Drug Of Choice Flashcards
(97 cards)
1
Q
DOC for chemoprophylaxis in areas with chloroquine
resistant P. falciparum
A
Doxycycline
2
Q
DOC for Trichomonas vaginalis
A
Metronidazole or Tindazole
3
Q
Animal bites
A
Amoxicillin/Clavulanate
4
Q
Ideal choice for treatment of mild-moderate
community-acquired-pneumonia
A
Macrolides and Ketolides
5
Q
Genital herpes
A
Valacyclovir
6
Q
Prophylaxis or treatment of uncomplicated malaria (effective against choloroquine resistant. P. Falciparum
A
Atovaquone proquanil
7
Q
Severe staph infections: osteomyelitis, joint, skin
A
Oxacillin or Nafcillin
MSSA coverage is key
-safe in pregnancy
8
Q
Syphillus
A
Penicillin G
9
Q
Uncomplicated pyelonephritis
A
TMP/SMX (if susceptible) ○ Fluoroquinolone ○ Alternative: β-lactam
10
Q
Lymphatic Filariasis
A
Diethycarbamazine (DEC)
Or ivermectin
11
Q
Bacteriostatic
A
Static: Money Gurus COST
■ Used in uncomplicated infxns … do not work in neutropenic pts ■ Tetracyclines (Tetracycline, Doxycycline, Minocycline)
■ Glycylcyclines (Tigecycline)
■ Chloramphenicol
■ Macrolides & Ketolides
■ Oxazalidinones (Lineazolid & Tedizolid)
■ Sulfonamides
12
Q
What are the drugs under MOA: RNA Polymerase inhibitor
A
-Rifampin
13
Q
All other biological warfare (plague, tularemia, brucellosis, Q fever)
A
Doxycycline
14
Q
Chlamydia
A
Azithromycin
15
Q
Patients with G6PD should avoid these meds
A
Chloramphenicol Sulfonamides Nitrofurantoin Primaquine (Quinilines) Isoniazid
16
Q
What meds work for MRSA
A
Trimethoprim/Sulfamethoxazole
Clindamycin
Doxycline
Vancomycin, dalbavancin, oritavancin,or televancin
Ceftaroline
Linezolid or Tedizolid
Daptomycin
17
Q
Time Dependent drugs
A
Time-Dependent: Go Tell Big Frank ■ Beta-Lactams ■ Glycopeptides (Vancomycin) ■ Tetracyclines ■ Folate Antagonists (Sulfonamides)
18
Q
Fungal Pneumonia; that does not respond to
antifungals
Pneumocystis (carinii) jiroveci pneumonia (PCP)
A
DOC: Sulfamethoxazole-Trimethoprim (Septra)
19
Q
Chemoprophylaxis in
areas with choloroquine resistance P. Falciparum
Areas with multi-drug resistant P. falciparum
Terminal prophylaxis of P. vivax and P. ovale infections; alternative for primary prevention
A
Malarone or mefloquine
Doxycycline
Primaquine
20
Q
Minor skin/soft tissue staph infections (impetigo, cellulitis)
A
Dicloxacillin
21
Q
Penicillin Allergy
A
Clindamycin
22
Q
What PCNs cover pharyngitis
A
PCN, antistaph, amino
23
Q
Complicated UTI
A
Complicated UTI
○ Fluoroquinolone ○ Aminoglycoside ○ Extended spectrum β-lactam
24
Q
DOC: onychomycosis
A
Terbinafine
25
C. Dif
Vancomycin
26
CAP no cormobidities
No comorbidities
| ● Macrolide: clarithromycin or azithromycin ● Doxycycline ● Amoxicillin
27
Cephalosporins
Otitis Media –
* SSTI (MSSA) –
* Surgical Prophy –
* Psuedomonas –
* MRSA SSTI/CAP –
* Critically ill/empiric treatment –
* Syphilus/Meningitis
Otitis Media – 1 st and 2nd generation
• SSTI (MSSA) – 1st and 2nd generation
• Surgical Prophy – cefazolin
– Anaerobic: cefoxitin, cefotetan
* Psuedomonas – Ceftazidime, Cefepime
* MRSA SSTI/CAP – Ceftaroline
* Critically ill/empiric treatment – Cefepime
* Syphilus/Meningitis - Ceftriaxone
28
DOC in combination for M. tuberculosis, M. leprae and M. kansasii
(Non-tuberculosis mycobacteria)
Rifampin
29
TB (active)
Rifampin
30
What are the drugs under MOA: DNA grasses inhibitors
-Fluroquinolones
31
Sensitive P. Falciparum
Chloroquine
32
Trichomoniasis
Metronidazole or tinidazole (single dose)
33
CAP inpatient
■ Inpatient Treatment
● Respiratory fluoroquinolone (if ward patient)
● Anti-pneumococcal β-lactam* PLUS azithromycin
● Anti-pneumococcal β-lactam* PLUS moxifloxacin or levofloxacin
● PCN allergy: aztreonam PLUS moxifloxacin or levofloxacin
■ *anti-pneumococcal β-lactams: cefotaxime, ceftriaxone, ceftaroline,
ampicillin/sulbactam
34
Hospital acquired pneumonia
Intra-abdominal infections
SSTI
Sepsis
Gynecological infections
Ampicillin/Sulbactam
35
Latent TB
Isoniazid + Pyridoxine (B6)
36
Medications that cover P. aeruginosa
PCN - Ticarcillic/Clavulanate
Piperacillin/Tazobactam
Cephalosporins - Ceftazidime/Cefepime
Cephalosporin - beta lactamase inhibitor combos - ceftazidime/Avibactam and ceftolozane/Tazobactam
Monobactams - Aztreonam
Floroquinolones - Ciprofloxacin/Levofloxacin
Carbapenems - Imipenem, Meropenem, Doripenem
Aminoglycosides - Gentamycin, Tobramycin, Amikacin
Polymyxins - Colistin
37
Amoeba & Giardia = know treatment
Asymptomatic infxns: paromomycin or iodoquinol
Symptomatic disease: metronidazole or tinidazole followed by treatment w/
paromomycin or iodoquinol
38
Prevents relapse of P. Vivax and Ovale
Primaquine
39
What are the drugs under MOA: Cell membrane inhibitors
-Amphotericin
Ketoconazole
Polymyxins
40
VRE coverage
Daptomycin
Tigecycline
Quinopristin/dalfopristin
Linezolid
41
Severe gram negative infections including: meningitis, endocarditis, joint infections, resistant otitis media, pharyngitis, pneumonia
Ceftriaxone
42
PCN sensitive gangrene
Penicillin (1st gen)
43
Atypical organisms
Tetracyclines
Macrolides/ketolides
Cirpfloxacin/ofloxacin
44
Can be administered as inhalation for pulmonary infections and to reduce adverse effects
Only active against gram (-) organisms
• Has activity against highly resistant strains:
– Examples: P. aeruginosa, K. pneumonia, Acinetobacter
Polymyxins (Colistimethate)
45
DOC in invasive pulmonary or extra pulmonary infections caused by
Candida Spp.
Voriconazole
46
Candida infections in immunocompromised patients
Fluconazole
47
What PCNs cover Pseudomonas
Piperacillin/Tazobactam
48
severe or difficult-to-treat HSV infections
Acyclovir IV
49
Amebiasis
Metronidazole or tinidazole
50
LTBI treatment of choice in pregnancy
For women at risk of progression of latent to
active disease, treatment should not be
delayed even during the 1st trimester –
If active disease excluded may delay initiation
of therapy until after delivery unless patient
had recent contact with active case or is HIV+
INH once daily or twice weekly for 9 months with
Pyridoxine supplementation
51
Visceral Leishmaniasis
Liposomal amphotericin B
52
What are the drugs under MOA: Cell wall synthesis inhibitors
-B-Lactam abx: carbapenems, cephalosporins, monobactams, PCN
Other abx: bacitracin, fosfomycin, and vancomycin
53
What are the drugs under MOA: Protein synthesis inhibitors
```
-aminoglycosides
Chloramphenicol
Clindamycin
Macrolides
Mupirocin
Streptomycin
Tetracylines
```
54
pre/post surgery not involving
| the abdomen
First generation Cephalosporins - Cefazolin
55
Drug Toxicity - Diarrhea/ Colotis (C. Diff)
clindamycin [pseudomembranous colitis]
( diarrheas and colitis may also occur with other
antibiotics)
56
Prophylaxis against invasive fungal infections in immunocompromised
patients (e.g. bone marrow, solid organ transplant, etc…)
Fluconazole
57
What are the drugs under MOA: Folate synthesis inhibitors
Sulfonamides
| Trimethoprim
58
What Pencillins are for MSSA
• MSSA – Dicloxacillin, Nafcillin, oxacillin
Ampicillin/Sulbactam,
Piperacillin Tazobactam
– Severe infection (osteomyelitis, endocarditis) must confirm susceptibility- go with either Nafcillin or oxacillin
59
CAP Cormorbidities
Comorbidities or Abx w/in past 3 months ● Moxifloxacin or levofloxacin
● Macrolide or doxycycline PLUS amoxicillin/clavulanate or cephalosporin (
ceftriaxone (IV/IM), cefpodoxime, or cefuroxime)
60
Trichomonas vaginalis
Metronidazole or Tindazole
61
Surgical prophylaxis
Cefazolin or Clindamycin if allergy to PCN
62
Complicated intra-abdominal infections in combination with metronidazole
Ceftazidime/ Avibactam (Avycaz)
63
Prophylaxis for organ transplant and high-risk patients
Fluconazole
64
1st line option for Candida prophylaxis in hematopoietic cell transplant
recipients
Micafungin
65
Uncomplicated VVC
DOC: Oral Azoles
– Fluconazole 150mg po x 1
– Alternative: Itraconazole: 200mg po BID x 1 day
66
Bacteriocidal
```
Cidal
■ Use these in immunocompromised pts ■ B-Lactams
■ Glycopeptides (Vancomycin)
■ Cyclic Lipopeptides (Daptomycin)
■ Polymyxins (Colistimethate)
■ Aminoglycosides
■ Streptogramins (Quinupristin)
■ Fluoroquinolones
■ Fidaxomicin
■ Rifampin
■ Pyrazinamide
■ Allylamines (fungicidal)
■ Polyenes (Fungicidal)
■ Echinocandins (Fungicidal)
■ Tinea Pedis Meds (Lotrim & lamisil) ■ Malathion 0.5% Lotion (Ovicidal)
■ Ivermectin (ovicidal)
```
67
Toxoplasmosis Gondi
• Treatment:
Pyrimethamine + Sulfadiazine
• Prophylaxis:
Sulfamethoxazole-Trimethoprim (Septra®, SMX/TMP)
68
Surgical abdominal infections
Cefoxitin, cefotetan, Ertapenem, or cefazolin
+ metronidazole
69
Anthrax
Ciprofloxacin
70
Mycobacterium Adium Complex (MAC)
Rifabutin
71
Herpes Enchephalitis
Acyclovir
72
Impetigo
Mupirocin
73
Mild to moderate onychomycosis of fingernails and toenails (nail lacquer)
Ciclopirox
74
Aspergillosis
Voriconazole
75
What PCNs cover upper respiratory
aminopenicillin, better
| coverage with beta-lactamase inhibitor
76
DOC in Aspergillus infections
Voriconazole
77
Drug Toxicity - Nephrotoxicity
aminoglycosides and
| vancomycin
78
N. Gonorrhea infections of the cervix, urethra, and rectum
Ceftiaxone
79
Drug Toxicity - Photosensitivity
quinolones, tetracyclines,
| sulfonamides
80
DOC for many susceptible fungal infections, including invasive and noninvasive candidiasis and cryptococcal disease
Fluconazole
81
Endocarditis in persons with valvular heart disease undergoing oral, dental, or upper respiratory procedures
Amoxicilin/Clindamycin
82
Concentration Dependent
```
Concentration Dependent: F.A.D.
■ Cyclic Lipopeptides (Daptomycin)
■ Aminoglycosides
● (Gentamicin, Tobramycin, Amikacin, Streptomycin, Neomycin B)
■ Fluroquinolones
```
83
Otitis Media
Endocarditis Prophylaxis
Duodenal ulcers caused by H. Pylori
Amoxicilin PO
84
DOC for serious forms of invasive fungal infections
Amphotericin B
85
Giardiasis
Metronidazole or tinidazole
86
Uncomplicated cystitis
● Uncomplicated cystitis ○ TMP/SMX
| ○ Nitrofurantoin ○ Fosfomycin
87
Gram neg coverage only
Aztreonam
Colistimethate
Polymyxins B
Ceftazidime
88
Gram positive coverage only
Vancomycin
Bacitracin
Daptomycin
89
Pseudomonas coverage only
Piperacillin/Tazobactam
Ceftazidime
Carbapenem (Except Erta)
Aztreonam
90
Anaerobic coverage
Ampicillin/Tazobactam
Piperacillin/Tazobactam
Cefoxitin/Cefotetan
Carbapenem
91
Surgical proph
Cefazolin
Cefoxitin
Cefotetan
92
BBB
PCN
3rd and 4th gen cephalosporins (ceftriaxone best) - cefotaxamine and ceftazidime options
Vancomycin
Carbapenem
93
Adverse side effects
```
PCN
Cephalosporins
Carbapenems
Vancomycin
Telavancin
Daptomycin
Colistimethate
```
PCN - Diarrhea
Cephalosporins - Steven Johnson
Carbapenems - seizure (highest with imipenem)
Vancomycin - red man syndrome, nephrotitoxity, ototoxicity
Telavancin - taste disturbances and foamy urine
Daptomycin - rhabdo
Colistimethate - nephrotoxiicity and ototoxicity
94
What is purpose of cilastin when combo with imipenem
Block renal conversion of imipenem to the nephrotoxic product
95
Monitoring req for vancomycin and daptomycin
Van - trough levels 10-15 for less serious infections. 15-20 mcg/ml for serious infections
Daptomycin - CK every week
96
Aztreonam has cross sensitivity with
Ceftazidime
97
Ertapenam exceptoin
No enterococcus coverage
| No pseudomonas or acinetobacter coverage
