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ID3 Flashcards

1
Q

Emp Abx for pts 1-23 months 2

A
  1. Ceftriaxone or cefotaxime
    • Vanc
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2
Q

Nitrofurantoin Contraindication

A

CrCl < 60

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3
Q

What drug has no activity against the 3 Ps?

A

Pseudomonas

Proteus

Providencia

Tigecycline

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4
Q

Empiric tx for CAP when patient has no recent abx use?

A

Macrolide or Doxy

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5
Q

Gonorrhea Tx:

What is not recommended?

A

Ceftriaxone + Azithromycin (Preferred) or doxy

250 mg IM x 1 for cef

Monotherapy is not recommended

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6
Q

In the intensive phase how long is RIPE therapy

A

8 wks

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7
Q

Weights to use for AGs?

A

Underweight < IBW use actual

Obese use adjusted

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8
Q

What drug is rec’d for all categories of HAP or VAP?

A

Zosyn

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9
Q

What are the common uses for Minocycline and Doxy

A

CA-MRSA skin infections, acne

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10
Q

Severe ICU patients Peritonitis and Cholangitis

What pathogens to cover? 12

A
  1. PEK
  2. CAPES
  3. Pseudomonas
  4. Anaerobes
  5. Strepto
  6. +- enterococcus
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11
Q

Symptoms of syphillis

A

painless smooth genital warts (chancre)

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12
Q

Metronidazole SE

A

Metallic taste

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13
Q

What Abx’s can increase INR? 6

A

Tigecycline

Metronidazole

Telavancin ortivancin false elevation in both aPTT and INR

Bactrim

Tetracyclines

Quinolones

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14
Q

What is the main drug for Rocky mountain spotted fever, typhus, lyme disease and Ehrilichiosis

A

Doxy

Rocky: 5-7 days

Typhs 7 days

Lyme 10-21

Ehrlith: 7-14

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15
Q

Absess Perulent Infections

Treatment 2

A

Commly caused by CA-MRSA

Bactrim

Doxy

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16
Q

Bactrim dosing for Uncomplicated UTIs?

A

1 DS tab PO BID x 3 days

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17
Q

Tigecycline boxed warnings and what should it not be used for?

A
  1. Increased risk of death
  2. Not for blood stream infections
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18
Q

When are IV Abxs preferred in CAP patients?

What are the preferred beta lactams?

Preferred macrolides?

What if the patient has risk factors for pseudomonas?

What about MRSA?

A
  1. IV abx for patients in the ICU
  2. Ceftriaxone, cefotaxime
  3. Azithromycin
  4. Pseudomonas: Zoysn, cefepime, or meropenem + either levo or an AG and Azithromycin
  5. If MRSA: add vanc or linezolide
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19
Q

Treatmetn for Pharyngitis?

A

PCN, Amox

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20
Q

Meng pt with severe PCN allergy

A

Quinolones

moxi or levo

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21
Q

What is the treatment and durtation for conuation phase

A

2 drugs for 4 months

INH and RIF if susceptible

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22
Q

More Severe SSTIs needing IV abx or Hospitalization cover what 2 things? and what are the 3 main drugs?

A
  1. Cover MRSA and Streptococcus
  2. Vanc
  3. Linezolid
  4. Daptomycin
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23
Q

Abx for COPD exacerbation?

A

Amox/clav

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24
Q

Common pathogens for meningitis in patients <1 months

A
  1. S. Agalacticae
  2. E. Coli
  3. Listeria
  4. Klebseilla
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25
How is syphillis diagnosed?
Rapid Plasmin Reagen Also called the Vinereal Disease Research Lab
26
CMV Preferred 2 Alt and why Secondary prophy
1. Valacylovir, ganciclovir 2. ALt: If toxicity to gan or resitant: foscarnet, cidovir 3. No agent recd for secondary keep CD4\> 100
27
Isoniazid INH SEs
1. Peripheral neuropathy give with pyridoxine 25 mg PO qday 2. Monitor S/Sx of DILE
28
2 drugs that only covers E. faecalis?
Pen G or Amp
29
Max dose of conventional ampho B
Black Box: Not exceed 1 .5 mg/kg /day
30
How to you confirm the Dx of Active TB?
Skin test likely means active but need to confirm with a sputum culture AFB stain Definitive With PCR slow growing
31
What 3 drugs are always used in combination with other antipseudomonal meds?
Colismethane, Polymxyin, AGs
32
Fidaxomicin warnings?
Not effective in systemic infections
33
What latent TB regimen is not rec'd for HIV, children \< 2 or pregnant women
INH and Rifapentine
34
Bactrim Coverage? 2 sets What type? 8 main What 4 things are not covered?
* Broad gram negative bacteria and some oppurtunistic infections 1. Gram Negative: Haemaphilus, Proteus, Klebsella, E. Coli, Enterobacter, SHigella, salmenella, Stenotrophomonas 2. Opp: Pneumocytis, Toxoplasmosis 3. DOES NOT COVER: Pseudomonas, Enterococci, atypicals or anaerobes
35
When someone is on roids what is the criteria for them to be considered immunocompromised?
systemic roid for 14 days or longer at pred dose \>= 20 mg/day or \>= 2 mg/kg/day
36
Nitrofurantoin counseling
Take with food to prevent nausea and cramping can discolor urine brown
37
Cryptococcal meningitis Induction Therapy Alternative Reg Secondary PRophy
Ampho B + flucytosine Alt: Fluconazole +- flucytosine Secondary prophylaxis low dose fluconazole
38
Tx duration for pharyngitis?
10 5 days for azithro
39
Other treatment options for Travelers Diarhea if dysentary not present not pregnant and pediatric
Cipro 3 days Levo x 1 or daily 1-3 days Ofloxacin 400 PO x 1 or BID x 3 days Rifaximin TID x 3 days
40
Cellulitis Non-purulent infections
Cephalexin 500 mg QID
41
Second line tx for sinusitis failure of first
Oral 2nd or 3rg gen cephs + clinda, doxy or Resp FQ
42
Chlamydia Tx:
Azithromycin 1 gram PO x 1 or Doxy
43
First line tc for sinusitis?
Amox/clav
44
Preferred Treatment for Travelers Diarrhea if fever, Blood is present or pregnant or pediatric
Azithromycin 1000 mg PO or 500 mg PO daily 1-3 days
45
Mild to moderate Peritonitis and Cholangitis What to cover? 6
1. PEK 2. Anaerobes 3. Strepto 4. +- enterococcus
46
Tigecycline coverage? 5
MRSA, VRE, g(-), anaerobes, and atypicals
47
What patients are at risk of IE during dental procedures? 4
1. Prosthetic heart valve or heart valve repair with artificial material 2. Hx of endo 3. Heart transplant with abnormal heart valve function 4. Certain congenital heart defects including heart/lung valve disease
48
PCP Tx duration alt Prophy
* Bactrim +- pred * For 21 days * ALt: pentamidine IV * Secondary Bactrim
49
Nitrofurantoin warnings? 2
Hemolytic anemia found through positive coombs test caution in pts with G6DP Def
50
Duration of treatment of DM foot infections 4 total
1. 7-14 2. More severe: 2-4 wks 3. Bone and joint: 4-6 wks 4. Osteo longer
51
Empiric treatment for mengigitis in pts \< 1month 2 drugs and an or
Amp (listeria coverage) Cefotaxime (not cetriaxone) or gentamicin
52
Other drugs besides Ceftriaxone that can be used for primary or secondary prophylaxis of SBP?
1. Bactrim 2. Cipro
53
Metronidazole contraindications? 2
Pregnancy in the first trimester Alcohol or propylene glycol contain products during treatment within 3 days of tx dc
54
Latent TB Tx 3 possible
1. Isoniazid 300 mg max 900 for 9 months 2. Rifampin 4 months 3. INH + rifapentine q wk for 12 wks
55
Different treatments for each phase of syphillis Primary, secondary or early latent? Latent \> 1 y or unknown duration Neurosyphilis including ocular and congenital What is the treatment and duration for alternatives?
1. PEN G benzathine 2.4 million units IM x 1 2. PEN G Benzathine IM wkly for 3 wks 3. Pen G aqeous, Alternative Pen G procain
56
HAP risk factors for MRSA or MDR Pseudomonas
IV Abx within the past 90 days
57
Emp meng tx for patients 2 -50?
Ceftriaxone 2 g q12 Cefotaxime 2 g q4-6 + vanc 30-45mg/kg/day
58
Primary Prophylaxix in pts with HIV MAC:
CD4 \< 50 Preferred Azithro 1200 CD4 \> 100 for \>= 3 months on ART
59
A TST is also called what?
A purified protein derivative test
60
Drug interaction wiht metronidazole?
Warfarin Increase INR
61
Pyrazinamide SEs
Causes increased uric acid dont use with acute gout
62
When can a false positive TB skin test occur?
When a patient has received the BCG vaccine
63
CAP risk of S.pneumo? Drug choices 3 potential
Beta lactam (Amox high dose, Amox/clav, Cefpodoxime, cefdinir, cefuroxime, or ceftriaxone) + macrolide or doxy Potential monotherapy with respiratory FQ moxi, levo gemi
64
Rifampin and INH admin and risks
1. Take on an empty stomach 2. Risk of hemolytic anemia through positive coombs test
65
Trichomoniasis Tx and CDC recs
* Metronidazole 2 grams PO * CDC recs Metro in all trimesters
66
What drug used to treat MDR g(-) pathogens in combo with other drugs has dose dependent nephrotoxicity?
Colistimethate
67
DM foot infections Anaerobic G(+) 2 Aaerobic G (-) 1
1. Peptostrepto 2. Clostridium Perfringes 1. B. Fragilis
68
What is ciprofloxacin not used for?
Pneumonia not a respiratory FQ and does not have reliable coverage against S. pneomo
69
What drugs need increased dosing interval in renal impairment? For TB drugs
Ethambutol and Pyrazinamide
70
MAC crtieria treatment and DC And drug treatment and duration
* CD4 \< 50 must rule out active disseminated DX * Preferred Azithromycin 1200 mg PO weekly * CD4 \> 100 for \>= 3 months on ART
71
MAC
Clarithromycin or Azithromycin + ethambutol Alt: Add a 3rd or 4th agent using rifabutin, amikacin, or streptomycin, moxi or levo secondary prophylaxis is the same as primary tx
72
Common Cold MCPs 2 Influenza 1 Pharyngitis 2 Sinusitis 7
1. Resp Virus: Rhinovirus and coronavirus 2. Infuenza 3. Resp viruses and S. Pyrogenes 4. Resp viruses, S. Pneumo, H. Flu, M. Mat, staphylococcus, anaerobes, and g (-) rods
73
Gonorrhea and Chlamydia?
Gonorrhea: Ceftriaxone 250 IM + Azithromycin 1 gram or doxy 100 mg BID x 7 (These treat chlamydia too)
74
Primary Prophylaxix in pts with HIV Toxo
1. \<100 Toxo IgG + 2. Preferred Bactrim 3. Alt dapson + pyrimethamine + leucovorin 4. DC when CD4 \> 200 for \> 3 months on ART
75
Community Associated MRSA SSTIs drugs 3
1. Bactrim 2. Doxy 3. Minocycline
76
Bacterial Vaginosis Tx WHat should pts not do?
Metro or Metro 0.75% gel Pts should not douche
77
What regimen is recommend for HIV, pregnant and children? and for what?
INH: 300 mg per day max 900 per dose 9 months for Latent TB
78
Preferred beta lactam for CAP when patient has risk of S. Pneumo?
Ceftriaxone or cefotaxime + azithromycin
79
Metronidazole Interactions?
Weak 3A4 and 2C9 inhibitor
80
When should you take a trough for AGs?
right before or 30 min before the Peak 30 minutes after
81
What drugs are used for E.Faecium and E. Faecalis? 6
1. Dapto 2. Linezolid 3. Tigecycline 4. Cystitis only: Nitro, fosgomycin and doxy
82
Tx of syphillis What about pregnant patients?
* Pen G 2.4 millions units IM wkly for 3 wks if latent \>1 yo or tertiary * Bicillin L-A dont sub with the C-R * Alternative Doxy 100 mg PO BID or tetracycline PO QID * Pregnant patients with PCN allergy should be desensitized and use L-A
83
patient at high risk for pseudomonas CAP what should be added?
Zosyn and If MRSA concern Vanc or linezolid
84
Rifampin Info? 3 SEs and other things
1. Orange bodily secretions 2. Strong CYP inducer (rifabutin can be used instead due to drug interactions 3. Cause flu like symptoms
85
Toxo Gondi Treatment regimen not prophylaxis
Pyrimethamine + leucovorin + sulfadiazine Alt: Bactrim Same as tx but at reduced dose
86
What does ethambutol cause? 2
Visual changes Hallucinations/confusion
87
12 total drugs that cover pseudomonas?
1. Zosyn 2. Cefepime 3. Ceftazidime 4. Caftaz/Avibactam 5. Ceftolozane/Tazobactam 6. Carbapenems but not Ertra 7. Cipro, Levofloxacin 8. Aztreonam 9. AGs 10. Colistimethate, polymyxins
88
What quinolone should not be used in UTIs and why?
Moxifloxacin: not enough conc in urine
89
WHen should IV abxs be admin for surgical prophylaxis?
Cefazolin and Cefuroxime ( 1hour before surgery) If using quinolones or Vanc 120 minytes before
90
Mild to Moderate Peritonitis and Cholangitis 5 possible regimens
1. Cefoxitin 2. Ertrapenem 3. Moxi 4. Cefazolin, cefuroxime or ceftriaxone + metro 5. Cipro or Levo + metro
91
Lyme Disease vs Ring Worm?
Lymre: bacterial: Bullseye rash DX ELISA, DOxy Ringworm: Fungal: 1+ reddish raised rings: tx with clotrimazole or other topical
92
What is the DOC for uncomplicated UTIs?
Nitro
93
3 most common pathogens of CAP? When do you use cipro?
1. S. Pneumo 2. H. INflu 3. M. Pneumo Never use cipro not a resp FQ and does not cover S. Pneumo relialbly
94
Drugs that cause QT prolongation Abxs
FQs Macrolides
95
Impetigo Honey COmb Crust First choice If numerous lesions
1. Mupirocin (Bactroban) ointment 2. Cover MSSA if systemmic: Cephalexin (Keflex)
96
What drug is added for meng tx in patients \<1 month and \> 50
Ampicillin for Listeria coverage
97
Drugs that cover atypical organisms? 3
Azithro Doxy Quinolones
98
Dificid
Fidaxomicin
99
5 common pathogens in mengitis
1. S. Pneumo 2. N. Meningitis 3. S agal 4. H flu 5. E. COli
100
Macrobid and Macrodantin Dosing
Dantin QID Macrobid 100 mg BID x 5 days
101
DM Foot infections G (+) Pathogens 4 G (-) 5
1. S. Aureus Including MRSA 2. Group A Strepto 3. Viridan group strep 4. S. Epidermidis 1. E. Coli 2. Klebsiella 3. Proteus 4. Enterobacter 5. Pseudomonas
102
RIPE Therapy for Active TB All RIPE drugs cause what 2 things?
Increase LFTs, including total bilirubin
103
Primary Prophylaxix in pts with HIV PCP Indication for proph Tx regimen preferred and Alt (2 sets) Criteria to DC
1. CD4 \< 200 2. Preferred Bactrim DS 3. Alt: Dapsone or Dap +pyrimethamine + Leucovorin 4. DC when CD4 \>= 200 for \>= 3 months on ART
104
Adult prophylaxis regimens for Pts at risk of IE during dental procedure? 3 options
1. Oral: amox 2 g 30-60 min before procedure 2. Cant take oral: Amp 2 g or cefazolin 1 g 3. Can take oral but PCN allergy: 1. Clindamycin 600 2. Azithro or clarithromycin 500
105
First line abx tx for Acute Otitis media What is the dosing?
1. Amoxicillin 80-90 mg/kg/day in 2 divided doses 2. Amox/clav 90 mg/kg/day if pt has gotten Amox in the past 30 days

ID 1183 (19 decks)

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