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Pharm > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

Common drugs

MSSA

A
  1. Dicloxacillin, oxacillin, naficillin
  2. 1st gen cephs (cefazolin, cephalexin)
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2
Q

Common drugs

CA-MRSA SSTI

A
  1. Bactrim
  2. doxycycline
  3. clindamycin
  4. linezolid
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3
Q

Common drugs

VRE (E. faecalis)

A
  1. Pen G, ampicillin
  2. linezolid
  3. daptomycin
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4
Q

Common drugs

VRE (E. faecium)

A
  1. linezolid
  2. daptomycin
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5
Q

Common drugs

HNPEK

GNR (H. influenzae, Neisseria, Proteus, E.coli, Klebsiella)

A
  1. B-lactams/B-lactamase inhibitor (Avycaz, Zerbaxa)
  2. amoxicillin
  3. cephs (except 1st gen)
  4. carbapenems
  5. Bactrim
  6. AG
  7. FQ
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6
Q

Common drugs (DOC)

Atypicals

Legionella, Chlamydia, Mycoplasma, Mycobacterium tuberculosis

A
  1. macrolides (azithromycin, clarithromycin)
  2. doxycycline
  3. FQ
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7
Q

Common drugs

Pseudomonas

GNR

A
  1. Zosyn
  2. cefepime
  3. ceftazidime
  4. Avycaz, Zerbaxa
  5. carbapenem (except ertapenem)
  6. aztreonam
  7. cipro, levofloxacin
  8. AG
  9. colistimethate, polymyxin B
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8
Q

Common drugs

Acinetobacter baumannii

Gram (-) coccobacilli

A
  1. carbapenems (except ertapenem)
  2. Unasyn
  3. FQ
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9
Q

Common drugs

ESBL GNR

ES b-lactamase
E. coli, K. pneumoniae, Proteus mirabilis (PEK)

A
  1. carbapenems
  2. Avycaz, Zerbaxa
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10
Q

Common drugs

CRE GNR

A
  1. Avycaz
  2. colistimethate, polymyxin B
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11
Q

Common drugs

Bacteroides fragilis

aneaerobe

A
  1. metronidazole
  2. BL/B-lactamase inhib (Avycaz, Zerbaxa)
  3. cefotetan, cefoxitin (2nd gen cephs)
  4. carbapenem
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12
Q

Common drugs

Clostridium difficile

A
  1. Vancomycin (PO)
  2. Fidaxomicin (Dificid)
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13
Q

ABX - No renal dose adj

NOT CLeAReD

A
  1. naficillin
  2. oxacillin
  3. tigecycline
  4. clindamycin
  5. linezolid
  6. azithromycin (+ erythomycin)
  7. Rocephin (ceftriaxone)
  8. doxycycline
  9. metronidazole
  10. moxifloxacin
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14
Q

3rd ceph

ceftriaxone, cefotaxime

coverage AND DOC?

A
  1. MDR Strep. pneumoniae
  2. MDR HNPEK

DOC: sepsis, CAP, S. pneumoniae,

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15
Q

ceph/B-lactamase inhib combo

Avycaz, Zerbaxa

coverage?

A
  1. MDR Pseudomonas
  2. MDR GNR
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16
Q

Cephs

What do ALL cephs do not cover?

A
  1. Enterococci (E. faecalis, E. faecium)
  2. atypicals (Chlamydia, Mycobact…)
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17
Q

Cephs

Cephlasporins

Class effect?

A
  1. PCN allergy cross-sensitvity
  2. Seizure risk
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18
Q

Carbapenems

Carbapenems

Indication?

A
  1. Reserved for MDR GNR
  2. Pseudomonas
  3. ESBL grm (-)
  4. most grm (+)
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19
Q

Carbapenems

Carbapenem

Does not cover?

A
  1. atpicals
  2. MRSA
  3. VRE
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20
Q

Carbapenems

Ertapenem

Does not cover? (hint: PEA)

A
  1. Pseudomonas
  2. Enterococcus
  3. Acinetobacter
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21
Q

Carbapenem

Carbapenem

Class effect?

A
  1. CI: PCN allergy
  2. Seizure risks
  3. Monitor renal fxn
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22
Q

Monobactam

Aztreonam

Indication?

A

when b-lactam allergy is present

No cross-sensitvity to PCN

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23
Q

Monobactam

Aztreonam

Coverage?

A
  1. Many gm (-)
  2. Pseudomonas
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24
Q

Monobactam

Aztreonam

Does not cover?

A
  1. gm (+)
  2. anaerobes
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25
Q

Aminoglycosides

Aminoglycosides

Coverage?

A
  1. gm (-)
  2. Pseudomonas
  3. gm (+) WHEN USED FOR SYNERGY WITH b-lactam or vancomycin

Primarily used as EMPIRIC tx when in combo w/ other abx (not monotx)

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26
Q

Aminoglycosides

Aminoglycosides

BBW?

A
  1. nephrotoxcity (caution: renal imp.)
  2. ototoxicity
  3. neuromuscular bloackade
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27
Q

Aminoglycosides

Aminoglycosides

Monitoring? based on dosing?

A
  1. renal fxn
  2. traditional dosing - draw trough right before/30 min prior to 4th dose, draw peak 30 min after the end of 30-min infusion for the 4th dose
  3. extended-interval dosing - draw random level
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28
Q

Fluoroquinolones

Fluoroquinolones

Class effect? (BBW, SE, DDI) (note: SPRING)

A
  1. BBW - tendon rupture, peripheral neuropathy, CNS effects (seizures, tremor, hallucinations, etc)
  2. SE - skin (photosensitvity), prolong QT, increase C. diff risk, glycemia (hyper/hypo)
  3. DDI - multivitamin (polyvalent cations), antiacids, lanthum, sevelamer, QT prolonging drugs (e.g. azole, macrolides)
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29
Q

Fluoroquinolones

What FQs cover Pseudomonas?

A

Cipro, levofloxacin

30
Q

Macrolides (-mycins)

Macrolides

Coverage?

A
  1. atypicals (Legionella, Chlamydia, Mycoplasma, Mycobacterium)
31
Q

Macrolides (-mycin)

Macrolides

Tx indication?

A
  1. CA-URTI, LRTI
  2. Chlamydia (atypical)
32
Q

Macrolides (-mycin)

Macrolides

DDI?

A
  1. Clarithromycin, erythromycin (CYP3A4 inhib) - do not use with simvastatin and lovastatin
  2. warfarin
  3. QT prolonging drugs (azoles, FQ)
33
Q

Macrolides (-mycins)

Macrolides

Class effect

A
  1. QT prolongation
  2. hepatoxicity (liver)
  3. GI upset
34
Q

Tetracyclines

Tetracyclines

Coverage?

A
  1. gm (-)
  2. atypicals (Legionella, Chlamydia, Mycobact…)
  3. Rickettsiae/tick-bourne dz
35
Q

Tetracyclines

Tetracyclines

Class effect?

A
  1. Do not use in pregnancy, breastfeeding, or children <8 yo
  2. SE: photosensitivity
36
Q

Tetracyclines

Doxycycline

First-line?

A
  1. Lyme disease
  2. Rocky mountain spotted fever (tick-bourne)
  3. CAP
  4. COPD exacerbations
  5. VRE UTI
  6. Chlamydia
37
Q

Tetracyclines

Tetracyclines

DDI

A
  1. multivitamins, antiacids (polyvalent cations)
  2. bismuth salicylate (Pepto-bismul)
  3. bile acid resins
38
Q

Sulfonamides

TMP/SMX

Class effect?

A
  1. CI: sulfa allergy, pregnancy/breasfeeding
  2. Warnings - skin rxns (SJS, TTP), G6PD def (hemolysis risk)
  3. SE - inc K, photosensitvity, hemolytic anemia, crystalluria (take with 8 oz water)
39
Q

Sulfonamides

TMP/SMX

Coverage

A
  1. MRSA
  2. CA-MRSA
  3. HPEK
  4. Shigella, Salmonella, Stenotrophomonas
  5. opportunistic infections (Toxiplasmosis, Pneumocystitis (PJP))
40
Q

Sulfonamides

TMP/SMX

Does not cover?

A
  1. Pseudomonas
  2. Enterococcu
  3. atypicals
  4. anaerobes
41
Q

Sulfonamides

TMP/SMX

DDI

A
  1. CYP2C9 inhibitor - warfarin (inc INR).. use alternative
  2. Other meds that cause hyperkalemia
42
Q

Gm (+) abx; no gm (-)

Vancomycin

Covers?

A
  1. ONLY COVERS GM (+)
  2. MRSA
  3. C. diff (PO only)
43
Q

Gm (+) abx; no gm (-)

Vancomycin

Class effect?

A
  1. SE - redman syndrome (infusion rxn; no >1 g/hr), ototoxicity, nephrotoxicity
44
Q

Gm (+) abx; no gm (-)

Vancomycin

Therapeutic drug levels?

A
  1. AUC/MIC 400-600
  2. Trough 15-20 (draw 30 min before 4th or 5th dose)
45
Q

Gm (+) abx; no gm (-)

Daptomycin

Warnings?

A
  1. Inc CPK - rhabdomyolysis, myopathy
  2. False inc of PT/INR

Monitor CPK weekly

46
Q

Gm (+) abx; no gm (-)

Daptomycin

Does not treat?

A

Pneumonia
(inactivated by lung surfacants)

47
Q

Gm (+) abx; no gm (-)

Daptomycin

Covers?

A
  1. MRSA
  2. VRE
48
Q

Gm (+) abx; no gm (-)

Linezolid

Covers?

A
  1. MRSA
  2. VRE
49
Q

Gm (+) abx; no gm (-)

Linezolid

Class effects?

A
  1. CI - do not use within 2 weeks of MOA inhibitors
  2. Warning - myelosuppression (thrombocytopenia, anemia, leukopenia), optic neuropathy, serotonin syndrome, hypoglycemia
  3. SE - dec plts
  4. Monitor CBC qweek
50
Q

Gm (+) abx; no gm (-)

Clindamycin

Coverage?

A
  1. most gm (+)
  2. CA-MRSA
  3. aneaerobes
51
Q

Gm (+) abx; no gm (-)

Clindamycin

BBW?

A

CI - colitis (C. diff)

52
Q

Metronidazole

Covers?

A
  1. anaerobes
  2. B. frag
  3. protozoal organisms (bacterial vaginosis, trichomoniasis)
53
Q

Metronidazole

Indication?

A

Used in combo for intra-abdominal infections

54
Q

Metronidazole

Class effect?

A
  1. CI - pregnancy (1st trimester), alcohol during treatment or within 3 days of d/c (disulfiram rxn)
  2. SE - metallic taste
55
Q

Metronidazole

Covers?

A
  1. anaerobes
56
Q

Community-acquired pneumonia (CAP)

Common pathogens?

A
  1. S. pneumoniae
  2. H. influezae
  3. M. pneumoniae
57
Q

Community-acquired pneumonia (CAP)

outpatient tx for healthy PTs

A
  1. High-dose amoxicillin
  2. Doxycycline
  3. Macrolide

Usually PO meds

58
Q

Community-acquired pneumonia (CAP)

outpatient tx for high-risk PTs

A
  1. B-lactam (Augmentin OR ceph) + (macrolide OR doxycycline)
  2. Respiratory FQ monotx (moxi, levofloxacin)

Usually PO meds

59
Q

Community-acquired pneumonia (CAP)

inpatient tx in non-severe/general med unit PTs

A
  1. B-lactam (Unasyn OR ceph) + (macrolide OR doxycycline)
  2. Respiratory FQ monotx (moxi, levofloxacin)

Usually IV meds

60
Q

Community-acquired pneumonia (CAP)

inpatient tx in severe/ICU PTs

A
  1. B-lactam + macrolide
  2. B-lactam + resp FQ

Usually IV meds; no FQ monotx

61
Q

HAP/VAP

Definitions?

A

HAP - onset >48hrs after hospital admission
VAP - onset >48 hours after start of mechanical ventilation

62
Q

HAP/VAP

Common pathogens

A
  1. S. aureus (+ MRSA)
    MDR GNR
  2. Enterobacter
  3. Pseudomonas
  4. Acinetobacter
  5. E. coli
  6. Klebsiella
63
Q

HAP/VAP

Tx in ALL pts

A

ALL PTs need abx for Pseudomonas AND MSSA
E.g.
1. cefepime
2. Zosyn
3. cipro/levofloxacin

64
Q

HAP/VAP

If at risk for MRSA?

A

ADD vancomycin (combo regimen)

65
Q

HAP/VAP

If at risk for MDR GNR?

A

Need 2 abx for **Pseudomonas **
E.g.
1. Zosyn + cipro/levo + vanco
2. **Cefepime + gentamicin **+ linezolid

Typically MRSA risk is present as well

66
Q

DOC

MSSA

A

Nafcillin/oxacillin

67
Q

DOC

CA-MRSA

A
  1. doxycycline
  2. Bactrim
68
Q

DOC

non-CA-MRSA

A

Vancomycin

69
Q

DOC

Enterococcus

A

Ampicillin

70
Q

DOC

ESBL

A

Carbapenems

71
Q

Cephs that cover anaerobes/B. frag

TITANIC

A
  1. Cefotetan
  2. Cefoxitin

2nd gen cephs

Pharm (7 decks)

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