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IE Pharmacology > Bugs & Drugs > Flashcards

Bugs & Drugs Flashcards

1
Q

In a patient with NKDA, how do you treat them for an infection w/ Streptococci?

A

Beta-lactams

e.g., Pencillin, Oxicillin

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2
Q

In a patient with a known allergy to β-lactam antibiotics, how do you treat them for an infection w/ Streptococci?

A

Macrolides

e.g., Azithromycin, Erythromycin

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3
Q

In a patient with NKDA, how do you treat them for an infection w/ Streptococcal TSS?

A

Clindamycin, but it’s linked to C. diff so… (see weekly essay 9B)

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4
Q

In a patient with NKDA, how do you treat them for an infection w/ MSSA?

A

Either:

**A semi-synthetic penicillin: Amoxicillin or Amoxicillin + Clavulunate **

OR

An antistaphylococcal penicillin: Nafcillin or oxocillin

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5
Q

In a patient with a known allergy to β-lactam antibiotics, how do you treat them for an infection w/ MSSA?

A

IV Vancomycin

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6
Q

In a patient with NKDA, how do you treat them for an infection w/ MRSA?

A

IV Vancomycin

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7
Q

How do you treat a patient w/ Clostridium difficile colitis as a result of clindamycin use? (Why?)

A

Oral vancomycin

(Because it oral vancomycin does not get absorbed into systemic circulation in the gut, so it remains in the gut lumen where it can have its effect on the colon)

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8
Q

In a patient with NKDA, how do you treat them for an infection w/ Neisseria meningitidis?

A

Ceftriaxone

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9
Q

In a patient with NKDA, how do you treat them for an infection w/ Chlamydia trachomatis?

A

Oral azithromycin (favored b/c it’s a one-time tx)

Doxycycline

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10
Q

In a patient with NKDA, how do you treat them for an infection w/ Neisseria gonorrheae?

A

Ceftriaxone + azithromycin (to cover potential coinfection w/ Chlamydia)

OR

Ceftriaxone + doxycycline

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11
Q

In a patient with NKDA, how do you treat them for an infection w/ Pseudomonas aeruginosa?

A
  • Beta-lactams:
    • Piperacillin-Tazobactam
    • 3rd Generation Cephalosporins (Ceftriaxone)
    • 4th Generation Cephalosporins (Cefepime)
    • **Carbapenems **(Meropenem)
    • Monobactems: **Aztreonam **(very strange properties)
  • Aminoglycosides
  • Fluoroquinolone (Ciprofloxacin)

Since Pseudomonas is so hard to treat you’ll typically treat with two different antibioitics of those listed above

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12
Q

In a patient with NKDA, how do you treat them for an infection w/ anaerobic bacteria?

A

Metronidazole

2nd choice: Clindamycin

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13
Q

In a patient with NKDA, how do you treat them for an infection w/ Listeria monocytogenes?

A

Ampicillin

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14
Q

In a patient with NKDA, how do you treat them for an infection w/ Atypicals?

A

Macrolides

2nd choice: Doxycycline

3rd choice: Fluoroquinolones (Ciprofloxacin, Levofloxacin)

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15
Q

In a patient with NKDA, how do you treat them for an infection w/ an Arthropod-borne pathogen?

(e.g., Borellia, Rickettsia)

A

Doxycycline (drug’s ability to accumulate intracellularly makes it very effective against Rickettsia and Chlamydia)

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16
Q

In a patient with NKDA, how do you treat them for an infection w/ Treponema pallidum?

A

Penicillin

17
Q

In a patient with NKDA, how do you treat them for an infection w/ an uncomplicated UTI?

A
  • Nitrofurantoin
  • TMP-SMX
  • Fosfomycin
18
Q

In a patient with NKDA, how do you treat them for an infection w/ complicated UTI?

(Give the class and an example)

A

**Fluroquinolone **(e.g., Ciproflaxacin)

19
Q

In a patient with NKDA, how do you treat them for an infection w/ uncomplicated pyelonephritis?

A

Fluoroquinolone (e.g., Ciprofloxacin) as an outpatient

20
Q

In a patient with NKDA, how do you treat them for an infection w/ complicated pyelonephritis?

A

Fluoroquinolone (Ciprofloxacin)** **or 3rd gen. cephalosporin (Ceftriaxone) as an inpatient

21
Q

In a patient with NKDA, how do you treat them for an infection w/ Blastomyces dermatidis?

A

Amphotercin B

22
Q

In a patient with NKDA, how do you treat them for an infection w/ Coccidioides immitis?

A

Amphotercin B

23
Q

In a patient with NKDA, how do you treat them for an infection w/ Paracoccidioides brasiliensis?

A

Amphotercin B

24
Q

In a patient with NKDA, how do you treat them for an infection w/ Histoplasma capsulatum?

A

Voriconazole

2nd choice: Amphotercin B

25
Q

In a patient with NKDA, how do you treat them for an infection w/ Crpytococcus neoformans?

A

Amphotercin B + Flucytosine

26
Q

In a patient with NKDA, how do you treat them for an infection w/ Nematodes (roundworms)?

A

Albendazole

27
Q

In a patient with NKDA, how do you treat them for an infection w/ Trematodes (flatworms/flukes)?

A

Praziquantel

28
Q

In a patient with NKDA, how do you treat them for an infection w/ Cestodes?

A

Praziquantel

29
Q

What drugs should not be used to treat pregnant women w/ infections?

(Try to give the reason why if you can)

A
  • Aminoglycosides → ototoxicity
  • Fluoroquinolones → cartilage damage
  • Metronidazole → mutagenesis
  • Ribavirin → Teratogenic
  • Sulfonamides → Kernicterus
  • Tetracyclines → Inhibition of bone growth (& discolored teeth)
30
Q

In a patient with NKDA, how do you treat them for an infection w/ Cryptosporidium parvum?

A

Nitazoxanide

31
Q

How do you treat RSV in a wheezing 3 yr old?

What would you give for prophylaxis in high risk patients?

A
  • Bronchodilator (albuterol or epi) by inhalation for wheezing
  • Ribavirin by aerosol
  • For prophylaxis: Palivizumab
32
Q

What tests would you order for watery, traveler’s diarrhea?

A

Stool culture

CBC and electrolytes to check hydration status of patient

33
Q

What tests would you order for bloody diarrhea?

A

Stool culture

Immunoassay for toxins (e.g., Shiga)

CBC and electrolytes to check hydration status of patient

Renal chemistries (BUN, Cr) and U/A to check for RBCs, RBC casts, and protein (concern for HUS)

34
Q

How would you treat a patient w/ traveler’s diarrhea?

A
  • Rehydration
  • Anti-peristaltic like loperamide
  • Macrolide
35
Q

How would you treat a patient w/ bloody diarrhea?

A
  • Rehydration until the causative agent is defined
  • No antibiotics until then because these ⇡the level of Shiga toxin produced by E. coli
  • No antiperistaltics because this ⇡the duration of E. coli contact w/ the gut
36
Q

How do you treat Toxoplasma gondii? (alone)

A

Pyrimethamine-Sulfadiazine

37
Q

How do you treat Pneumocystic jiroveci?

A

TMP-SMX

IE Pharmacology (5 decks)

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