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HuntsClinMed1B > Treatments, exam 1 > Flashcards

Treatments, exam 1 Flashcards

more than skin

1
Q

Coag negative staph infection

A

vancomycin

Reasoning: occurs on postop patients, on like in a hip replacement. Most states have aureus is MRSA so its a dire situation, might as well use the big gun.

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2
Q

impetigo

A

topical mupirocin/bactroban

Keflex, dicloxacillin, omicef/cefdinir

If MRSA- bactrim, clinda, doxy

Keflex = kleenex like they wiped their nose too many times and now they have impetigo.
Dicloxacillin because its a skin condition similar to staph skin infections, and its not MRSA.
MRSA always gets the big guys like doxy, clinda

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3
Q

erysipelas

A

OP w/o systemic:
■ Pick either, PCN VK, amoxicillin, dicloxacillin, Keflex, Clinda/Erythromycin

IP w/ systemic: vanc, cefazolin, ceftriaxone, clindamycin

PACK + D; v x 3

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4
Q

strep agalactiae

A

○ Prophylactic PCN G or cefazolin, vancomycin, ampicillin, clindamycin Q4h until delivery

Clap + VC (vacation)

ampicillin because giving birth is a positive feedback cycle.
Cl- a- p + V C
You could also do Clap + v-ancef like for example we are about to give birth, get ready, clap, we are going in the van.. ??

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5
Q

OM

A

○ Analgesics/antipyretics
○ 1st Amoxicillin for ten days
○ 2nd augmentin or cephalosporin
○ 3rd cephalosporin or augmentin
○ 4th Rocephin injection 1x a day for three days
○ 5th Ear tubes

  1. first line is ammo. when you shoot a gun, it hurts your ears. OM. pain. i hate shooting guns.
  2. C August Race Tubes - cephalosporin, Augmentin, Roce-ephin, Ear tubes
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6
Q

acute sinusitis

A

○ Augmentin for 14 to 21 days since it’s a cavity. Alternative is doxycycline or clindamycin.

Claud (ia) Cl- au- d
Think Claudia has a clogged up nose

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7
Q

Pneumococcal pneumonia

A

○ Outpatient –
■ First Line: amoxicillin, doxycycline, Z pack if less than 25% resistance in area
■ If COPD/comorbidities/recent abx treatment/inpatient:
● Levofloxacin
● combo of (Augmentin or cephalosporin) + Z max or doxycycline)
○ Inpatient –
■ Levofloxacin
■ combo macrolide + (amox or ceftriaxone)

OP- D’ ammo’ z (mon) - a coughing troll
If copd/IP: Levofloxacin
if copdinpatient only: Aug/ceph + Z/doxy
if IP only: macrolide + ammo/axe

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8
Q

Strep pneumo meningitis

A

○ Ceftriaxone or Rifampin QID dosing for two days.

associate the brain as the castle, and 3 warriors with axes, RIPping Rifampin throug the invaders

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9
Q

Endocarditis (enterococcus)

A

● Ampicillin + gentamicin

picture a gentlemen looking up at a window to sing to a lady. uses a music amp. it warms her heart.

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10
Q

Bacillus anthracis

& duration of treatment

A

○ Cipro PO or IV ASAP, alternative is Doxy
■ Cutaneous: 7-10 days
■ Inhalation: 60 days
○ Prophylactic cipro if exposed

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11
Q

Listeriosis

A

○ IP Ampicillin + gentamicin
○ OP amoxicillin for 2-3 weeks

Same as endocarditis ~ then gun
Think… lovers quarrel. She gets mad after he sings to her. She goes on a hunt for 2 to 3 weeks
You use mouthwash before a date.

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12
Q

P. Aeruginosa

A

o OP
 Cipro (oral), Levofloxacin (oral)
 Tobramycin (inhaled 9 mo)
o IP
 All meds IV
 Pip/taz
 Ceftazidime
 Cefepime
 Meropenem
 Aztreonam
o OP Inhaled
 tobramycin

OP: Lift (the cup or your spirits) & Sip T - Levofloxacin Cipro Tobramycin

IP: Pip/Taz pine & dime Mr. Penem, as three. own em! aka pip/taz cefepime meropenem aztreonam

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13
Q

Corynebacterium diplitherae

A

○ Diphtheria equine antitoxin (from CDC)
○ PCN or erythromycin
○ Contacts: erythromycin

Purple and red corn - VIOLET! corn.
Purple = penicillin
Red = erythromycin
corn = coryne
CDC must be notified so they can provide the antitoxin.

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14
Q

Neisseria meningococcal meningitis

A

○ PCN G (if known susceptibility)
○ Rocephin (empiric) – covers atypicals, group B strep, S pneumo, and H flu, all the causative agents
■ Continue until afebrile for 5 days
○ Contacts: prophylactic rocephin

Assoicate neisseria with the lochness monster Nessie.
Nessie races (roce) towards penicillin G (the gate or finish line)

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15
Q

Neisseria gonorrhoeae

A

○ Rocephin + azithromycin

Roce ~ Race
Azithromycin ~ Z (for z pack)
Racy = sexual
which is fitting for a STI

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16
Q

Bordetella pertussis

A

○ Supportive care
○ 1st Azithromycin
○ 2nd alternative is Bactrim

Give them the A - B - C ‘s
They are a baby, so they are learning their alphabet!
Azithromycin, Bactrim, Care (supportive care)

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17
Q

Legionaires

& duration of treatment

A

○ Macrolide (Azithromycin, Clarithromycin) or Fluroquinolone (levofloxacin)
○ 10 to 14 days of abx
○ 21 d for IC

The Legion macroleads/macroguides through flowers (fluroquinolones)

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18
Q

Klebsiella pneumumoniae

A

○ Empiric: resp. fluoroquinolone (levo, moxi, gemi) or carbapenem

Mneumonic for Klebsiella is Sierra is at the club with her red jelly lipstick. She drinks alcohol and contracts HIV from the men at the club.
Extending this, she parties in Penem w/ flowers (a rose, like president snow)

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19
Q

UTI

A

1st line Bactrim – CI in 1st trimester but is 1st line in kids
1st line Nitrofurantoin (Macrobid) - (avoid in last trimester)
○ Ciprofloxacin – last line, like saving for pyelo
○ Fosfomycin (good for everyone)
○ Cephalexin or cefdinir (use in children and last trimester pregnancy)
○ Omnicef or Keflex (good for everyone)

Kids trim dinner, a reflex
Kids: (1st line)-Bactrim Cefdinir keflex

Will have to study pregnant UTIs in a seperate section

Adult UTIs-
Nitrofurantoin, Fosfo, Keflex, Dinner, Omnicef. Cipro is usually saved for last

Mneumonic kids trim dinner inflexibly

Adults: nights trimmed

Pregnant: nights ( use in first trimester) trimmed ( use in last trimester)

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20
Q

Yersinia Pestis

A

○ Gentamicin or doxycycline x 10 days
○ Streptomycin x 10 d
○ Fluoroquinolone (cipro, levo, moxi)
○ Prophylactic doxy AND cipro for contacts for 7 d
○ Strict isolation for pneumonia

10 gentlemen strip down + flowers
Gentamicin, streptomycin, Doxycycline 10 days each. + fluroquinolone (posies)

they are stripping down to quarantine. posies are a type of flower.

7 contacts sip drinks
Contacts get cipro and doxycycline for 7 days

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21
Q

Francisella Tularensis Tularemia

A

Treatment: identical to bubonic plague
○ Gentamicin or doxy, Streptomycin, fluroquinolones

10 gentlemen strip down + flowers

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22
Q

Mycoplasma pneumoniae

A

○ 1st Azithromycin (macrolides) – both kids and adults
○ Fluroquinolones – adults only. Bactericidal and MIC higher than macrolides.
○ Tetracyclines – older children and adults

This mneumonic is a bit rough

Rated - Z’ for Z’everyone (azithromycin)
Tetris is for teens and adults to play (Tetracyclines)
Fluroquinolones = fully grown - sounds phonetically similar if you say it out loud

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23
Q

Chlamydia psittaci

A

● Treatment:
○ Tetracycline or erythromycin

Red bird with four feathers
or, red teradactyl

24
Q

Syphillis

A

○ PCN G IM (single dose) aka Bicillin
○ TREAT PARTNERS + REPORT
○ If we don’t have Bicillin in stock, then treat with amoxicillin or penicillin VK

25
Q

Lyme

Duration of treatment

A

○ Pregnant - amoxicillin
○ Adults: doxycycline
○ Children: doxycycline as long as your treat under 21 days
○ Treat for 10-21 days
○ Refer to criteria if someone wants prophylaxis

26
Q

Rocky mtn rickettsia rickettsii

A

doxy even for pregnancy

27
Q

Staph skin infections

Low MRSA, high MRSA, IP, 2nd line after IP, and kids

A

○ DRAIN THE ABSCESS
○ Low MRSA risk: keflex or dicloxacillin
■ Know that most cases are going to be MRSA

○ High MRSA risk: clinda, or doxy/mino, Bactrim

○ Inpatient: 1st line vancomycin IV.
■ After 1st line, clindamycin, cefazolin, nafcillin/oxacillin, linezolid ($)
■ Also give them pip/taz empirically until the cx r/o pseudomonas

○ Children: 1st Bactrim (BID) or 2nd Clindamycin (TID)

kids = bad clean (bactrim clindamycin) or clean trim
Low MRSA risk = keflex or dicloxacillin
High MRSA = BCD (bactrim, clinda, doxy)
IP= vanco. 2nd- NO Ants Cl-imb
N (naf)/ O(oxa) Ants (Ancef) CL (clinda) -line (macrolide)

Note: very similar to impetigo tx

28
Q

Staph osteomyelitis

A

○ Empiric first: vanc + Rocephin (cephtriaxone) IV (or other 3rd/4th gen cephalosporin)
○ Prolonged therapy required after culture 4-6 weeks
○ MSSA (with report): nafcillin IV or oxacillin or cefazolin
○ MRSA (with report): vanc IV
○ May require surgery and debride bone

Empiric: positive vampire races and win 3/4 (van + roce or 3/4 cephalosporin)
MSSA - NO Ants (Nacillin/oxacillin) Ancef
MRSA- vanco IV

29
Q

Toxic shock

A

○ Hospitalize
○ Supportive: antipyretics, IV fluids, monitor liver and kidney function
○ Debride local infections
○ Empiric: Combo of vanc + clinda + (pip/taz or cefepime or imipenem or meropenem)
○ When we get the culture back, stop the empiric treatment and keep the one that is sensitive

Peter Piper Picked a clean vampire
(pime, penem, pip/taz, + clinda, + van)

30
Q

scalded skin syndrome

A

○ Supportive: fluids, skin care (treat like burns)
○ MSSA: oxacillin or nafcillin
○ MRSA: vanc

“NO vampires”! the sun gives you blisters
Nafacillin/oxacillin – van if you mrsa

31
Q

staph food poison

A

self limiting

32
Q

Strep pyogenes pharyngitis

A

○ 1st PCN G (IM)
○ PCN VK (oral) or amoxicillin.
○ Kids prefer amoxicillin (available as a liquid)
○ If allergic to penicillin, cephalosporin- Cefalexin, Omnicef (once a day), Keflex
○ If they are positive, you treat. If they are negative you don’t treat.

PAC: Penicillin IM, Amoxicillin (or P VK), Cephalosporin
Kids: Amoxicillin

33
Q

Impetigo

A

● Treatment:
○ If localized, topical mupirocin/bactroban
○ Systemic
■ Keflex, Dicloxacillin
○ If MRSA suspected (rare): Bactrim (TMP-SMZ), doxy, or clinda
○ Clears up in 24-48 hours

MRSA: BCD

34
Q

Update version

Erysipelas

A

○ OP (no fever or sepsis)
■ PCN VK, amoxicillin, dicloxacillin, Clinda/Erythromycin
■ If allergic, Keflex
○ If severe/staph aureus suspected: vanc, cefazolin, ceftriaxone, clindamycin

PACK( K is alt) + D, V x 3

35
Q

updated version

Strep agalactiae

A

○ Prophylactic PCN G IV infusion Q4h, ampicillin, cefazolin, Q4h until delivery
○ Alternative – Clinda, Vanco
○ If the mom wasn’t cultured before going to the hospital to deliver, then you treat the baby with penicillin.
○ Mom should be on antibiotics if culture comes back positive
○ Don’t do this for C section

P-amp ants 2 clean the van
Penicillin ampicillin ancef 2nd clinda vanco

36
Q

updated

OM

A

○ Analgesics/antipyretics
○ 1st Amoxicillin for ten days (80-90 mg) x 10 d. 2 week f/u to check if the abx is working
○ 2nd augmentin or cephalosporin (like Omnicef)
○ 3rd cephalosporin or augmentin
○ 4th Rocephin injection 1x a day for three days
○ 5th Ear tubes

37
Q

updated

Pneumococcal pneumonia

A

○ Determine pneumonia severity index, or curb score 65. Need for hospitalization based on this.
○ Outpatient –
■ First Line: amoxicillin, doxycycline, Z pack if less than 25% resistance in area

■ If COPD/comorbidities/recent abx treatment in last 3 months:
● 1st - Levofloxacin (either for IP or this comorbid)
● 2nd - combo of (Augmentin or cephalosporin) + Z max or doxycycline)
● 3rd line Rocephin IM + Z pack

○ Inpatient (comorbidities) –
■ Levofloxacin
■ combo macrolide (z) + (amox or ceftriaxone)

38
Q

Bacillus anthracis

Duration of treatment

A

○ Cipro PO or IV ASAP, alternative is Doxy
■ Cutaneous: 7-10 days
■ Inhalation: 60 days
■ Doxycycline is alternative
■ Don’t need to know dose/mg

Anthrax phoneticallly “an-thrax” “in-….” relax breathe and SIP tea (cipro)

39
Q

P. Aeruginosa

A

o OP
 1st Cipro (oral), Levofloxacin (oral)
 Tobramycin (inhaled 9 mo), if CF, last line in children (CI’d normally)
o IP
 All meds IV
 1st Pip/taz
 Ceftazidime
 Cefepime
 Meropenem
 Aztreonam
o OP Inhaled
 tobramycin

40
Q

N. Meningococcal meningitis

A

○ PCN G (if known susceptibility)
○ Rocephin (empiric) – covers atypicals, group B strep, S pneumo, and H flu, all the causative agents
■ Continue until afebrile for 5 days
○ Contacts: prophylactic rocephin
○ Have to notify the health department

41
Q

Whooping Bordatella pertussis

A

○ Supportive care
○ 1st Azithromycin (the only time you use in kids)
○ 2nd alternative is Bactrim

42
Q

Legionaires

A

○ Macrolide (Azithromycin, Clarithromycin) or Fluroquinolone (levofloxacin)
○ 10 to 14 days of abx
○ 21 d for IC

43
Q

updated

UTI

A

○ 1st Bactrim – CI in 1st trimester but is 1st line in kids
○ Nitrofurantoin (Macrobid) - (avoid in last trimester)
○ Ciprofloxacin – last line, like saving for pyelo
○ Fosfomycin (good for everyone)
○ Cephalexin or cefdinir (use in children and last trimester pregnancy)
○ Omnicef or Keflex (good for everyone)

44
Q

Pyelonephritis

A

○ Treatment: Cipro or Levofloxacin,
○ Or combo of Ceftriaxone, X1 dose + (Bactrim, Augmentin or Omnicef)

45
Q

Chlamydia pneumoniae

A

same as walking pneumonia

46
Q

Syphillis

A

○ PCN G IM (single dose) aka Bicillin
○ TREAT PARTNERS + REPORT
○ If we don’t have Bicillin in stock, then treat with amoxicillin or penicillin VK

47
Q

Lyme Disease

A

Doxycycline (under 21 days for kids), pregnant is amoxicillin

think *dog has ticks

48
Q

Leptospirosis

A

Doxycycline

same as lyme

49
Q

Rocky mtn spotted fever

A

○ DOXY FOR ANY AGE. Even for pregnancy. No amoxicillin use. 100 mg Twice a day, PO or IV 3 days after fever subsides. Minimum course of treatment is 5 to 7 days.

think *dog has ticks

50
Q

Clostridial soft tissue infections

A

○ Drainage and debridement
○ Hyperbaric therapy
○ Pip/taz + clinda (covers strep and clostridium)
■ May switch to PCN + clinda if culture shows clostridium only

pip and taz (maids) clean first
If that doesn’t work, then we use purple cleaner

51
Q

Tetanus

A

○ Hospitalization
○ Supportive care (respiratory, spasms)
○ Wound debridement
○ Tetanus immune globulin (HTIG) within 24 hours
○ Full tetanus vaccine series
○ PCN or metronidazole

purple metro

52
Q

Botulism

A

○ Hospitalization
○ Supportive care (respiratory, NG tube)
○ Antitoxin (from CDC)
○ Wound botulism only: PCN G or metronidazole

(purple metro)

53
Q

Pseudomembrane colitis

A

○ Mild
■ Both are 1st Vanc 125 mg PO QID (NOT IV) or Fidaxomicin 200 mg BID
○ Severe:
■ Both are 1st Vanco 125-500 PO QID or enema, (Fidaxomicin 200mg BID+- Metronidazole)
○ Refractory – fecal transplant
○ Recurrent – Fidaxomicin or vancomycin 500 mg PO q6hrs

54
Q

BV (Gardnerella MC)

A

○ Metro or clinda (PO or vaginal)
○ Tinidazole (PO only)

vagina = subway station.
Clean the metro (as in, clean the infection out)
-+ Tinidazole

55
Q

VRE skin/wound

A

short for vancomycin resistant enterococcus
Linezolid, Daptomycin

56
Q

Staph. enterococcus skin wound

A

amp or vanc

Vampire + amp

HuntsClinMed1B (19 decks)

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