Infectious Disease pt 2 Flashcards
Perioperative Abx Prophlyaxis:
start _____ before the incision
or start ______ before if using quinolones or vanc
start 60 minutes before
120 mins before if quinolone or vanc
Perioperative Abx Prophlyaxis:
If continued into post-op: typically should be discontinued within ______
24 hours
Perioperative Abx Prophlyaxis:
_____ is preferred drug of choice
cefazolin (1st or 2nd gen cephs are good)
Perioperative Abx Prophlyaxis:
If beta lactam allergy or MRSA concern – give what drug?
vanc
Perioperative Abx Prophlyaxis:
If bowel surgery and concerned for anaerobic infection – give what for prophylaxis?
cefotetan, cefoxitin, ertapenem, or ceftriaxone + metronidazole
(aka drugs with broad gram - coverage AND aneraobe coverage)
3 classic symptoms of meningitis?
stiff neck
severe headache
altered mental status
How to diagnose meningitis?
lumbar puncture
what drug is given 15 - 20 minutes prior to first abx for meningitis treatment (this drug will help prevent neurological complications)
dexamethasone
acute otitis media: may do an observation period for ______ to assess clinical need of abx
48 - 72 hours
AOM (acute otitis media) treatment:
what is 1st line (drug and dose)
Amoxicillin 80 -90 mg/kg/day - divided into 2 doses
or Amox/Clav 90 mg/kg/day divided into 2 doses
what is t/he dose of clavulanate when using amox/clav for AOM
6.4 mg/kg/DAY
what bug typically causes pharyngitis?
and how to treat it?
Respiratory viruses and S. pyogenes
if S. pyogenes - give PCN
Acute bronchitis is primarily caused by what?
respiratory viruses (about 90%…)
what is the gold standard for diagnosing pneumonia?
chest x-ray
outpt CAP (community acquired pneumonia) treatment: what bug most commonly causes this
S. pneumoniae…
outpt CAP (community acquired pneumonia) treatment: \_\_\_\_\_\_\_ is not a respiratory quinolone/does not cover S.pneumoniae and thus would not be a good option
Ciprofloxacin
outpt CAP (community acquired pneumonia) treatment:
when picking abx must look at if…
the patient has used abx in the past _______
3 months
outpt CAP (community acquired pneumonia) treatment:
when picking abx must look at if…
if the pt has ______ or _____
comorbid conditions or immunosuppression
outpt CAP (community acquired pneumonia) treatment: What abx are good options if healthy pt and no abx use in the past 3 months
macrolides (azithromycin, clarithromycin, erythromycin)
or
doxycycline
outpt CAP (community acquired pneumonia) treatment:
What abx are good options if risk for drug resistant S. pneumoniae (aka drug in past 3 months)
or comorbidities?
beta lactam + macrolide
or Respiratory quinolone monotherapy
inpatient CAP treatment:
what drug regimens are used
beta lactam + macrolide
or Respiratory quinolone monotherapy
can do IV or PO drugs for these patients
Hospital acquired pneumonia has an onset of > ______ after hospital admission
48 hours
ventilator assoc. pneumonia has an onset of > ______ after mechanical ventilation
48 hours
Latent TB treatment options? (drug and dosing)
Isoniazid twice weekly for 9 months
Rifampin daily for 4 months
INH and rifampin once weekly for 12 weeks
test to do to check if active TB?
AFB stain (acid fast bacilli)
Active TB treatment regimen?
4 drug regimen (RIPE) for 2 months
then continuation phase
what drugs make up RIPE for active TB treatment?
rifampin
isoniazid (INH)
pyrazinamide
ethambutol
what is given to reduce risk of isoniazid associated peripheral neuropathy?
pyriodoxine
ADEs of isoniazid?
Peripheral neuropathy HA GI upset increased LFTs DILE - drug induced lupus positive coombs test
ADEs of Rifampin?
increased LFTs
orange-red discoloration of body secretions
+ coombs test
flu like syndrome
what drug can replace rifampin for TB treatment if too many drug interactions?
rifabutin
ADEs of pyrazinamide?
increased LFTs hyperuricemia gout GI upset malaise
ADEs of Ethambutol?
optic neuritis (dose related) increased LFTs
what is the drug interaction issues seen with rifampin?
it is a potent INDUCER of 3A4
- affects protease inhibitors
- decreases INR
- decreases oral contraceptive efficacy
stopped pg 423
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