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Pharmacology > GYN/Final: drugs & tx > Flashcards

GYN/Final: drugs & tx Flashcards

1
Q

Severe life threatening infections

A

IV amphotericin B–>DOC

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2
Q

Leishmaniasis

A

IV amphotericin B

PO and IV Fluconazole

Pentamidine –alternative

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3
Q

systemic mycoses infection

A

Amphotericin B

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4
Q

Candida Albicans

A

**Amphotericin B– severe infections only

*fluconazole (PO, IV) esp good if candidemia

IV caspofungin

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5
Q

Aspergillus

  • doc
  • second line
A

*Amphotericin B– severe infections only

DOC: Voriconazole

IV Caspofungin SECOND line after failing or intolerant to azole or amphotericin B

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6
Q

Blastomyces

-doc?

A

*Amphotericin B– severe infections only

**DOC=Itraconazole

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7
Q

Cryptococcus

  • initial tx
  • maintenance tx
A

Amphoterin B (+/-) flucytosine (5-FC) THEN change to fluconazole

Maintenance: fluconazole 6-12 MO in pt with or without AIDS
*Amphotericin B– severe infections only

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8
Q

Histoplasmosis

  • DOC
  • others
A

DOC for severe requiring hospitalization=Amphotericin B IV–>then switch to itraconazole once stable and afebrile

FOR EXAM: ALWAYS ANSWER ITRACONAZOLE

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9
Q

Candidiasis-

  • first line for invasive?
  • cutaneous?
  • esophageal–DOC?
  • thrush/oral
  • systemic/invasive
A

oral, esophageal and cutaneous— **Nystatin (oral suspension, cream, ointment, powder)

*clotrimazole=PO, cutaneous and vaginal

**DOC for esophageal=FLuconazole

*Miconazole=oral and vaginal

INVASIVE INFECTION IN IMMUNO COMP PT=IV caspofungin–DOC **

esophageal in immuno comp use IV caspofungin first line

Cutaneous=Ciclopirox–cream, gel, suspension

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10
Q

thrush
DOC
others

A

DOC= Nystatin swish and spit— if not compliant than PO

  • Fluconazole PO
  • Fenoconazole PO
  • Clotrimazole pouches

Nystatin-swish and spit/swallow

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11
Q

Coccoides

A

*fluconazole PO or IV

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12
Q

Candida glabrata

A

Voriconazole

IV caspofungin

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13
Q

Candida Krusei

A

Voriconazole

IV caspofungin

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14
Q

Tinea spp.

A

Clotrimazole

Miconazole

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15
Q

Trichophyton rubrum

A

Efinaconazole x48 weeks

PO terbinafine X3MO

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16
Q

Trichophyton mentagrophytes

A

Eficonazole x48 weeks

PO terbinafine x30MO

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17
Q

Dermatophyte onychomycoses

  • doc
  • other options
A

DOC=PO terbinafine*******

Ciclopirox nail lacquer formation

PO Griseofulvin for 6-12MO

topical Tavaborole

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18
Q

Tinea Capitis

A

PO terbinafine
Topical terbinafine

Ciclopirox–cream, gel, suspension

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19
Q

Tinea cruris

A

Topical terbinafine

Ciclopirox–cream, gel, suspension

topical Tavaborole

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20
Q

Tinea versicolor

A

topical terbinafine

Ciclopirox–cream, gel, suspension

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21
Q

tinea pedis

A

topical terbinafine

Ciclopirox–cream, gel, suspension

topical Tavaborole

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22
Q

neutropenic fever

A

IV caspofungin

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23
Q

fluconazole resistant Candida glabrata and C. krusei

A

Echinocandins aka Caspofungin

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24
Q

Cryptococcal meningitis

A

Amphotericin B + 5-FC (Flucytosine)

INTRA-FECAL ONLY** cannot do IV because amphotericin does not cross CNS IV

*Fluconazole IV

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25
Q

Candiduria

A
  • pharmacotx if persistent*
  • ->fluconazole PO 7-14 days

OTHER:
5-FC/Flucytosine

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26
Q

chromoblastomycosis

A

5-FC

Flucytosine

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27
Q

dermatophytosis of scalp + hair

A

Griseofluvin

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28
Q

Seborrheic dermatitis

A

Ciclopirox shampoo

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29
Q

tinea corporis

A

topical Tavaborole

Imidazoles

  • clotrimazole
  • miconazole
  • Efinaconazole
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30
Q

Esophageal candidiasis

A
  • Fluconazole daily x14-21 days
  • Fluconazole IV or Caspofungin for interolerance to PO therapy

*use PO itraconazole, PO/IV Voriconazole or Caspofungin for strains refractory to fluconazole

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31
Q

Vulvovaginal Cadidiasis

A
  • Fluconazole PO
  • Clotrimazole vaginally
  • miconazole vaginally

PO is the same as above

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32
Q

Candidemia
1st line
-other
-when to discontinue tx?

A

1st line: Echinocandin–>Caspofungin IV

others:
* Fluconazole PO/IV for less severe disease

***tx should continue 2 weeks after last positive blood culture and s/s resolution

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33
Q

Bacterial vaginosis

A

metronidazole

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34
Q

Gardnerella vaginalis

A

metronidazole

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35
Q

Bacteriodes fragilis

A

metronidazole

36
Q

CLostridium perfinges

A

metronidazole

37
Q

C. Diff (not first line)

A

metronidazole

38
Q

H. pylori

A

metronidazole

39
Q

Ambeiasis-entamoeba histolytica

A

metronidazole

tinidazole

40
Q

Giardiasis

A

metronidazole

tinidazole

41
Q

amebic liver abscess

A

Tinidazole

metronidazole + Chloroquine*

42
Q

trichomonas

A

Tinidazole

Metronidazole

43
Q

invasive intestinal or extraintestinal amebic dz

A

Tinidazole
Metronidazole
aka the mixed agents

44
Q

Asymptomatic colonization state of amebic dz

A

LUMINAL drugs: Iodoquinol or Paromycin

45
Q

E. Histolytica

A

Mixed: metronidazole or Tinidazole

THEN use a luminal agent—-> Iodoquinol or Paromycin

If its extraintestinal infection or intestinal wall infection– need a systemic amebicide–> Chloroqine or dehydroemetine

46
Q

extraintestinal amebiasis and/or intestinal wall infeection

A

SYSTEMIC drugs– chloroquine or dehydroemetine

47
Q

Malaria prophylaxis

-DOC

A

sensitive area=Primaquine

Resistant areas=Mefloquine

48
Q

Malaria

  • general drugs to use
  • P. vivax
  • P. ovale
  • P. falciparum
  • sensitive areas DOC
  • resistant areas DOC
A

-Primaquine

  • Chloroquine–does NOT eradicate hepatic stages
  • *use with Primaquine for Plasmodium vivax and P. ovale

Atovaquone-proguanil for resistant strains P. falciparum (erythrocytic and hepatic stages) can be used for tx and prevention

Mefloquine

Artemisinins–multi drug resistance of P. falciparum

Pyrimethamine + Sulfadoxine

sensitive area DOC=Chloroquine

Resistant areas DOC= Atovaquone-Proguanil

49
Q

Plasmodium falciparum DOC

*others

A

Chloroquine–DOC

Atovaquone-proguanil for chloroquine resistant strains (erythrocytic and hepatic stages)

Quinine– not first line

50
Q

Liver forms of plasmodia DOC

A

Primaquine

51
Q

Prevention of relapse for P. vivax and P. ovale

A

Primaquine

52
Q

Babesia

A

Atovaquone-proguanil

53
Q

Pneumocystis jirovecci

A

Atovaquone-proguanil

Pentamidine— used as alternative when sulfa allergy present

54
Q

malaria prophylaxis

  • sensitive area
  • resistant area
A

sensitive area=Primaquine

Resistant area=Methloquine

55
Q

multi-drug resistant P. falciparum

A

Artemisinins + another agent —–>DOC

56
Q

Toxoplasmosis Gondii

A

Pyrimethamine + Sulfadiazine

57
Q

early stages of African Sleeping Sickness

A

Suramin IV

Pentamidine IV, IM, Neb

58
Q

Late stage of African sleeping sickness

A

Melosoprol

59
Q

Chagas dz

A
  1. Benznidazole– better tolerated

2. Nifurtimox

60
Q

Respiratory viruses

  • pref tx
  • others
A
  • vaccination is preferred method*

* other: Neuraminidase inhibitors

61
Q

Influenza A, B, **

and RSV

A

Neuraminidase inhibitors

  • Oseltamivir
  • Zanamivir
  • has to be within 48 hrs of s/s**
62
Q

RSV

A

Ribavirin–PO or INH

63
Q

Active Acute Hep B

A

Nucleoside Reverse Transcript Inhibitors (NRTIs)

**Lamivudine

Tenofovir

Entecavir

Ribavirin

64
Q

Chronic Hep B

A
  • Interferons: alpha, beta, gamma and pegylated***
  • -> Peginterferon alfa-2

NRTIs:
Tenofovir (NRTI)
Entecavir

Ribavirin

65
Q

Lamivudine resistant strains of HBV infection

66
Q

Hep C

A

Ledipasvir-Sofobuvir NS5A replication complex inhibitor + Protease inhibitor

Ribavirin and Interforn are older txs

67
Q

Chronic Hep C

68
Q

Herpes Viruses in general

A
  • Acyclovir
  • Cidofovir
  • Foscarnet
  • ganciclovir
69
Q

HSV encephalitis

-TOC

A

TOC= acyclovir

70
Q

Genital Herpes

A

MC used=Acyclovir

71
Q

CMV retinitis in pts with AIDS

-other immunocomp

A
  • Cidofovir–AIDS

* Foscarnet–other immunocomp

72
Q

how to decr incidence rate of nephrotoxicty with IV Cidofovir

A

IV NSS + PO probenecid

73
Q

Acyclovir HSV infections

74
Q

CMV

  • greatest efficacy?
  • others
A

Ganciclovir (»»efficacy)
Acyclovir

OTHERS

  • Cidofovir—AIDS + CMV
  • Foscarnet–OTHER IMMUNO + CMV
75
Q

CMV prophylaxis in transplant PT

A

Ganciclovir

76
Q

TX for AIDS in NAIVE patients
1st line
2nd line

A

1st= 2 diff NRTIs + INSTI and CD4 monitoring

2nd= PI + 2 NRTIs

77
Q

DOC esophageal candida

A

Fluconazole

78
Q

DOC for a non-compliant pt with vaginal candida

A

one dose fluconazole PO

79
Q

Candidemia (candida in blood)

1st and 2nd choices

A

IV caspofungin **** first choice

second choice=fluconazole IV

80
Q

PT wanting an OCP but has acne

A

combination estrogen + prgesterones of either Norgestimate or Drospirenone

81
Q

termination of pregnancy

A

PO—Combo of

  1. Mifepristone (progesterone antag)
  2. Misoprostol (prostaglandin analog)– causes uterine contractions
82
Q

BCA

83
Q

BCA prophylaxis in high risk PT

84
Q

post-menopausal osteoporosis

A

Raloxifene

85
Q

anovulation

A

Clomiphene

86
Q

BPH

A

Finasteride

87
Q

Prostate CA

Pharmacology (28 decks)

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