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PHRM 865 > Tieman > Flashcards

Tieman Flashcards

(70 cards)

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1
Q

candida risk factors

A

prolonged ICU stay
pic/port line
TPN
gastro surgery

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2
Q

aspergillus risk factors

A

immunocompromised hosts
neutropenia

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3
Q

cryptococcus side effects

A

CNS effects

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4
Q

cryptococcus common pathogen

A

neoformans

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5
Q

amphotericin B first line fungi

A

cryptococcus
blastomyces
histoplasma
mucor

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6
Q

amphotericin B adverse effects

A

nephrotoxicity
increase in SCr and BUN
electrolyte abnormalities
hypokalemia
hypomagnesemia

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7
Q

dosing of liposomal amphotericin B

A

liposomal 3-5 mg/kg/day

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8
Q

flucystosine 1st line

A

cryptococcus

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9
Q

adverse effect of flucytosine

A

bone marrow suppression

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10
Q

monitoring of flucytosine

A

CBC
platelets
SCr
BUN

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11
Q

flucytosine indication

A

cryptococcal meningitis in combo with amphotericin B

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12
Q

which antifungals require dose adjustment in renal

A

flucytosine
fluconazole

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13
Q

fluconazole adverse effects

A

QTc prolongation

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14
Q

fluconazole dose for candida albicans in candidemia

A

800 mg load then 400 mg daily

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15
Q

fluconazole 1st line

A

candida albicans
candida parapsilosis
candida tropicalis
candida lusitaniae
plat
coccidioides

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16
Q

itraconazole 1st line

A

blastomyces
histoplasmosis

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17
Q

itraconazole contraindication

A

CHF

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18
Q

itraconazole adverse effects

A

hepatotoxicity
QTC prolongation

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19
Q

itraconazole drug interactions

A

CYP3A4 inhibitor

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20
Q

itraconazole dosing for histo

A

200 mg TID x 3 days then 200 mg PO BID

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21
Q

which drugs to avoid if CrCl < 50

A

posaconazole IV
voriconazole

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22
Q

posconazole adverse effects

A

QT prolongation
inccreased liver enzymes

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23
Q

posconazole 1st line

A

nothing
broad spectrun

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24
Q

voriconazole interactions

A

CYP3A4

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25
voriconazole use
invasive aspergillosis
26
voriconazole adverse effect
visual disturbances
27
isavuconazole adverse effect
no QT interval prolongation (shortens)
28
which azole has the least interactions
isavuconazole
29
contraindication in isavuconazole
those with shortened QT interval
30
echinocandins 1st line coverage
candida glabrata candida krusei candida lusitaniaw candida auris GALK - can add to voriconazole in severe aspergillus
31
caspofungin adverse effects
histamine related symptoms rash face swelling pruritic flushing phlebitits fever
32
micafungin dosage form
IV
33
micafungin dosage adjustment for renal and CYPs
no dose adjust renal no CYP interactions
34
micafungin adverse effects
very minimal hyperbilirubinemia
35
ibrexafungerp consideration
contraindicated in pregnancy use effective contraception during and 4 days after treatment
36
echinocandins coverage
candida only glabrata auris lusitaniae krusei
37
most common OI in HIV
oropharyngeal candidiasis
38
what is the primary line of defense against superficial candida infections
cell mediated immunity T cells
39
risk factors for oropharyngeal and esophageal candidiasis
inhaled steroid use chemo HIV antibiotic use immunosuppression after transplant
40
treatment mild oropharyngeal candidiasis
nystatin 100,000 units /ml 5 ml QID x 7-14 days
41
treatment moderate to severe oropharyngeal
fluconazole 100-200 mg daily x 7-14 days
42
treatment of esophageal candidiasis
fluconazole 200-400 mg x 14-21 days
43
can we do oral therapy for esophageal candidiasis
no always systemic
44
vulvovaginal candidiasis biggest risk factor
antibiotic use
45
vulvovaginal candidiasis treatment
fluconazole 150 mg PO one dose topical OTC azoles
46
candidiasis symptoms similar to what
bacteremia fever, chills, tachycardia, hypotension
47
risk factors for candidiasis
use broad spectrum antibiotics CVC, PIC use TPN neutropenia (ANC<500) immunosuppressive agents surgery (intraabdominal)
48
candidemia first lines
micafungin 100 mg fluconazole 800 mg load, then 400 mg
49
candidemia with albicans preferred
fluconazole
50
candidemia with glabrata preferred
micafungin
51
candidemia with paapsilosis preferred
fluconazole (amphotericin B)
52
candidemia with tropicales preferred
fluconazole
53
candidemia with krusei preferred
micafungin voriconazole amphotericin B
54
candidemia with lusitaniae preferred
fluconazole micafungin
55
candidemia with auris preferred
micafungin
56
how long is candidemia treated
14 days after first negative culture
57
disseminated histoplasmosis symptoms
weight loss night sweats hepatosplenomegaly fever chills
58
CNS histoplasmsosis symptos
fever seizure mental status changes
59
mild to moderate acute pulmonary histo treatment (sx >4 weeks)
itraconazole 200 mg TID x 3 days then 200 BID x 6-12 weeks
60
moderate to severe acute pulmonary histo treatment
lipid amphotericin B 3-5 mg/kg/day x 1-2 weeks then itraconazole 200 mg TID x 3 days then 200 mg BID x 12 weeks
61
disseminated histo treatment
lipid amphotericin B 3-5 mg/kg/day x 1-2 weeks then itraconazole 200 mg TID x 3 days, then 200 mg BID x 12 months!
62
duartion of pulmonary histo vs disseminatedd histo
pulmonary 6-12 weeks disseminated 12 months
63
blastomycosis treatment
mild itraconazole x 6 months mod-severe lipid amphot + itraconazole x 6-12 months
64
coccidioidomycosis presentation
primary pulmonary disease
65
coccidioidonycosis treatment
fluconazole 400-800 x 3-6 months (primary resp) x 12 months (pneumonia)
66
how is cryptococcus diagnosed
lumbar puncture meningitis presentation
67
cryptococcus meningitis non HIV infected treatment
Induction amphotericin B + flucytosine (2 weeks HIV, 4 weeks non-HIV) consolidation fluconazole 800 mg x 8 weeks Maintenance fluconazole 400 mg x 12 months
68
invasive pulmonary aspergillosis treatment
voriconazole x 6-12 weeks
69
aspergillosis prophylaxis
posaconazole
70

PHRM 865 (33 decks)

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