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NAPLEX > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

1st line treatments with Penicillins

A

Pen VK - strep throat, nonprurulent skin infections
Amoxicillin - otitis media, endocarditis prophy before dental
Augmentin - otitis media, sinus infection
Pen G - Syphillis
Zosyn - pseudomonas

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2
Q

1st gen Cephalosporins

A

cephalexin, cefazolin
GPC, MSSA, GNR(PEK)
cephalosporins have <10% risk of causing PCN allergy

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3
Q

2nd gen Cephalosporins

A

cefuroxime, cefotetan, cefoxitin

GNR (HNPEK), cefuroxime for S. pneumo

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4
Q

3rd gen Cephalosporins

A

ceftriaxone, ceftazidime, cefotaxime
ceftazidime for pseudomonas
ceftaz/aavibactam for MDR pseudomonas
avoid ceftriaxone in infants

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5
Q

4th gen Cephalosporins

A

cefepime

gram neg, gram pos, pseudomonas

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6
Q

5th gen Cephalosporins

A

ceftaroline

MRSA - only penicillin against MRSA

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7
Q

Carbapenems

A

doripenem, imipenem/cilastatin, meropenem, ertamenem
do not use if PCN allergy
gram pos, gram neg (ESBLs), anaerobes
s/e: seizures (decrease valproate conc.), SJS/TEN

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8
Q

Aztreonam

A

use if PCN allergy

gram neg, pseudomonas

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9
Q

Aminoglycosides

A

gentamycin, tobramycin, streptomycin, amikacin
extended interval dosing
desired peak >10x MIC, peak 5-10, trough <2
s/e: nephrotoxic, ototoxicity, respiratory paralysis

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10
Q

Quinolones

A

ciprofloxacin, levofloxacin, moxifloaxacin, delfloxacin (Baxdela)
resp. quinolones (levo, moxi) cover S. pneumo
cipro, levo cover pseudomonas
delafloxacin (Baxdela) covers MRSA
s/e: tendon rupture, peripheral neuropathy, seizures, QT prolongation, photosensitivity
separate from cations (Tums, multivitamins)

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11
Q

Macrolides

A

azithromycin, clarithromycin, erythromycin
atypical coverage: legionella, chlamydia, Mycoplasma, Mycobacterium
azithromycin (Z-pack) - 500mg day 1, 250 mg days 2-5
clarithro, erythromycin - do not use w/ statins
s/e: QT prolongation, hepatotoxicity, GI upset

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12
Q

Tetracyclines

A

doxycycline, tetracycline, minocycline
c/i in pregnancy, breastfeeding, children <8 yrs - decreased bone growth, skeletal development
s/e: teeth discoloration, photosensitivity, DILE, SJS/TEN
separate from divalent cations
doxy treats CA-MRSA, skin infections, VRE, UTIs

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13
Q

Sulfonamides

A 
Bactrim (SMZ/TMP) 800/160 DS
severe infection: 2 DS BID-TID
uncomplicated UTI: 1 DS BID x3 days
PCP prophy: 1 DS tab daily
s/e: SJS/TEN, photosensitivity, crystalluria, pos. Coombs test
increases INR - monitor warfarin
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14
Q

Vancomycin

A

gram pos, MRSA, strep, C. diff
s/e: nephrotoxicity, otooxicity, red man syndrome
trough 15-20
1st line for MRSA

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15
Q

Lipoglycopeptides

A

telavancin, oritavancin, dalbavancin

telavancin = fetal risk, increased mortality, metallic taste

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16
Q

Daptomycin

A

monitor CPK - d/c if myopathy, rhabdo (CPK >1,000)

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17
Q

oxalidinones

A

linezolid, tedizolid
do not use w/ MAOIs
caution w/ serotonergic/adrenergic drugs

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18
Q

Polymyxins

A

colistin, Polymyxin B
MDR gram negs
s/e: nephrotoxic, neurotoxic

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19
Q

Chloramphenicol

A

s/e: gray syndrome, myelosuppression

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20
Q

Clindamycin

A

s/e: C. diff colitis

induction test should be performed

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21
Q

Metronidazole

A

use: anaerobes, protozoa, vaginosis, C. diff
don’t use 1st trimester pregnancy
avoid alcohol
s/e: metallic taste

22
Q

Misc antibiotics and uses

A

fidaxomicin (Difcid) - C. diff infection
rifaximin (Xifaxin) - E. coli, traveler’s diarrhea
fosfomycin (Monurol) - uncomplicated UTI, ESBLs, VRE
ntrifurantoin (Macrobid) - uncomplicated UTI (cystitis) s/e: brown urine
mypirocin ointment - eliminate MRSA colonization

23
Q

CA-MRSA, SSTIs

A

Bactrim, doxycycline

IV: vanc, linezolid, daptomycin

24
Q

nosocomial MRSA

A

vanc, linezolid, telavancin, daptomycin

25
Q

VRE

A

E. fecalis: Pen G, ampicillin, linezolid

E. faecium: daptomycin, linezolid

26
Q

Pseudomonas

A

Zosyn, cefepime, imipenem, cipro/levo, aztreonam, aminoglycosides

27
Q

ESBLs, E. coli, Klebsiella, Proteus

A

carbapenems - imipenem, doripenem, ertapenem

28
Q

Bacteroides

A

metronidazole, augmentin, unasyn, cefotetan, cefoxitin, carbapenems

29
Q

C. diff

A

metronidazole, oral vanc, fidaxomicin

30
Q

Atypicals

A

azithromycin, doxycycline, quinolones

31
Q

HNPEK

A

amoxicillin, augmentin, unasyn

32
Q

meningitis

A

s/sx: stiff neck, HA, AMS, photophobia
age <1month: ampicillin + cefotaxime or gent
age 1-23 mo: ceftriaxone + cefotaxime + vanc
age 2-50 yrs: ceftriaxone + vanc
age >50 or immunocompromised: ceftriaxone + vanc + ampicillin
PCN allergy: quinolone + vanc

33
Q

acute otitis media

A

observe for 48-72 hours
amoxicillin or augmentin in 2 divided doses x7-10d
PCN allergy = ceftriaxone
PCV13, PPSV23, flu vaccines help prevent

34
Q

pharyngitis

A

S. pyogenes

tx: PCN, azithromycin

35
Q

Bronchitis

A

primarily respiratory virus
w/o COPD exacerbation: supportive care
w/ COPD exacerbation: augmentin

36
Q

CAP

A

no abx past 90d nor cormorbidity: macrolide (azithromycin, clarithro, erythro) or doxycycline
abx past 90d or comorbidity: ccefpodoxime/cefdinir + macrolide/doxy; resp. quinolone (levo, moxi)
inpatient: ceftriaxone/cefotaxime + azithromycin; or resp quinolone

37
Q

HAP

A

onset >48hrs after admission
MDR pseudomonas risk (abx last 90d): zosyn, cefepime, ceftazidime, levo, cipro, aztreonam, tob/gent PLUS vanc or linezolid
no MDR risk: zosyn, cefepime, levo, imipenem, meropenem x7d

38
Q

Tuberculosis

A

intensive phase: RIPE (rifampin, isoniazid, pyrazinamide, ethambutol) - 4 drugs x2 months
continuation phase: 2 drugs x4 months

39
Q

endocarditis

A

PCN, ampicillin, nafcillin, cefazolin
use vanc + gent if prosthetic valve
dental prophy: amoxicillin 2g, clinda 600mg, or azithro/clarithromycin if PCN allergy. 1 dose 30-60 min before procedure

40
Q

SSTIs

A

impetigo: honey-colored crust. tx: mupirocin, cephalexin
folliculitis: MSSA=cephalexin, MRSA=Bactrim, doxy
cellulitis: cephalexin
abscess: Bactrim, doxy

41
Q

Diabetic Foot Infection

A

vanc + ceftazidime/cefepime/carbapenem

42
Q

UTI

A

s/sx: dysuria, urgency, frequency, burning
pyuria (WBC >10), bacteriuria (> 10^2 bacteria/mL)
uncomplicated: nitrofurantoin 100mg BID x5d
pyelonephritis: cipro, levo, ceftriaxone, Bactrim

43
Q

C. difficile

A

mild/moderate 1st infection: metronidazole 500 ID x10-14d
2nd infection: vanc taper
severe: oral vanc 125mg QID x10-14d

44
Q

Traveler’s Diarrhea

A

bloody = dysentery = azithromycin

not bloody = cipro, levo, rifaximin

45
Q

Syphillis

A

2.4 M units Pen G IM x1

46
Q

Gonnorrhea

A

ceftriaxone + azithromycin or doxycycline

47
Q

Chlamydia

A

azithromycin 1g x1

48
Q

Vaginosis

A

fishy ordor

metronidazole

49
Q

Antifungals

A

fluconazole for C. albicans
voriconazole for aspergillus
s/e: optic neuritis, vision problems

50
Q

herpes labialis

A

acyclovir 400 5x daily x5d

valacyclovir 2g BID x1d

51
Q

CMV

A

ganciclovir, valganciclovir (Valcyte)

52
Q

Opportunistic Infections in HIV

A

PCP if CD4 <200: Bactrim DS daily
Toxoplasma if CD4 <100: Bactrim DS daily
MAC if CD4 <50: azithromycin

NAPLEX (20 decks)

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