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IPAP 21-2 Soph Semester > DOC Cards > Flashcards

DOC Cards Flashcards

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1
Q

What is the DOC for early or late syphillis

A

PCN G benzathine

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2
Q

What is the DOC of rPCN Sensitive Gangrene (C. Perfringens)

A

1* gen PCN

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3
Q

DOC of PCN Endocarditis

A

1* PCN

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4
Q

WHAT PCN should be used on MSSA Endocarditis

A

D.O.N.

Dicloxacillin
Fafcillin
Oxacillin

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5
Q

What is the 1st line DOC in OTitis Media

A

Amoxicillin

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6
Q

What is the DOC in early animal bites

A

Augmentin

DOGmentin

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7
Q

What is the DOC in late animal bites

A

Ampicillin/ Sulbactam

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8
Q

What PCN can be used in UTI pregnant pts

A

Amoxicillin or Ampicillin

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9
Q

What ABX is used for endocarditis prophylaxis

A

Amoxicillin PO

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10
Q

What is the ABX used for H. Pylori (Duodenal)

A

Amoxicillin PO

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11
Q

Ampicillin IV + Aminoglycosides can be used for..

A

Meningitis

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12
Q

Ampicillin IV + Macrolides or Doxycycline can be used for

A

CAP

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13
Q

What is the ABX combination used in OM resistant to amoxicillin

A

Augmentin (Amoxicillin/ Clauvanic Acid)

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14
Q

In human bites, if the pt is allergic to PCN, use…

A

Clindamycin + ciprofloxacin or TMP/SMX

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15
Q

DOC in Gynecological infx caused by B- Lactamase producing E. Coli

A

Ampicillin/ Sulbactam (Unasyn) IV

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16
Q

What is the PCN combination used for HAP

A

Ampicillin/ Sulbactam

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17
Q

Piperacillin+ Tazobactam is used for

A 
Pseudomonas Coverage 
(Often combined with Aminoglycosides)
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18
Q

Which two PCN cover Abdominal Anaerobes

A

Piperacillin/ tazobactam

Ampicillin/. Sulbactam

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19
Q

What is the DOC for pre/post surgery not involving the Abdomen

A

Cefazolin IV (Ancef)

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20
Q

What are the Cephalosporins for surgery prophylaxis involving the abdomen

A

Cefoxitin and Cefotetan

2* gen cephalosporins

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21
Q

What is the DOC to tx N. Gonorrhea and Complicated pyleonephritis

A

Ceftriaxone

3* Cephalosporin

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22
Q

CAn neonates metabolize Ceftriaxone

A

NO

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23
Q

What is the Cephalosporin DOC for CNS penetration

A

Ceftriaxone

All 3* tends have good CNS penetration, however Ceftriaxone is DOC

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24
Q

What is the broadest spectrum Cephalosporin

A

Cefepime

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25
What is the cephalosporin of r empiric therapy in critically ill high risk PTs (HAP, VAP, Comp UTI) a
Cefepime | 4* gen Cephalosporin
26
What is the clinical use of 5* gen cephalosporin Ceftaroline
MRSA (SSTI)
27
What gen Cephalosporins are used for OM
1* and 2*
28
What 2 Cephalosporin cover pseudomonas
Cefepime and Ceftazadime
29
Why is Imipenem and Cilastatin always given together
Imipenem is metabolized in the kidney to a nephrotoxic product Cilastatin blocks the renal dehydropeptidase that catalyzes this reactions and prevent this metabolism from occurring
30
Which Carbapenems has the highest risk of SZR
Imipenem @ >4g/d
31
What is the name of the monobactam that can be used in PCN/ cephalosporin allergic pts
Aztreonam
32
Aztreonam has cross reactivity with what 3*gen cephalosporin
Ceftazadime
33
What 2 Carbapenems cover psuedomonas
Azteronam and Meropenem
34
Does Aztreonam cover MSSA
No
35
Which Carbapenems cover Anerobic abdominals
Ertapenem and Meropenem
36
What does Vancomycin cover
MRSA and MSSA
37
What is oral vancomycin used for
C. Diff
38
What is the coverage of Daptomycin
VRE, MRSA, MSSA
39
What is the major ADE of Daptomycin
Rhabdomyolysis
40
What can Daptomycin not be used for specifically
Pulmonary infx, it’s degraded by surfactant
41
What is the coverage of Colistimethate
Pseudomonas
42
What is the major ADE of Colistimethate
Nephro and Nuero Toxic
43
What is the DOC in pneumonia accosicated with cystic fibrosis
Colistimethate inhaled
44
Does Doxycycline cover pseudomonas
No
45
Of the tetracyclines (DMT), which have to be taken on an empty stomach, and which need renal adjustment
Tetracycline- Empty Stomach and avoid in renal dysfunction
46
What are the major ADE of tetracyclines (DMT)
N/V TISSUE HYPERPIGMENTATION Photosensitivity Not Advised in Pregnancy/ Breasfeading/ or children under 8 yo
47
What is the 1* line agent DOC in tick borne diseases
Doxycycline
48
Which tetracycline (DMT) can be used for malaria
Doxycycline
49
Which tetracycline (DMT) can be used for chlamydia
Doxycycline
50
Aminoglycosides (GNT) have a synergistic effect with what other class of drugs
Cell wall inhibitors like β-Lactams, vancomycin, daptomycin
51
What is the coverage of Aminoglycosides (GNT)
Psuedomonas
52
Do Aminoglycosides (GNT) require renal adjustment
YES
53
Are Aminoglycosides (GNT) safe for pregnancy
No, Preg Cat D
54
What are the major ADE of aminoglycosides (GNT)
Nephro (reversible) and Oto toxicity (irreversible)
55
What is the coverage of Azithromycin
Atypicals | Mycoplasma, Chlamydia, Legionella
56
What are the Major ADE of Macrolides (Azithromycin and Clarithromycin)
QT elongation Hepatic and Gastrointestianl RXNs
57
What is the preg cat for MAcrolides (Azithromycin and Clarithromycin)
Azithromycin- B | Clarithromycin-C
58
Of the Macrolides (Azithromycin and Clarithromycin) | Which has the lower DDI
Azithromycin (does not significantly inhibit CYP3A4
59
Can macrolides (Azithromycin and Clarithromycin) be used on Endocarditis or Meningitis
NO! They are not bactericidal
60
What is the use of Azithromycin
Chlamydia Upper and lower RTI
61
What is the use of Clarithromycin
Upper and lower RTI H. Pylori induced GI ulcer
62
Does clindamycin cover psuedomonas
NO
63
What is the coverage of Clindamycin
MRSA, MSSA, abdominal anaerobes and Atypicals
64
What is the major ADE of clindamycin
C. Diff and Steven-Johnson Syndrome
65
Is clindamycin safe for pregnancy
Yes, Cat B
66
What is the use of Oral/ IV clindamycin
SSTI, MRSA, Nec Fasc, Polymicrobial INfx in DM
67
What is the second line agent in Penicillin/ Cephalosporin allergic pts
Clindamycin
68
What is Topical Clindamycin used for
Acne and BV
69
What is the coverage of linezolid
VRE, MRSA, MSSA
70
What is the preg cat for linezolid and does it require renal adjust
C , and No
71
Can linezolid be used for bacteremia
NO, its too widely distributed
72
What is linezolid used for
Nosocomial pneumonia CAP complicated and uncomplicated SSTI
73
What is the major ADE of linezolid
Anemia, Luekopenia, pancytopenia, thrombocytopenia Weak MAO inhibitor (serotonin syndrome)
74
What two fluoroquinolones cover Pseudomonas
Ciprofloxacin and Levofloxacin
75
Which fluoroquinolones covers anaerobes
Moxifloxacin
76
What is the coverage of Moxifloxacin
MSSA, And Atypicals
77
What is the coverage of ciprofloxacin
Psuedomonas and Atypicals
78
What is the major ADE of Fluoroquinolones (CLeM)
Mainly in elderly/critically ill can cause hallucinations, delirium, seizures Rashes Photosensitivity Risk to athletes (tendon rupture) Variable QTC
79
What is the risk to athletes taking fluoroquinolones (CLeM)
Tendon Rupture, for up to 6 months post course
80
Besides tendon rupture for athletes what are the other ADE of fluoroquinolones
Tendon rupture for pts older than 60, taking corticosteroids, or in renal failure Athralgias in pts less than 18 y/o Variable QTC elongation
81
What is the pregnancy cat and absorption advisory for Fluoroquinolones (CLeM)
Cat C Reduced by anti acids for absorption -penetrated CNS and Bone
82
What is the DOC for anthrax
Ciprofloxacin
83
Can Moxifloxacin be used for UTI
No
84
What is the Fluoroquinolones DOC for p. Aeruginosa RTI
Levofloxacin
85
Which fluoroquinolones has the best anerobic coverage
Moxifloxacin
86
What ABX can not be used with a G6PD def.
``` Sulfonamides Nitrofurantoin Dapsone Primaquine Quinidine ```
87
What is the DOC for toxoplamsa Gondi
Sufladiazine
88
What is the coverage for Sulfamethoxazole and Trimethoprim
MRSA, MSSA
89
Can Sulfonamides be used in neonates
NO! Pump and dump, Causes congenital malformations
90
How are sulfanomides excreted
Renally, concentrates in the urine
91
Do Sulfonamides penetrate CNS
Yes
92
What is the folate synth inhibitor that is used to treat Pneumocystis pneumonia (PCP)
SMX/TMP
93
What are the Major ADE of Sulfonamides
Stevens Johnson Syndrome Bien marrow Supresión Hemolytic anemia with G6PD Crystalurea
94
What is the DOC for Trichomonas vaginalis
Tinidazole or Metronidazole
95
What are the major ADE of Nitroimidazoles (metronidazole and Tinidazole)
Metallic taste Warfarin DDI Avoid in alcohol due to disulfiram RXNs
96
What is the DOC to cover amebiasis (E. Histolitica, Giardiasis, Trichomnas)
Metronidazole or Tindazole
97
Metronidazole when combined with a PPI can treat
H. Pylori
98
What is the DOC in nfections with documented or suspected abdominal anaerobic bacteria, with adjunctive coverage of aerobes by a second drug when necessary
Metronidazole or Tindazole | Nitroimidazoles
99
What is the more expensive version of vancomycin, used to treat C. Diff and is a protein synth inhibitor
Fidaxomicin
100
Fidaxomicin should not be used in what pts.
Pts with macrolide allergies (Azithromycin or clarithromycin) Or in combination with vancomycin (destroys too much flora)
101
What is the DOC for impetigo
Mupirocin
102
What is the coverage of mupirocin
MRSA and group A strep
103
What is the DOC for MRSA in adult patients and healthcare workers during institutional outbreaks
Mupirocin
104
What is Nitrofurantoin used for
Uncomplicated cystitis and UTI
105
What is fosfomycin used for
Uncomplicated UTI
106
What is Methanamine used for
Uncomplicated UTI (prophylaxis and suppression only) not TX
107
What is the use of phenazopyridine
Analgesic used in UTI (colors urine orange)
108
What is the DOC for acute OM
Amoxicillin Recurrent? Augmentin Allergy to PCN? 2* GEn Cephalosporin or Ceftriaxone
109
What is the standard regimen for CAP in a pt without comorbiditieds
Amoxicillin Or Doxycycline or Azithromycin or Clarithromycin
110
What is the Standard regimen for CAP with comorbisites
Augmentin or cephalosporins And Azithromycin or Clarithromycin or Doxycyline Or monotherapy with a fluoroquinolones (CLeM)
111
What is the Tx for native value endocarditis
NAfcillin or oxacillin PCN allergic: cefazolin Oxacillin resistantL vancomycin or Daptomycin
112
What is the Tx for prosthetic value endocarditis
Nafcillin or Oxacillin plus rifampin plus gentamicin (NRG or ORG) X6 wks Methicillin resistant?: Vancomycin plus rifampin plus gentamicin (VRG) X 6 wks
113
What is the DOC for high MRSA risk SSTI
Doxycycline or SMX/TMP
114
What is the DOC for low risk MRSA SSTI
Antistaph penicillins ( METHICILIN, dicloxacillin, oxacillin, nafcillin, cloxcillin) Or 1* gen cephalosporin (Cephridine, Cephazolin, Cephadroxil, Cephalexin)
115
What drugs treat MRSA
``` Trimethoprim/sulfamethoxazole (PO/IV) Clindamycin (PO/IV) Doxycycline (PO/IV) Vancomycin (IV) Ceftaroline (IV) Linezolid or Tedizolid (PO/IV) Daptomycin (deactivated in the lungs) (IV) ```
116
Does Trimethoprim treat MRSA
Yes
117
Does Clindamycin Tx MRSA
Yes
118
Does Doxycycline tx MRSA
Yes
119
Does Vancomycin tx MRSA
Yes
120
Does Ceftaroline tx MRSA
Yes
121
Does linezolid tx MRSA
Yes
122
Does Daptomycin tx MRSA
Yes, but it’s deactivated in the lungs
123
If using vancomycin or CLeM (fluoroquinolones) | For surgical prophylaxis, what is the time frame for administration
Wishing 60- 120 minutes of incision
124
When should you redose surgery prophylaxis
If the surgery last longer than 4 hrs
125
What is the prophylaxis DOC for Endocarditis in pts with vulvar HDz
Amoxicillin or clindamycin
126
What is the prophylaxis DOC for surgical wound infections
Cefazolin or Clindamycin
127
What is the prophylaxis DOC for surgical abdominal infections
Cefoxitin or Cefotetan Ertapenem, Or cefazolin +metronidazole
128
What is the DOC for C. Diff
Vancomycin
129
What should persistent/ resistant C. Diff be treated with
Intracolonic Vancomycin Fidaxomicin x 10 days if not used previously Fecal bacteriotherapy (fecal microbiota transplant) Subtotal colectomy
130
What is the DOC for uncomplicated cycling
TMP/SMX x 3 days Nitrofurantoin x 5 days Fosfomycin x 1 dose Methenamine (prophylaxis) Alternative: fluroquinolone x 3 days or β-lactam x 3-7 days
131
What is the DOC for uncomlicated plyeonephritis
TMP/SMX x 14 days (if susceptible) Fluoroquinolone x 5-7days Alternative: β-lactam x 10-14 days
132
What is the DOC in complicated UTI
Fluoroquinolone (CLeM) Aminoglycoside (GNT) Extended spectrum β-lactam
133
What is the DOC in a pregnant UTI
Amoxicillin Nitrofurantoin (up to 37th week) Cephalexin
134
Can fluoroquinolones (CLeM) be used in pregnancy UTI
No
135
Can Trimethoprim or Sulfamethoxazole be used in pregnant UTI
No
136
Can Aminoglycosides (GNT) be used in pregnant UTI
No
137
Can tetracyclines (DMT) be used in pregnant UTI
No
138
What is the DOC for Chlamydia
Azithromycin Or Doxycycline
139
What are the 4 Meds used to treat Active TB
Rifamycins Isoniazid Pyrazniamide Ethambutol RIPE
140
What is the Active Tb drug regiment
RIPE x 2 months | Then Isoniazid and Rifampin x 4 months
141
When tx TB, if the patient has HIV what drug should be used instead of Rifampin
Rifabutin
142
Can Pyrazinamide be used in Pregnant Pts with active TB
No
143
In tx active TB in pregnant women, what drug must be added
Pyridoxine
144
What is the DOC in Latent TB for children under 2
Isoniazid
145
What is the DOC for Latent TB in pregnancy
Isoniazid with pyridoxine
146
What is the DOC for latent TB in children older than 2
Isoniazid and Rifapentine
147
Should the combination of Rifampin and Pyrazinamide be used in Tx latent TB
No Causes severe liver injury and death
148
What is the DOC for latent TB in pregnancy
INH once daily or twice weekly for 9 months with Pyridoxine supplementation
149
What is the -cidal -static activity of isoniazid
Bacteriostatic in stationary phase | Bactericidal for dividing organisms
150
What is the DDI and food precautions of Isoniazid
Carbs and Aluminim impair absorption Inhibits CYP3A4
151
What are the MAJOR ADE of isoniazid
Peripheral neuropathy Excretion of B6 ( reversed with pyridoxine) Hepatotoxicity Hemolysis in G6PD def. Lupus and SZR
152
What are the ADE of rifamycins
Potent CYP450 inducers Hepatotoxic Orange/ red secretions (Don’t wear contact lenses)
153
For tx can reifampin be used as monotherapy
No Must always be combined with other agents
154
What is the clinical use of rifampin
S. Aureus, MRSA, TB tx
155
What are the ADE of rifampin
Hepatitis and liver failure | Must monitor LFTs
156
What is the role of rifabutin
Preferred drug for use in TB-infected patients with HIV
157
What is the ADE of using rifabutin
Uveitis Skin pigmentation And neutropenia
158
What is the role of Rifapentine
LTBI once weekly by direct observation therapy (DOT) Should NOT be used as monotherapy, to avoid resistance Often used in combination with INH for latent tb in children older than 2 years old
159
What is the role of Pyrazinamide in TB tx
Part of the initial four-drug regimen to shorten the overall duration of therapy from nine months to six months
160
In latent Tb, if the pt is resistant to Isoniazid and Rifampin, what drug combination should be used?
Ethambutol and Pyrazinamide
161
What is the ADE of Pyrazinamide
Hepatitis/ Heptaotoxic Arthralgias
162
What is the 2nd line drug used pts unable to tolerate rifampin during continuation phase of active TB Tx
Ethambutol
163
What are the ADE and Contraindications for Ethambutol
Optic neuritis Contra: Patients that are not able to reliably perform visual acuity and red-green color discrimination test Children < 5yo Unconscious patients Not recommended in patients with decreased uric acid excretion
164
What are the 1st line frugs for treating MAC infections
Ethambutol with rifabutin and macrolides ( Azithromycin and clarithromycin)
165
Is ethambutol associated with heptotoxicicioty
No
166
What stage of malaria does Atovaquone-proguanil have MOA on
Blood stage and Hepatic Stage
167
What stage of malaria does doxycyline have MOA
Blood stage
168
What stage of malaria does mefloquine have MOA
Blood stage
169
What stage of malaria does chloroquine have MOA
Blood stage
170
What stage of malaria does tafenoquine have MOA
Hepatic stage
171
What stage of malaria does primaquine have MOA
Hepatic stage (off label use)
172
What are the 5 malaria drugs (MAD TC)
Mefloquine, Atovaqoune-proguanil, Doxycyline, Tafenoquine, Chloroquine
173
What are the ADE of primaquine
Hemolysis in G6PD pts
174
What is the ADE of Mefloquine
psychiatric disturbances ranging from insomnia, vivid dreams, and mood swings, to depression, psychosis, and suicide
175
What are the ADE and contraindications for chloroquine
Irreversible retinal damage, ototoxicity, myopathy, and peripheral neuropathy in patients receiving long term or high dose Contra: Patients with psoriasis or preexisting retinopathy of the eye
176
What are the ADE of mefloquine
Exacerbation of psychiatric disorders; vivid dreams; seizures Dizziness, headache, loss of balance, or ringing in ears Cardiac arrhythmias and bradycardia Do not administer concomitantly with other medications that cause QTc prolongation N/V/D, abdominal pain
177
Can pts one antipsychotic or anticonvulsant meds take mefloquine
No
178
What age range in melfoquine safe for, who is it not safe for?
Safe in young children, Not safe below 6 months Not safe in psych or cardiac pts
179
What is the DOC to prevent relapse of P. Vivax and P. Ovale
Primaquine
180
What are the ADE of primaquine
Prolonged QTc interval; anemia CANT USE IN G6PD
181
Is primaquine safe for pregnancy
NO
182
What is the DOC for terminal prophylaxis of malaria
Tafenoquine w/ chloroquine
183
Can tafenoquine be used in pregnancy
No
184
What is the ADE and food warnings for atovaqoune- proguanil
Avoid in renal impairment (CrCl<30 ml/min) Avoid in pregnant or breastfeeding <11 kg babies Should be taken with food or milk
185
What is the DOC for chemoprophylaxis in areas with chloroquine resistant P. falciparum
Doxycyline
186
what patients can you not use Doxycyline for when treating malaria
Children less than 8 or pregnant women
187
What malaria drugs can be used 1-2 days pre travel
Atovaqoune-proguanil and Doxycyline and Primaquine
188
When must mefloquine (malaria) be initialed before travel
2-3 weeks prior
189
When must tafenoquine be initiated before malaria travel
Within one week of travel (loading dose of 200 mg Qd x 3 days)
190
When must chloroquine be initiated for malaria travel
1-2 weeks pre travel
191
How long should atovaqoune-proguanil and primaquine be used Post malaria travel
7 days post
192
How long my Doxycyline, chloroquine, and mefloquine be used o post malaria travel
4 weeks post travel
193
How long must tafenoquine be used post malaria travel
One dose within one week post travel
194
What is the DOC for trich vaginalis
Metronidazole or Tinidazole
195
What is the DOC for tx of toxoplasmosis Gondi
Pyrimethamine + clindamycin or Sulfadiazine
196
What is the DOC of Prophylaxis Toxoplasmosis Gondi
Sulfamethoxazole- Trimethoprim
197
What is the DOC of giardiasis
Metronidazole or Tinidazole
198
What is the DOC for pin words for pts older than 2 years old
Albendazole
199
What is the ADE of albendazole
Increased liver enzymes | Monitor LFT
200
CAn Albendazole be used in pregnancy
No, discontinue use if pregnant, and avoid pregnancy for 1 month following therapy
201
What is the MOA of pyrantel Pamoate
depolarizing neuromuscular blocker works to cause paralysis in worm (causes acetylcholine release and inhibition of cholinesterase)
202
What is the clinical use of pyrantel pamoate
Effective against mature and immature forms of susceptible helminthes within intestinal tract NOT effective against migratory stages in tissues or eggs
203
Can you use pyrantel pamoate in children under 2 years or pregnancy
No, avoid in 1st trimester
204
What are the 1st line agents for lice
Permethrin and pyrethrins
205
What are the age indications for Permethirn and pyrethrin
Permethrin > 2 months old | Pyrtethrin >2 years old
206
What is the OVicidal drug for lice Tx
Malathion
207
What is the age range for use of malathion in lice Tx
Older than 2 years old
208
What is the occlusive based therapy drug for Lice Tx
Benzyl Alcohol Lotion
209
What is the MOA of ivermectin
Binds to chloride ion channels in nerve and muscle cells | Leads to muscle paralysis of the parasite
210
What is ivermectin used for
Lice only one treatment
211
What is the age range for ivermectin
patients 6 months and older
212
``` What is the MOA of Imidazoles (Clot/Mic azole) and triazoles (Fluc/Vori/Posa conazole) ```
Fungal membrane inhibitors
213
What is clotrimazole used for
``` Cutaneous or vaginal candidiasis Oral candidiasis (Tx and prophylaxis) ```
214
What is the ADE with clotrimazole
Monitor hepatic function with longer term use
215
What is the Primary option for many susceptible fungal infections, including invasive and noninvasive candidiasis and cryptococcal disease
Fluconazole
216
What is antifungal that is used for Prophylaxis against invasive fungal infections in immunocompromised patients
Fluconazole
217
What is the DOC for VVC
Fluconazole
218
What is the DOC for invasive and non invasive candiadisis
FLuconazale
219
What is the DOC in aspergillus infx
Voriconazole
220
What is the primary option for invasive pulmonary and extra pulmonary candida infx
Voriconazole
221
What is the ADE associated with voriconazole
High trough concentrations associated with transient visual disturbances (color perception) Auditory hallucination Monitor Liver and Renal function Increased risk of hepatotoxicity
222
What DDI must you be aware of with voriconazole
Drug Interactions: Inhibitor and substrate of CYP2C19, 2C9, and 3A4 Significant drug interactions prevents its use with many drugs. e.g. Rifampin, rifabutin, carbamazepine,
223
What is the MOA of terbinafine, naftitine, Butenafine
Cell membrane inhibitor | FUNIGICIDAL
224
What is the DOC for onchymycosis
Terbinafine
225
What drug is fungicidal to tineas
Terbinafine
226
What is the ADE of Terbinafine
Taste disturbance and hepatotoxicity
227
Can terbinafine (lamisil) be used in pregnancy
NO , it accumulates in the breast milk
228
What is the MOA of Amphotericin B and Nystatin
Membrane inhibitor (Fungal) Fungicidal
229
What is the DOC for invasive fungal infections
Amphotercin B
230
What drug is used empirically when fungal infection is suspected like febrile neutropenia
Amphotericin B
231
What drug is use prophylactically in patients at signifigant risk of fungal infections like bone marrow transplant
Amphotericin B
232
What are the ADE of Amphotericin B
Fever, chills, rigors, (may you acetaminophen to help or diphenhydramine) Nephro toxic, can lead to anemia SZR if injected into spinal colomn
233
What are the DOC for Candida infections in immunocompromised patients
Fluconazole - Prophylaxis for organ transplant and high-risk patients Or Posaconazole
234
What is the DOC for aspergillus infx
Voriconazole
235
What is the DOC for fungal pneumonia that does not respond to antifungals (PCP)
Sulfamethoxazole-Trimethoprim
236
What are the DOC in uncomplicated Vulvovaginal Candidiasis
Fluconazole
237
What is the standard therapy of Uncomplicated Oropharyngeal and Esophageal Candidiasis
Nystatin and clotrimazole rinses
238
What is the DOC for tinea pedis (athletes foot)
Topical : Lotrim ( butenafine) or lamisil (Terbinafine) Oral: Fluconazole
239
What is the Tx for inflluenza
5 days for oseltamivir or zanamivir May extend for patients who remain severely ill after 5 days 1 day for uncomplicated influenza with IV peramivir
240
What is the influenza DOC for pregnant women
Oseltamivir
241
Who should not receive zanamivir in influenza tx
Not for people with breathing problems like asthma or COPD, for example.
242
What demographic does peramivir adversely effect
Japanese populations (delirium)
243
What is the age range for Oseltamivir Tx and prophylaxis
Tx: older than 2 weeks Prophylaxis: older than 3 months
244
What are the age ranges for Zanamivir Tx and Prophylaxis
Tx: 7 years and Older Prophylaxis: 5 yrs and older
245
What are the age ranges for Peramivir Tx
18 years and older
246
What is the DOC for RSV Prophylaxis
Palivizumab
247
What is the Tx for RSV
Supportive Care
248
What is the role of Zostavax
Herpes zoster vaccine
249
What is the role of Verivax
Varicella zoster vaccine
250
What is the recommended dosing schedule for VArivax
Recommended for all children at 12 to 18 months old. Second dose prior to entering school between ages 4 and 6 yrs
251
FOr best results when should antivirals be started to Tx herpes
With in 72 hours of S/s
252
What are the DOC for Shinlges
Valacyclovir: TID for 7 days Famciclovir: TID for 7 days Acyclovir: five time a day for 7 days
253
What is the DOC for the 1st clinical episode of Herpes
Valacyclovir 1 gram PO 2x/day for 7-10 days
254
What are the DOC for episodic therapy for recurrent genital herpes
Valacyclovir 500mg PO 2x/day for 3 days Or Valacyclovir 1 gram PO 1x/day for 5 days
255
What is the DOC for severe or difficult-to-treat HSV infections
Acyclovir IV
256
What are the ADE of nucleoside analogs
Acute renal failure through crystallization in urine Mostly associated with IV acyclovir in higher doses Prevent crystallization through hydration and correct dosing in renally impaired patients Seizures, tremors, or other CNS effects can occur Nausea, diarrhea, and rash are more common
257
What is the MOA of tenofovir
Nucleotide Reverse Transciptase inhibitor (HIV)
258
What is the DOC for HIV tx
Truvada: Tenofovir (TDF) (NRTI) + Emtricitabine (NRTI) Descovy: Tenofvir (TAF) (NRTI) and Emtricitabine (NRTI)
259
What is the ADE of Truvada: Tenofovir (TDF) (NRTI) + Emtricitabine (NRTI) Descovy: Tenofvir (TAF) (NRTI) and Emtricitabine (NRTI)
Hyperpigmentation of the palms or soles may be observed In ~3% particularly African Americans (up to 13%)
260
What is the MOA of Raltegravir, Dolutegravir
Option for initial treatment as an additive agent to 2 NRTI’s
261
What are the ADE of Raltegravir and | Dolutegravir
Myopathy/rhabdomyolysis | Insomnia, depression and suicidal ideations
262
What is the recommended therapy for Post-Exposure Prophylaxis (PEP) of HIV
``` emtricitabine/tenofovir (Truvada) daily and dolutegravir (Tivicay) twice a day ```
263
What is the substitution made for pregnancy in Post-Exposure Prophylaxis (PEP) of HIV
If pregnant substitute raltegravir (Isentress) instead of dolutegravir
264
How long is PEP for HIV
28 days unless the pt test negative for HIV, meaning worker not exposed
265
What is PrEP
Daily Emtricitabine (FTC) + Tenofovir disoproxil fumarate (TDF) (Truvada)
266
CanPrep be used in a patient with active HIV
No! The 2-drug regimen of TDF/FTC is inadequate therapy for established HIV infection, its use may causes resistance in active infection

IPAP 21-2 Soph Semester (20 decks)

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