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IPAP 21-2 Soph Semester > DOC Cards > Flashcards

DOC Cards Flashcards

1
Q

What is the DOC for early or late syphillis

A

PCN G benzathine

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2
Q

What is the DOC of rPCN Sensitive Gangrene (C. Perfringens)

A

1* gen PCN

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3
Q

DOC of PCN Endocarditis

A

1* PCN

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4
Q

WHAT PCN should be used on MSSA Endocarditis

A

D.O.N.

Dicloxacillin
Fafcillin
Oxacillin

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5
Q

What is the 1st line DOC in OTitis Media

A

Amoxicillin

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6
Q

What is the DOC in early animal bites

A

Augmentin

DOGmentin

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7
Q

What is the DOC in late animal bites

A

Ampicillin/ Sulbactam

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8
Q

What PCN can be used in UTI pregnant pts

A

Amoxicillin or Ampicillin

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9
Q

What ABX is used for endocarditis prophylaxis

A

Amoxicillin PO

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10
Q

What is the ABX used for H. Pylori (Duodenal)

A

Amoxicillin PO

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11
Q

Ampicillin IV + Aminoglycosides can be used for..

A

Meningitis

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12
Q

Ampicillin IV + Macrolides or Doxycycline can be used for

A

CAP

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13
Q

What is the ABX combination used in OM resistant to amoxicillin

A

Augmentin (Amoxicillin/ Clauvanic Acid)

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14
Q

In human bites, if the pt is allergic to PCN, use…

A

Clindamycin + ciprofloxacin or TMP/SMX

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15
Q

DOC in Gynecological infx caused by B- Lactamase producing E. Coli

A

Ampicillin/ Sulbactam (Unasyn) IV

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16
Q

What is the PCN combination used for HAP

A

Ampicillin/ Sulbactam

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17
Q

Piperacillin+ Tazobactam is used for

A 
Pseudomonas Coverage 
(Often combined with Aminoglycosides)
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18
Q

Which two PCN cover Abdominal Anaerobes

A

Piperacillin/ tazobactam

Ampicillin/. Sulbactam

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19
Q

What is the DOC for pre/post surgery not involving the Abdomen

A

Cefazolin IV (Ancef)

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20
Q

What are the Cephalosporins for surgery prophylaxis involving the abdomen

A

Cefoxitin and Cefotetan

2* gen cephalosporins

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21
Q

What is the DOC to tx N. Gonorrhea and Complicated pyleonephritis

A

Ceftriaxone

3* Cephalosporin

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22
Q

CAn neonates metabolize Ceftriaxone

A

NO

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23
Q

What is the Cephalosporin DOC for CNS penetration

A

Ceftriaxone

All 3* tends have good CNS penetration, however Ceftriaxone is DOC

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24
Q

What is the broadest spectrum Cephalosporin

A

Cefepime

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25
Q

What is the cephalosporin of r empiric therapy in critically ill high risk PTs (HAP, VAP, Comp UTI) a

A

Cefepime

4* gen Cephalosporin

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26
Q

What is the clinical use of 5* gen cephalosporin Ceftaroline

A

MRSA (SSTI)

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27
Q

What gen Cephalosporins are used for OM

A

1* and 2*

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28
Q

What 2 Cephalosporin cover pseudomonas

A

Cefepime and Ceftazadime

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29
Q

Why is Imipenem and Cilastatin always given together

A

Imipenem is metabolized in the kidney to a nephrotoxic product
Cilastatin blocks the renal dehydropeptidase that catalyzes this reactions and prevent this metabolism from occurring

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30
Q

Which Carbapenems has the highest risk of SZR

A

Imipenem @ >4g/d

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31
Q

What is the name of the monobactam that can be used in PCN/ cephalosporin allergic pts

A

Aztreonam

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32
Q

Aztreonam has cross reactivity with what 3*gen cephalosporin

A

Ceftazadime

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33
Q

What 2 Carbapenems cover psuedomonas

A

Azteronam and Meropenem

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34
Q

Does Aztreonam cover MSSA

A

No

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35
Q

Which Carbapenems cover Anerobic abdominals

A

Ertapenem and Meropenem

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36
Q

What does Vancomycin cover

A

MRSA and MSSA

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37
Q

What is oral vancomycin used for

A

C. Diff

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38
Q

What is the coverage of Daptomycin

A

VRE, MRSA, MSSA

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39
Q

What is the major ADE of Daptomycin

A

Rhabdomyolysis

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40
Q

What can Daptomycin not be used for specifically

A

Pulmonary infx, it’s degraded by surfactant

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41
Q

What is the coverage of Colistimethate

A

Pseudomonas

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42
Q

What is the major ADE of Colistimethate

A

Nephro and Nuero Toxic

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43
Q

What is the DOC in pneumonia accosicated with cystic fibrosis

A

Colistimethate inhaled

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44
Q

Does Doxycycline cover pseudomonas

A

No

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45
Q

Of the tetracyclines (DMT), which have to be taken on an empty stomach, and which need renal adjustment

A

Tetracycline- Empty Stomach and avoid in renal dysfunction

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46
Q

What are the major ADE of tetracyclines (DMT)

A

N/V
TISSUE HYPERPIGMENTATION
Photosensitivity
Not Advised in Pregnancy/ Breasfeading/ or children under 8 yo

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47
Q

What is the 1* line agent DOC in tick borne diseases

A

Doxycycline

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48
Q

Which tetracycline (DMT) can be used for malaria

A

Doxycycline

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49
Q

Which tetracycline (DMT) can be used for chlamydia

A

Doxycycline

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50
Q

Aminoglycosides (GNT) have a synergistic effect with what other class of drugs

A

Cell wall inhibitors like β-Lactams, vancomycin, daptomycin

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51
Q

What is the coverage of Aminoglycosides (GNT)

A

Psuedomonas

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52
Q

Do Aminoglycosides (GNT) require renal adjustment

A

YES

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53
Q

Are Aminoglycosides (GNT) safe for pregnancy

A

No, Preg Cat D

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54
Q

What are the major ADE of aminoglycosides (GNT)

A

Nephro (reversible) and Oto toxicity (irreversible)

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55
Q

What is the coverage of Azithromycin

A

Atypicals

Mycoplasma, Chlamydia, Legionella

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56
Q

What are the Major ADE of Macrolides (Azithromycin and Clarithromycin)

A

QT elongation

Hepatic and Gastrointestianl RXNs

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57
Q

What is the preg cat for MAcrolides (Azithromycin and Clarithromycin)

A

Azithromycin- B

Clarithromycin-C

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58
Q

Of the Macrolides (Azithromycin and Clarithromycin)

Which has the lower DDI

A

Azithromycin (does not significantly inhibit CYP3A4

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59
Q

Can macrolides (Azithromycin and Clarithromycin) be used on Endocarditis or Meningitis

A

NO! They are not bactericidal

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60
Q

What is the use of Azithromycin

A

Chlamydia

Upper and lower RTI

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61
Q

What is the use of Clarithromycin

A

Upper and lower RTI

H. Pylori induced GI ulcer

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62
Q

Does clindamycin cover psuedomonas

A

NO

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63
Q

What is the coverage of Clindamycin

A

MRSA, MSSA, abdominal anaerobes and Atypicals

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64
Q

What is the major ADE of clindamycin

A

C. Diff and Steven-Johnson Syndrome

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65
Q

Is clindamycin safe for pregnancy

A

Yes, Cat B

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66
Q

What is the use of Oral/ IV clindamycin

A

SSTI, MRSA, Nec Fasc, Polymicrobial INfx in DM

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67
Q

What is the second line agent in Penicillin/ Cephalosporin allergic pts

A

Clindamycin

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68
Q

What is Topical Clindamycin used for

A

Acne and BV

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69
Q

What is the coverage of linezolid

A

VRE, MRSA, MSSA

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70
Q

What is the preg cat for linezolid and does it require renal adjust

A

C , and No

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71
Q

Can linezolid be used for bacteremia

A

NO, its too widely distributed

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72
Q

What is linezolid used for

A

Nosocomial pneumonia
CAP complicated and uncomplicated
SSTI

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73
Q

What is the major ADE of linezolid

A

Anemia, Luekopenia, pancytopenia, thrombocytopenia

Weak MAO inhibitor (serotonin syndrome)

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74
Q

What two fluoroquinolones cover Pseudomonas

A

Ciprofloxacin and Levofloxacin

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75
Q

Which fluoroquinolones covers anaerobes

A

Moxifloxacin

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76
Q

What is the coverage of Moxifloxacin

A

MSSA, And Atypicals

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77
Q

What is the coverage of ciprofloxacin

A

Psuedomonas and Atypicals

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78
Q

What is the major ADE of Fluoroquinolones (CLeM)

A

Mainly in elderly/critically ill can cause hallucinations, delirium, seizures

Rashes

Photosensitivity

Risk to athletes (tendon rupture)

Variable QTC

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79
Q

What is the risk to athletes taking fluoroquinolones (CLeM)

A

Tendon Rupture, for up to 6 months post course

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80
Q

Besides tendon rupture for athletes what are the other ADE of fluoroquinolones

A

Tendon rupture for pts older than 60, taking corticosteroids, or in renal failure

Athralgias in pts less than 18 y/o

Variable QTC elongation

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81
Q

What is the pregnancy cat and absorption advisory for Fluoroquinolones (CLeM)

A

Cat C

Reduced by anti acids for absorption
-penetrated CNS and Bone

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82
Q

What is the DOC for anthrax

A

Ciprofloxacin

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83
Q

Can Moxifloxacin be used for UTI

A

No

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84
Q

What is the Fluoroquinolones DOC for p. Aeruginosa RTI

A

Levofloxacin

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85
Q

Which fluoroquinolones has the best anerobic coverage

A

Moxifloxacin

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86
Q

What ABX can not be used with a G6PD def.

A 
Sulfonamides 
Nitrofurantoin 
Dapsone 
Primaquine 
Quinidine
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87
Q

What is the DOC for toxoplamsa Gondi

A

Sufladiazine

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88
Q

What is the coverage for Sulfamethoxazole and Trimethoprim

A

MRSA, MSSA

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89
Q

Can Sulfonamides be used in neonates

A

NO!
Pump and dump,
Causes congenital malformations

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90
Q

How are sulfanomides excreted

A

Renally, concentrates in the urine

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91
Q

Do Sulfonamides penetrate CNS

A

Yes

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92
Q

What is the folate synth inhibitor that is used to treat Pneumocystis pneumonia (PCP)

A

SMX/TMP

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93
Q

What are the Major ADE of Sulfonamides

A

Stevens Johnson Syndrome
Bien marrow Supresión
Hemolytic anemia with G6PD
Crystalurea

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94
Q

What is the DOC for Trichomonas vaginalis

A

Tinidazole or Metronidazole

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95
Q

What are the major ADE of Nitroimidazoles (metronidazole and Tinidazole)

A

Metallic taste

Warfarin DDI

Avoid in alcohol due to disulfiram RXNs

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96
Q

What is the DOC to cover amebiasis (E. Histolitica, Giardiasis, Trichomnas)

A

Metronidazole or Tindazole

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97
Q

Metronidazole when combined with a PPI can treat

A

H. Pylori

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98
Q

What is the DOC in nfections with documented or suspected abdominal anaerobic bacteria, with adjunctive coverage of aerobes by a second drug when necessary

A

Metronidazole or Tindazole

Nitroimidazoles

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99
Q

What is the more expensive version of vancomycin, used to treat C. Diff and is a protein synth inhibitor

A

Fidaxomicin

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100
Q

Fidaxomicin should not be used in what pts.

A

Pts with macrolide allergies (Azithromycin or clarithromycin)

Or in combination with vancomycin (destroys too much flora)

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101
Q

What is the DOC for impetigo

A

Mupirocin

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102
Q

What is the coverage of mupirocin

A

MRSA and group A strep

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103
Q

What is the DOC for MRSA in adult patients and healthcare workers during institutional outbreaks

A

Mupirocin

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104
Q

What is Nitrofurantoin used for

A

Uncomplicated cystitis and UTI

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105
Q

What is fosfomycin used for

A

Uncomplicated UTI

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106
Q

What is Methanamine used for

A

Uncomplicated UTI (prophylaxis and suppression only) not TX

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107
Q

What is the use of phenazopyridine

A

Analgesic used in UTI (colors urine orange)

108
Q

What is the DOC for acute OM

A

Amoxicillin

Recurrent? Augmentin

Allergy to PCN? 2* GEn Cephalosporin or Ceftriaxone

109
Q

What is the standard regimen for CAP in a pt without comorbiditieds

A

Amoxicillin Or
Doxycycline or
Azithromycin or
Clarithromycin

110
Q

What is the Standard regimen for CAP with comorbisites

A

Augmentin or cephalosporins

And

Azithromycin or Clarithromycin or Doxycyline

Or monotherapy with a fluoroquinolones (CLeM)

111
Q

What is the Tx for native value endocarditis

A

NAfcillin or oxacillin

PCN allergic: cefazolin

Oxacillin resistantL vancomycin or Daptomycin

112
Q

What is the Tx for prosthetic value endocarditis

A

Nafcillin or Oxacillin plus rifampin plus gentamicin
(NRG or ORG)
X6 wks

Methicillin resistant?: Vancomycin plus rifampin plus gentamicin
(VRG)
X 6 wks

113
Q

What is the DOC for high MRSA risk SSTI

A

Doxycycline or SMX/TMP

114
Q

What is the DOC for low risk MRSA SSTI

A

Antistaph penicillins ( METHICILIN, dicloxacillin, oxacillin, nafcillin, cloxcillin)

Or 1* gen cephalosporin (Cephridine, Cephazolin, Cephadroxil, Cephalexin)

115
Q

What drugs treat MRSA

A 
Trimethoprim/sulfamethoxazole (PO/IV)
Clindamycin (PO/IV)
Doxycycline (PO/IV)
Vancomycin (IV)
Ceftaroline (IV)
Linezolid or Tedizolid (PO/IV)
Daptomycin (deactivated in the lungs) (IV)
116
Q

Does Trimethoprim treat MRSA

A

Yes

117
Q

Does Clindamycin Tx MRSA

A

Yes

118
Q

Does Doxycycline tx MRSA

A

Yes

119
Q

Does Vancomycin tx MRSA

A

Yes

120
Q

Does Ceftaroline tx MRSA

A

Yes

121
Q

Does linezolid tx MRSA

A

Yes

122
Q

Does Daptomycin tx MRSA

A

Yes, but it’s deactivated in the lungs

123
Q

If using vancomycin or CLeM (fluoroquinolones)

For surgical prophylaxis, what is the time frame for administration

A

Wishing 60- 120 minutes of incision

124
Q

When should you redose surgery prophylaxis

A

If the surgery last longer than 4 hrs

125
Q

What is the prophylaxis DOC for Endocarditis in pts with vulvar HDz

A

Amoxicillin or clindamycin

126
Q

What is the prophylaxis DOC for surgical wound infections

A

Cefazolin or Clindamycin

127
Q

What is the prophylaxis DOC for surgical abdominal infections

A

Cefoxitin or Cefotetan
Ertapenem,
Or cefazolin +metronidazole

128
Q

What is the DOC for C. Diff

A

Vancomycin

129
Q

What should persistent/ resistant C. Diff be treated with

A

Intracolonic Vancomycin

Fidaxomicin x 10 days if not used previously

Fecal bacteriotherapy (fecal microbiota transplant)

Subtotal colectomy

130
Q

What is the DOC for uncomplicated cycling

A

TMP/SMX x 3 days

Nitrofurantoin x 5 days

Fosfomycin x 1 dose

Methenamine (prophylaxis)

Alternative: fluroquinolone x 3 days or β-lactam x 3-7 days

131
Q

What is the DOC for uncomlicated plyeonephritis

A

TMP/SMX x 14 days (if susceptible)

Fluoroquinolone x 5-7days

Alternative: β-lactam x 10-14 days

132
Q

What is the DOC in complicated UTI

A

Fluoroquinolone (CLeM)

Aminoglycoside (GNT)

Extended spectrum β-lactam

133
Q

What is the DOC in a pregnant UTI

A

Amoxicillin

Nitrofurantoin (up to 37th week)

Cephalexin

134
Q

Can fluoroquinolones (CLeM) be used in pregnancy UTI

A

No

135
Q

Can Trimethoprim or Sulfamethoxazole be used in pregnant UTI

A

No

136
Q

Can Aminoglycosides (GNT) be used in pregnant UTI

A

No

137
Q

Can tetracyclines (DMT) be used in pregnant UTI

A

No

138
Q

What is the DOC for Chlamydia

A

Azithromycin

Or

Doxycycline

139
Q

What are the 4 Meds used to treat Active TB

A

Rifamycins
Isoniazid
Pyrazniamide
Ethambutol

RIPE

140
Q

What is the Active Tb drug regiment

A

RIPE x 2 months

Then Isoniazid and Rifampin x 4 months

141
Q

When tx TB, if the patient has HIV what drug should be used instead of Rifampin

A

Rifabutin

142
Q

Can Pyrazinamide be used in Pregnant Pts with active TB

A

No

143
Q

In tx active TB in pregnant women, what drug must be added

A

Pyridoxine

144
Q

What is the DOC in Latent TB for children under 2

A

Isoniazid

145
Q

What is the DOC for Latent TB in pregnancy

A

Isoniazid with pyridoxine

146
Q

What is the DOC for latent TB in children older than 2

A

Isoniazid and Rifapentine

147
Q

Should the combination of Rifampin and Pyrazinamide be used in Tx latent TB

A

No

Causes severe liver injury and death

148
Q

What is the DOC for latent TB in pregnancy

A

INH once daily or twice weekly for 9 months with Pyridoxine supplementation

149
Q

What is the -cidal -static activity of isoniazid

A

Bacteriostatic in stationary phase

Bactericidal for dividing organisms

150
Q

What is the DDI and food precautions of Isoniazid

A

Carbs and Aluminim impair absorption

Inhibits CYP3A4

151
Q

What are the MAJOR ADE of isoniazid

A

Peripheral neuropathy

Excretion of B6 ( reversed with pyridoxine)

Hepatotoxicity

Hemolysis in G6PD def.

Lupus and SZR

152
Q

What are the ADE of rifamycins

A

Potent CYP450 inducers

Hepatotoxic

Orange/ red secretions
(Don’t wear contact lenses)

153
Q

For tx can reifampin be used as monotherapy

A

No

Must always be combined with other agents

154
Q

What is the clinical use of rifampin

A

S. Aureus, MRSA, TB tx

155
Q

What are the ADE of rifampin

A

Hepatitis and liver failure

Must monitor LFTs

156
Q

What is the role of rifabutin

A

Preferred drug for use in TB-infected patients with HIV

157
Q

What is the ADE of using rifabutin

A

Uveitis
Skin pigmentation
And neutropenia

158
Q

What is the role of Rifapentine

A

LTBI once weekly by direct observation therapy (DOT)

Should NOT be used as monotherapy, to avoid resistance

Often used in combination with INH for latent tb in children older than 2 years old

159
Q

What is the role of Pyrazinamide in TB tx

A

Part of the initial four-drug regimen to shorten the overall duration of therapy from nine months to six months

160
Q

In latent Tb, if the pt is resistant to Isoniazid and Rifampin, what drug combination should be used?

A

Ethambutol and Pyrazinamide

161
Q

What is the ADE of Pyrazinamide

A

Hepatitis/ Heptaotoxic

Arthralgias

162
Q

What is the 2nd line drug used pts unable to tolerate rifampin during continuation phase of active TB Tx

A

Ethambutol

163
Q

What are the ADE and Contraindications for Ethambutol

A

Optic neuritis

Contra: Patients that are not able to reliably perform visual acuity and red-green color discrimination test

Children < 5yo

Unconscious patients

Not recommended in patients with decreased uric acid excretion

164
Q

What are the 1st line frugs for treating MAC infections

A

Ethambutol with rifabutin and macrolides ( Azithromycin and clarithromycin)

165
Q

Is ethambutol associated with heptotoxicicioty

A

No

166
Q

What stage of malaria does Atovaquone-proguanil have MOA on

A

Blood stage and Hepatic Stage

167
Q

What stage of malaria does doxycyline have MOA

A

Blood stage

168
Q

What stage of malaria does mefloquine have MOA

A

Blood stage

169
Q

What stage of malaria does chloroquine have MOA

A

Blood stage

170
Q

What stage of malaria does tafenoquine have MOA

A

Hepatic stage

171
Q

What stage of malaria does primaquine have MOA

A

Hepatic stage (off label use)

172
Q

What are the 5 malaria drugs (MAD TC)

A

Mefloquine, Atovaqoune-proguanil, Doxycyline, Tafenoquine, Chloroquine

173
Q

What are the ADE of primaquine

A

Hemolysis in G6PD pts

174
Q

What is the ADE of Mefloquine

A

psychiatric disturbances ranging from insomnia, vivid dreams, and mood swings, to depression, psychosis, and suicide

175
Q

What are the ADE and contraindications for chloroquine

A

Irreversible retinal damage, ototoxicity, myopathy, and peripheral neuropathy in patients receiving long term or high dose

Contra: Patients with psoriasis or preexisting retinopathy of the eye

176
Q

What are the ADE of mefloquine

A

Exacerbation of psychiatric disorders; vivid dreams; seizures
Dizziness, headache, loss of balance, or ringing in ears

Cardiac arrhythmias and bradycardia

Do not administer concomitantly with other medications that cause QTc prolongation

N/V/D, abdominal pain

177
Q

Can pts one antipsychotic or anticonvulsant meds take mefloquine

A

No

178
Q

What age range in melfoquine safe for, who is it not safe for?

A

Safe in young children,
Not safe below 6 months

Not safe in psych or cardiac pts

179
Q

What is the DOC to prevent relapse of P. Vivax and P. Ovale

A

Primaquine

180
Q

What are the ADE of primaquine

A

Prolonged QTc interval; anemia

CANT USE IN G6PD

181
Q

Is primaquine safe for pregnancy

A

NO

182
Q

What is the DOC for terminal prophylaxis of malaria

A

Tafenoquine w/ chloroquine

183
Q

Can tafenoquine be used in pregnancy

A

No

184
Q

What is the ADE and food warnings for atovaqoune- proguanil

A

Avoid in renal impairment (CrCl<30 ml/min)
Avoid in pregnant or breastfeeding <11 kg babies

Should be taken with food or milk

185
Q

What is the DOC for chemoprophylaxis in areas with chloroquine resistant P. falciparum

A

Doxycyline

186
Q

what patients can you not use Doxycyline for when treating malaria

A

Children less than 8 or pregnant women

187
Q

What malaria drugs can be used 1-2 days pre travel

A

Atovaqoune-proguanil and Doxycyline and Primaquine

188
Q

When must mefloquine (malaria) be initialed before travel

A

2-3 weeks prior

189
Q

When must tafenoquine be initiated before malaria travel

A

Within one week of travel (loading dose of 200 mg Qd x 3 days)

190
Q

When must chloroquine be initiated for malaria travel

A

1-2 weeks pre travel

191
Q

How long should atovaqoune-proguanil and primaquine be used Post malaria travel

A

7 days post

192
Q

How long my Doxycyline, chloroquine, and mefloquine be used o post malaria travel

A

4 weeks post travel

193
Q

How long must tafenoquine be used post malaria travel

A

One dose within one week post travel

194
Q

What is the DOC for trich vaginalis

A

Metronidazole or Tinidazole

195
Q

What is the DOC for tx of toxoplasmosis Gondi

A

Pyrimethamine + clindamycin or Sulfadiazine

196
Q

What is the DOC of Prophylaxis Toxoplasmosis Gondi

A

Sulfamethoxazole- Trimethoprim

197
Q

What is the DOC of giardiasis

A

Metronidazole or Tinidazole

198
Q

What is the DOC for pin words for pts older than 2 years old

A

Albendazole

199
Q

What is the ADE of albendazole

A

Increased liver enzymes

Monitor LFT

200
Q

CAn Albendazole be used in pregnancy

A

No, discontinue use if pregnant, and avoid pregnancy for 1 month following therapy

201
Q

What is the MOA of pyrantel Pamoate

A

depolarizing neuromuscular blocker works to cause paralysis in worm (causes acetylcholine release and inhibition of cholinesterase)

202
Q

What is the clinical use of pyrantel pamoate

A

Effective against mature and immature forms of susceptible helminthes within intestinal tract

NOT effective against migratory stages in tissues or eggs

203
Q

Can you use pyrantel pamoate in children under 2 years or pregnancy

A

No, avoid in 1st trimester

204
Q

What are the 1st line agents for lice

A

Permethrin and pyrethrins

205
Q

What are the age indications for Permethirn and pyrethrin

A

Permethrin > 2 months old

Pyrtethrin >2 years old

206
Q

What is the OVicidal drug for lice Tx

A

Malathion

207
Q

What is the age range for use of malathion in lice Tx

A

Older than 2 years old

208
Q

What is the occlusive based therapy drug for Lice Tx

A

Benzyl Alcohol Lotion

209
Q

What is the MOA of ivermectin

A

Binds to chloride ion channels in nerve and muscle cells

Leads to muscle paralysis of the parasite

210
Q

What is ivermectin used for

A

Lice only one treatment

211
Q

What is the age range for ivermectin

A

patients 6 months and older

212
Q 
What is the MOA of Imidazoles (Clot/Mic azole) 
and triazoles (Fluc/Vori/Posa conazole)
A

Fungal membrane inhibitors

213
Q

What is clotrimazole used for

A 
Cutaneous or vaginal candidiasis 
Oral candidiasis (Tx and prophylaxis)
214
Q

What is the ADE with clotrimazole

A

Monitor hepatic function with longer term use

215
Q

What is the Primary option for many susceptible fungal infections, including invasive and noninvasive candidiasis and cryptococcal disease

A

Fluconazole

216
Q

What is antifungal that is used for Prophylaxis against invasive fungal infections in immunocompromised patients

A

Fluconazole

217
Q

What is the DOC for VVC

A

Fluconazole

218
Q

What is the DOC for invasive and non invasive candiadisis

A

FLuconazale

219
Q

What is the DOC in aspergillus infx

A

Voriconazole

220
Q

What is the primary option for invasive pulmonary and extra pulmonary candida infx

A

Voriconazole

221
Q

What is the ADE associated with voriconazole

A

High trough concentrations associated with transient visual disturbances (color perception)

Auditory hallucination

Monitor Liver and Renal function
Increased risk of hepatotoxicity

222
Q

What DDI must you be aware of with voriconazole

A

Drug Interactions:

Inhibitor and substrate of CYP2C19, 2C9, and 3A4

Significant drug interactions prevents its use with many drugs.
e.g. Rifampin, rifabutin, carbamazepine,

223
Q

What is the MOA of terbinafine, naftitine, Butenafine

A

Cell membrane inhibitor

FUNIGICIDAL

224
Q

What is the DOC for onchymycosis

A

Terbinafine

225
Q

What drug is fungicidal to tineas

A

Terbinafine

226
Q

What is the ADE of Terbinafine

A

Taste disturbance and hepatotoxicity

227
Q

Can terbinafine (lamisil) be used in pregnancy

A

NO , it accumulates in the breast milk

228
Q

What is the MOA of Amphotericin B and Nystatin

A

Membrane inhibitor (Fungal)

Fungicidal

229
Q

What is the DOC for invasive fungal infections

A

Amphotercin B

230
Q

What drug is used empirically when fungal infection is suspected like febrile neutropenia

A

Amphotericin B

231
Q

What drug is use prophylactically in patients at signifigant risk of fungal infections like bone marrow transplant

A

Amphotericin B

232
Q

What are the ADE of Amphotericin B

A

Fever, chills, rigors, (may you acetaminophen to help or diphenhydramine)

Nephro toxic, can lead to anemia

SZR if injected into spinal colomn

233
Q

What are the DOC for Candida infections in immunocompromised patients

A

Fluconazole
- Prophylaxis for organ transplant and high-risk patients

Or Posaconazole

234
Q

What is the DOC for aspergillus infx

A

Voriconazole

235
Q

What is the DOC for fungal pneumonia that does not respond to antifungals (PCP)

A

Sulfamethoxazole-Trimethoprim

236
Q

What are the DOC in uncomplicated Vulvovaginal Candidiasis

A

Fluconazole

237
Q

What is the standard therapy of Uncomplicated Oropharyngeal and Esophageal Candidiasis

A

Nystatin and clotrimazole rinses

238
Q

What is the DOC for tinea pedis (athletes foot)

A

Topical : Lotrim ( butenafine) or lamisil (Terbinafine)

Oral: Fluconazole

239
Q

What is the Tx for inflluenza

A

5 days for oseltamivir or zanamivir

May extend for patients who remain severely ill after 5 days

1 day for uncomplicated influenza with IV peramivir

240
Q

What is the influenza DOC for pregnant women

A

Oseltamivir

241
Q

Who should not receive zanamivir in influenza tx

A

Not for people with breathing problems like asthma or COPD, for example.

242
Q

What demographic does peramivir adversely effect

A

Japanese populations (delirium)

243
Q

What is the age range for Oseltamivir Tx and prophylaxis

A

Tx: older than 2 weeks
Prophylaxis: older than 3 months

244
Q

What are the age ranges for Zanamivir Tx and Prophylaxis

A

Tx: 7 years and Older
Prophylaxis: 5 yrs and older

245
Q

What are the age ranges for Peramivir Tx

A

18 years and older

246
Q

What is the DOC for RSV Prophylaxis

A

Palivizumab

247
Q

What is the Tx for RSV

A

Supportive Care

248
Q

What is the role of Zostavax

A

Herpes zoster vaccine

249
Q

What is the role of Verivax

A

Varicella zoster vaccine

250
Q

What is the recommended dosing schedule for VArivax

A

Recommended for all children at 12 to 18 months old.

Second dose prior to entering school between ages 4 and 6 yrs

251
Q

FOr best results when should antivirals be started to Tx herpes

A

With in 72 hours of S/s

252
Q

What are the DOC for Shinlges

A

Valacyclovir: TID for 7 days

Famciclovir: TID for 7 days

Acyclovir: five time a day for 7 days

253
Q

What is the DOC for the 1st clinical episode of Herpes

A

Valacyclovir 1 gram PO 2x/day for 7-10 days

254
Q

What are the DOC for episodic therapy for recurrent genital herpes

A

Valacyclovir 500mg PO 2x/day for 3 days

Or

Valacyclovir 1 gram PO 1x/day for 5 days

255
Q

What is the DOC for severe or difficult-to-treat HSV infections

A

Acyclovir IV

256
Q

What are the ADE of nucleoside analogs

A

Acute renal failure through crystallization in urine
Mostly associated with IV acyclovir in higher doses

Prevent crystallization through hydration and correct dosing in renally impaired patients

Seizures, tremors, or other CNS effects can occur

Nausea, diarrhea, and rash are more common

257
Q

What is the MOA of tenofovir

A

Nucleotide Reverse Transciptase inhibitor (HIV)

258
Q

What is the DOC for HIV tx

A

Truvada: Tenofovir (TDF) (NRTI) + Emtricitabine (NRTI)

Descovy: Tenofvir (TAF) (NRTI) and Emtricitabine (NRTI)

259
Q

What is the ADE of
Truvada: Tenofovir (TDF) (NRTI) + Emtricitabine (NRTI)
Descovy: Tenofvir (TAF) (NRTI) and Emtricitabine (NRTI)

A

Hyperpigmentation of the palms or soles may be observed In ~3% particularly African Americans (up to 13%)

260
Q

What is the MOA of Raltegravir, Dolutegravir

A

Option for initial treatment as an additive agent to 2 NRTI’s

261
Q

What are the ADE of Raltegravir and

Dolutegravir

A

Myopathy/rhabdomyolysis

Insomnia, depression and suicidalideations

262
Q

What is the recommended therapy for Post-Exposure Prophylaxis (PEP) of HIV

A 
emtricitabine/tenofovir (Truvada) daily 
and dolutegravir (Tivicay) twice a day
263
Q

What is the substitution made for pregnancy in Post-Exposure Prophylaxis (PEP) of HIV

A

If pregnant substitute raltegravir (Isentress) instead of dolutegravir

264
Q

How long is PEP for HIV

A

28 days unless the pt test negative for HIV, meaning worker not exposed

265
Q

What is PrEP

A

Daily Emtricitabine (FTC) + Tenofovir disoproxil fumarate (TDF) (Truvada)

266
Q

CanPrep be used in a patient with active HIV

A

No!

The 2-drug regimen of TDF/FTC is inadequate therapy for established HIV infection, its use may causes resistance in active infection

IPAP 21-2 Soph Semester (20 decks)

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