BID or 2DS BID

CRCL< 15 DO NOT GIVE
—————————————-
Bactrim IV infusion must be diluted in D5W

  • EACH 5mL should be ADDED to 125mL of D5W
  • DO NOT REFRIGERATE AND USE W/I 6 HRS
  • If cloudiness happens, DISCARD!!
124
Q

Xifaxan

A

Rifaximin

  • Travelers diarrhea

Prevention of HEPATIC ENCEPHALOPATHY DUE TO CIRRHOSIS

  • Kills bacteria in the gut that PRODUCES AMMONIA
  • IBS-D
125
Q

Mepron

A

Atovaquone

Indication: PCP treatment ; ppx in HIV patients w/ SULFA ALLERGY

DOSE-

Treatment: 750mg po BID X21 days
Prevention: 1500mg PO DAILY

126
Q

ABX SAFE TO USE IN PREGNANCY!!

A

Penicillins/ cephalosporins

ERYTHROMYCIN/ Azithromycin (B)

Clindamycin (alt to metronidazole in first trimester for anaerobic coverage)

Nitrofurantoin

Daptomycin

127
Q

ABX NOT REFRIGERATED?

A
  • Biaxin
  • cleocin
  • omnicef
128
Q

Which ABX CANNOT be left at ROOM TEMP?

A
  • Augmentin
129
Q

Fungizone

A

Ampho B (Conventional)

MOA: binding to ergosterol (part of cell wall/Membrane)

SE: Infusion related shaking/CHILLS, Hypotension, NEPHROTOX, Hypomag/ hypokalemia.

PREMediCATE w/ APAP, diphenhydramine, HYDROCORTISONE, Meperidine(for SHAKING/CHILLS)

Ampho B(IV): Give IV test dose of 1mg**
———————————————————
D5W (ONLY)

1mg/10mL

130
Q

Abelcet/ AmBisone/ Amphotec

A

Ampho-B LIPID Formulations

-Less toxic but more EXPENSIVE than CONVENTIONAL
—————————————————-
MUST meet at least one of the following criteria:

1) Significant Renal Impairment : Scr> 2.4 or CrCL < 50ml/min, or a rise in Scr 1mg/dL over BASELINE
2) Patient is unable to tolerate regular AMPHO-B
3) Transplant PATIENTS, generally exempt.

131
Q

Azole AntiFungals

GENERAL INFO

A

MOA: Inhibit cyp450 DEPENDENT ERGOSTEROL SYNTHESIS*

SE: Hepatotoxicity

DI: CYP3A4 (Ketoconazole/ itraconazole), ^ INR

Counseling points:

1) Itra/keto- conazole NEED ACIDIC ENVIRONMENT, Avoid giving with ANTACIDS!! (W/ FOOD)
2) Fluconazole/Itraconazole penetrate BBB and thus can cause HA AND VERTIGO

132
Q

Diflucan

A

Fluconazole

Forms: tabs/ susp/ IV

TREATS: 1) Vaginal candidiasis

           2) Oropharynge CANDIDIASIS (Thrush)
           3) Systemic Candiasis (400mg/d)
           4) Coccidiomycosis
           5) Cryptococcus Meningitis

SE: Hepatoxicity, HA, NAUSEA, abd pain, pruritis

Pregnancy: Single 150mg dose CAT C, all other CAT D.

CDC recommend ONLY using TOPICAL ANTIFUNGALS (vaginal azoles for 7 days to treat PREGNANT WOMEN WITH VulvoVAGINAL INFECTIONS

133
Q

SporaNOX (L/C)

A

Itraconazole

Form: 100mg caps
200mg Tabs
Solution
IV

DOSE: 200mg PO QD for Onychomycosis
NEED ACIDIC STOMACHE FOR TABS/CAPS

        HOWEVER, soln on EMPTY STOMACHE!!!

        * MORE ACTIVE AGAINST ASPERGILLUS THAN OTHER AZOLES* - ALSO cab be used for THRUSH!!

SE: Hepatoxicity/ Negative inotrope (Avoid in CHF), Edema, HTN, Hypokalemia, CNS, GI

DI: CYP450 3A4 inhibitor and SUBSTRATE

CONTRAINDICATED W/: Felodipine, dofetilide, ergot Alkaloids, Lovastatin, Simvastatin, PO Midazolam, Triazolam, Methadone.

134
Q

Nizoral

A

Ketoconazole

Forms: Shampoo, 2% Cream, 200mg Tabs

Dose/Indications

1) Tinea versicolor: 2% shampoo
2) dandruff: 1% shampoo
3) Systemic Fungal Infections: 200-400mg QD

CYP3A4 Inhibitor/ Substrate

SUPRESSES TESTOSTERONE

  • Gynecomastia

**SUPRESSES CORTISOL PRODUCTION—> Cushing SYNDROME

NEEDS ACIDIC STOMACHE, TAKE WITH FOODS, avoid antacids

135
Q

Vfend (L/C)

A

Voriconazole

Indications: DOC- Aspergillosis
                     Esophageal Cadidiasis (THRUSH)

Forms: 1) Injection

         2) Tabs
         3) Oral SUSP (NOT in FRIDGE)
         4) EMPTY STOMACHE(Different!**)

WARNING:

1) Monitor VISION w/ Treatment > 28 days
2) CNS(hallucination)
3) CYP3A4 SUBSTRATE
4) Photosensitivity/ RASH
5) Periostatis (Inflammation of tissue surrounding bone)

6) QT prolongation

136
Q

CresembA

A

Isavuconazonium

Indication: 1) Aspergillosis
2) Mucormycosis

Form: Caps/ IV

  • Oral caps: w or w/o FOOD
  • IV: infuse over 1 HOUR

Contraindications:

  - MAJOR CYP3A4 SUBSTRATE
  - Familial short QT syndrome

Monitoring:
- LFT @ baseline and PERIODICALLY

137
Q

CanciDAS

A

CapsofunGIN

MOA: Inhibit synthesis of GLUCAN; component of fungal cell wall

Indication: INVASIVE ASPERGILLOSIS

DOSE: 70mg IV first day then 50mg IV qd
- Dilution w/ NS or LACTATED RINGERS

138
Q

Eraxis

A

AnidulaFuGIN

MOA: Inhibits fungal CELL-WALL

INDICATION: Severe Candida

Form: IV (Dilute w/ NS or D5W)

SE: Histamine rxn, give it slowly

139
Q

NOXAFIL

A

Posconazole

MOA: Inhibit synthesis of ergosterol

Indications: PREVENTION/ TREATMENT of invasive Aspergillosis and CANDIDA Infections in IMMUNOCOMPRAMISED

Forms: 40mg/mL ORAL SUSP (HIGH FAT MEALS)

100mg delayed-release tabs

IV 18mg/mL - avoid in RENAL Impairment
———————————————————-
SE: N/V- HA/ HEPATOX/ Hypokalemia

DI: CYP3A4 Inhibitor/ substrate

Precautions: WATCH LFT
                       QT PROLONGATION (watch for hypokelamia)

CORRECT ELECTROLYTE ABNORMALITIES before initiating therapy

140
Q

Lotrimin

A

ClotrimAZOLE

Forms:

1) Topical cream for ATHLETES FOOT
2) Troche “lozenge” for ORAL THRUSH

3) Gyne-Lotrimin (OTC) for vaginal YEAST INF
- USEFUL IN 1st TRIMESTER

4) Vaginal tablet for VAGINAL YEAST INF
- Insert 100mg/d x7 d or 500mg single DOSE.

141
Q

Nystatin

A

DOC- THRUSH

Forms: Topical/ Oral

          - oral: caps/tabs, powder, susp 
          - Topical: Cream/Oint/ Powder

Oral THRUSH:

  - Use 5mL swish/ swallow for ORAL THRUSH
  - 400k-600k units QID; swish in mouth several minutes before SWALLOWING

  - **CAN GIVE TO INFANTS**  - Causes DIARRHEA and N/V  - NO SYSTEMIC ABSORPTION!!! So it is okay to SWALLOW!!

Contains alcohol!!

142
Q

Miconazole

Zeasorb, Moni-STAT

A

MOA: Inhibits ERGOSTEROL synthesis

(OTC) - COMMONLY SEEN IN MONOSTAT?

Forms: powder/ Liquid spray cream

Tinea corporis
Tinea pedis

VULVOVAGINAL CANDIDIASIS
- BEST TO USE AT BEDTIME SO IT ISN’T EXCRETED OUT OF VAGINA WHILE WALKING

DI: decrease effect of progesterone

  Increase WARFARIN
143
Q

Lamisil

A

TerbiNAFINE

MOA: Inhibits fungal ergosterol SYNTHESIS

Dose for Onychomycosis:

 - Fingernail: 250mg PO qd for 6 WEEKS
 - Toenails: 250mg PO qd for 12 WEEKS
 * *MONITOR LFTS WHEN TAKING PO**

Lamisil 1% cream (OTC)

- Apply QD/BID for 1-4 WKS
144
Q

PenLAC

A

Ciclopirox 8% (6.6mL)

  • Topical NAIL lacquer for ONYCHOMYCOSIS of Fingernails/ toenails
  • APPLY OVER ENTIRE NAIL PLATE, AND UNDER NAIL PLATE SURFACE, AND SURROUNDING SKIN AT BEDTIME (OR ALLOW 8 HOURS BEFORE WASHING)
  • APPLY daily over previous coat for 7 DAYS; after 7 days, REMOVE WITH ALCOHOL and continue cycle.
145
Q

Jublia

A

Efinaconazole

Indication: Fingernails

RX: Topical

QD for 48 WKS

-Similar to PENLAC, However more effective

For patients who cant or wont use oral therapy

  • **RECOMMEND ORAL TERBINAFINE(Lamisil) first line (MORE EFFECTIVE)*
146
Q

Kerydin

A

Tavaborole

Indication: onychomycosis

Dose: 5% topical SOLUTION

  • Apply to affected toenails for QD for 48 wks
  • Should be applied to the entire toenail surface and under the TIP
147
Q

Luzu

A

Luliconazole (RX)

  • Cream
    ————————————
148
Q

OTC FUNGAL TOPICALS

A

Butenafine - LOTRIMIN ULTRA

Clotrimazole - LOTRIMIN AF

Terbinafine - Lamisil AF

Tinactin - Tolnaftate

149
Q

Ancobon

A

Flucytosine

Forms: ONLY PO

  • synergistic w/ ampho B OR Fluconazole jn cryptococcal MENINGITIS

Caution:

1) Causes myeloSUPP
2) Caution w/ Renal Impairment

150
Q

Zovirax

A

Acyclovir (K/B)

Forms: Topical/ Oral/ IV

  • Herpes
  • Zoster (Shingles)
  • Varicella (chk pox)

RENAL - Drink A LOT of FLUIDS

SE: (Ha, agitation, confusion), N/V/D

151
Q

Valtrex

A

Valacyclovir (K/B)

1st episode 1g BID x10

Then: 500mg BID x3d

MUCH BETTER FOR COMPLIANCE

watch for RENAL < 50mL/min

152
Q

Famvir

A

FAMCICLOVIR

(K/B)

-converted to penciclovir in intestine and liver

153
Q

Tamiflu

A

Oseltamivir

MOA: Neurominidase Inhibitor

Treat: Influenza A and B

Treatment

  • 75mg BID x 5d w/ FOOD to help N/V
  • > 2wks old 3mg/kg BID X5d
  • Prevention: 75mg PO QD x 7d
    - Oral susp for > 1 yo and 30mg, 45mg caps.
    • SUSP expires in 10 days once mixed
154
Q

Relenza

A

Zanamivir

Neurominidase Inhibitor

Treats Influenza A and B

Treatment 10mg (2 PUFFs) BID X 5 days

Ppx: 2 puff QD x7 d

Caution: In asthma and COPD

155
Q

Rapivab

A

Peramivir (IV)

  • PRESERVATIVE FREE

Dose: 600mg single DOSE

dose adjust in RENAL IMPAIRMENT

CONCERNS: derma rxn, hypersensitivity, neuro events

156
Q

Symmetrel

A

Amantidine

AntiViral
Reduce dose in RENAL impairment
Can cause CUTANEOUS RXN.

 Nausea, anorexia, depression, suicidal ideation, seizure, Orthostatic Hypotension, anti-cholinergic
157
Q

Flumadine

A

Rimantadine

  • LESS CNS SIDE EFFEXTS
158
Q

Cytovene;
Vitrasert;
Zirgan: eye gel

A

Ganciclovir (IV ONLY)

Treats: CMV

MONITOR: CBC, Seizure

  • BONE MARROW SUP**
  • NEPHROTOXICITY; SEIZURES!!

Do not use if ANC < 500 or plt< 25,000

159
Q

Valcyte

A

Valganciclovir

PO Renal

  • Forms: 450mg tabs and 50mg/ mL solution
  • Refrigerate constituted oral soln

Caution: NEphroTOXICITY, SEIZURes

160
Q

Vistide

A

Cidofovir (IV ONLY)

Renal TOXICITY!!

SE: Eyes, neutropenia

BONE MARROW SUPP

Give PROBENECID** for renal toxicity!!

Monitor IOP(EYES)

161
Q

Foscavir

A

Foscarnet (IV ONLY)

** RENAL TOXICITY**

Seizure due to electrolyte imbalance/ neutropenia

BONE MARROW SUPP

Supplied in glass bottles or IV bags!!

162
Q

Baraclude

A

Entecavir

 -nucleotide analog

Form: ORALLY ONLY

  1. 5-1mg PO QD
    - Generally well TOLERATED/ pregnNcy cat C
163
Q

Tyzeka

A

Telbivudine

HEP-B

Form: ORAL ONLY

600mg PO QD (PREGNANCY CAT B)

SE: 1) Peripheral Neuropathy
2) MYOPATHY (^CPK)

164
Q

HepserA

A

Adefovir

HEP-B

Form: ORAL ONLY

10mg PO QD

-Generally LESS EFFECTIVE

165
Q

Epivir-HB

A

Lamivudine

HEP B/ HIV

Form: ORAL ONLY

100mg PO QD (HEP-B ONLY)

166
Q

Viread

A

Tenofovir (DF)

HEP-B/HIV

300mg PO QD (HB)

  • RENAL TOXICITY Fanconi SYNDROME**
  • DECREASE BONE DENSITY/ osteomalacia
167
Q

Vemlidy

A

Tenofovir alafenamide (AF)

HEP-B/ HIV

25mg PO QD w/ FOOD

168
Q

Intron-A

A

Interferon alfa-2B

HEP-B

  • **FLU-LIKE* s/s
  • monitor for DEPRESSION
  • THYROID ABNORMALITIES
  • HEPATOTOXICITY

Pulmonary/ CVD rxns

** RETINAL DAMAGE**

** BONE MARROW SUPP**
——————————————-
Monitor: CBC, LFT, TSH, Electrolytes

169
Q

Pegasys

A

Pegylated interferon alfa-2a

HEP-B

170
Q

okySio

A

Simeprevir (Protease Inhibitor)

Watch for SULFA allergy

Treats: HCV 1/4

Dose: 150mg w/ FOOD

SE: Rash, Photosensitivity (SULFA DRUG)

DI: Major CYP3A4 Substrate

BBW: HB virus reactivation!!

171
Q

Sovaldi

A

Sofosbuvir

MOA: Nucleotide analog Polymerase Inhibitor (NS5B NPI)

Dose: 400mg QD + Ribavirin and w or W/o Pegingerferon alfa for 12 WEEKS

SE: SEVERE BRADYCARDIA when given w/ AMIODARONE

DI: dont give w/ AMIODARONE

Combo: Harvoni (ledipasvir/sofosbuvir)

172
Q

Harvoni

A

Ledipsavir + Sofosbuvir

(DOES NOT REQUIRE INTERFERON OR RIBAVIRIN)

Spectrum: GENOTYPE 1 (MOST COMMON)

Dose: PO WD w or w/o FOOD

Counseling pt: AVOID ANTACIDS

DI: co-admin w/ P-gp inducers such as RIFAMPIN, st. johns wort, can DECREASE Harvoni LEVELS

**Avoid CRESTOR(Rosuvastatin)

Caution: EXTREME CAUTION WHEN COMBINING AMIODARONE W/ Sofosbuvir due to EXTREME BRADYCARDIA

173
Q

Viekira pak

A

Ombitasvir, Paritaprevir, ritonavir , dasabuvir (PORD)

Treats: HCV (GT1a/ GT1b)

Dose: Take w/ FOOD.

Pregnancy CATEGORY B (Safe in pregnancy)

174
Q

Technivie

A

Ombitasvir/ paritaprevir/ ritonavir (POR)

Treats: HCV (GT-4)

Dose: TAKE W/ FOOD

PREGNANY CAT B

175
Q

Daklinza

A

Daclatasvir

PO QD W/ sofosbuvir (GT3)

Dose: 60mg WD + SOFOSBUVIR

DI: Substrate of CYP3A4

Caution: bradycardia w/ Sofosbuvir + Amiodarone

176
Q

Zepatier

A

GraZoprevir + elbasvir

Treats: HCV (Ns5A)/ HCV NS3/4A

Dose: 1 tab QD w/o regard to meals

SE: Fatigue, HA, nausea, insomnia. Dizziness,

BBW: risk of HEP B reactivation

COUNSELING POINT:

1) Recommend Zepatier in DIALYSIS
2) RECOMMEND ZEPATIER OR VIEKIRA in SEVERE RENAL IMPAIRMENT

177
Q

Epclusa

A

Sofosbuvir + velpatasvir

PAN-genotype (can be used for ALL)

DI: DONT USE PPI’s (NEED ACIDIC pH)

Caution:

  • Amiodarone
  • Atorvastatin, Colchicine,

BBW: Hepatitis B reactivation

178
Q

Mavyret

A

Glecaprevir + pibrentasvir

QD w/ food x 8 WEEKS

179
Q

Copegus; Rabetrol; Ribasphere

A

Ribavirin

Treats: Oral (HCV); Inhaled used for RSV infection (off-label)

MOA: Inhibits RNA/DNA synthesis

Caution: Pregancy CATEGORY X

           TWO RELIABLE CONTRACEPTIVES!!

           Hemolytic ANEMI!!
180
Q

SYnagjs

A

Palivizumab

  • prevention of RSV in HIGH RISK PATIENTS

Preservative FREE

15mg/kg IM QMONTH during RSV season (November-April)

181
Q

Emverm

A

Mebendazole

Dose: 100mg SINGLE DOSE (Pinworm), REPEAT IN 3 weeks

182
Q

Albenza

A

Albendazole

400mg PO Single DOSE

183
Q

Pin-x, Pin-RID

A

Pyrantel (OTC)

> 2 YO

  • Capsules/Liquid taken as a SINGLE DOSE for pinworm/ roundworm and 3 days QD for hook worms
  • REPEAT IN 2Weeks. Treat entire family
184
Q

Impavido

A

Miltefosine

Treats: leishmaniasis

PREGnancy CATEGORY D

185
Q

Aralen

A

Chloroquine

Malaria PPX

Dose: 500mg qwk start 1-2 weeks prior to departure and continue for FOUR WEEKS

186
Q

Lariam

A

Mefloquine

  • Malaria PPX for Chloroquine RESIST

Dose: 250mg qWK

Start 1-2 WKS prior to departure and continue 4 wks after return

CNS: Contraindicated in psych, epilepsy, CVD

187
Q

Doxycycline

As an anti-malarial

A

100mg Qd for adults.

Begin 1-2 d prior to travel, Continued for 4 WEEKS after

  • Avoid in children < 8 YO/ photosensitivity
188
Q

Malarone

A

Atovaquone/Proguanil

Dose: QD 2 days prior, then continue for SEVEN(7) days afterwards

SE: HA, insomnia, GI, mouth ulcers, SJS, hepatitis

Avoid in cL< 30ml/min

189
Q

Plaquenil

A

Hydroxychloroquine SulFATE

Qwk, start 2 weeks prior to departure and 8 weeks after return

SE: VISUAL CHANGES (EYE EXAM/ CBC)

190
Q

VSL#3

A

High potency probiotic with 450 Billion live bacteria per packet

Approved for:

1) Ulverative colitis
2) ileal pouch
3) Irritable bowel syndrome (IBS)

191
Q

Hiprex

A

Methenamine

Treats: PPX for patients w/ RECURRENT UTi

CONTRAINDICATED W/ SULFONAMIDES

Antacids/PPI’s or anything that RAISES urinary pH may DECREASE LEVELS OF METHENAMINE

Top 100 Drugs (Brand-Generic) (19 decks)

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