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95 Cards in this Set
- Front
- Back
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Difficult to Treat Bacteria |
Pseudomonas Staph Aureus (MRSA) Strep pneumoniae Anaerobes |
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Lipophilic Antibiotics “McDonald’s For Today” |
Macrolides Fluoroquinolones Tetracyclines |
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Hydrophilic Antibacterials “Asian Baby V” |
Aminoglycosides B Lactams Vancomycin |
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Drugs that Inhibit Cell Wall Synthesis |
B Lactams (penicillin and cephalosporins) Vancomycin |
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Meds good for Urine Infection |
B Lactam, FQ, AG |
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Drugs good for Blood Infection |
B Lactams Aminoglycosides Vancomycin |
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Drugs good for Lung Infection |
B Lactams, FQ, macrolides |
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Drugs good for CSC Infection |
B Lactams FQ Metronidazole Sulfa |
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Meds that DO NOT need dose adjustment |
Nafcillin Erythromycin Azithromycin Ceftriaxone Moxifloxacin Doxycycline Clindamycin |
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What causes cross reactions in Penicillins? |
b Lactam ring |
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Natural Penicillins |
Penicillin G and VK |
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Antistaph Pencillins |
Nafcillin, Dicloxacillin, methicillin |
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Broad spectrum penicillin |
Amoxicillin |
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B Lactamase producing bacteria are inhibited by: |
Augmentin= amoxicillin + clavulanate |
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Penicillin that is good against strep pneumoniae |
Amoxicillin |
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Anti pseudomonas penicillins “Methods To Treat Pseudmonas” |
Mezlocillin, Ticarcillin, piperacillin |
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If you have a type 1 hypersensitivity reaction to Penicillins, you will probably also react to: |
Cephalosporins |
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All Penicillins should be taken without food (bc they cannot survive stomach acid) except |
Augmentin! |
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1st generation cephalosporins (Used for penicillin allergic patients) |
Cefazolin Cephalexin |
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2nd Generation Cephalosporin and great against anaerobes
“It’s a smooth fox so it’s good against the difficult anaerobes” |
Cefoxitin |
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3rd generation Cephalosporins |
Ceftazidime (Fortaz, Tazicef) anti pseudomonas Ceftriaxone (Rocephin) Does not need dose adjustment and anti strep pneumo Cefotaxime (claforan) anti strep pneumo |
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Protein Synthesis Inhibitors (Affect bacteria and mammalian cells) |
Macrolides Aminoglycosides Tetracyclines Oxazolidinones Chloramphenicol Lincosamides Streptogramins Rifamycins
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Anti bacterial that binds to RNA polymerase to block transcription |
Rifamycins |
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Protein Synthesis Inhibitors |
Affect bacterial and mammalian cells Have potential for more side effects, especially in the skin, gut and bone marrow |
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Macrolides |
Azithromycin (z pak) Erythromycin Clarithromycin (biaxin)
High potential for GI side effects Do not treat any difficult bacteria |
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Metabolic Inhibitors |
Fluoroquinolones |
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Respiratory FQ’s
“Let Me Go” |
Treats strep pneumo (very well!!), MRSA, anaerobes and pseudomonas!! However it is a dangerous set of drugs- only use when absolutely necessary.
Levofloxacin (levaquin) Moxifloxacin (avelox) Gemifloxacin (factive) |
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FQs that treat pseudomonas well |
Ciprofloxacin (Cipro) Ofloxacin (Floxin) |
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FQ resistance risk factors include: |
Age > 65 COPD Previous treatment with FQ |
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FQ Adverse Reactions |
Prolongation of QT interval from respiratory FQ (Levo, moxi, gemi) Phototoxicity Tendinitis and tendon rupture Peripheral neuropathy |
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Contraindications for FQ |
Avoid in pregnancy, breastfeeding, and children < 18 Can cause damage to joints and tendons |
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Tetracyclines great against MRSA “MRSA can’t tetch this dunuhnuhnuh” |
Tetracycline Doxycycline (taken with food) Minocycline |
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Anti inflammatory tetracycline is: |
Doxycycline Used to treat inflammation in derm and opt patients. Does NOT increase resistance |
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Tetracyclines are contraindicated in |
Pregnancy, breastfeeding and kids < 8 |
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Aminoglycosides |
Gentamicin Tobramycin Amikacin
High concentrations in the kidney and inner ear (can cause ototoxicity or nephrotoxicity) Treat pseudomonas |
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Vancomycin |
Treats MRSA Adverse Reaction: “red man syndrome” histamine release = tachycardia, flushing, paresthesias, hypotension |
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Monitor peak and trough levels to combat toxicity for: |
Aminoglycosides Vancomycin |
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TMP Sulfa aka Co-trimoxazole (Bactrim, Septra) |
Bactrim is good for MRSA orally Good for enteric gram - bugs
Adverse effects: dermatologic- Stevens Johnson syndrome Toxic epidermal necrolysis Phototoxicity Bone marrow suppression |
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Metronidazole (flagyl) |
Good for CSF infections Good against anaerobes |
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Meds that are good against anaerobes |
Metronidazole (flagyl) Clindamycin Cefoxitin |
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Do not use these meds during pregnancy, breastfeeding, or kids |
Fluoroquinolones < 18 Tetracyclines < 8 |
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Metronidazole (flagyl) is good for: |
Anaerobes STIs Parasitic infections C diff 1st line treatment (vancomycin is 2nd line) |
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When taking metronidazole, what do you absolutely need to avoid? |
Alcohol! During treatment and for 72 hrs after discontinuation Causes “disulfiram like reaction” - flushing, vomiting, headache |
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Clindamycin |
Good for anaerobes and MRSA Great for cellulitis |
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Most infamous agent in antibiotic associated diarrhea is: |
C diff |
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4 most commonly used drug vehicles, most absorbent to least absorbent |
Girls Overdo Cream and Lotion Gel > Ointment > Cream > Lotion |
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Avoid use of ointments in what areas? |
Intertriginous areas (body folds) Use lotions and creams here |
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What to use for dry skin? |
Ointments and oils |
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Medication is absorbed more slowly from: |
Ointments, even though the amount of drug absorbed is high |
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Topical corticosteroids |
Decrease inflammation Reduce itching Low potency agents- eczema, irritant dermatitis, atopic dermatitis, seborrhea High potency agents- psoriasis, lichen planus, allergic contact dermatitis |
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The more potent an agent is, the more likely it is to cause |
More side effects that are more severe |
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Which class of topical corticosteroids is the most potent? |
Class 1 Higher classes are safer to use for an extended period of time |
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If a topical steroid is placed in an optimized vehicle, it is automatically |
Class 1 |
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Agents can go up or down a class depending on the |
Vehicle |
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What is the only topical corticosteroid sold OTC? |
Hydrocortisone up to 1% (Class 7, least potent) |
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What does an optimized vehicle do for class 1drugs? |
Increased solubility and absorption |
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Use a Class 1 Super Potent Corticosteroid... |
As an alternative to systemic steroids Short term Small areas Thick chronic lesions Do not use with occlusive dressings (increases absorption by 50 fold) |
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Class 2 corticosteroids |
May be used on the face and intertriginous areas for short time |
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Keratolytic Drugs for Acne |
Benzoyl Peroxide Salicylic Acid |
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How does Benzoyl peroxide work? |
Releases oxygen to destroy anaerobic Propionibacterium Causes peeling of outer layer of skin |
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Benzoyl peroxide side effect |
May bleach hair or fabrics |
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Trade names of Azalaic Acid 20% for Acne |
Azelex Finacea |
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Side effects of Azelaic Acid (Azelex and Finacea) |
Hypopigmentation (bleaches skin) |
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Acne does not develop much resistance against: |
Benzoyl peroxide and azelaic acid |
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Topical anti microbial therapy for acne |
Clindamycin Erythromycin |
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Oral antimicrobial therapy against acne |
Tetracycline Doxycycline (preferred over tetra) Minocycline (preferred over tetra) Erythromycin Clindamycin |
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We try to avoid using antimicrobials for acne because of |
Resistance |
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Tetracycline potential side effects |
Skin, GI, bone marrow |
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Topical Dapsone (Aczone) 5% for Acne |
Do not use often bc it is very expensive Anti inflammatory and antimicrobial |
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What is the only acne treatment that heals comedones? |
Retinoids |
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Retinoids |
Tretinoin Adapalene Tazarotene Isotretinoin (accutane)
Decrease sebum productions Heals comedones Decrease inflammation The heavy hitters- most potent- most severe side effects Only use for severe cases that leave scarring |
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Retinoids |
Tretinoin Adapalene Tazarotene Isotretinoin (accutane)
Decrease sebum productions Heals comedones Decrease inflammation The heavy hitters- most potent- most severe side effects Only use for severe cases that leave scarring |
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Because retinoids are super potent |
We need to give good patient counseling for these meds |
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Retinoids |
Tretinoin Adapalene Tazarotene Isotretinoin (accutane)
Decrease sebum productions Heals comedones Decrease inflammation The heavy hitters- most potent- most severe side effects Only use for severe cases that leave scarring |
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Because retinoids are super potent |
We need to give good patient counseling for these meds |
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What is the only oral retinoid? |
Isotretinoin (accutane) Reduces 90% sebum production everywhere in the body Only use for severe nodulocystic acne that does not respond to other therapies Required > 3 years of oral antibiotic therapy |
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Patients on Isotretinoin(accutane) must be monitored how? |
lipid panel Liver function test Complete blood counts Pregnancy tests |
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Patients who take Isotretinoin must enroll in |
Ipledge Very strictly monitored FDA program to minimize fetal exposure to isotrinoin (it is a teratogenic drug-can cause birth defects) Monthly program requirements- pregnancy test and methods of contraception must be used 1 month prior and after completion of therapy |
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Local anesthetic treatments for dermatitis and eczema |
Benzocaine Pramoxine “I got the Bens and the Porscha locally” |
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Systemic antihistamine |
Diphenhydramine (Benadryl) |
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What kind of soap is best for eczema and dermatitis? |
Castille soap |
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Emollients |
Increase moisture of stratum corneum Petrolatum Lanolin Mineral oil |
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Topical immunomodulators for dermatitis and eczema |
Have the potential to produce cancer and hypersensitivity reactions! Inhibit release of cytokines Tacrolimus (prograf) Pimecrolimus (elidel) |
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Allergic contact dermatitis Aka rhus dermatitis |
Poison ivy, oak, sumac Plants of genus Rhus Small vesicles that spreads quickly - not contagious Rash appears after latent period 4hrs-10 days |
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Types of Rhu dermatitis |
Mild- localized, on extremities, topical Tx Moderate- extensive, topical Tx Severe- extreme, widespread, anything on the face, genitals, respiratory needs oral corticosteroid tx |
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Types of Rhu dermatitis |
Mild- localized, on extremities, topical Tx Moderate- extensive, topical Tx Severe- extreme, widespread, anything on the face, genitals, respiratory needs oral corticosteroid tx |
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Ivyblock |
Bentoquatam 5% |
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Types of pediculosis |
Head lice- pediculus humanus Capitus Body lice- pediculus humanus corporis Pubic lice- phthirus pubis Pruritus is the most common symptom |
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Treatment for pediculus humanus (lice) |
Pyrethrin and Permethrin(Chemical derivative of pyrethrin) Block transmission of nerve cell impulses in lice=paralysis Leave in Hair for 10 mins and comb out |
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CI for permethrin and pymethrin |
Allergy to chrysanthemums and children < 2 |
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Heavy hitter for lice and scabies |
Lindane Not the 1st line agent!!! Given only when absolutely necessary Lots of CNS side effects |
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Warts are caused by |
Human papilloma virus Contagious Common in immunocompromised and children |
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Types of Warts |
Common- verruca vulgaris- on fingers hands and knees Common flat- verruca plana- face hands and legs Plantar- verruca plantaris- soles of feet Anogenital- verruca genitalia |
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Types of Warts |
Common- verruca vulgaris- on fingers hands and knees Common flat- verruca plana- face hands and legs Plantar- verruca plantaris- soles of feet Anogenital- verruca genitalia |
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Wart treatment |
Direct application of caustics -salicylic Acid -formalin -podophyllin Cryotherapy w liquid nitrogen, dimethyl ether, propane Surgery |
