Pharm Block 3 Detailed Flashcards
Define Chemotherapy
What other important group of meds fall under this class?
Use of meds to eradicate pathogenic organisms/neoplastic cells to Tx an infectious dz/ca
ABX
Define Anti-Microbial/Infective agent
What are the two types of anti-microbials
Any substance that suppresses/kills microbes
- cidal- kills reqs no effort from immune system
- static- prevents growth so immune system can catch up
Define Immunocompromised
What class of anti-microbial should be used in this PT group?
No complement or proper Ab function
Bactericidal
What drugs cover MRSA
Vancomycin Linezolid Daptomycin TMP/SMX Clindamycin Doxycycline
What is the only ABX for anaerobe only Tx?
What is the only ABX for Gram Pos only microbes?
Metrindazole
Vanomycin
Streptogramins and Oxazolidinones are used for Tx of ? only
Aztreonam is used only for the Tx of ? two microbe classes?
Gram Pos
Aerobic gram-neg
Pseudomonas
What drugs cover VRE?
Daptomycin
Linezolid
Doxycycline
What drugs provide Pseudomonas Spp coverage?
Piper/Tazo Aztreonam Meropenem Ciprofloxacin Gent/Tobra/Amikarin Colistin
What drugs provide Abdominal anaerobe coverage?
Cefazolin Amp/Sulbactam Merpenam Piper/Tazo Ertampenam Doxycycline Meropenem Clindamycin Moxyifloxacin
What drugs provide Atypical microbe coverage
Moxifloxacin Ciprofloxacin Azithromycin Clindamycin Doxycycline
A microbes ability to produce a B-lactamase is important to what 4 ABX?
What are the SPACE bugs?
PCN, Cephalosporins, Carbapenems, Aztreonam
Gram- Extended Spectrum B-Lactamase (ESBL) Serratia Pseudomonas aeruginosa Acinetobacter Citrobacter Enterobacter
PTs are more likely to have a resistant infection in what 3 scenarios?
What lab result would show a PT has an infection?
Prior ABX use
Hospitals w/ high resistance/ABX use
Inc duration of therapy
Shift to Left from inc Immature Band cells
More immature= greater the infection/further behind the immune system is
What are examples of infection sites that have poor perfusion to deliver ABX?
What adjustment has to be made when applying ABX to MDROs?
DM foot infxn
Bone, Lung, Abscess, CNS
Require broader coverage
What drugs are more likely to cause nephrotoxicity, and photosensitivity?
Aminoglycosides Vancomycin
Quinolones
Tetracyclines
Sulfonamides
Define Concentration dependent killing and an example
Define Time dependent and 2 examples
Inc in rate of killing as concentration increases 4-64x the MIC; Aminoglycosides
% of time that blood concentration must be above MIC, but is not enhanced by drug concentration above MIC; PCN, Cephalosporin
When are ABX combos used for Tx?
Life threatening infxn
Polymicrboial- DM foot wound, immunocompromised PTs
Empiric therapy when one agent isn’t effective- Comm Acq Pneumo
Resistant strain- Pseudomonas, TB
Dec toxicity by using lower doses
Define Synergism
1 + 1= 3 PCM + Aminoglycoside Combo give more than twice the benefits PCN breaks cell wall Aminoglycoside can now enter and effect protein synthesis
What would be a disadvantage of using an ABX combo?
Normal flora includes what 3 types of microbes?
-static w/ a -cidal
Tetracycline (static) inhibits protein synthesis, slows growth
PCN reqs bacterial growth to be effective, antagonized by tetracycline
Bacteria, fungi, protozoa
What are the two types of surgical prophylaxis and when are they given?
Surgical- dirty surgery
Prevention- TB, UTIs, GI bugs
Surgery- ABX in tissue at time of incision; redose if longer than 4hrs or two t1/2 of ABX
Most surgical procedures need protection from ? skin flora?
If a hollow/mucous organ is penetrated ? coverage is needed?
Colorectal surgery needs ? type of coverage?
Strep, Staph, Coag-neg Staph
Gram neg rods and Enterococci
Broad spectrum a/naerobic coverage
Surgical wound infection prophylaxis includes protection against ? with ?
Surgical abdominal infection prophylaxis includes protection against ? with ?
Staph A, Enteric Gram neg Rods w/ Cefazolin, Clindamycin
Enteric Gram neg bacilli, Anaerobes w/ Cefoxitin, Cefotetan, Ertapenem, Cefazolin + Metronidazole
What is the benefit of using Cefazolin + Metronidazole combo?
Cefazolin= Gram Pos coverage Metron= anaerobic coverage
What drugs MOA is cell wall synthesis inhibition?
B-Lactam (PCN, Carbapenem, Cephalosporin, Monobactam)
Vancomycin
Bacitracin
Fofomycin
What drugs MOA is cell membrane inhibition?
Daptomycin Ketoconazole Polymyxin Amphotericin Colisin
Bacteriostatic agent coverage is often adequate in ? infections
When is bactericidal coverage necessary?
Uncomplicated
Neutropenic PTs will render this class ineffective Protected areas from host immune response (endocarditis, CSF, blood infxn)
PCN, B-lactam, Cephalosporin ABXs are all ? and utilize ? dependent killing
-cidal
Time
Renal excretion
Safe for pregnancy
What are the only 4 B-lactams that are NOT renal excreted?
What is the MOA of B-Lactams?
PCN, Cephalosporin, Carbapenem, Monobactam
Interfere w/ last step of cell wall synthesis, transpeptidation/cross-linkage, creating unstable membranes and lysis
Most PCNs are incompletely absorbed after PO administration EXCEPT for ?
PCN has the ability to cross what two important barriers?
Amoxicillin- don’t use for GI infections
Placenta
CSF- empiric meningitis Tx
All B-Lactam PCNs are renally excreted except for what three?
What is the most common type of reaction to PCNs?
Nafcillin, Dicloxacillin, Oxacillin- no adjustments needed due to biliary excretion
Exanthematous (morbilliform) rash
If PT has anaphylactic reaction to PCN, what other ABXs need to be avoided?
What are the three more common s/e of PCN use?
B-lactams
Diarrhea-
Nephritis- use of high/combo doses
Neurotoxicity- irritation to neuronal tissue leading to somnolence, stupor, seizure, coma w/ high doses
Natural PCN use can be broken into what two groups?
Aminopenicillin/Antipseudomonal: better for Gran Neg rods
Anti-staph PCN
What are the four 1st Generation PCNs?
PCN G: produces high plasma levels, short duration of action
PCN G Benzathine- IM only, released over 28 days, DOC for syphilis
PCN G Procaine- IM only, released over 24hrs
PCN V- PO only, resists acid degradation for use against mild throat, ear, and UR infections
1st Generation PCNs can be effective against what three groups of microbes?
What are the anti-staph PCNs?
T Pallidum
Strep Spp
N Meningitidis
Methicillin Oxacillin Naficillin Cloxacililn Dicloxacillin
Why are anti-staph PCNs used for?
What can they be used against?
Resistant against destruction by penicillinase/B-lactamse
Staph/Strep infection Prosthetic infection Osteomyelitis Skin infection Septic arthritis Impetigo Endocarditis- Nafcillin w/ Gent
How are the anti-staph PCNs excreted?
Two of them can cause what two adverse effects?
Nafcillin- biliary, no renal adjustment needed
Oxa/Dicloxacillin- biliary and kidney
Nafcillin- neutropenia
Oxacillin- hepatotoxicity
What are the two aminopenicillins?
What B-lactam inhibitors can it be combined with and what form are they administerred?
Amoxicillin
Ampicillin
Clavulanic Acid/Amox- PO
Sulbactam/Amp- IV
Tazobactam/Piper- IV
When are aminopenicillins used for?
Bite wound- dog, cat, man Otitis media UTI- only if pregnant or known susceptible Listeria infection Diabetic foot wound Endocarditis Respiratory infection Skin/soft tissue
What respiratory infections can aminopenicillins be used against?
What do they have to be combined with for this use?
Community/Nosocomial pneumonia
Combo w/ Macrlide/Doxycycline
When is Amoxicillin used?
What is it combined w/ to provide B-lactam coverage?
Duodenal ulcer by H Pylori
Otitis media- only for non B-lactamase H Influenza
UTI- only if susceptible or pregnant
Endocarditis prophylaxis
Augmenten
When/why is Ampicillin used?
Same as Amoxicillin but in IV form
Meningitis/endocarditis + aminoglycoside
CAP w/ macrolide/doxy
Why are Ampicillin and Aminiglycosides used together so much?
When/why is Amoxicillin/Clavulanate combo used?
Synergy- PCN destroys cell wall to allow aminoglycoside entry to the cell
Otitis media resistant to Amoxiicillin
Comm Acq Pneumonia Acute bacteria infxn Uncomplicated endocarditis prophylaxis SSTI Animal bites- first line
By using Amox/Clavulanate for otitis media, the addition of Clavulanate increases coverage over what three microbes?
B-lactamse producing H Influenza, M Catarrhalis, Staph A
What is the first line agent against dog and cat bites?
What is used for early/late human bites?
Amoxicillin/Clavulanate
Early: Amox/Clavulanate
Late: Amp/Sulbactan
PCN allergy: Clindamycin + Cipro or TMP/SMX
What is Ampicillin/Sulbactam used for?
What three drug combos do provide some anaerobic coverage for infections?
SSTI Sepsis Intrabdominal infxn Nosocomial pneumo w/ macrolide/quinolone Gyn infection
Amoxicillin/Claculanate
Ampicillin/Sulbactam
Piperacillin/Tazobactam
None of the PCNs have MRSA coverage except for which comb that has MSSA coverage?
What three drugs have MSAA coverage?
Anti-Pseudomonal PCN: Piper/Tazo
Dicloxacillin
Amp/Sulbactam
Piper/Tazo
What three groups of drugs can be used for pharyngitis?
What ABX is used for upper respiratory infections?
PCN, Anti-staph, Amino
Amino but better coverage w/ B-lactamase inhibitor
Which group out of PCN ABX do not need to have doses renally adjusted?
Don’t use Cephalosporins in PTs w/ ? allergy
Anti-Staph PCNs
PCN
Most Cephalosporins have renal clearance and require no adjustment except for ?
What are the only two ABXs in all of the B-Lactams that don’t require any renal adjustment?
Ceftriaxone- biliary
Ceftriaxone
Anti-Staph
Steven Johnson Syndrome is a toxic epidermal necrolysis reaction to ? ABX?
What are the names of Generation 1-5?
Cephalosporin
1st= Cefazolin 2nd= Cefuroxime 3rd= Ceftriaxone 4th= Cefepime 5th= Ceftaroline
What are the First Generation Cephalosporins good/used for?
Gram + MSSA, Strep
No BBB/CNS crossing
STI, Surgery prophylaxis, MSSA Endocarditis
? are good alternative to anti-staph PCNs?
What is the DOC for pre/post surgery not involving the abdomen?
First Gen Cephalosporins
Cefazolin
What are the First Generation Cephalosporins and their route of administration?
If PT is allergic to PCN and Cephalosprins, what ABX is next in line for use?
PO: Cephradine, , Cefadroxil, Cefalexin
Injectable: Cefazolin
Clindamycin
What are the 2nd Generation Cephalosporins
What are they used for?
Cefuroxeime- alternative for cat bite
Cefoxitin/Cefotetan- pre/post surgery of the abdomen due to having ANAEROBIC coverage
No BBB/CNS coverage
Better Gram -: H Influenza, M Catarrhalis, Neisseria
What are the ABX options for resistant Otitis Media and Pharyngitis?
Cefactor
Cefprozil
Cefuroxime Axetil
3rd Generation Cephalosporins
Ceftazidime- Pseudomonas coverage
Ceftriaxone
Cefotaxime
Ceftazidime
Cross BBB
No anaerobe coverage
What is the DOC for gonorrhea Tx?
Why would that drug be combined w/ Azithromycin?
Ceftriaxone
Azithromycin added for Clamydia Tx
Urethritis, Prostatitis, PID
Which Cephalosporin has excellent CNS penetration?
What is another unique/identifying fact about this specific cephalosporin that alters who we can give it to?
Ceftriaxone
No renal adjustment needed, no neonate usage.
Will cause biliary sludge development
What is the only 4th Generation Cephalosporin?
What combo of Cephalosporins makes this drug?
Cefepime- broadest spectrum, no anaerobic
Cefazolin + Ceftazidime
What is the 4th Generation Cephalosporin used for?
What is the only 5th Genearation Cephalosporin and it’s unique fact?
Empiric therapy for febrile neutropenia/nosocomial pneumonia w/ MDR risk
Post-neurosurgical meningitis
Ceftaroline- MRSA coverage
What ABX is an alternative for Vancomycin?
What is the original ABX used for?
Ceftaroline
Community acquired pneumonia
SSTI
What are the two cephalosporin/B-lactamse combos?
What are these used for?
Ceftolozane/Tazobactam
Ceftazidime/Avibactam
Approved by infectious dz for Pseudomonas aeurginosa
What ABX are used for Otitis Media and SSTI/MSSA Tx?
What ABX are used for surgical prophylaxis including anaerobic coverage?
1st and 2nd Gen Cephalosporins
Cefazolin
Cefoxitin, Cefotetan
What two Cephalosporings provide Pseudomonas coverage?
What are the Carbapenems and what are they generally used for?
Ceftazidime
Cefepime
Imipenem/Cilastatin Doripenem Meropenem Ertapenem Very broad spectrum w/ anaerobic, no MRSA coverage
What are the Carbapenems specifically used for?
What is an important/unique exception for Ertamenem?
Febrile neutropenia
Nosocomial infections
Mixed infections
No Pseudomonas
No Enterococci coverage
No Acinetobacter
Why is Imipenem/Cilastatin only avail in combo?
What are the adverse effects of using Carbapenems?
Imipenem is metabolized in kidney to nephrotoxic product but Cilastatin blocks renal dehydropeptidase to prevent metabolism
N/V/Rashes
Imipenem has highest risk of seizure
Aztreonam
Coverage similar to Ceftazidime and Aminoglycosides
+ Pseudomonas coverage
- Gram+/Anaerobic coverage
No cross reactivity w/ B-Lactams
PCN/Cephalosporin allergic PTs can get what B-Lactam AMX with the condition that the PTs reaction wasn’t to ?
What is the MOA of the Glycopeptides and Lypoglycopeptide?
Aztreonam
Ceftazidime
Cell wall inhibition
What is a unique adverse reaction Glycopeptides and Lypoglycopeptide can cause?
How can this adverse reaction be avoided?
Red neck/Red man syndrome- caused by histamine release
Vancomycin infusion 1hr prior to administration
What are the more concerning adverse reactions when using Vancomycin?
What is are two adverse reactions of using Telavancin?
Nephrotoxicity
Ottotoxicity
Taste disturbance
Foamy urine
What 3 ABX only have Gram + coverage?
Which Glycopeptides and Lypoglycopeptide are pregnancy safe or unsafe?
Vancomycin
Linezolid
Daptomycin
Vanc PO- safe, Cat B
Vanc IV- crosses, no adverse
Telavancin- adverse development
Glycopeptides and Lypoglycopeptide are only effective against Gram + microbes that include what 3?
PO Vancomycin is used for ? while IV is used for treating ?
MRSA, Strep, C Diff
PO- DOC for C Diff
IV- systemic only
What is the Cyclic Lipopeptide ABX and how is it different?
Daptomycin
-cidal, Concentration dependent
Safe for pregnancy
Gram + only- MRSA, VRE
What is the MOA for Daptomycin
What type of monitoring must be done for these PTs?
Binds to bacterial cell membraine and causes rapid depolarization and death
CK weekly for rhabdo
Daptomycin can’t be used for ? infections
What drug is included under Polymyxin?
Pulmonary- degraded by surfactant
Colistimethate
What is the MOA for Colistimethate?
What are two adverse effects of this drug?
Acts as a detergent and damages bacterial cytoplasmic membrane
Nephrotoxicity
Neurotoxicity
What type of infections would Colistimethate be selected for use?
Polymyxins are only used against ? organisms especially ?
Acenobacter infections
Gram Neg
Pseudomonas, Klebsiella, Acinetobacter
What drug would be chosen for CF PTs w/ a Gram Neg pneumonia/pulmonary infections?
What topical ABX can be used for Gram +/- microbes?
Polymyxin due to inhalation delivery
Bacitracin: Gram +
Neomycin/Polymyxin: Gram -
When would topical polymyxins be used?
External ear infection
Badder irrigation w/ Neomycin sulfate
Ocular infection
What is the MOA of Bacitracin
What types of RNA subunits do mammal and bacterial cells have?
Cell wall synthesis inhibition for Gram + microbes
Mammal- 80S (60 and 40)
Bacteria- 70S (50 and 30)
What ABX have a MOA of Protein Synthesis inhibition?
What is the only ABX w/ a MOA of DNA Gyrase inhibition?
Mupirocin Clindamycin Strepgramins Macrolides Aminoglycosides Chloramphenicol Tetracyclines
Fluoroquinolones
What ABX have a MOA of Folate Synthesis inhibition?
What ABX have a MOA of RNA polymerase inhibition?
Sulfonamides
Trimethoprim
Rifampin
Which ABX that are protein synthesis inhibitors are -cidal/concentration dependent?
Aminoglycosides: GNATS
Gentamicin Neomycin B Amikacin Tobramycin Streptomycin
Which ABX that are protein synthesis inhibitors are -static/time dependent?
Tetracylcines:
Tetra/Doxy/Minocycline
Glycylcyclines:
Tigecycline- IV, good coverage of MRSA including VRE
Why are Tetracycline ABXs less effective at protein synthesis inhibition?
What are Tetracyline used for specifically?
Only incorporate incorrect amino acid, Step C
Atypical coverage (Rickettsia, Spirochetes, Plasmodium)
Tetracycline ABXs are alternatives for what 3 things?
What are is an important PT education piece for PTs taking Doxy/Minocycline?
SSTI
Syphilis
PID in combo w/ Cefoxitin
Take w/ food
What are the adverse reactions of using Tetracyclines/Glycylcyclines?
Where is there use c/i?
N/V- significant and severe w/ Tigecycline, pre-Tx prior to use
Tissue hyperpigmentation
Photosensitivity
Pregnancy
Breastfeeding
Kids under 8y/o
What is usually not an adverse effect of use for aminoglycosides?
These ABX are very effective against what 4 microbes?
All depend on O2 transport channels to access bacteria meaning anaerobes are inherently resistant
E Coli
Klebsiella
Pseudomonas
Acinetobacter
What is the only time Aminoglycosides would be used as monotherapy?
What ABX would be used for surgical prophylaxis in a PT having hip surgery w/ a PCN allergy?
Gram negative UTI
Clindamycin
Why is Chloramphenicol used?
What is it’s unique s/e?
Last resort infection Tx
Gray Baby Syndrome- inability to glucoronidate for degredation/detox
What meds are avoided in PTs w G6PD deficiency?
What is the MOA of Macrolides and Ketolides?
Dapsone Quinidine Sulfonomides Premiquine ASA Nitrofurantoin
Protein synthesis inhibitor
What are the Macrolides?
What is the Ketolide?
Erythromycin
Azithromycin
Clarithromycin
Telithromycin
When would the Ketolide ABX Telithromycin be used?
What type of coverage are these good for?
Macrolide resistant strains may be susceptible due to the additional binding site
Atypical
What are the adverse effects of Macrolides/Ketolides?
What two are more likely to have heaptotoxicity?
GI and ATc prolongation- mostly Erythromycin
Telithromycin/Azithromycin
Teli- associated w/ failure leading to death/transplant
What are the pregnancy categories of Macrolides/Ketolides?
What are Macrolide/Ketolides used against?
B- Ezith*/Azithromycin
C- Clari/Telithromycin
Upper/Lower Resp infection
Chlamydia- Azithromycin
H Pylori ulcer- Clarithromycin
Macrolides/Ketolides are not good choices for infection that req ? activity for ? or ?
What is unique about Azithromycin use?
Bactericidal
Endocarditis, Meningitis
Long t1/2, 3-5 day usage
What ABX are the ideal choice for Tx for mild-moderate community acquired pneumonia?
What class of ABX is used as an alternate for PTs allergic to B-Lactams?
Macrolide/Ketolide
Macrolides
What is the MOR of Clindamycin?
Further testing of this MOR is only going to be done if suspected resistance to ?
Inducible is common
Erythromycin
Verify w/ D-Test: Inducible, Sudsceptible to Clinda, Susceptible to Clinda/Eryth
What is the most common s/e of Clindamycin use in HIV PTs?
What is a more rare s/e?
Rash
Steven Johnson syndrome
What is the unique fact about the Streptogramin ABX?
When are they used?
Quinupristin/Dalfopristin resistance is not common
Severe infection
MDRO
Most protein synthesis inhibitors are bacterio- unless aminoglycosides are added which makes them bacterio-
What are the s/e of using Oxazolidinones?
Static
Cidal
Hematological- anemia, leukopenia, pancytopenia, thrombocytopenia
Serotonin syndrome
When would Oxazolidinone be used?
When would they NOT be used?
Nosocomial pneumonia
CAP
SSTIs
Bacteremia
What are the Generations of Fluoroquinolones?
What are each ones used for?
2nd: Cipro/Ofloxacin
3rd: Levofloxacin
4th: Moxifloxacin
Cipro/Oflo: GNR (Traveler Diarrhea)
Levo: Gram Neg, pseudomonas coverage
Moxi- Pseudomonas and Anaerobe coverage
What is the difference between Moxifloxacin and Ciprofloxacin
Mox- Anaerobe, S Pneumo coverage, NO Pseudomonas
Levo- S Pneumo, Pseudomonas, NO anaerobes
Cipro: Gram Neg, Pseudomonas, NO anaerobes
ALL cover atypical
What are the s/e of fluoroquinolones?
What pregnancy category are these and what education piece is needed?
Achilles tendon ruptures
CNS- hallucination, seizure
Rash/photosensitivity
GI
Preg Cat C
Take on empty stomach, reduced by anti-acids
What is the agent of choice against anthrax?
When are fluoroquinolones used for UTIs?
Cipro
Cipro/Levo- prostatitis, GI infection
DONT use Moxi (low gram neg coverage, low urinary concentration)
Which Fluoroquinolones are used for respiratory infections?
How would a respiratory infection by Pseudomonas be treated?
Levo/Moxi- Strep Pneumo coverage
Levo
What are the Folate Antagonists and their primary uses?
Sulfamethoxazole Sulfadiazine- toxoplasma gondi Sulfadoxine- malaria Tx Sulfasalazine- UC Sulfacetamide- skin condition Silver Sulfadizine- burns Mafenide- burn
What are the alternate folate antagonists?
What is the MOA of Sulfonamides?
Trimethoprim
Dapsone- Leprosy
Pyrimethamine- anti-malarial
Inhibits utilization of PABA for synthesis of folic acid
Time dependent, -static
Preg Cat D
What is an s/e of Sulfonamides?
At a molecular level, how do folate antagonists work?
Crystalurea
Bacteria make folic acid from p-arminobenzoic acid; suflonamides are analogs of PABA
Folate antagonists don’t have good ? coverage and no coverage for ?
What is the only Sulfonamide used for monotherapy?
Strep
No atypical, anaerobes, Psuedomonas
Sulfadiazine- toxoplasma gondi
PTs w/ G6PD need to avoid sufonamides due to inc risk for ?
What is the MOA of Nitroimidazoles?
Hemolytic anemia
Interact w/ DNA to cause loss of helical structure and strand breakage
Majority of Nitroimidazole coverage is for ?
What are the major s/e?
Anaerobes
GI
Metalic taste
Warfarin interaction, lower Warfarin dose
What is the name of the reaction that occurs if PTs taking Nitroimidazole drink alcohol?
Why does this reaction occur?
Disulfiram reaction- inc temp, projectile vomit
Build up of aldehyde dehydrogenase
Nitroimidazoles are an alternative Tx for ? and the DOC for Tx of ?
What is the MOA and usage of Fidaxomicin?
C Diff
Trichomonas Vaginalis
Protein synthesis inhibitor
Tx of C Diff
PTs w/ a macrolide allergy can’t take ? ABX
This same ABX has similar efficacy to PO ?
Fidaxomicin
Vancomycin
What is the MOA of Mupirocin
What is the DOC for ?
Protein synthesis inhibitor
Impetigo
Eradication nasal MRSA colonization
What are the 3 UTI treatment agents?
What types are they used in?
Nitrofurantoin
Fosfomycin
Methenamine
Uncomplicated cystitis Tx/Prophylaxis
What is the MOA of Nitrofurantoin
What PT population can’t take this?
Inibits protein synthesis in the Tx of UTIs
G6PD deficient
What is the MOA of Fosfomycin
What is the MOA of Methenamine but can only be used for ?
Inhibits bacteria wall synthesis by inactivating pyruvyl transferase
Hydrolyzed to formaldehyde/ammonia in acidic urine
Prophylaxis
What med can be given during UTIs for analgesic relief but no anti-infective properties?
What is a s/e of this med?
Phenazopyridine
Colors urine orange
If pediatric PT has Otitis media, what ABX is used?
What is given if the area has high resistance?
Amoxicillin
Amoxicillin/Clavulanate
What ABX is used for Otitis Media if PT has PCN allergy?
When is watchful waiting conducted for these PTs?
2nd Gen Cephalosporin
Ceftriaxone
6-24mon w/ unilateral, non-severe
>24mon w/ uni/bilat non-severe AOM
What are the criteria for PTs must not have in order to be Dx w/ CAP?
Hospitalization +2 days in past 90 days
Long term care resident
IV ABX therapy/Chemo/wound care in past 30 days
Hospital/hemodialysis attendance
How CAP w/ no comorbidities Tx?
How is CAP w/ comorbidities Tx?
Clarith or Azithromycin
Doxycycline
Moxi or Levofloxacin
Macrolide or Doxycycline
Amoxicillin (clavulanate, cephalosporin)
