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0. Step Ia > Drugs & Bugs > Flashcards

Drugs & Bugs Flashcards

1
Q

pt with oral candidiasis

A

nystatin or fluconazole

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2
Q

pt with oral candidiasis who is allergic to azole

A

caspofungin

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3
Q

pt w/ vaginal candidiasis

A

nystatinor topical fluconazole

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4
Q

pt with invasive candidiasis (sepsis)

A

fluconazole

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5
Q

pt with disseminated candidiasis (multi-organ involvement)

A

amphotericin B

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6
Q

pt with invasive or disseminated candidiasis who is allergic to azole

A

caspofungin

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7
Q

pt w. cystitis candidiasis

A

fluconazole or amphotericin (did not specify)

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8
Q

pt w. aspergillus

A

voriconazole + surgical debridement w/ good response rates

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9
Q

pt w. aspergillus who is allergic to azoles

A

caspofungin

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10
Q

cryptococcus

A

serial lumbar puncture to reduce ICP

amphotericin B + 5 flucytosine + fluconazole

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11
Q

mucormycosis in DKA patient

A

posconazole + surgical debridement + reverse hyperglycemia and acidosis

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12
Q

severe systemic mucormycosis

A

amphotericin B

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13
Q

pneumocystis jirovecii

A

TMP/SMX (both trmt and prophylaxis)

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14
Q

histoplasmosis in a HIV pt (usually a systemic dz)

A

Amphotericin B

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15
Q

histoplasmosis in a pt w/ emphysema (usually a chronic lung dz)

A

itraconazole

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16
Q

histoplasmosis in a normal patient

A

ø treatmentfluconazole (mild)

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17
Q

blastomycosis in a HIV pt (w/ meningeal involvement)

A

amphotericin B

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18
Q

blastomycosis in a non-HIV pt (no meningeal involvement)

A

ø treatmentfluconazole (mild)

itraconaozle (moderate)

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19
Q

coccidiomycosis

A

ø treatmentfluconazole (mild)

amphotericin B (severe)

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20
Q

sporotrichosis

A

itraconazole or KI

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21
Q

Norovirus

A

supportive

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22
Q

Rotavirus

A

supportive

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23
Q

Shigella

A

Ampicillin

remember Ampicillin HELPSS to kill enterococci

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24
Q

Salmonella enteritidis

A

supportive becauseantibiotics may prolong fecal excretion of organismsimmunocompromised/severe cases: TMP/SMX or cipro

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25
Q

salmonella typhi

A

Ampicillin

remember Ampicillin HELPSS to kill enterococci

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26
Q

EIEC

A

supportive

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27
Q

ETEC

A

loperamide(slows down gut motility) Fluoroquniolones (inhibits DNA gyrase and DNA topo) Azithromycin (macrolide, blocks 50s) Rafaximin (rifamycin derivative - RNA pol inhibitor)Notice this spells FAR - as travelers like to travel far…

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28
Q

EHEC

A

supportive

antibiotics can lead to HUS

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29
Q

Clostridium difficile (2)Bonus: which antibiotics typically cause this?

A

Metronidazole orVancomycin (severe)

generally caused by ampicillin + clindamycin

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30
Q

Yersinia enterocolitica (2)

A

Tetracycline

TMP/SMX

(enTerocoliTica)

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31
Q

Vibrio parahemolyticus

A

Supportive

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32
Q

Vibrio cholera

A

SupportiveorTetracycline

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33
Q

Listeria Monocytogenes

A

Ampicillin

remember Ampicillin HELPSS to kill enterococci

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34
Q

MSSA in acute infectious endocarditis

A

Nafcillin

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35
Q

MRSA in acute infectious endocarditis

A

Vancomycin

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36
Q

ß hemolytic Streptococci in acute infectious endocarditis

A

Penicillin + Gentamicin

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37
Q

Viridans Streptococci in sub-acute infectious endocarditis

A

Pencillin

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38
Q

HACEK organisms in endocarditisHaemophilusActinobacillusCardiobacterium hominisEikenellaKingella

A

Ceftriaxone

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39
Q

streptococci in a prosthetic valve patient with endocarditis

A

gentamicin (AG that blocks 30S)

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40
Q

enterococci in a prosthetic valve patient with endocarditis

A

gentamicin (AG that blocks 30S)

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41
Q

MSSA or MRSA in a prosthetic valve patient with endocarditis

A

gentamicin + rifampin

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42
Q

Rhinovirus

A

supportive

  • nasal sx: ipratropium bromide or cromolyn
  • decongestants: phenylephrine
  • sore throat: ibuprofen
  • cough: antitussives
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43
Q

RSV

A

supportive

  • nasal sx: ipratropium bromide or cromolyn
  • decongestants: phenylephrine
  • sore throat: ibuprofen
  • cough: antitussives
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44
Q

Coronavirus

A

supportive

  • nasal sx: ipratropium bromide or cromolyn
  • decongestants: phenylephrine
  • sore throat: ibuprofen
  • cough: antitussives
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45
Q

S. pyogenes pharyngitis

A

Penicillin

in benzathine solution if patient is non-compliant

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46
Q

S. pyogenes pharyngitis in a penicilin-allergic patient

A

Azithromycin (macrolide - blocks 50s)

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47
Q

mono

A

supportive

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48
Q

bronchitis due tomycoplasma pneumoniae

A

erythromycin or azithromcin (macrolides; inhibits 50s)(mycoplasma pneumoniae = atypical pneumonia)

49
Q

bronchitis due tochlamydia pneumoniae

A

erythromycin or azithromcin (macrolides; inhibits 50s)(chlamydia pneumoniae = atypical pneumonia)

50
Q

sinusitis due to H. influenza

A

amoxicillin-clavulanate(HELPSS)

51
Q

someone who has mild CAP

A

assume atypical + s. pneumo and start the patient out withazithromycin + doxycycline

52
Q

CAP due to strep. pneumoniae

A

doxycycline (tetracycline, 30S)

53
Q

CAP due to H. influenzae

A

azithromycin (prototype for atypical pneumonia)

54
Q

CAP due to chalmydophilia

A

azithromycin (prototype for atypical pneumonia)

55
Q

CAP due to mycoplasma

A

azithromycin (prototype for atypical pneumonia)

56
Q

CAP due to legionella

A

azithromycin (prototype for atypical pneumonia)

57
Q

patient admitted to the hospital due to pneumonia

A

since the patient is admitted, cover both atypicals (azithromycin) and other causes of serious pneumonia /hospital acquired pneumonia ieGNazithromycin + ceftriaxone

58
Q

pneumonia due to MRSA

A

vancomycin

59
Q

HAP due to S. aureus

A

Vancomycin + ceftriaxone(always assume MRSA in this setting until proven otherwise; also want coverage for pneumonia caused by GN bugs)

60
Q

aspiration pneumoniae

A

metronidazoleclindamycin (according to FA)(good for anaerobes)

61
Q

ventilator acquired pneumonia

A

pseudomonas

COMBO therapy

piperacillin + gentamycin (AG) or ceftazidime

62
Q

Simple UTI due to E. coli

A

amoxicillin

same class as ampicillin, which HELPSS to kill enterococci

63
Q

Simple UTI due to S. saprophyticus

A

Ciprofloxacin (fluroquinolone- inhibits DNA gyrase)

64
Q

Recurring UTI

A

think E. coli, S. saprophyticus, Klebsiella combination (treating one with a particular antibiotic will only let the others grow so you want to use a broader-spectrum antibiotic)use: TMP-SMX (which has broader spectrum activity)

65
Q

Chlamydia

A

Azithromycin (macrolide)orDoxycycline (tetracycline)

66
Q

Gonorrhea

A

Ceftriaxone (3rd gen)in reality, add Azithromycin or doxycycline to cover Chlamydia since they are usually coinfected!

67
Q

Syphillis

A

Penicillin G

68
Q

LOL in nursing home with indwelling foley

A

GNR (E Coli or Klebsiella) =Ceftazidimeor Pseudomonas=Piperacillin

69
Q

Influenza

A

Zanamivir

Oseltamivir

70
Q

HSV

71
Q

HSV resistant to acyclovir

A

Cidofovir

Foscarnet

72
Q

VZV, uncomplicated

A

Famciclovir

73
Q

VZV in pregnant women/neonates

A

valacyclovir

74
Q

CMV prophyaxis

A

Valganciclovir

75
Q

CMV

A

Ganciclovir

76
Q

CMV resistant to ganciclovir

A

Cidofovir

Foscarnet

77
Q

HepA

78
Q

HepC - acute

79
Q

HepC chronic

80
Q

Molluscum contagiosum (pox)

81
Q

Kaposi Sarcoma

82
Q

Hairy Cell Leukemia

83
Q

Condyloma acuminatum (HPV)

84
Q

eryspielas

A

grp A streppenicillin

85
Q

impetigo

A

S. aureus

mild: mupirocin - reduces nasal carriage of staph/MRSA
severe: cephalexin - good for GP and GN (proteus, E. coli, and klebsiella, since it’s near the mouth

if MRSA is involved: add TMP/SMX (standard protocol if there is MRSA skin + soft tissue infections; notvanco b/c that is for systemic/IV infections)

86
Q

Cellulitis due to S. pyogenes

A

Penicillin

87
Q

Cellulitis due to Staph aureus

A

make sure to cover for MSSA/MRSA

MSSA: usesemi-synthetics -nafcillin “naf for staph” or oxacillin

MRSA: use TMP/SMX since it’s a skin/soft tissue infection

if this somehow progressed to systemic infection:Vancomycin

88
Q

Cellulitis due to Vibrio vulnificuls

A

GN can be acquired due to eating raw oysters/salt water exposure

Ciprofloxacin (fluoroquinolone - good GN coverage)

89
Q

Furuncles/Carbuncles

A

make sure to cover for MSSA/MRSA

MSSA: usesemi-synthetics -nafcillin”naf for staph” or oxacillin

MRSA:useTMP/SMXsince it’s a skin/soft tissue infection

if this somehow progressed to systemic infection:Vancomycin

90
Q

Folliculitis

A

S. aureus, usually superficial only w/ ø systemic toxicity

MupirocinPolymyxin B-neomycin-bacitracin

91
Q

Cellulitis due to cat bite

A

cat/dog bite - often polymicrobial - cover for Pasturella multocia + anaerobes in the animal’s mouth

Augmentin (Amoxicillin + clavulanate)

remember Amp HELPSS to kill enteroccocci)

92
Q

Human bites

A

often polymicrobial - cover for Eikenella Corrodens + anaerobes in the animal’s mouth

Augmentin, IV(Amoxicillin + clavulanate)

remember Amp HELPSS to kill enteroccocci)

93
Q

Necrotizing Fasciitis

A

MRI + exploratory surgery

94
Q

Lyme Disease (early)

A

Doxocycline

95
Q

Lyme disease (late)

A

Ceftriaxone

just a fact that you have to remember..

96
Q

Osteomyelitis due to streptoccci

A

pencillin G

97
Q

Osteomyelitis due to MSSA

A

nafcillin or oxacillinuse naf for staph

98
Q

Osteomyelitis due to MRSA

A

vancomycin

(not TMP/SMX b/c it is only used for skin and soft tissue infections)

99
Q

Osteomyelitis due to Pseudomonas (2)

A

Piperacillin + Gentamicin

(gentamicin has synergistic effects w/ ß-lactam antibiotics)

or Ciprofloxacin

100
Q

Enterobius vermicularis

A

Bendazole + treat entiire family for 2 wks

101
Q

Strongyloides Stercoralis

A

Bendazole (or Ivermectin)

shoes

102
Q

Ascaris lumbricoides

A

Piperazine (both remind me of pipe-cleaners..)

103
Q

Visceral Larva Migrans

A

Dog/cat Toxocariasis

Bendazole or Diethylcarbamazine

104
Q

Schistosomiasis

A

Praziquantel

105
Q

Giardia lamblia

A

Metronidazole (lacks mitochondria)

106
Q

Cryptosporidium parvum

A

supportive

filter water

107
Q

trichomonas vaginalis

A

metronidazole

108
Q

toxoplasmosis

A

pyrimethamine-sulfadiazine + leucovorin (rescue) both are anti-folate

Rx:
sulfadiazine blocks DHF synthesis
pyrimethamine - blocks DHFR action

109
Q

Malaria

A

Chloroquine

110
Q

Malaria in a patient with eczema

A

atovaquone-proguanil (malarone)

111
Q

malaria in a patient who is resistant to chloroquine

A

atovaquone-proguanil (malarone)

112
Q

P. vivax treatment

A

Chloroquine or Malarone (atovaquone-proquanil)PLUS primaquine”preema queen” to hypnozoites (latent forms)

(google image for “preema queen” –> indian woman –> malaria endemic area - don’t judge)

113
Q

Babesiosis

A

Atovaquone + Azithromycin

114
Q

Latent TB

A

INH x 9 mo

115
Q

Active TB

A

RIPE x 6 mo

116
Q

2 drugs that you must infuse slowly

A

amphotericin B

Vancomycin (red man syndrome)

117
Q

MAC treatment

A

Clarithromycin + rifabutin + ethambutol

(last 2 are also MTB trmts: RE)

gotRiCE??

118
Q

MAC prophylaxis

A

Azithromycin

119
Q

prophylaxis for Cryptococus in HIV patient

A

lifelong fluconazole

0. Step Ia (28 decks)

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