Drugs & Bugs Flashcards
1
Q
pt with oral candidiasis
A
nystatin or fluconazole
2
Q
pt with oral candidiasis who is allergic to azole
A
caspofungin
3
Q
pt w/ vaginal candidiasis
A
nystatinor topical fluconazole
4
Q
pt with invasive candidiasis (sepsis)
A
fluconazole
5
Q
pt with disseminated candidiasis (multi-organ involvement)
A
amphotericin B
6
Q
pt with invasive or disseminated candidiasis who is allergic to azole
A
caspofungin
7
Q
pt w. cystitis candidiasis
A
fluconazole or amphotericin (did not specify)
8
Q
pt w. aspergillus
A
voriconazole + surgical debridement w/ good response rates
9
Q
pt w. aspergillus who is allergic to azoles
A
caspofungin
10
Q
cryptococcus
A
serial lumbar puncture to reduce ICP
amphotericin B + 5 flucytosine + fluconazole
11
Q
mucormycosis in DKA patient
A
posconazole + surgical debridement + reverse hyperglycemia and acidosis
12
Q
severe systemic mucormycosis
A
amphotericin B
13
Q
pneumocystis jirovecii
A
TMP/SMX (both trmt and prophylaxis)
14
Q
histoplasmosis in a HIV pt (usually a systemic dz)
A
Amphotericin B
15
Q
histoplasmosis in a pt w/ emphysema (usually a chronic lung dz)
A
itraconazole
16
Q
histoplasmosis in a normal patient
A
ø treatmentfluconazole (mild)
17
Q
blastomycosis in a HIV pt (w/ meningeal involvement)
A
amphotericin B
18
Q
blastomycosis in a non-HIV pt (no meningeal involvement)
A
ø treatmentfluconazole (mild)
itraconaozle (moderate)
19
Q
coccidiomycosis
A
ø treatmentfluconazole (mild)
amphotericin B (severe)
20
Q
sporotrichosis
A
itraconazole or KI
21
Q
Norovirus
A
supportive
22
Q
Rotavirus
A
supportive
23
Q
Shigella
A
Ampicillin
remember Ampicillin HELPSS to kill enterococci
24
Q
Salmonella enteritidis
A
supportive becauseantibiotics may prolong fecal excretion of organismsimmunocompromised/severe cases: TMP/SMX or cipro
25
salmonella typhi
Ampicillin
| remember Ampicillin HELPSS to kill enterococci
26
EIEC
supportive
27
ETEC
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...
28
EHEC
supportive
antibiotics can lead to HUS
29
Clostridium difficile (2)Bonus: which antibiotics typically cause this?
Metronidazole or Vancomycin (severe)
generally caused by ampicillin + clindamycin
30
Yersinia enterocolitica (2)
Tetracycline
TMP/SMX
(enTerocoliTica)
31
Vibrio parahemolyticus
Supportive
32
Vibrio cholera
Supportive orTetracycline
33
Listeria Monocytogenes
Ampicillin
| remember Ampicillin HELPSS to kill enterococci
34
MSSA in acute infectious endocarditis
Nafcillin
35
MRSA in acute infectious endocarditis
Vancomycin
36
ß hemolytic Streptococci in acute infectious endocarditis
Penicillin + Gentamicin
37
Viridans Streptococci in sub-acute infectious endocarditis
Pencillin
38
HACEK organisms in endocarditisHaemophilusActinobacillusCardiobacterium hominisEikenellaKingella
Ceftriaxone
39
streptococci in a prosthetic valve patient with endocarditis
gentamicin (AG that blocks 30S)
40
enterococci in a prosthetic valve patient with endocarditis
gentamicin (AG that blocks 30S)
41
MSSA or MRSA in a prosthetic valve patient with endocarditis
gentamicin + rifampin
42
Rhinovirus
supportive
* nasal sx: ipratropium bromide or cromolyn
* decongestants: phenylephrine
* sore throat: ibuprofen
* cough: antitussives
43
RSV
supportive
* nasal sx: ipratropium bromide or cromolyn
* decongestants: phenylephrine
* sore throat: ibuprofen
* cough: antitussives
44
Coronavirus
supportive
* nasal sx: ipratropium bromide or cromolyn
* decongestants: phenylephrine
* sore throat: ibuprofen
* cough: antitussives
45
S. pyogenes pharyngitis
Penicillin
| in benzathine solution if patient is non-compliant
46
S. pyogenes pharyngitis in a penicilin-allergic patient
Azithromycin (macrolide - blocks 50s)
47
mono
supportive
48
bronchitis due to mycoplasma pneumoniae
erythromycin or azithromcin (macrolides; inhibits 50s)(mycoplasma pneumoniae = atypical pneumonia)
49
bronchitis due to chlamydia pneumoniae
erythromycin or azithromcin (macrolides; inhibits 50s)(chlamydia pneumoniae = atypical pneumonia)
50
sinusitis due to H. influenza
amoxicillin-clavulanate (HELPSS)
51
someone who has mild CAP
assume atypical + s. pneumo and start the patient out withazithromycin + doxycycline
52
CAP due to strep. pneumoniae
doxycycline (tetracycline, 30S)
53
CAP due to H. influenzae
azithromycin (prototype for atypical pneumonia)
54
CAP due to chalmydophilia
azithromycin (prototype for atypical pneumonia)
55
CAP due to mycoplasma
azithromycin (prototype for atypical pneumonia)
56
CAP due to legionella
azithromycin (prototype for atypical pneumonia)
57
patient admitted to the hospital due to pneumonia
since the patient is admitted, cover both atypicals (azithromycin) and other causes of serious pneumonia /hospital acquired pneumonia ie GNazithromycin + ceftriaxone
58
pneumonia due to MRSA
vancomycin
59
HAP due to S. aureus
Vancomycin + ceftriaxone(always assume MRSA in this setting until proven otherwise; also want coverage for pneumonia caused by GN bugs)
60
aspiration pneumoniae
metronidazole clindamycin (according to FA)(good for anaerobes)
61
ventilator acquired pneumonia
pseudomonas
COMBO therapy
piperacillin + gentamycin (AG) or ceftazidime
62
Simple UTI due to E. coli
amoxicillin
| same class as ampicillin, which HELPSS to kill enterococci
63
Simple UTI due to S. saprophyticus
Ciprofloxacin (fluroquinolone- inhibits DNA gyrase)
64
Recurring UTI
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
Chlamydia
Azithromycin (macrolide)orDoxycycline (tetracycline)
66
Gonorrhea
Ceftriaxone (3rd gen)in reality, add Azithromycin or doxycycline to cover Chlamydia since they are usually coinfected!
67
Syphillis
Penicillin G
68
LOL in nursing home with indwelling foley
GNR (E Coli or Klebsiella) = Ceftazidimeor Pseudomonas = Piperacillin
69
Influenza
Zanamivir
Oseltamivir
70
HSV
acyclovir
71
HSV resistant to acyclovir
Cidofovir
Foscarnet
72
VZV, uncomplicated
Famciclovir
73
VZV in pregnant women/neonates
valacyclovir
74
CMV prophyaxis
Valganciclovir
75
CMV
Ganciclovir
76
CMV resistant to ganciclovir
Cidofovir
Foscarnet
77
HepA
IFN-a
78
HepC - acute
IFN-a
79
HepC chronic
ribavarin
80
Molluscum contagiosum (pox)
Cidofovir
81
Kaposi Sarcoma
IFNa
82
Hairy Cell Leukemia
IFNa
83
Condyloma acuminatum (HPV)
IFN-a
84
eryspielas
grp A streppenicillin
85
impetigo
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; not vanco b/c that is for systemic/IV infections)
86
Cellulitis due to S. pyogenes
Penicillin
87
Cellulitis due to Staph aureus
make sure to cover for MSSA/MRSA
MSSA: use semi-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
Cellulitis due to Vibrio vulnificuls
GN can be acquired due to eating raw oysters/salt water exposure
Ciprofloxacin (fluoroquinolone - good GN coverage)
89
Furuncles/Carbuncles
make sure to cover for MSSA/MRSA
MSSA: use semi-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
90
Folliculitis
S. aureus, usually superficial only w/ ø systemic toxicity
MupirocinPolymyxin B-neomycin-bacitracin
91
Cellulitis due to cat bite
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
Human bites
often polymicrobial - cover for Eikenella Corrodens + anaerobes in the animal's mouth
Augmentin, IV (Amoxicillin + clavulanate)
remember Amp HELPSS to kill enteroccocci)
93
Necrotizing Fasciitis
MRI + exploratory surgery
94
Lyme Disease (early)
Doxocycline
95
Lyme disease (late)
Ceftriaxone
| just a fact that you have to remember..
96
Osteomyelitis due to streptoccci
pencillin G
97
Osteomyelitis due to MSSA
nafcillin or oxacillinuse naf for staph
98
Osteomyelitis due to MRSA
vancomycin
(not TMP/SMX b/c it is only used for skin and soft tissue infections)
99
Osteomyelitis due to Pseudomonas (2)
Piperacillin + Gentamicin
(gentamicin has synergistic effects w/ ß-lactam antibiotics)
or Ciprofloxacin
100
Enterobius vermicularis
Bendazole + treat entiire family for 2 wks
101
Strongyloides Stercoralis
Bendazole (or Ivermectin)
shoes
102
Ascaris lumbricoides
Piperazine (both remind me of pipe-cleaners..)
103
Visceral Larva Migrans
Dog/cat Toxocariasis
Bendazole or Diethylcarbamazine
104
Schistosomiasis
Praziquantel
105
Giardia lamblia
Metronidazole (lacks mitochondria)
106
Cryptosporidium parvum
supportive
filter water
107
trichomonas vaginalis
metronidazole
108
toxoplasmosis
pyrimethamine-sulfadiazine + leucovorin (rescue) both are anti-folate
Rx:
sulfadiazine blocks DHF synthesis
pyrimethamine - blocks DHFR action
109
Malaria
Chloroquine
110
Malaria in a patient with eczema
atovaquone-proguanil (malarone)
111
malaria in a patient who is resistant to chloroquine
atovaquone-proguanil (malarone)
112
P. vivax treatment
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
Babesiosis
Atovaquone + Azithromycin
114
Latent TB
INH x 9 mo
115
Active TB
RIPE x 6 mo
116
2 drugs that you must infuse slowly
amphotericin B
Vancomycin (red man syndrome)
117
MAC treatment
Clarithromycin + rifabutin + ethambutol
(last 2 are also MTB trmts: RE)
got RiCE??
118
MAC prophylaxis
Azithromycin
119
prophylaxis for Cryptococus in HIV patient
lifelong fluconazole
