infectious diseases Flashcards
gram positive cocci - clusters
staph
gram positive cocci - pairs & chains
strep & enterococcus
gram positive rods
listeria & corynebacterium
gram positive anaerobes
peptostrep, propionibacterium, C. diff
atypical bacteria
chlamydia
legionella
mycoplasma
mycobacterium tuberculosis
gram negative anaerobes
bacteroides fragilis
prevotella
gram negative cocci
neisseria
gram negative coccobaccili
acinetobacter, bordatella, moraxella
gram negative rods
HENPEKS, pseudomonas
common resistant pathogens
Kill Each And Every Strong Pathogen
Klebsiella (ESBL, CRE)
E. coli
Acinetobacter
Enterococcus
Staph (MRSA)
Pseudomonas
which antibiotics are hydrophilic
beta lactams
aminoglycosides
vancomycin
daptomycin
polymyxin
which antibiotics are lipophilic
quinolones
macrolides
tetracyclines
rifampin
linezolid
penicillin coverage
natural - gram positive cocci (strep & enterococcus)
antistaph - staph & strep
amino - staph & strep & enterococcus + HNPE
extended penicillins - amino coverage + CAPES + pseudomonas
penicillin side effects & info
seizures, GI upset, diarrhea, rash, hemolytic anemia
antistaph - preferred MSSA coverage, no renal adjustments, nafcillin is a vesicant (hyaluronidase)
cephalosporin coverage
1st - staph/strep (MSSA) + PEK
2nd - staph/strep + HNPEK (cefotetan & cefoxitin add B fragilis coverage)
3rd - staph/strep (resistant) + HNPEK (ceftazidime covers pseudomonas and NO gram positive)
4th - gram positive + HNPEK + CAPES + pseudomonas
5th - + broad gram positive + MRSA
cephalosporin info
CI (ceftriaxone) - biliary sludging in neonates
W (cefotetan) - disulfiram like reaction
SE - seizures, hemolytic anemia, GI upset, diarrhea, rash
carbapenem coverage
MDR gram negative infections
gram positive + gram negative (ESBL) + anaerobes + pseudomonas
ertapenem does not cover pseudomonas, acinetobacter, enterococcus (PEA)
monobactam coverage
gram negative + pseudomonas
aminoglycoside coverage
gram negative + pseudomonas
aminoglycoside dosing for extended interval
4-7 mg/kg/dose (AdjBW unless underweight)
aminoglycoside info
BW - nephrotoxic, ototoxic, NM blockade
quinolone coverage & MOA
DNA gyrase and topo IV
broad spec + atypicals
cipro & levo have pseudomonas
quinolone info
BW - tendon, peripheral neuropathy, seizures
W - QT, hypo/hyperglycemia, psych, photosensitivity
macrolide coverage & MOA
50S
broad spec + atypicals
macrolide info
W - QT, hepatotoxicity, CAD (clarithromycin)
tetracycline coverage & MOA
30S
broad spec + atypicals
doxycycline for CA-MRSA and VRE
tetracycline info
BW - teeth, photosensitivity, DILE (minocycline)
IV:PO is 1:1
sulfonamide coverage & MOA
folic acid pathway
broad spec + shigella, salmonella, strenotrophomonas + OI
NO PSEUDO, ANAEROBE, ATYPICAL
sulfonamide info
5:1 SMP:TMP ratio
BW - SJS, TTP, hemolytic anemia
SE - increased K, photosensitivity, crystalluria
vancomycin MOA & info
D-ala-D-ala
nephro & oto
infusion reaction
do NOT use for MRSA if MIC >2
lipoglycopeptides MOA & info
D-ala and bacterial wall synthesis
cover
BW - fetal risk (telavancin), do not use IV UFH for 120 hours
W - can falsely increase PT/INR and aPTT
dalbavancin & oritavancin are a single dose regimen
daptomycin coverage & info
VRE & MRSA
BW - myopathy, rhabdo, can falsely increase PT/INR
SE - increase CPK
linezolid info
no renal adjustments
1:1
myelosuppression, thrombocytopenia, neuropathy, hypoglycemia
synercid info
VRE faceium ONLY
BW - arthralgias, hyperbilirubinemia
tigecycline coverage
3 Ps
pseudomonas
proteus
providencia
which antibiotic causes gray syndrome
chloramphenicol
clindamycin coverage & info
gram positive + CA-MRSA + anaerobes
no renal adjustment
D-test done to indicate resistance
metronidazole coverage & info
anaerobes + protozoal
1:1
CI - pregnancy, disulfiram reaction
nitrofurantoin coverage & info
VRE
hemolytic anemia
which antibiotics do not require renal adjustment
antistaph penicillins
doxycycline
ceftriaxone
clindamycin
macrolides
metronidazole
moxifloxacin
linezolid
common pathogens for meningitis
Neisseria, strep pneumoniae, haemophilus
listeria in neonates and >50 and immunocompromised
meningitis treatment
dexamethasone prior or WITH
amp + cefotaxime/gent in neonates
amp + cef + vanc in >50 or immunocompromised
cef/cefotaxime + vanc
common acute otitis media pathogens
strep, H. influenzae, moraxella
acute otitis media treatment
observe 48-72 hours in non severe >6 months and symptoms in one ear
amox or augmentin 90 mg/kg OR cefdinir, cefuroxime, cefpodoxime, ceftriaxone
pertussis treatment
macrolides
COPD exacerbation treatment
augmentin
CAP pathogens
SMH
CAP treatment
amox OR doxy OR macrolide - healthy
beta lactam + macrolide OR doxy
quinolone monotherapy
HAP/VAP treatment
pseudomona coverage + vanc
2 antipseudomonas + vanc if MDR
latent TB treatment
INH + rifapentine weekly x 12 weeks
INH + rifampin x 3 months
rifampin x 4 months
INH x 6-9 months
active TB treatment
RIPE x 2 months then RI x 4 months
RIPE info
R - hemolytic anemia, hepatotoxicity, flu like symptoms, orange/red discoloration
I - peripheral neuropathy, hemolytic anemia, DILE, hepatotoxicity
P - gout, hepatotoxicity
E - optic neuritis, hepatotoxicity, connfusion
IE treatment
viridans - penicillin or cef
MSSA - nafcillin or cefazolin
MRSA - vanc
enterococci - penicillin or amp
VRE - dapto or linezolid
intra abdominal infection treatment
SBP - cef
SBP prophylaxis - bactrim, cipro
secondary peritonitis - PEK coverage + metronidazole
impetigo treatment
mupirocin
cephalexin
folliculitis treatment
cephalexin
bactrim or doxy
cellulitis treatment - mild
cephalexin
CA-MRSA abscess
bactrim, doxy
severe SSTI treatment
vanc, dapto, linezolid
necrotizing fasciitis treatment
vanc + beta lactam
DFI treatment
unasyn, zosyn, carbapenem, moxifloxacin
vanc + something else
cystitis treatment
macrobid x 5
bactrim x 3
fosfomycin x 1
amoxicillin or cephalexin in pregnancy
pyelonephritis treatment
quinolone or ceftriaxone if resistance
complicated UTI treatment
carbapenem
syphilis treatment
bicillin LA (pen G) 2.4 x 1
doxy x 14
2.4 x 3 weeks if late latent or tertiary
or doxy
neurosyphilis treatment
pen G IV
gonorrhea treatment
ceftriaxone (add doxy if chlamydia is not excluded)
chlamydia treatment
doxy
azithro if pregnant
bacterial vaginosis treatment
metro
trichomoniasis treatment
metro
genital warts treatment
imiquimod cream
azole class issues
hepatotoxicity, QT, drug interactions
HIV replication stages
- binding - maraviroc
- fusion - enfuvirtide
- reverse transcriptase - NRTI/NNRTI
- integration - INSTI
- replication
- assembly
- budding - PI
biktarvy generic
bictegravir/TAF/emtracitabine
triumeq generic
dolutegravir/abacavir/lamivudine
dovato generic
dolutegravir/lamivudine
tivicay generic
dolutegravir
truvada generic
TDF/emtricitabine
descovy generic
TAF/emtricitabine
NRTI info
lactic acidosis, nausea, diarrhea, LFT, headache
HBV
emtricitabine - hand pigmentation
didanosine/stavudine - pancreatitis
INSTI info
B - SCr
R - CPK
E - proteinuria
D - HSR, neural tube defects, CPK
headache, insomnia, diarrhea, weight gain
separate from polyvalent ions
raltegrevir brand
isentress
NNRTI info
efavirez - take without food QHS
rilpivirine - take with food & do not use with PPI
hepatotoxicity and rash
PI info
take with food
metabolic abnormalities
drug interactions
atazanavir brand
reyataz
darunavir brand
prezista
stribild generic
elvitegravir/cobicistat/emtricitabine/TDA
take with food
genvoya generic
elvitegravir/cobicistat/emtricitabine/TAF
take with food
atripla generic
efavirenz/3tc/TDF
complera generic
rilpivirine/3TC/TDF
odefsey generic
rilpivirine/3TC/TAF
epzicom
abacavir/lamivudine
