Infectious Disease Final Exam Material Flashcards
Veetids
Penicillin V Potassium
1. Pharyngitis
2. SSTIs
3. Endocarditis Prophylaxis
4. TAKE with empty stomach
Dicloxacillin
- SSTIs
- TAKE with empty stomach
Nafcillin
- SSTIs
- Eliminated by the liver, no renal adjustment
Pfizerpen-G
Penicillin G
1. Endocarditis
2. Neurosyphilis
Amoxil
Amoxicillin
1. Pharyngitis
2. Otitis Media
Principen
Ampicillin
1. Respiratory Tract Infections
2. Meningitis
Augmentin
Amoxicillin/Clavulanate
1. Suspension = otitis media
2. Tablets = sinusitis/CAP
3. DIARRHEA = TAKE WITH food
4. CI with CrCl <30
Unasyn
Ampicillin/Sulbactam
1. SSTI
Zosyn
Piperacillin/Tazobactam
Keflex
Cephalexin
1. Pharyngitis
2. SSTIs
3. Endocarditis Prophylaxis
4. TAKE on empty stomach
Ancef
Cefazolin
1. SSTIs
2. Endocarditis Treatment
3. Surgical Prophylaxis
4. INCREASED INR
Ceftin
Cefuroxime
1. Otitis Media
2. CAP
3. Suspension = WITH FOOD
3. Tablet = without regard to food
Omnicef
Cefdinir
1. Pharyngitis
2. Otitis Media
3. CAP
4. DISCOLORED stools
Rocephin
Ceftriaxone
1. UTIs
2. Gonococcal Infections
3. Meningitis
4. CAP
5. BILIARY elimination, no renal dose adjustment
Maxipime
Cefepime
1. Febrile neutropenia
2. HAP/VAP
3. Noscomial Infections
Teflaro
Ceftaroline
1. Severe CAP
2. SSTIs
Primazin
Imipenem/Cilastatin
1. Renal Adjust CrCl <90
Invanz
Ertapenem
1. Renal Adjust CrCl <30
2. NOT active against: Pseudomonas, Acinetobacter, or Enterococcus
Merrem
Meropenem
1. Renal Adjust CrCl <50
Ery-Tab
Erthromycin
1. HIGHEST risk of QT prolongation of the macrolides
2. Upper and Lower Respiratory Tract Infections
3. Base and Salt forms are NOT interchangeable
Biaxin
Clarithromycin
1. COPD Exacerbation
2. CAP
3. H. pylori
Zithromax
Azithromycin
1. Otitis Media
2. CAP
3. COPD Exacerbation
4. BILIARY excretion
Cipro
Ciprofloxacin
1. Complicated UTIs
2. Gram Neg Pneumonia
3. RENAL dose adjust
Levaquin
Levofloxacin
1. HAP/VAP
2. CAP
3. Complicated UTI
4. RENAL dose adjust
Avelox
Moxifloxacin
1. CAP
2. NO renal adjustment
Sumycin
Tetracycline
1. RENAL adjust
2. Atypical and Mycoplasma pneumonia
3. Chlamydia
Vibramycin
Doxcycline
1. NO renal adjustment
2. CAP
3. Chlamydia
Minocin
Minocycline
1. RENAL adjust
2. Atypical and Mycoplasma Pneumonia
3. Chalmydia
4. Can cause vertigo
Bactrim
Sulfamethoxazole/Trimethoprim
AE: Photosensitivity and Rash
CI: Sulfa Allergy
PC: Take with EMPTY stomach and ample water
Macrobid/Macrodantin
Nitrofurantoin
1. Uncomplicated UTIs
2. AE: Nausea
3. Take with Food
4. Avoid in >65 yrs w/CrCl <30
Monurol
Fosfomycind
1. UTIs
2. Oral powder for solution
Flagyl
Metronidazole
1. Anaerobic Infections
2. AE: Nausea and Metallic Taste
3. Take with FOOD
Metrogel-Vaginal
Metronidazole
1. Topical Gel
2. Candida Superinfection
Dificid
Fidaxomicin
1. C.diff colitis
Rifampin
- Always used in combination with other agents
- Red/Orange discoloration
Vancocin
Vancomycin
1. ORAL = C. diff
2. IV = MRSA
2. AE: Nephrotoxicity
Dalvance
Dalbavancin
1. MRSA
2. Complicated SSTI
3. HALF LIFE 346 HOURS
Cubicin
Daptomycin
1. SSTI
2. MRSA
3. Endocarditis
AE: Myopathy/rhabdomyolysis
Cleocin
Clindamycin
1. Anaerobic infections
2. Can cause Risk of C.diff
AE: diarrhea
Zyvox
Linezolid
1. SSTI
2. HAP/VAP
Diflucan
Fluconazole
1. Oropharyngeal/Esophageal Candidiasis
DDI: Warfarin
Sporanox
Itraconazole
1. Systemic Candidasis
DDI: Antacids and Acid Suppressants
AE: Hepatotoxicity and QT Prolongation
CI: Dofetilide
Nizoral
Ketoconazole Topical
1. Seborrheic Dermatitis
AE: Skin irritation
Nystatin Topical
- Topical powder, cream, ointment
- Cutaneous fungal infections
Griseofulvin
- Ringworm infections
DDI: Warfarin and Oral Contraceptives
PC: Take with a FATTY MEAL
Lamisil
Terbinafine
1. Oncyhomycosis
AE: RASH or Local Irritation
PC: Take with FOOD
Zovirax
Acyclovir
1. Genital Herpes
2. Acute Herpes Zoster
AE: Nephrotoxicity, CNS Toxicity
PC: Drink ample fluids
Valtrex
Valacyclovir
1. Genital Herpes
2. Acute Herpes Zoster
PRODRUG
Tamiflu
Oseltamivir
1. Influenza with symptoms <48 hrs
2. Prophylaxis of influenza
Start within 2 days of symptom onset if used for treatment
Paxlovid
Nirmatrelvir/Ritonavir
CYP3A4 inhibitor
Hepatoxicity
Permethrin
- Head Lice
- Scabies
CI: Do not use on infants <2 months of age
Peridex
Chlorhexidine
1. Antibacterial Oral Hygiene Rinse
AE: Staining oral surfaces
PC: Rinse and spit do not swallow
AVOID food of water immediately after the rinse
Bactroban
Mupirocin
1. Impetigo
Topical Cream or Ointment
Community Acquired Pneumonia CAPs Outpatient
Causative Organisms: s. pneumo, h. flu, m. catarr
Empiric Treatment: amoxicillin with no co-morb but with co-morbid just AUGMENTIN or Cephalosporin + Macrolide or Doxycycline
Duration of Treatment: 5 days minimum
Community Acquired Pneumonia CAPs Hospitalized
Causative Organisms: Strep pneumo, H. flu, and M. catarr
Empiric Treatment: IV Beta Lactam + Macrolide or Resp FQ
Duration of Treatment: 5 days minimum
If MRSA Duration of Treatment: 7 days
HAP/VAP
Causative Organisms: Klebsiella, E. coli, Pseudomonas
Empiric Treatment:
Duration of Treatment: 7 days minimum
Acute Exacerbation of Chronic Bronchitis/COPD Exacerbation
Causative Organisms: Mycoplasma pneumo, strep pneumo, and h. flu
Empiric Treatment:
Duration of Treatment: 5-7 days
Acute Sinusitis
Causative Organisms: strep pneumo, h flu, m catarr
Empiric Treatment: AUGMENTIN
Duration of Treatment: 5-10 days
Acute UTI Cystitis
Causative Organisms:
Empiric Treatment:
Duration of Treatment: 3-5 days
Skin and Soft Tissue Infection Purulent
Causative Organisms:
Empiric Treatment:
Duration of Treatment:
Skin and Soft Tissue Infection Non-Purulent
Causative Organisms:
Empiric Treatment:
Duration of Treatment:
Drugs with Contraindicated CrCl Cutoffs
Augmentin: CrCl <30 CI
Macrobid: >65 yrs w/ CrCl <30 CI
CAP vs HAP
Timing of Onset of Symptoms
1st Generation Cephalosporins
- Cefazolin
- Cephalexin
- Cefadroxil
2nd Generation Cephalosporins
- Cefoxitin
- Cefuroxime
- Cefaclor
3rd Generation Cephalosporins
- Cefotaxime
- Ceftriaxone
- Ceftazidime
- Cefdinir
- Cefpodoxime
4th Generation Cephalosporins
- Cefepime
5th Generation Cephalosporins
- Ceftaroline
- Ceftolozane/Tazobactam
What drugs are preferred for the treatment for Extended Spectrum Beta-Lactamase ESBL?
Carbapenems
Which drug is the only one in the penicillin class that does NOT need renal adjustment?
Nafcillin
Penicillin and Cephalosporin DDIs
- Oral Contraceptives: potential to alter gut flora and absorption
- Probenecid: decreases renal excretion of penicillin agents
Are penicillins bactericidal or bacteriostatic?
Bactericidal
What is the dosing strategy for Zosyn in most indications and for HAP/VAP?
- 3.375 g Q6hr for most indications
- 4.5 g Q6hr for HAP/VAP
What is the dosing strategy for Zosyn in extended interval dosing?
3.375 g or 4.5 g q8 hrs INFUSED OVER 5 HOURS
Which cephalosporin does NOT need renal adjustment while the rest do?
Ceftriaxone
Ancef is a good alternative to anti-staphylococci penicillins except in what type of infections?
CNS infections
Which cephalosporin has DDIs with aluminum, magnesium, iron and is recommended to avoid antacids/iron within 2 hours?
Omnicef
Which cephalosporin has AEs of biliary slugging that can lead to hyperbilirubinemia in infants and neonates?
Rocephin
Which cephalosporin is used as an alternative to Zosyn in cases if mild penicillin allergy when anti-pseduomonal activity is needed and has a MAJOR warning of neurotoxicity: AMS/seizures?
Maxipime
Which carbapenem has the highest risk of GI, Rash, and SEIZURES (class AE)?
Imipenem
What are the DDIs of Carbapenems?
- Lower serum concentration of valproic acid (increases seizure risk)
- Probenecid decreases renal excretion
Macrolide: Clarithromycin and Erythromycin INCREASE serum levels of what?
- Carbamazepine: avoid
- Lovastatin/Simvastatin: avoid
- Triazolam: avoid
- Theophylline: avoid
- Warfarin: MONITOR INR, recommend azithromycin
Macrolide: Azithromycin, Clarithromycin, and Erythromycin INCREASE serum levels of what?
- Digoxin: MONITOR
What are the concerns of AEs in Macrolides?
- GI Upset = recommend to take with food for all of them
- Hepatotoxicity
- QT PROLONGATION
What are the MAJOR warnings of fluoroquinolones?
- Tendonitis and Tendon Rupture
- CNS Effects: SEIZURES
- Hypo-Hyperglycemia
- OT PROLONGATION
When are fluoroquinolones contraindicated?
- Children <18 yr old
- Pregnant women
Fluoroquinolones can cause sun photosensitivity AEs, which one has the least likelihood of causing sun photosensitivity but the higher risk of QT prolongation?
Moxifloxacin
Fluoroquinolone DDIs
- INCREASED Warfarin and Theophylline levels
- Antacids, Iron, and Sucralfate DECREASES absorption (chelation)
Tetracyclines should be avoided in children ___ years of age due to tooth discoloration and be avoided in what other population?
<8 years of age and pregnant women
What are the DDIs of tetracyclines?
- Oral Contraceptives
- Aluminum, bismuth, calcium, magnesium, zinc, and iron salts
Photosensitivity is a major AE of tetracyclines except for which one?
Minocycline
When counseling patients on tetracyclines what are 2 points to mention?
- Take on EMPTY stomach
- No antacids, iron, or dairy, within 2 hours
What are the DDIs of Flagyl?
- Warfarin
- Alcohol - Disulfiram Like Reactions
For non-severe infections, what is the trough monitoring for Vancomycin?
Trough Concentration 30 minutes before 4th dose
For severe infections, what is the AUC/MIC target goal for Vancomycin?
400-600 mg*hr/L
Linezolid is contraindication with SSRIs, however what are 3 AEs possible?
- Bome Marrow Suppression
- Peripheral and Optic Neuropathy
- Serotonin Syndrome
What is the recommended administration for Sporanox Capsules vs Solution?
Capsule: WITH FOOD
Solution: EMPTY STOMACH
What is the duration of therapy for gram positive bacteremia?
14 days
What is the duration of therapy for gram negative bacteremia?
7-14 days
Macrolide antibiotics are most commonly used for what type of infections?
Respiratory Infections
Which macrolide is the least likely to interact with other drugs?
Azithromycin
Which fluoroquinolone does NOT require renal adjustment?
Moxifloxacin
Veetids and Dicloxacllin have this dosing pearl but not Pfizerpen-G…
Take on an EMPTY stomach
What is the dosing for Amoxil?
500 mg Q6h OR
875 mg Q12h
on an EMPTY STOMACH
What is the high dose for Amoxil Suspension?
90 mg/kg divided Q8-12h
What is the MEDIUM dose for Augmentin?
500 mg Q8-12h
Take at START of meal
What is the HIGH dose for Augmentin?
875 mg Q12h
Take at START of meal
What is the high does of Augmentin ES-600?
90 mg/kg divided q12h
Take at START of meal
What is the dose of AugmentinXR 1000 mg?
2 tablets q12h
Take at START of meal
What is the dosing for Zosyn in most indications with traditional dosing protocol?
3.375 g q6h
Infused over 30 mins
What is the dosing for Zosyn in HAP/VAP with traditional dosing protocol?
4.5 g q6h
Infused over 30 mins
What is the dosing for Zosyn in with extended interval dosing?
3.375 g q8h or 4.5q q8h
Infused over 4 HOURS
What is the dosing of Keflex?
500 mg q8-12h
Take on an EMPTY stomach
What is the dosing of Ceftin?
Take with FOOD
What is the dosing of Omnicef Capsules?
300 mg q12h
AVOID antacids within 2 hrs
What is the dosing of Omnicef Suspension?
14 mg/kg/day in 1 or 2 doses
AVOID antacids within 2 hrs
Does Rocephin need renal adjustment?
NO, high biliary elimination
Does Primaxin need renal adjustment?
YES, adjust for CrCl <90
What is the dosing for Dilfucan in vaginal candidiasis?
150 mg PO QD one time dose
What is the dosing for Diflucan in oropharyngeal candidiasis?
200 mg IV/PO one time dose then 100-200 mg QD
What is the duration of treatment when using Lamisil tablets?
Fingernails = 6 weeks
Toenails = 12 weeks
What is the duration of treatment when using Lamisil topical?
Tinea Pedis = 7-28 days
What is the dosing for Zovirax Treatment?
400 mg TID x 7-10 days
What is the dosing for Zovirax Suppression?
400 mg BID x 1 year
What is the dosing for Zovirax Zoster?
800 mg 5times/day x 7-10 days
What is the dosing of Valtrex Treatment?
1 gram BID x 10 days
What is the dosing of Valtrex Suppression?
500-1000 mg QD
What is the dosing of Valtrex Zoster?
1 gram TID x 7 days
What is the dosing of Tamiflu outpatient adult?
75 mg BID x 5 days
What is the dosing of Tamiflu prophylaxis >13 yrs?
75 mg QD x 10 days
What is the dosing of Paxlovid?
Nirmatrelvir 300 gm with Ritonavir 100 mg BID x 5 days
Must initiate within 5 days of symptom onset
What is the dosing for Erythromycin?
Take with food
What is the dosing for Biaxin?
XR = With FOOD
Norm = without regard to food
What is the dosing for Zithromax CAP outpatient?
500 mg x 1 day
250 mg x 4 days
What is Cipro abdominal dosing?
500 mg PO q12h
What is Cipro respiratory dosing?
750 mg PO q12h
What is Levaquin respiratory dosing?
750 mg PO QD
Sunmycin dosing prefers what?
EMPTY stomach but food can be given if needed
What is the dosing of Vibramycin respiratory?
100 mg BID
EMPTY stomach, take with food if needed
Minocin dosing prefers what?
EMPTY stomach, take with food if needed
What is the dosing of Bactrim for Acute UTI?
1 DS tablet BID x 3 days, take on EMPTY stomach
What is the dosing of Bactrim for CA-MRSA/SSTI treatment?
1-2 DS tablets BID
What is the dosing of Macrobid for Acute UTI?
100 mg q12h x 5 days and take with FOOD
What is the dosing for Monurol?
3 grams PO ONCE
What is the dosing for Flagyl in intra-abdminonal infections?
500 mg IV/PO q8h + Cipro
What is the dosing for Mupirocin?
TID to affected areas, for impetigo
What is the counseling for Peridex?
- Spit, do not swallow
- After brushing
- Wait 60 mins before eating or drinking
What is the dosing of Vancocin for C.diff?
PO x 10 days
What is the dosing of Cleocin for serious gram + infections?
150-450 mg q6h