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NAPLEX > ID3 > Flashcards

ID3 Flashcards

1
Q

Emp Abx for pts 1-23 months 2

A
  1. Ceftriaxone or cefotaxime
    • Vanc
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2
Q

Nitrofurantoin Contraindication

A

CrCl < 60

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3
Q

What drug has no activity against the 3 Ps?

A

Pseudomonas

Proteus

Providencia

Tigecycline

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4
Q

Empiric tx for CAP when patient has no recent abx use?

A

Macrolide or Doxy

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5
Q

Gonorrhea Tx:

What is not recommended?

A

Ceftriaxone + Azithromycin (Preferred) or doxy

250 mg IM x 1 for cef

Monotherapy is not recommended

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6
Q

In the intensive phase how long is RIPE therapy

A

8 wks

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7
Q

Weights to use for AGs?

A

Underweight < IBW use actual

Obese use adjusted

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8
Q

What drug is rec’d for all categories of HAP or VAP?

A

Zosyn

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9
Q

What are the common uses for Minocycline and Doxy

A

CA-MRSA skin infections, acne

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10
Q

Severe ICU patients Peritonitis and Cholangitis

What pathogens to cover? 12

A
  1. PEK
  2. CAPES
  3. Pseudomonas
  4. Anaerobes
  5. Strepto
  6. +- enterococcus
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11
Q

Symptoms of syphillis

A

painless smooth genital warts (chancre)

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12
Q

Metronidazole SE

A

Metallic taste

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13
Q

What Abx’s can increase INR? 6

A

Tigecycline

Metronidazole

Telavancin ortivancin false elevation in both aPTT and INR

Bactrim

Tetracyclines

Quinolones

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14
Q

What is the main drug for Rocky mountain spotted fever, typhus, lyme disease and Ehrilichiosis

A

Doxy

Rocky: 5-7 days

Typhs 7 days

Lyme 10-21

Ehrlith: 7-14

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15
Q

Absess Perulent Infections

Treatment 2

A

Commly caused by CA-MRSA

Bactrim

Doxy

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16
Q

Bactrim dosing for Uncomplicated UTIs?

A

1 DS tab PO BID x 3 days

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17
Q

Tigecycline boxed warnings and what should it not be used for?

A
  1. Increased risk of death
  2. Not for blood stream infections
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18
Q

When are IV Abxs preferred in CAP patients?

What are the preferred beta lactams?

Preferred macrolides?

What if the patient has risk factors for pseudomonas?

What about MRSA?

A
  1. IV abx for patients in the ICU
  2. Ceftriaxone, cefotaxime
  3. Azithromycin
  4. Pseudomonas: Zoysn, cefepime, or meropenem + either levo or an AG and Azithromycin
  5. If MRSA: add vanc or linezolide
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19
Q

Treatmetn for Pharyngitis?

A

PCN, Amox

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20
Q

Meng pt with severe PCN allergy

A

Quinolones

moxi or levo

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21
Q

What is the treatment and durtation for conuation phase

A

2 drugs for 4 months

INH and RIF if susceptible

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22
Q

More Severe SSTIs needing IV abx or Hospitalization cover what 2 things? and what are the 3 main drugs?

A
  1. Cover MRSA and Streptococcus
  2. Vanc
  3. Linezolid
  4. Daptomycin
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23
Q

Abx for COPD exacerbation?

A

Amox/clav

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24
Q

Common pathogens for meningitis in patients <1 months

A
  1. S. Agalacticae
  2. E. Coli
  3. Listeria
  4. Klebseilla
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25
Q

How is syphillis diagnosed?

A

Rapid Plasmin Reagen Also called the Vinereal Disease Research Lab

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26
Q

CMV

Preferred 2

Alt and why

Secondary prophy

A
  1. Valacylovir, ganciclovir
  2. ALt: If toxicity to gan or resitant: foscarnet, cidovir
  3. No agent recd for secondary keep CD4> 100
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27
Q

Isoniazid INH

SEs

A
  1. Peripheral neuropathy give with pyridoxine 25 mg PO qday
  2. Monitor S/Sx of DILE
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28
Q

2 drugs that only covers E. faecalis?

A

Pen G or Amp

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29
Q

Max dose of conventional ampho B

A

Black Box: Not exceed 1 .5 mg/kg /day

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30
Q

How to you confirm the Dx of Active TB?

A

Skin test likely means active but need to confirm with a sputum culture AFB stain

Definitive With PCR slow growing

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31
Q

What 3 drugs are always used in combination with other antipseudomonal meds?

A

Colismethane, Polymxyin, AGs

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32
Q

Fidaxomicin warnings?

A

Not effective in systemic infections

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33
Q

What latent TB regimen is not rec’d for HIV, children < 2 or pregnant women

A

INH and Rifapentine

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34
Q

Bactrim Coverage? 2 sets

What type? 8 main

What 4 things are not covered?

A
  • Broad gram negative bacteria and some oppurtunistic infections
  1. Gram Negative: Haemaphilus, Proteus, Klebsella, E. Coli, Enterobacter, SHigella, salmenella, Stenotrophomonas
  2. Opp: Pneumocytis, Toxoplasmosis
  3. DOES NOT COVER: Pseudomonas, Enterococci, atypicals or anaerobes
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35
Q

When someone is on roids what is the criteria for them to be considered immunocompromised?

A

systemic roid for 14 days or longer at pred dose >= 20 mg/day or >= 2 mg/kg/day

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36
Q

Nitrofurantoin counseling

A

Take with food to prevent nausea and cramping

can discolor urine brown

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37
Q

Cryptococcal meningitis

Induction Therapy

Alternative Reg

Secondary PRophy

A

Ampho B + flucytosine

Alt: Fluconazole +- flucytosine

Secondary prophylaxis low dose fluconazole

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38
Q

Tx duration for pharyngitis?

A

10

5 days for azithro

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39
Q

Other treatment options for Travelers Diarhea if dysentary not present not pregnant and pediatric

A

Cipro 3 days

Levo x 1 or daily 1-3 days

Ofloxacin 400 PO x 1 or BID x 3 days

Rifaximin TID x 3 days

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40
Q

Cellulitis Non-purulent infections

A

Cephalexin 500 mg QID

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41
Q

Second line tx for sinusitis failure of first

A

Oral 2nd or 3rg gen cephs + clinda, doxy or Resp FQ

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42
Q

Chlamydia Tx:

A

Azithromycin 1 gram PO x 1

or Doxy

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43
Q

First line tc for sinusitis?

44
Q

Preferred Treatment for Travelers Diarrhea if fever, Blood is present or pregnant or pediatric

A

Azithromycin 1000 mg PO or 500 mg PO daily 1-3 days

45
Q

Mild to moderate Peritonitis and Cholangitis

What to cover? 6

A
  1. PEK
  2. Anaerobes
  3. Strepto
  4. +- enterococcus
46
Q

Tigecycline coverage? 5

A

MRSA, VRE, g(-), anaerobes, and atypicals

47
Q

What patients are at risk of IE during dental procedures? 4

A
  1. Prosthetic heart valve or heart valve repair with artificial material
  2. Hx of endo
  3. Heart transplant with abnormal heart valve function
  4. Certain congenital heart defects including heart/lung valve disease
48
Q

PCP Tx

duration

alt

Prophy

A
  • Bactrim +- pred
  • For 21 days
  • ALt: pentamidine IV
  • Secondary Bactrim
49
Q

Nitrofurantoin warnings? 2

A

Hemolytic anemia found through positive coombs test

caution in pts with G6DP Def

50
Q

Duration of treatment of DM foot infections

4 total

A
  1. 7-14
  2. More severe: 2-4 wks
  3. Bone and joint: 4-6 wks
  4. Osteo longer
51
Q

Empiric treatment for mengigitis in pts < 1month

2 drugs and an or

A

Amp (listeria coverage)

Cefotaxime (not cetriaxone)

or gentamicin

52
Q

Other drugs besides Ceftriaxone that can be used for primary or secondary prophylaxis of SBP?

A
  1. Bactrim
  2. Cipro
53
Q

Metronidazole contraindications?

2

A

Pregnancy in the first trimester

Alcohol or propylene glycol contain products during treatment within 3 days of tx dc

54
Q

Latent TB Tx

3 possible

A
  1. Isoniazid 300 mg max 900 for 9 months
  2. Rifampin 4 months
  3. INH + rifapentine q wk for 12 wks
55
Q

Different treatments for each phase of syphillis

Primary, secondary or early latent?

Latent > 1 y or unknown duration

Neurosyphilis including ocular and congenital

What is the treatment and duration for alternatives?

A
  1. PEN G benzathine 2.4 million units IM x 1
  2. PEN G Benzathine IM wkly for 3 wks
  3. Pen G aqeous, Alternative Pen G procain
56
Q

HAP risk factors for MRSA or MDR Pseudomonas

A

IV Abx within the past 90 days

57
Q

Emp meng tx for patients 2 -50?

A

Ceftriaxone 2 g q12

Cefotaxime 2 g q4-6

+ vanc 30-45mg/kg/day

58
Q

Primary Prophylaxix in pts with HIV

MAC:

A

CD4 < 50

Preferred Azithro 1200

CD4 > 100 for >= 3 months on ART

59
Q

A TST is also called what?

A

A purified protein derivative test

60
Q

Drug interaction wiht metronidazole?

A

Warfarin Increase INR

61
Q

Pyrazinamide SEs

A

Causes increased uric acid dont use with acute gout

62
Q

When can a false positive TB skin test occur?

A

When a patient has received the BCG vaccine

63
Q

CAP risk of S.pneumo?

Drug choices

3

potential

A

Beta lactam (Amox high dose, Amox/clav, Cefpodoxime, cefdinir, cefuroxime, or ceftriaxone) + macrolide or doxy

Potential monotherapy with respiratory FQ moxi, levo gemi

64
Q

Rifampin and INH admin and risks

A
  1. Take on an empty stomach
  2. Risk of hemolytic anemia through positive coombs test
65
Q

Trichomoniasis Tx and CDC recs

A
  • Metronidazole 2 grams PO
  • CDC recs Metro in all trimesters
66
Q

What drug used to treat MDR g(-) pathogens in combo with other drugs has dose dependent nephrotoxicity?

A

Colistimethate

67
Q

DM foot infections

Anaerobic G(+) 2

Aaerobic G (-) 1

A
  1. Peptostrepto
  2. Clostridium Perfringes
  3. B. Fragilis
68
Q

What is ciprofloxacin not used for?

A

Pneumonia not a respiratory FQ and does not have reliable coverage against S. pneomo

69
Q

What drugs need increased dosing interval in renal impairment?

For TB drugs

A

Ethambutol and Pyrazinamide

70
Q

MAC crtieria treatment and DC

And drug treatment and duration

A
  • CD4 < 50 must rule out active disseminated DX
  • Preferred Azithromycin 1200 mg PO weekly
  • CD4 > 100 for >= 3 months on ART
71
Q

MAC

A

Clarithromycin or Azithromycin + ethambutol

Alt: Add a 3rd or 4th agent using rifabutin, amikacin, or streptomycin, moxi or levo

secondary prophylaxis is the same as primary tx

72
Q

Common Cold MCPs 2

Influenza 1

Pharyngitis 2

Sinusitis 7

A
  1. Resp Virus: Rhinovirus and coronavirus
  2. Infuenza
  3. Resp viruses and S. Pyrogenes
  4. Resp viruses, S. Pneumo, H. Flu, M. Mat, staphylococcus, anaerobes, and g (-) rods
73
Q

Gonorrhea and Chlamydia?

A

Gonorrhea: Ceftriaxone 250 IM

+

Azithromycin 1 gram or doxy 100 mg BID x 7 (These treat chlamydia too)

74
Q

Primary Prophylaxix in pts with HIV

Toxo

A
  1. <100 Toxo IgG +
  2. Preferred Bactrim
  3. Alt dapson + pyrimethamine + leucovorin
  4. DC when CD4 > 200 for > 3 months on ART
75
Q

Community Associated MRSA SSTIs drugs 3

A
  1. Bactrim
  2. Doxy
  3. Minocycline
76
Q

Bacterial Vaginosis Tx

WHat should pts not do?

A

Metro or

Metro 0.75% gel

Pts should not douche

77
Q

What regimen is recommend for HIV, pregnant and children? and for what?

A

INH: 300 mg per day max 900 per dose

9 months for Latent TB

78
Q

Preferred beta lactam for CAP when patient has risk of S. Pneumo?

A

Ceftriaxone or cefotaxime + azithromycin

79
Q

Metronidazole Interactions?

A

Weak 3A4 and 2C9 inhibitor

80
Q

When should you take a trough for AGs?

A

right before or 30 min before the

Peak 30 minutes after

81
Q

What drugs are used for E.Faecium and E. Faecalis? 6

A
  1. Dapto
  2. Linezolid
  3. Tigecycline
  4. Cystitis only: Nitro, fosgomycin and doxy
82
Q

Tx of syphillis

What about pregnant patients?

A
  • Pen G 2.4 millions units IM wkly for 3 wks if latent >1 yo or tertiary
    • Bicillin L-A dont sub with the C-R
  • Alternative Doxy 100 mg PO BID or tetracycline PO QID
  • Pregnant patients with PCN allergy should be desensitized and use L-A
83
Q

patient at high risk for pseudomonas CAP what should be added?

A

Zosyn

and If MRSA concern Vanc or linezolid

84
Q

Rifampin Info? 3 SEs and other things

A
  1. Orange bodily secretions
  2. Strong CYP inducer (rifabutin can be used instead due to drug interactions
  3. Cause flu like symptoms
85
Q

Toxo Gondi

Treatment regimen not prophylaxis

A

Pyrimethamine + leucovorin + sulfadiazine

Alt: Bactrim

Same as tx but at reduced dose

86
Q

What does ethambutol cause? 2

A

Visual changes

Hallucinations/confusion

87
Q

12 total drugs that cover pseudomonas?

A
  1. Zosyn
  2. Cefepime
  3. Ceftazidime
  4. Caftaz/Avibactam
  5. Ceftolozane/Tazobactam
  6. Carbapenems but not Ertra
  7. Cipro, Levofloxacin
  8. Aztreonam
  9. AGs
  10. Colistimethate, polymyxins
88
Q

What quinolone should not be used in UTIs and why?

A

Moxifloxacin: not enough conc in urine

89
Q

WHen should IV abxs be admin for surgical prophylaxis?

A

Cefazolin and Cefuroxime ( 1hour before surgery)

If using quinolones or Vanc 120 minytes before

90
Q

Mild to Moderate Peritonitis and Cholangitis

5 possible regimens

A
  1. Cefoxitin
  2. Ertrapenem
  3. Moxi
  4. Cefazolin, cefuroxime or ceftriaxone + metro
  5. Cipro or Levo + metro
91
Q

Lyme Disease vs Ring Worm?

A

Lymre: bacterial: Bullseye rash DX ELISA, DOxy

Ringworm: Fungal: 1+ reddish raised rings: tx with clotrimazole or other topical

92
Q

What is the DOC for uncomplicated UTIs?

93
Q

3 most common pathogens of CAP?

When do you use cipro?

A
  1. S. Pneumo
  2. H. INflu
  3. M. Pneumo

Never use cipro not a resp FQ and does not cover S. Pneumo relialbly

94
Q

Drugs that cause QT prolongation Abxs

A

FQs

Macrolides

95
Q

Impetigo

Honey COmb Crust

First choice

If numerous lesions

A
  1. Mupirocin (Bactroban) ointment
  2. Cover MSSA if systemmic: Cephalexin (Keflex)
96
Q

What drug is added for meng tx in patients <1 month and > 50

A

Ampicillin for Listeria coverage

97
Q

Drugs that cover atypical organisms? 3

A

Azithro

Doxy

Quinolones

98
Q

Dificid

A

Fidaxomicin

99
Q

5 common pathogens in mengitis

A
  1. S. Pneumo
  2. N. Meningitis
  3. S agal
  4. H flu
  5. E. COli
100
Q

Macrobid and Macrodantin Dosing

A

Dantin QID

Macrobid 100 mg BID x 5 days

101
Q

DM Foot infections

G (+) Pathogens

4

G (-) 5

A
  1. S. Aureus Including MRSA
  2. Group A Strepto
  3. Viridan group strep
  4. S. Epidermidis
  5. E. Coli
  6. Klebsiella
  7. Proteus
  8. Enterobacter
  9. Pseudomonas
102
Q

RIPE Therapy for Active TB

All RIPE drugs cause what 2 things?

A

Increase LFTs, including total bilirubin

103
Q

Primary Prophylaxix in pts with HIV

PCP Indication for proph

Tx regimen preferred and Alt (2 sets)

Criteria to DC

A
  1. CD4 < 200
  2. Preferred Bactrim DS
  3. Alt: Dapsone or Dap +pyrimethamine + Leucovorin
  4. DC when CD4 >= 200 for >= 3 months on ART
104
Q

Adult prophylaxis regimens for Pts at risk of IE during dental procedure?

3 options

A
  1. Oral: amox 2 g 30-60 min before procedure
  2. Cant take oral: Amp 2 g or cefazolin 1 g
  3. Can take oral but PCN allergy:
    1. Clindamycin 600
    2. Azithro or clarithromycin 500
105
Q

First line abx tx for Acute Otitis media What is the dosing?

A
  1. Amoxicillin 80-90 mg/kg/day in 2 divided doses
  2. Amox/clav 90 mg/kg/day if pt has gotten Amox in the past 30 days

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