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Pharm Block 2 - Current Semester > Drug Of Choice > Flashcards

Drug Of Choice Flashcards

1
Q

DOC for chemoprophylaxis in areas with chloroquine

resistant P. falciparum

A

Doxycycline

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2
Q

DOC for Trichomonas vaginalis

A

Metronidazole or Tindazole

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3
Q

Animal bites

A

Amoxicillin/Clavulanate

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4
Q

Ideal choice for treatment of mild-moderate

community-acquired-pneumonia

A

Macrolides and Ketolides

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5
Q

Genital herpes

A

Valacyclovir

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6
Q

Prophylaxis or treatment of uncomplicated malaria (effective against choloroquine resistant. P. Falciparum

A

Atovaquone proquanil

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7
Q

Severe staph infections: osteomyelitis, joint, skin

A

Oxacillin or Nafcillin

MSSA coverage is key
-safe in pregnancy

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8
Q

Syphillus

A

Penicillin G

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9
Q

Uncomplicated pyelonephritis

A

TMP/SMX (if susceptible) ○ Fluoroquinolone ○ Alternative: β-lactam

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10
Q

Lymphatic Filariasis

A

Diethycarbamazine (DEC)

Or ivermectin

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11
Q

Bacteriostatic

A

Static: Money Gurus COST
■ Used in uncomplicated infxns … do not work in neutropenic pts ■ Tetracyclines (Tetracycline, Doxycycline, Minocycline)
■ Glycylcyclines (Tigecycline)
■ Chloramphenicol
■ Macrolides & Ketolides
■ Oxazalidinones (Lineazolid & Tedizolid)
■ Sulfonamides

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12
Q

What are the drugs under MOA: RNA Polymerase inhibitor

A

-Rifampin

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13
Q

All other biological warfare (plague, tularemia, brucellosis, Q fever)

A

Doxycycline

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14
Q

Chlamydia

A

Azithromycin

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15
Q

Patients with G6PD should avoid these meds

A 
Chloramphenicol
Sulfonamides
Nitrofurantoin
Primaquine (Quinilines)
Isoniazid
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16
Q

What meds work for MRSA

A

Trimethoprim/Sulfamethoxazole

Clindamycin

Doxycline

Vancomycin, dalbavancin, oritavancin,or televancin

Ceftaroline

Linezolid or Tedizolid

Daptomycin

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17
Q

Time Dependent drugs

A 
Time-Dependent: Go Tell Big Frank
■ Beta-Lactams 
■ Glycopeptides (Vancomycin) 
■ Tetracyclines 
■ Folate Antagonists (Sulfonamides)
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18
Q

Fungal Pneumonia; that does not respond to
antifungals

Pneumocystis (carinii) jiroveci pneumonia (PCP)

A

DOC: Sulfamethoxazole-Trimethoprim (Septra)

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19
Q

Chemoprophylaxis in

areas with choloroquine resistance P. Falciparum

Areas with multi-drug resistant P. falciparum

Terminal prophylaxis of P. vivax and P. ovale infections; alternative for primary prevention

A

Malarone or mefloquine

Doxycycline

Primaquine

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20
Q

Minor skin/soft tissue staph infections (impetigo, cellulitis)

A

Dicloxacillin

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21
Q

Penicillin Allergy

A

Clindamycin

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22
Q

What PCNs cover pharyngitis

A

PCN, antistaph, amino

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23
Q

Complicated UTI

A

Complicated UTI

○ Fluoroquinolone ○ Aminoglycoside ○ Extended spectrum β-lactam

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24
Q

DOC: onychomycosis

A

Terbinafine

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25
Q

C. Dif

A

Vancomycin

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26
Q

CAP no cormobidities

A

No comorbidities

● Macrolide: clarithromycin or azithromycin ● Doxycycline ● Amoxicillin

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27
Q

Cephalosporins

Otitis Media –

  • SSTI (MSSA) –
  • Surgical Prophy –
  • Psuedomonas –
  • MRSA SSTI/CAP –
  • Critically ill/empiric treatment –
  • Syphilus/Meningitis
A

Otitis Media – 1 st and 2nd generation

• SSTI (MSSA) – 1st and 2nd generation

• Surgical Prophy – cefazolin
– Anaerobic: cefoxitin, cefotetan

  • Psuedomonas – Ceftazidime, Cefepime
  • MRSA SSTI/CAP – Ceftaroline
  • Critically ill/empiric treatment – Cefepime
  • Syphilus/Meningitis - Ceftriaxone
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28
Q

DOC in combination for M. tuberculosis, M. leprae and M. kansasii
(Non-tuberculosis mycobacteria)

A

Rifampin

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29
Q

TB (active)

A

Rifampin

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30
Q

What are the drugs under MOA: DNA grasses inhibitors

A

-Fluroquinolones

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31
Q

Sensitive P. Falciparum

A

Chloroquine

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32
Q

Trichomoniasis

A

Metronidazole or tinidazole (single dose)

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33
Q

CAP inpatient

A

■ Inpatient Treatment

● Respiratory fluoroquinolone (if ward patient)

● Anti-pneumococcal β-lactam* PLUS azithromycin

● Anti-pneumococcal β-lactam* PLUS moxifloxacin or levofloxacin

● PCN allergy: aztreonam PLUS moxifloxacin or levofloxacin

■ *anti-pneumococcal β-lactams: cefotaxime, ceftriaxone, ceftaroline,
ampicillin/sulbactam

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34
Q

Hospital acquired pneumonia

Intra-abdominal infections

SSTI

Sepsis

Gynecological infections

A

Ampicillin/Sulbactam

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35
Q

Latent TB

A

Isoniazid + Pyridoxine (B6)

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36
Q

Medications that cover P. aeruginosa

A

PCN - Ticarcillic/Clavulanate
Piperacillin/Tazobactam

Cephalosporins - Ceftazidime/Cefepime

Cephalosporin - beta lactamase inhibitor combos - ceftazidime/Avibactam and ceftolozane/Tazobactam

Monobactams - Aztreonam

Floroquinolones - Ciprofloxacin/Levofloxacin

Carbapenems - Imipenem, Meropenem, Doripenem

Aminoglycosides - Gentamycin, Tobramycin, Amikacin

Polymyxins - Colistin

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37
Q

Amoeba & Giardia = know treatment

A

Asymptomatic infxns: paromomycin or iodoquinol

Symptomatic disease: metronidazole or tinidazole followed by treatment w/
paromomycin or iodoquinol

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38
Q

Prevents relapse of P. Vivax and Ovale

A

Primaquine

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39
Q

What are the drugs under MOA: Cell membrane inhibitors

A

-Amphotericin
Ketoconazole
Polymyxins

40
Q

VRE coverage

A

Daptomycin
Tigecycline
Quinopristin/dalfopristin
Linezolid

41
Q

Severe gram negative infections including: meningitis, endocarditis, joint infections, resistant otitis media, pharyngitis, pneumonia

A

Ceftriaxone

42
Q

PCN sensitive gangrene

A

Penicillin (1st gen)

43
Q

Atypical organisms

A

Tetracyclines
Macrolides/ketolides
Cirpfloxacin/ofloxacin

44
Q

Can be administered as inhalation for pulmonary infections and to reduce adverse effects

Only active against gram (-) organisms
• Has activity against highly resistant strains:
– Examples: P. aeruginosa, K. pneumonia, Acinetobacter

A

Polymyxins (Colistimethate)

45
Q

DOC in invasive pulmonary or extra pulmonary infections caused by
Candida Spp.

A

Voriconazole

46
Q

Candida infections in immunocompromised patients

A

Fluconazole

47
Q

What PCNs cover Pseudomonas

A

Piperacillin/Tazobactam

48
Q

severe or difficult-to-treat HSV infections

A

Acyclovir IV

49
Q

Amebiasis

A

Metronidazole or tinidazole

50
Q

LTBI treatment of choice in pregnancy

A

For women at risk of progression of latent to
active disease, treatment should not be
delayed even during the 1st trimester –

If active disease excluded may delay initiation
of therapy until after delivery unless patient
had recent contact with active case or is HIV+

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

51
Q

Visceral Leishmaniasis

A

Liposomal amphotericin B

52
Q

What are the drugs under MOA: Cell wall synthesis inhibitors

A

-B-Lactam abx: carbapenems, cephalosporins, monobactams, PCN

Other abx: bacitracin, fosfomycin, and vancomycin

53
Q

What are the drugs under MOA: Protein synthesis inhibitors

A 
-aminoglycosides 
Chloramphenicol 
Clindamycin
Macrolides
Mupirocin 
Streptomycin
Tetracylines
54
Q

pre/post surgery not involving

the abdomen

A

First generation Cephalosporins - Cefazolin

55
Q

Drug Toxicity - Diarrhea/ Colotis (C. Diff)

A

clindamycin [pseudomembranous colitis]
( diarrheas and colitis may also occur with other
antibiotics)

56
Q

Prophylaxis against invasive fungal infections in immunocompromised
patients (e.g. bone marrow, solid organ transplant, etc…)

A

Fluconazole

57
Q

What are the drugs under MOA: Folate synthesis inhibitors

A

Sulfonamides

Trimethoprim

58
Q

What Pencillins are for MSSA

A

• MSSA – Dicloxacillin, Nafcillin, oxacillin

Ampicillin/Sulbactam,
Piperacillin Tazobactam

– Severe infection (osteomyelitis, endocarditis) must confirm susceptibility- go with either Nafcillin or oxacillin

59
Q

CAP Cormorbidities

A

Comorbidities or Abx w/in past 3 months ● Moxifloxacin or levofloxacin
● Macrolide or doxycycline PLUS amoxicillin/clavulanate or cephalosporin (
ceftriaxone (IV/IM), cefpodoxime, or cefuroxime)

60
Q

Trichomonas vaginalis

A

Metronidazole or Tindazole

61
Q

Surgical prophylaxis

A

Cefazolin or Clindamycin if allergy to PCN

62
Q

Complicated intra-abdominal infections in combination with metronidazole

A

Ceftazidime/ Avibactam (Avycaz)

63
Q

Prophylaxis for organ transplant and high-risk patients

A

Fluconazole

64
Q

1st line option for Candida prophylaxis in hematopoietic cell transplant
recipients

A

Micafungin

65
Q

Uncomplicated VVC

A

DOC: Oral Azoles
– Fluconazole 150mg po x 1
– Alternative: Itraconazole: 200mg po BID x 1 day

66
Q

Bacteriocidal

A 
Cidal
■ Use these in immunocompromised pts ■ B-Lactams 
■ Glycopeptides (Vancomycin) 
■ Cyclic Lipopeptides (Daptomycin) 
■ Polymyxins (Colistimethate) 
■ Aminoglycosides 
■ Streptogramins (Quinupristin) 
■ Fluoroquinolones 
■ Fidaxomicin 
■ Rifampin 
■ Pyrazinamide 
■ Allylamines (fungicidal)
■ Polyenes (Fungicidal) 
■ Echinocandins (Fungicidal) 
■ Tinea Pedis Meds (Lotrim & lamisil) ■ Malathion 0.5% Lotion (Ovicidal) 
■ Ivermectin (ovicidal)
67
Q

Toxoplasmosis Gondi

A

• Treatment:
Pyrimethamine + Sulfadiazine

• Prophylaxis:
Sulfamethoxazole-Trimethoprim (Septra®, SMX/TMP)

68
Q

Surgical abdominal infections

A

Cefoxitin, cefotetan, Ertapenem, or cefazolin

+ metronidazole

69
Q

Anthrax

A

Ciprofloxacin

70
Q

Mycobacterium Adium Complex (MAC)

71
Q

Herpes Enchephalitis

72
Q

Impetigo

73
Q

Mild to moderate onychomycosis of fingernails and toenails (nail lacquer)

A

Ciclopirox

74
Q

Aspergillosis

A

Voriconazole

75
Q

What PCNs cover upper respiratory

A

aminopenicillin, better

coverage with beta-lactamase inhibitor

76
Q

DOC in Aspergillus infections

A

Voriconazole

77
Q

Drug Toxicity - Nephrotoxicity

A

aminoglycosides and

vancomycin

78
Q

N. Gonorrhea infections of the cervix, urethra, and rectum

A

Ceftiaxone

79
Q

Drug Toxicity - Photosensitivity

A

quinolones, tetracyclines,

sulfonamides

80
Q

DOC for many susceptible fungal infections, including invasive and noninvasive candidiasis and cryptococcal disease

A

Fluconazole

81
Q

Endocarditis in persons with valvular heart disease undergoing oral, dental, or upper respiratory procedures

A

Amoxicilin/Clindamycin

82
Q

Concentration Dependent

A 
Concentration Dependent:  F.A.D.
■ Cyclic Lipopeptides (Daptomycin) 
■ Aminoglycosides
● (Gentamicin, Tobramycin, Amikacin, Streptomycin, Neomycin B)
■ Fluroquinolones
83
Q

Otitis Media
Endocarditis Prophylaxis
Duodenal ulcers caused by H. Pylori

A

Amoxicilin PO

84
Q

DOC for serious forms of invasive fungal infections

A

Amphotericin B

85
Q

Giardiasis

A

Metronidazole or tinidazole

86
Q

Uncomplicated cystitis

A

● Uncomplicated cystitis ○ TMP/SMX

○ Nitrofurantoin ○ Fosfomycin

87
Q

Gram neg coverage only

A

Aztreonam
Colistimethate
Polymyxins B
Ceftazidime

88
Q

Gram positive coverage only

A

Vancomycin
Bacitracin
Daptomycin

89
Q

Pseudomonas coverage only

A

Piperacillin/Tazobactam
Ceftazidime
Carbapenem (Except Erta)
Aztreonam

90
Q

Anaerobic coverage

A

Ampicillin/Tazobactam
Piperacillin/Tazobactam
Cefoxitin/Cefotetan
Carbapenem

91
Q

Surgical proph

A

Cefazolin
Cefoxitin
Cefotetan

92
Q

BBB

A

PCN
3rd and 4th gen cephalosporins (ceftriaxone best) - cefotaxamine and ceftazidime options
Vancomycin
Carbapenem

93
Q

Adverse side effects

PCN
Cephalosporins
Carbapenems 
Vancomycin
Telavancin
Daptomycin
Colistimethate
A

PCN - Diarrhea
Cephalosporins - Steven Johnson
Carbapenems - seizure (highest with imipenem)
Vancomycin - red man syndrome, nephrotitoxity, ototoxicity
Telavancin - taste disturbances and foamy urine
Daptomycin - rhabdo
Colistimethate - nephrotoxiicity and ototoxicity

94
Q

What is purpose of cilastin when combo with imipenem

A

Block renal conversion of imipenem to the nephrotoxic product

95
Q

Monitoring req for vancomycin and daptomycin

A

Van - trough levels 10-15 for less serious infections. 15-20 mcg/ml for serious infections

Daptomycin - CK every week

96
Q

Aztreonam has cross sensitivity with

A

Ceftazidime

97
Q

Ertapenam exceptoin

A

No enterococcus coverage

No pseudomonas or acinetobacter coverage

Pharm Block 2 - Current Semester (9 decks)

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