Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
350 Cards in this Set
- Front
- Back
|
What is the screening test for HIV called?
|
ELISA (Enzyme-linked Immunosorbent Assay)
|
|
|
What is the diagnosis test for HIV called?
|
Western Blot test
|
|
|
What are the blood tests done for HIV (3)?
|
CD4 T-cell Count
Viral Load Count Resistance testing |
|
|
What is the normal count of CD4 T-cells in the body?
|
500-1500 cells
|
|
|
New guidelines recommend starting treatment is CD4 count is below ____?
|
CD4 T-cell is <500
|
|
|
Treatment for PCP is done if CD4 count is _____. Treatment?
|
CD4 T-cell is <200
Px: Bactrim or Dapsone or Mepron (Atovaqone) Tx: (Clindamycin + Primaquine + Prednisone) x 21 Days |
|
|
Treatment for Toxoplasmosis is done if CD4 count is ____. Treatment?
|
CD4 T-cell is <100
Tx: Bactrim or Dapsone or Mepron (Atovaqone) |
|
|
Treatment for MAC is done if CD4 count is ____. Treatment?
|
CD4 T-cell is <50
Tx: Azithro or Clarithro |
|
|
Types of Resistance testing for HIV (2)?
|
Genotypic testing - looks at the HIV present in the person's blood and examines it to see what mutations exist.
Phenotypic testing - takes the virus and exposes it to different concentrations of HIV meds to determine which ones are effective. |
|
|
What is Genotypic testing?
|
Test looks at the HIV present in the person's blood and examines it to see what mutations exist.
|
|
|
What is Phenotypic testing?
|
Test takes the virus and exposes it to different concentrations of HIV meds to determine which ones are effective.
|
|
|
What are the steps of the HIV life cycle?
|
1. Binding
2. Reverse Transcription 3. Integration 4. Transcription 5. Translation 6. Viral Assembly and Maturation |
|
|
What are the drugs that work on the first step of HIV cycle?
|
Binding (Entry Inhibitors)
Enfuvirtide (Fuzeon) Maraviroc (Selezentry) |
|
|
What is Fuzeon? Where does it work? SE?
|
Enfuvirtide (Fuzeon) works on GP41 and GP120 (viral cell)
Dose: 90mg SC BID (upper arm, thigh, abd) SE: may cause respiratory infection |
|
|
What is Selezentry? Where does it work?
|
Maraviroc works on CCR5 (human cell)
Dose: 300mg BID (Inhibitors: 150 BID; Inducers: 600 BID) |
|
|
What is Agenerase? Forms? Contraindications?
|
Amprinavir (APV) (Agenerase) is a Protease Inhibitor.
Forms: gel caps and PO soln taken BID Contraindicated: Sulfa allergy |
|
|
What is Crixivan? Dosing? SE?
|
Indinavir (IDV) (Crixivan) comes in capsules and is given on EMPTY STOMACH, drink lots of water >1.5L; with liver disease, give 600mg Q8H.
SE: Protease inhibitor side effects Nephrolithiasis |
|
|
What is Kaletra? Forms? Storage?
|
Lopinavir/Ritonavir (RTV) (Kaletra) comes in tabs and PO solution (Fridge; RT: 60 days)
|
|
|
What is Viracept? SE?
|
Nefinavir (NPV) (Viracept)
SE: very bad diarrhea |
|
|
What is Norvir? Forms?
|
Ritonavir (RTV) (Norvir) comes in PO solution and capsules (Fridge, RT: 30 days)
|
|
|
What is Invirase? Forms? Must not use with what other Protease Inhibitor?
|
Saquinavir (SQV) (Invirase) comes in hard gel capsules and tabs given BID.
Antagonistic with Indinavir (Crixivan) |
|
|
What is Tiprinavir? Forms and storage? SE?
|
Aptivus (TPV) (Tiprinavir) comes in soft gell caps (Fridge, RT: 60 days) given BID.
SE: Sulfa allergy Hepatotoxicity Intra-cranial bleeding |
|
|
What is Lexiva? Forms? Monitor?
|
Fosamprenavir (FPV) (Lexiva) comes in tabs and PO solution (EMPTY STOMACH) given BID.
Monitor: Bleeding Sulfa allergy D/C if rash occurs |
|
|
What is Reyataz? What group does it belong to?
|
Atazanavir (ATZ) (Reyataz) comes in capsules kept at RT
Dose: 400mg QD with food SE: cardiac abnormalities, monitor for bleeding |
|
|
What is Prezista? Dose? Points to remember?
|
Darunavir (Prezista) comes in 300mg tabs (RT) given BID.
Points: Sulfa allergy Increases Pravastatin levels 5x; use Fluvastatin instead |
|
|
Where does Protease Inhibitors work?
|
Step 6: Viral Assembly and Maturation
|
|
|
What Protease Inhibitors are contraindicated in Sulfa Allergy (4)?
|
***DAFT
Darunavir (Prezista) Amprenavir (Agenerase) Fosamprenavir (Lexiva) Tiprinavir (Aptivus) |
|
|
What forms does Agenerase come in?
|
Amprenavir (Agenerase) comes in gel capsules and solution (not interchangeable)
|
|
|
Agenerase dosing?
|
Amprenavir (Agenerase)
>50kg: 1200 mg caps BID : 1400 mg solution BID <50kg: 200mg/kg BID |
|
|
What are the SE for Protease Inhibitors?
|
GI intolerance
Lipodystrophy Hyperglycemia Hyperlipidemia Weight Gain |
|
|
Crixivan dosing? Dosing if patient has liver disease? Renal patient?
|
Dosing: 800mg Q8H
Liver Px: 600mg Q8H Take on EMPTY STOMACH!! AVOID IN RENAL PATIENTS!!! |
|
|
SE for Crixivan?
|
GI intolerance
Hyperlipidemia Hyperglycemia Lipodystrophy NEPHROLITHIASIS |
|
|
Px counseling when taking Crixivan?
|
Take on empty stomach.
Drink >1.5L of water Call MD if blood in urine or flank pain. Very sensitive to moisture!!!! |
|
|
How do you store Kaletra?
|
Lopinavir/Ritonavir
Tabs: Room temperature Solution: Fridge : 60 days if RT |
|
|
Dosing for Kaletra? With or without food?
|
Tabs: 200mg/50mg
: 2 tabs BID Soln: 80mg/20mg mL : 10mL QD with FOOD |
|
|
What is the SE for Nelfinavir? Forms? Dosing?
|
Viracept, VERY BAD DIARRHEA
Forms: tabs & PO powder Dosing: 750mg TID |
|
|
What is EMS found in Viracept?
|
Ethyl methanesulfonate that has shown to be teratogenic, mutagenic & carcinogenic.
|
|
|
What forms does Norvir come in? Dosing?
|
Forms: caps and solution
Dosing: 600mg (6 caps) BID TITRATE!!!!! |
|
|
Storage for Norvir?
|
Caps: Fridge
: 30 days if RT Soln: Room temperature |
|
|
What form does Invirase come in? Dosing?
|
Hard gel capsule
Dose: 1000mg + 100mg Ritonavir BID |
|
|
Can you use Rifampin with Ritonavir + Saquinavir?
|
No, use is contrainidicated due to risk of HEPATOTOXICITY.
|
|
|
Invirase is contraindicated in what allergy?
|
Lactose allergy
|
|
|
Dosing for Aptivus? Storage?
|
Dose: 500mg (2 soft gel caps) + 200mg Ritonavir BID
Storage: Fridge before opening : RT for 60 days |
|
|
SE for Aptivus?
|
FATAL HEPATOTOXICITY
Intra-cranial bleeding (black box) |
|
|
Lexiva comes in what forms? Dosing?
|
Tabs: 700mg
Susp: 50mg/mL (2-18 YO) Dose: 1.4mg BID or 1.4mg + 200mg Ritonavir QD |
|
|
Reyataz dosing? Storage?
|
400mg QD with FOOD!!!
Storage: Keep at ROOM TEMP |
|
|
Precautions when using Reyataz?
|
Cardiac abnormalities
Bleeding |
|
|
Reyataz drug interactions (4)?
|
Atazanavir is a substrate & inh.
Crixivan, when combined can increase bilirubin. Viread, can decrease Reyataz and Reyataz can increase Viread. Clarithromycin levels are increased by Reyataz. |
|
|
Prezista dosing? Storage?
|
Dose: 600mg BID + 100mg Ritonavir BID
Storage: Room temp |
|
|
Can you use Prezista with Pravachol?
|
No, because Pravachol levels will be increased 5x. Use Fluvastatin.
|
|
|
Where does NRTI's work? Metabolized where?
|
Step 2: Reverse Transcription
Renal |
|
|
What is Ziagen? SE?
|
Abacavir (ABC) (Ziagen) is given 300mg BID
SE: Hypersensitivity |
|
|
What is Didanosine? How do you give it? SE?
|
Didanosine (Videx, Videx EC) must be given on EMPTY STOMACH or with Mg antacid.
SE: Peripheral neuropathy, Pancreatitis, Eye defects |
|
|
What is Lamivudine? Dose? Similar to what meds (2)?
|
Lamivudine (Epivir, Epivir HBV) (3TC)
HIV dose: 150mg BID Hepatitis dose: 100mg QD x 1 year Similar: Tyzeka (Telbivudine), for Hepatitis Emtricitabine (Emtriva) |
|
|
What is Zerit? Don't use with? Storage?
|
Stavudine (d4T) (Zerit) is antagonistic with Zidovudine.
Storage: RT, Fridge after reconstitution and good for 30 days SE: Lipodystrophy (similar to Protease Inh) Peripheral neuropathy Pancreatitis |
|
|
What is Retrovir? What group does it belong? Form?
|
Zidovudine (AZT, ADV) (Retrovir) is the only one to come in IV form
Forms: IV, caps, PO solution Headache/Nausea => #1 SE Bone marrow depression = neutropenia, anemia Myopathy Purple toenails |
|
|
What is Emtriva?
|
Emtricitabine (FTC) (Emtriva) is chemically similar to Epivir (Lamivudine).
|
|
|
What is Combivir? Dosing?
|
Zidovudine 300mg + Lamivudine 150mg
Dose: 1 PO BID |
|
|
What is Trizivir?
|
Zidovudine 300mg + Lamivudine 150mg + Abacavir 300mg
|
|
|
What is Epizicom?
|
Abacavir 600mg + Lamivudine 300mg
|
|
|
What is Truvada?
|
Tenofovir 300mg + Emtricitabine 200mg
|
|
|
What is Atripla? Dose?
|
Efavirenz 200mg + Emtricitabine 200mg + Tenofovir 300mg
Dose: 1 PO QHS |
|
|
SE of NRTI's (2)? Metabolized where?
|
SE: Lactic Acidosis & Headache
Metabolized: Renal With or without food EXCEPT FOR Didanosine which is ON EMPTY STOMACH |
|
|
What do you give with Videx?
|
Didanosine is given with Mg antacid bec stomach needs to be alkaline. EMPTY STOMACH.
|
|
|
Videx storage? Dose for renal patient?
|
Room temperature
Dose adjust in patients with CrCl <50mg/mL |
|
|
What do you monitor Q3 months when using Protease Inhibitors (4)?
|
LFT's
Glucose Cholesterol Look for fat redistribution |
|
|
Didanosine SE (4)?
|
Pancreatitis
Peripheral neuropathy Lactic acidosis Retinal pigmentation |
|
|
Lamivudine dosing?
|
Epivir: 150mg BID
Epivir HBV (Hep B): 100mg x 1 yr |
|
|
Stavudine dosing? Storage?
|
<60kg: 15-30mg BID
>60kg: 30-40mg BID Storage: Room Temp : Fridge after reconstitution, good for 30d |
|
|
Stavudine SE (5)?
|
LIPODYSTROPHY
GI intolerance Pancreatitis Peripheral neuropathy Lactic acidosis |
|
|
Retrovir comes in what forms?
|
Caps, IV solution, PO solution.
|
|
|
Retrovir dosing?
|
200mg (2 caps) TID with FOOD to decrease nausea
100mg TID with severe anemia or CrCl <25mL/min |
|
|
Zidovudine SE (4)?
|
Myelosuppression (anemia & neutropenia)
Purple toenails Headache Myopathy (>6mos of use) Lactic acidosis & hepatic steastosis (black box) |
|
|
Patient counseling for Zidovudine?
|
Advise Px of S/Sx of Neutropenia: fever, chills, sore throat, unusual weakness/tiredness
|
|
|
Treatment for Anemia?
|
Erythropoietin (Procrit, Epogen)
Darbepoietin (Aranesp) |
|
|
Treatment for Neutropenia?
|
Neupogen (Filgrastim)
Neulesta (Pegfilgrastim) |
|
|
Emtriva is chemically similar to which NRTI?
|
Emtriva (Emtricitabine) is chemically similar to Epivir (Lamivudine)
|
|
|
Emtriva comes in what forms? Approved for children aging ____?
|
Emtricitabine comes in caps and oral solution.
Children: >3 mos old (4mg/kg) |
|
|
Can you use Zerit with Retrovir?
|
No, you can't use Stavudine (Zerit) and Zidovudine (Retrovir) together bec of their antagonistic effects.
|
|
|
Class SE of NNRTI's? Metabolized where?
|
Hepatotoxicity & Rash
Liver |
|
|
What is Rescriptor? What group does it belong?
|
Delavirdine (DLV) is a NNRTI.
|
|
|
What is Sustiva? What group does it belong?
|
Efavirenz (EFV) is a NNRTI.
|
|
|
What is Viramune? What group does it belong?
|
Nevirapine (NVP) is a NNRTI.
|
|
|
What is Intelence? What group does it belong?
|
Etravirine is a NNRTI.
|
|
|
Sustiva SE?
|
Vivid dreams
False cannabinoid test Hepatotoxicity (inducer & inh) |
|
|
Sustiva dosing?
|
Efavirenz
Dose: 600mg QHS, EMPTY STOMACH |
|
|
Intelence dosing? Substrate, inducer, or inhibitor?
|
Dose: 200mg BID AC
3A4: substrate & inducer CYP2C: inhibitor |
|
|
What is Viread?
|
Tenofovir (TNV) is a NucleoTIDE reverse transcriptase inhibitor
|
|
|
Tenofovir dosing? Renal or hepatic?
|
Viread is metabolized both in the kidneys and liver.
Dose: 300mg QD CrCl 30-49mL/min: 300mg Q48H CrCl 10-29mL/min: 300mg 2x weekly |
|
|
Fuzeon dosing?
|
90mg BID SC injection
- rotate inj site (upper arm, thigh or abd) |
|
|
Selezentry dosing?
|
With Inhibitors: 150mg BID
With other HIV meds: 300mg BID With Inducers: 600mg BID |
|
|
Selezentry SE?
|
Hepatotoxicity
Heart problems Orthostatic hypotension |
|
|
What is Isentress?
|
Raltegravir is an Integrase Inhibitor
|
|
|
Isentress SE?
|
Diarrhea, nausea, HA
Myopathy Rhabdomyolysis |
|
|
Zidovudine dosing for pregnant patients?
|
Zidovudine (Retrovir)
300mg BID or 200mg TID at 14-34 weeks |
|
|
Zidovudine dosing during labor?
|
2mg/kg IV for 1H then 1mg/kg infusion until delivery
|
|
|
Zidovudine dose for babies?
|
Syrup, give within 8-12H of birth
2mg/kg Q6H x 6 weeks |
|
|
Chicken pox and shingles are caused by?
|
CMV - herpes zoster virus
|
|
|
Cold sores is caused by?
|
Herpes Simplex Virus I
|
|
|
Genital herpes is caused by?
|
Herpes Simplex Virus 2
|
|
|
What CMV medications cause Bone Marrow Suppression?
|
Cidofovir (Vistide) - neutropenia
Foscavir (Foscarnet) - granulocytopenia, anemia Valgancyclovir (Valcyte) Gancyclovir (DHPG, Cytrovene, Vitracert) |
|
|
What is the dosing for Ganciclovir? Brand names?
|
DHPG, Cytovene, Vitrasert
Dose -Px: 1g TID with food -IV: 5mg/kg Q12H over 1H |
|
|
What is Foscavir? SE?
|
Foscarnet, given thru IV line, causes hepatotoxicity & seizure.
|
|
|
What must be given with Vistide?
|
Cidofovir is given through an IV line, and must be taken with Probenecid to prevent kidney damage.
|
|
|
What is Vitrasert?
|
Ganciclover pellet that is implanted directly into the eye. Changed Q6 mos
|
|
|
What is Vitravene?
|
Fomivirsen (Vitravene), is a shot directly into the eye for CMV patients who have failed other therapies.
|
|
|
What is Ribavirin?
|
Rebetol, Copegus
Used to treat Hep C with Pegylated Interferons |
|
|
Dosing for FluMist?
|
General: 2 - 49 YO
2 - 8 YO: 2 doses of 0.1mL spray per nostril 1 mo apart 9 - 49 YO: 1 dose of 0.2mL |
|
|
What are the different brands of Flu vaccine (3)?
|
Fluzone
Fluvirin Flushield |
|
|
When is the optimal time for Flu administration?
|
September - November
|
|
|
Flu vaccine is contraindicated in (2)?
|
Gullain-Barre Syndrome
Egg or Thimerosal allergy |
|
|
What is Pneumovax? How many valence?
|
Adult Pneumococcal vaccine
23-valent vaccine |
|
|
Pneumovax is indicated for (5)?
|
>65 YO
Immunocompromised Chronic illness Pregnant women with high risk conditions All smokers >18 YO |
|
|
What is Prevnar? How many valences? Avoid in what allergy? How many shots?
|
Pediatric pneumococcal vaccine
7-valent and a NEWER!!! 13-valent vaccine Thimerosal allergy 4-shots |
|
|
Brands for Hep B vaccine (2)? How many doses?
|
Engerix-B
Recombivax HB - may interchange products 3 doses total |
|
|
Hep B vaccine is indicated for (5)?
|
Health care & public safety workers
IV drug users Hemodialysis patients Inmates Sexually active |
|
|
Hep B vaccine is contraindicated in what allergy?
|
Yeast allergy
|
|
|
Infants born to Hep B+ mothers should also be given what?
|
Hep B immune globulin (HBIG)
Heb B vaccine w/in 12H |
|
|
Brands for Hep A (2)? How many doses?
|
Havrix
Vaqta -given 2 doses (6 mos apart) |
|
|
What is Td and who should get it? What is the dose?
|
Tetanus/Diphtheria
Given to all adolescents & adults >7 YO Dose: booster dose Q10Y after primary series of 3 doses |
|
|
What is DTaP and who should get it?
|
Diphtheria/Tetanus/Pertussis
Given to infants and <7 YO |
|
|
Tetanus/Diphtheria/Pertussis is contraindicated in (3)?
|
DTaP: vaccine with the highest risk for ...
Kids with H/O -encephalopathy -unstable neurologic problems -Thimerosal allergy |
|
|
What is DAPTACEL?
|
Diphtheria & Tetanus Toxoids and Accellular Pertussis Vaccine Adsorbed, given to kids 6mos-6yrs.
|
|
|
What is ADACEL?
|
Active booster immunization for Diphtheria-Pertussis-Tetanus for people 11-64 YO
|
|
|
How is MMR given? Storage?
|
SC injection (12-15 mos & again at 4-6 YO)
Fridge |
|
|
Who should be given MMR(4)?
|
Health Care Workers
College students International travelers Women of child-bearing age |
|
|
MMR contraindication (4)?
|
Pregnancy
Immunocompromised (live vacc.) Neomycin allergy Thrombocytopenia |
|
|
Where do you store MMR products?
|
Fridge
|
|
|
What is ProQuad? Storage?
|
MMR + Varicella vaccine
Store in freezer for up to 18mos Can be stored in fridge up to 72H |
|
|
What is Varivax? Dose & age range? Storage?
|
Varicella vaccine (Varivax)
Dose: 0.5mL SC Age: >1 yo |
|
|
Varicella is contraindicated in (4)?
|
Pregnancy (live vaccine)
Immunocompromised Neomycin allergy Gelatin allergy |
|
|
What are the brands for Polio vaccine?
|
IPV
Orimune |
|
|
What are the brands for HiB? Vaccine against?
|
ActiHIB
HibTITER PedvaxHIB - to prevent meningitis in kids |
|
|
How do you give HiB vaccine? What is the frequency?
|
0.5mL SC for <5 yo
Dose: 2, 4, 6 12-18mos |
|
|
What is Menactra? Dose?
|
Meningococcal vaccine
Dose: 0.5mL SC once!!! |
|
|
Causes of Meningococcal meningitis(2)?
|
Haemophilus influenza
Neisseria meningitidis |
|
|
Menactra should be given to (6)?
|
Meningococcal meningitis is given to:
college freshmen military sickle cell diseease Asplenia Travelers |
|
|
What is Gardasil? Covers what valences?
|
Human papillomavirus
Types: 6 & 11 (genital warts) 16 & 18 (cervical cancer) |
|
|
Who do you give Gardasil to?
|
Male & Female, ages 9 - 16 yo
|
|
|
Gardasil dose?
|
0.5mL in 3 separate doses on the upper arm or thigh.
|
|
|
What is Cervarix? Who is it indicated for?
|
Human papillomaviurs given to girls and young women ( ages 10-26)
|
|
|
What are the valences in Cervarex?
|
Valents 16 & 18 for cervical cancer.
|
|
|
What is Zostavax? Dose? Storage?
|
Zoster Vaccine (shingles)
Dose: inject SC for >60 yo Storage: Freezer |
|
|
What is the Rotavirus vaccine given for?
|
Gastroenteritis in children
|
|
|
What are the 2 Rotavirus vaccines? Storage?
|
RotaTeq (Live), Fridge
Rotarix (Live), Fridge & 24H RT |
|
|
What is Ixiaro? Dose? Age?
|
Japanese encephalitis vaccine
Dose: 2 IM doses 28 days apart Age: >17 yo |
|
|
What are the vaccines given SC?
|
Varicella
MMR Meningococcal Zostavax |
|
|
What are the vaccines given SC or IM?
|
Polio
Adult pneumococcal |
|
|
What is Menomune? Dose?
|
Meningococcal vaccine, 0.5mL SQ
|
|
|
What is ComVax?
|
HiB + Hep B
|
|
|
What is TriHibit?
|
HiB + DTaP
|
|
|
What is TwinRix? Age?
|
Hep A + Hep B
Age: >18 yo |
|
|
What are the G+ cocci (2)?
|
Streptococci
Staphylococci |
|
|
What is Group A Strep? Causes what (2)?
|
Strep Pyogenes, causes:
- pharyngitis (strep throat) - cellulitis (deep skin inf., needs PO) |
|
|
What is Group B Strep? Causes what?
|
Strep agalactiae, causes NEONATAL MENINGITIS.
- Px: Ampicillin (3 doses) 24H prior to delivery |
|
|
What is Group D Strep? Causes what? Treatment?
|
Enterococcal & non-Enteroccocal which causes bacteremia and sepsis.
Tx: Vanco Daptomycin Synercid Tigecycline Zyvox |
|
|
Strep Viridans causes what?
|
Endocarditis (from mouth and dental procedures)
|
|
|
Strep pneumoniae causes what (4)?
|
Meningitis
Otitis media Pneumonia Sinusitis |
|
|
What is the #1 cause of endocarditis?
|
Staph aureus
|
|
|
What are the 2 types of Strep enterococci? Causes what?
|
E. faecalis
E. faecium Causes: Sepsis (blood stream) Endocarditis Infection of the colon, urinary tract, GI tract |
|
|
Types of Staph aureus?
|
MRSA
MSSA |
|
|
Oral Tx for MRSA?
|
Vancomycin
Bactrim DS Doxycycline Zyvox |
|
|
What is the cause of Impetigo? Treatment?
|
Staph aureus
Tx: Mupirosin (Bactroban) - TID x 3-5 days Altabax (retapamulin) - BID x 5 days |
|
|
What are the 3 kinds of Staphylococci?
|
S. aureus
S. epidermidis (endocarditis) S. saprophyticus (UTI) |
|
|
What IV antibiotics can you give to patients with MRSA (6)?
|
Vancomycin - first line
Daptomycin Linezolid Synercid Clindamycin Tigecycline |
|
|
What are the 2 Gram negative cocci?
|
Neisseria
- meningitidis - gonorrhea Moraxella |
|
|
What are the Gram positive rods?
|
***LAD
Listeria Anthrax Diphtheria Clostridium (anaerobic) - C. perfringens (gas gangrene) - C. difficile (colitis) - C. tetanus |
|
|
Listeria monocytogenes causes what? Treatment?
|
Meningitis & sepsis in newborn
Tx: Ampicillin & gentamycin, Bactrim |
|
|
What is the DoC for Anthrax?
|
Cipro
|
|
|
What is the Tx for N. meningitidis? Px? Vaccine?
|
Tx: Pen G
Px: Rifampin Vaccine: Menactra for MILITARY & COLLEGE |
|
|
What is the Tx for N. gonorrhea?
|
DoC: Ceftriaxone 250mg IM with LIDOCAINE 1%
Can also use AZITHRO 2g x 1 |
|
|
What is the treatment for Chlamydia?
|
Doxy 100mg BID x 7 days
Azithro 1g |
|
|
What are the bugs causing UTI?
|
Proteus
E. coli = #1 CAUSE!!!! Klebsiella Enterococci Pseudomona Staph saprophyticus |
|
|
How many days of treatment are needed for pylonephritis?
|
Pylonephritis is inf of the kidney
Sx: back pain, n/v, fever & chills 10-14 days |
|
|
How many days of treatment are needed for Cystitis?
|
Cystitis - bladder infection
3-7 days |
|
|
How many days of treatment are needed for Prostitis?
|
28 days
|
|
|
Abx for UTI?
|
Macrobid (Nitrofurantoin)
Septra (last choice) Cipro Keflex = elderly esp if using Warfarin Young kids/peds: Augmentin Bactrim Ceftin Macrobid |
|
|
Major causes of Otitis Media?
|
Pnuemococcus
Haemophilus Moraxella |
|
|
E. coli is the most common cause of what?
|
Traveler's diarrhea
UTI Neonatal meningitis |
|
|
What is the #1 Abx in surgery? Used for what organism?
|
Zosin (Pipercillin + Tazobactam), used for Pseudomonas
|
|
|
What are the Abx for Pseudomonas aeruginosa (5)?
|
Penicillins: ***PCAT Pipercillin, Carbecillin, Azlocillin, Ticarcillin
Cephalosporins: Ceftazidime, Cefepime Carbapenems: Imipenem, Meropenen, Doripenem (lowers seizure threshold) Flouroquinolones AminoGlycosides: GAT |
|
|
What is PrevPac? Tx for? What if patient has PCN allergy?
|
Helicobacter Pylori
Prevpac: 1. Lansoprazole 2. Amoxicillin 3. Clarithromycin PCN Allergy: Metronidazole 500mg BID |
|
|
What can you use in place of Prevpac?
|
Triple therapy, like Prevpac, (7-14 days)
1. Clarithromycin 500mg BID 2. Amoxicillin 1g BID 3. PPI If patient has PCN allergy, use METRONIDAXOLE 500mg BID |
|
|
What is Helidac? Tx for?
|
Helidac, for Helicobacter
1. Bismuth subsalicylate 2. Metronidazole 3. Tetracycline - 1 dose QID with meals & QHS for 2 wks + H2 antagonist |
|
|
What is Pylera?
|
Same as Helidac except the patient takes only ONE capsule instead of 3 different pills.
- 3 caps of Pylera AC & QHS + 20mg Omeprazole BID x 10 days |
|
|
What is H. influenza?
|
Leading cause of meningitis in young children but incidence has decreased due to vaccine (Hib).
|
|
|
What is the Tx for Meningitis due to Hib?
|
Tx: Ceftriaxone
Px: Rifampin |
|
|
What is Legionella? Causes what? Tx?
|
Gram negative ROD
Causes pneumonia - CAP Tx: Erythromycin + Rifampin |
|
|
What is the Tx for pseudomembranous colitis? Usually caused by what Abx?
|
Oral METRONIDAZOLE
or PO Vancomycin Causative Abx: Clindamycin |
|
|
What is B. fragilis? DoC?
|
Associated with intra-abdominal infections or localized abscesses.
DoC: Metronidazole |
|
|
What is Tinea capitis? Tx?
|
Fungal inf in the scalp
Tx: Griseofulvin PO x 4 wks |
|
|
What are the 4 Tinea infections?
|
T. capitis
T. versicolor T. cruris (jock itch) T. pedis (athlete's foot) |
|
|
What is onchomycosis? Tx?
|
Fungal inf of the nails
Tx: Lamisil & Itraconazole (Sporanox); Penlac (Ciclopirox) Tx timeframe: Toenails - 12 wks Fingernails - 6 wks |
|
|
What are the main organisms that cause surgical/abdominal infections?
|
Pseudomonas
B. fragilis |
|
|
What is Aspergillus? Tx?
|
Fungi that exists as mold.
Tx: Ampho B |
|
|
What is Candida? Tx?
|
Fungi that causes thrush, vaginitis, skin infections
Tx: Oropharyngel thrush - Diflucan Skin infection - topical nystatin or clotrimazole Vaginal thrush - Monistat/Diflucan |
|
|
What can you use in AIDS patients for long term suppression of meningitis?
|
Fluconazole
|
|
|
What are the meds for Influenza virus?
|
Amantadine
Rimantadine Oseltamivir (Tamiflu) Zanamavir (Relenza) - diskhaler, 1 inh BID |
|
|
What are the meds for Herpes simplex virus (HSV)?
|
Acyclovir
Famciclovir Valacyclovir |
|
|
What is Varicella zoster virus? Tx?
|
Chickenpox (varicella zoster)
Tx: no antiviral necessary but if immunocompromised, give ACYCLOVIR |
|
|
What is Cytomegalovirus (CMV) Tx?
|
*Foscarnet (Foscaver)
Cidofovir (Vistide) (IV) *Valgancyclovir (Valcyte) *Gancyclovir (DHPG, Cytovene, Vitrasert) |
|
|
What organism causes Mono?
|
Eipstenn-Barr virus (EMB)
|
|
|
Types of Hepatitis?
|
A - Fecal/Oral
B - blood transfusions C - IV drug users D E - Fecal/Oral |
|
|
What are the types of Chlamydiae?
|
C. pneumoniae
C. psittaci C. trachomatis - genital chlamydia |
|
|
Tx for C. trachomatis?
|
Doxy 100mg BID x 7 days
or Azithromycin 1gram PO x 1 |
|
|
Mycoplasma pneumoniae causes what? Tx?
|
Causes "atypical" pnemonia/walking pneumonia, which accounts for 10-15% of CAP
Tx: Macrolides Tetracyclines Quinolones |
|
|
Syphillis is caused by what organism? Tx?
|
Trepona pallidum
Tx: PCN |
|
|
Lyme disease is caused by what? Tx?
|
Borrelia burgdorferi
Tx: Tetracycline/doxycycline Amoxicillin Cefuroxime |
|
|
What are the Sx of Lyme disease? Affects what organs?
|
Bull's eye rash
Fever, H/A Muscle aches & joint pain Organs: Skin, Joints, CNS & CV |
|
|
Tx for Early Lyme Disease?
|
PO Doxycycline, Amox, or Cefuroxime x 14 days
|
|
|
Tx for Early Neurologic Lyme?
|
Early neurologic Lyme: meningitis/neuropathy
Tx: IV Ceftriaxone (14 days) PO Doxycycline (10-28 days) |
|
|
Tx for Late Lyme disease?
|
Late Lyme: arthritis
4 weeks of PO Doxycycline |
|
|
Main causes of skin & soft tissue bacterial infections? Tx?
|
MSSA & MRSA
Occasionally: Strep. A (pyogenes) Tx: Amox & Augmentin |
|
|
What Abx are used for Endocarditis prophylaxis?
|
Amox, 2g PO 30-60 min prior to dental procedure.
If PCN allergy: Clindamycin 600mg Azithro 500mg Clarithro 500mg |
|
|
What is Xifaxan?
|
Rifaximin, used for traveler's diarrhea due to E. coli and hepatic encephalopathy
|
|
|
What are the meds used for Traveler's Diarrhea (5)?
|
Bismuth subsalicylate, Tx: 2 tabs Q30 min up to 8 doses
Loperamide Quinolones Azithromycin -1g for 1 dose Xifaxan (Rifaximin) |
|
|
Abx used to treat CAP in adults?
|
Macrolides
Doxycycline Quinolones |
|
|
Tx for Chlamydia?
|
Doxycycline 100mg BID x 7 days
Azithromycin, 1g single dose |
|
|
Tx for Gonorrhea?
|
Ceftriaxone 250mg IM x 1 dose
Azithromycin, 2g single dose |
|
|
Tx for Syphillis?
|
Pen G IM
Doxy or Tetracycline x 14 days Ceftriaxone 1g QD x 8- 10 days |
|
|
Tx for Genital herpes?
|
Famciclovir, 1g BID x 1 day
Acyclovir 800mg TID x 2 days Suggest Valcyclovir 500mg/d to reduce heterosexual transmission |
|
|
Tx for Trichomonas?
|
2g dose of Metronidazole or Tinidazole (Tindamax)
|
|
|
Diaper rash is caused by what organism?
|
Candida albicans
|
|
|
What is Mycolog II? Used to treat what?
|
Nystatin (fungal inf) + Triamcinolone (inflammation)
Uses: - diaper rash - skin candidiasis |
|
|
What is Vusion? Tx for?
|
Zinc oxide + 0.25% Miconazole
For diaper rash, due to candida albicans |
|
|
What is Elimite cream? Px counseling ?
|
Permethrin 5%
Apply from heat to toe, wash off in 8-14H. May repeat in 2 weeks. Laundry all clothing, towels, bed sheets. |
|
|
Drugs for Pinworms?
|
Mebendazole (Vermox) for >2 mos up, SE: N/V, diarrhea
Albendazole (Albenza) Pyrantel pamoate (Pin-Rid, Pin-X) |
|
|
What is Bicillin LA? Dose?
|
Benzathin penicillin ---- IM ONLY!!!!
Grp Strep A: 1.2MU IM x 1 dose Rheumatic fever: 1.2MU IM Qmo Syphillis: 2.4MU IM x 1 dose Tertiary syphillis: 2.4MU IM Qweek x 3 doses |
|
|
What is Bicillin CR? Dose?
|
Procaine PCN + benzathine PCN ---- IM ONLY!!!!!
2.4MU IM x 1 dose NOT USED FOR SYPHILIS |
|
|
What form does Pen G come in? Indications (4)? Dose?
|
Form: IV
Indications: - Anthrax & Meningitis - Pneumonia & Neurosyphilis Dose: 8 - 24MU/day IV div 4-6 doses DECREASE DOSE BY 1/2 IF CrCl<10mL/min |
|
|
PVK dosing? Stable in the fridge for how long?
|
Dose: 250-500mg PO QID on EMPTY STOMACH
Storage: stable in the fridge for 14 days |
|
|
What is Pre-Pen?
|
Benzylpenicilloyl polylysine, used in skin testing for allergic patients (PCN)
|
|
|
What are the Penicillinase resistant PCN?
|
CONDM
- Cloxacillin - Oxacillin - Nafcillin - Doxacillin - Methcillin IV = MON PO = DC |
|
|
What are the AminoPCN? Dosing? DoC?
|
Ampicillin & Amoxicillin
Dose: Q6H on EMPTY STOMACH DoC: for enterococcus infection |
|
|
What is Moxatag?
|
Amoxicillin ER 775mg QD (strep throat)
|
|
|
Amoxicillin dosing for Otitis Media?
|
45 - 90mg/kg/day
|
|
|
What are the two anti-pseudomonal PCN's?
|
Ticarcillin
Pipercillin |
|
|
What are the Beta-Lactam Inhibitor combination agents?
|
Piperacillin/tazobactam (Zosyn)
Ticarcillin/clavulanate (Timentin) Ampicillin/sulbactam (Unasyn) Amoxicillin/clavulanate (Augmentin) |
|
|
What is the strength of Augmentin ES?
|
600mg suspension BID
Storage: MUST REFRIGERATE! |
|
|
What is the strength of Augmentin XR?
|
Amox: 1000mg
Clavu: 62.5mg/tab BID |
|
|
PCN adverse effects?
|
Hypersensitivity
CNS: seizures GI toxicity: diarrhea Decreases OCP |
|
|
Cephalosporin activity (MELC)?
|
MRSA
Enterococci Listeria C. difficile |
|
|
What are the 1st Gen Cephalosporins?
|
Cephalexin (Keflex)
Cefazolin (Ancef) Cefadroxil (Duricef) |
|
|
What are the 2nd Gen Cephalosporins(5)?
|
Cefproxil (Cefzil)
Cefuroxime (Zinacef, Ceftin) Cefaclor (Ceclor) Cefoxitin (Mefoxin) Loracarbef (Lorabid) |
|
|
Which Cephalosporins are active against anaerobes (B. fragilis)?
|
Cefoxitin (Mefoxin)
Cefmetazole Cefotetan |
|
|
Which Cephalosporins have an NMTT sidechain? SE?
|
***Man Met Operator For Tea
Cefamandole Cefmetazole Cefoperazone (Cefobid) Cefotetan SE: ethanol intolerance, disulfiram rxn with alcohol |
|
|
What are the 3rd Gen Cephalosporins?
|
Cefdinir (Omnicef) - DONT REFRIGERATE!!!
Cefditoren (Spectracef) Cefixime (Suprax) Cefoperazone (Cefobid) Cefotaxime (Claforan) Cefpodoxime (Vantin) Ceftazidime (Ceptaz,Fortaz) Ceftibutin (Cedax) Ceftizoxime (Cefizox) Cetriaxone (Rocephin) |
|
|
What is Maxipime?
|
Cefepime, a 4th Gen cephalosporin
|
|
|
What are the Carbapenems?
|
Primaxin (imipenem/cilastatin) IV/IM
Merrem (meropenem) IV Invanz (ertapenem) IV/IM Doribax (doripenem) IV |
|
|
Carbapenem coverage?
|
Gram (+) & (-) including pseudomonas (except for ertapenem) and anaerobes
|
|
|
What is the effect of Carbapenems to valproic acid?
|
Rapidly reduces valproic acid levels
|
|
|
Carbapenems SE?
|
Seizures
N/V |
|
|
What is Azactam? Coverage?
|
Aztreonam
GRAM NEGATIVE ONLY!!! |
|
|
What is the coverage for Vancomycin?
|
MRSA
ALL GRAM POSITIVE "Time dependent killing" |
|
|
Vancomycin dosing?
|
Severe staph inf & endocarditis --- 1g IV Q12H (infuse >1H)
C. difficile --- 125mg PO QID x 10 days |
|
|
Vanco SE?
|
Red Man Syndrome
Ototoxicity Nephrotoxicity --- due to histamine release |
|
|
Spectrum of activity for Aminoglycosides?
|
Pseudomonas
Gram (+) GRAM NEGATIVE!!!! "Concentration dependent" |
|
|
What is Cubicin?
|
Daptomycin, for injection (30 min infusion, QD)
Always use normal saline RT: 12H Fridge: 48H |
|
|
Daptomycin SE?
|
Cubicin
SE: myopathy, neuropathy, consider holding statins |
|
|
Daptomycin coverage? Dosing?
|
Complicated skin inf (MRSA & MSSA) --- 4mg/kg IV QDay x 7days
S. aureus bacteremia --- 6mg/kg IV QDay Streptococcus E. faecalis |
|
|
Flouroquinolones spectrum? Clinical use?
|
Atypicals (mycoplasma, legionella, chlamydia)
Gram (-) Clinical use: CAP, UTI, STD's |
|
|
What is the age range for Quinolone use?
|
>18 yo
|
|
|
Black box warning for Quinolones?
|
Black box: tendon rupture
SE: Crystalluria CNS (nephrotoxicity) Photosensitivity Seizure |
|
|
2nd Gen Quinolones?
|
Cipro
Ofloxacin Lomefloxacin |
|
|
3rd Gen Quinolone?
|
Levofloxacin, covers:
- MSSA - Gram (-) - Atypicals |
|
|
4th Gen Quinolone?
|
Moxifloxacin
Gatifloxacin - for anaerobic bacteria |
|
|
Cipro dose for UTI
|
PO: 250 - 500mg BID
IV: 200 - 400mg Q12H (80% of the oral dose) REDUCE DOSE IN RENAL DYSFUNCTION |
|
|
What is the strength for Cipro XR/ProQuin XR?
|
500mg QD
|
|
|
Can you use Cipro with Glyburide?
|
Watch out for HYPOGLYCEMIA
|
|
|
What is CIPRODEX?
|
Cipro + Dexamethasone
4 gtts QID x 7 days SHAKE WELL! |
|
|
What is Maxaquin? Dose?
|
Lomefloxacin, 400mg QHS to decrease photosensitivity
|
|
|
What is Noroxin?
|
Norfloxacin, for UTI
400mg BID |
|
|
Other names for Levofloxacin?
|
Levaquin (IV/PO)
Iquix (eye drops) - 1.5% Quixin (eye drops) - 0.5% |
|
|
Levaquin dosing?
|
IV/PO dose are equivalent.
Oral soln - take on EMPTY STOMACH CAP or acute sinusitis --- 750mg QD x 5 days Chronic bronchitis --- 500mg QD x 7 days Chronic bacterial prostatitis - 28 days |
|
|
Levaquin dose for renal patients?
|
CrCl <50mL/min --- 250mg Q48H
|
|
|
What is Zymar? Strength
|
Tequin
Gatifloxacin eye drops, 0.3% Dose: 1-2 gtts Q2H up to 8x/day for 1st 2 days, then 1-2 gtts Q4H up to 4x/day for 5 days |
|
|
Brands for Moxifloxacin? Dose?
|
Avelox --- 400mg PO/IV infusion QD
Vigamox eye drops (0.5%) --- 1 gtt TID x 7 days Moxeza (0.5%) --- 1 gtt BID x 7 days |
|
|
What is Besivance? Dose?
|
Besifloxacin, eye drops (0.6%)
Does: 1 gtt TID x 7 days |
|
|
What is Factiva? Strength?
|
Gemifloxacin, 320mg tabs
|
|
|
What are the Macrolide Abx?
|
Azithromycin --- MAC prophylaxis: 1200mg Qweek
Clarithromycin Erythromycin ***NEW!!! Fidaxomicin (Dificid) - 200mg BID x 10 days |
|
|
Azithromycin dosing?
|
Liquid form must be taken on EMPTY STOMACH!!!
Clamydia: 1g single dose N. gonorrhea: 2g single dose MAC prophylaxis: 1200mg once weekly |
|
|
Indications for Erythromycin?
|
Can use for PCN allergic patients with:
syphilis Strep gonorrhea |
|
|
Clarithromycin contraindication?
|
Pregnancy
|
|
|
Clarithromycin dosing and storage?
|
Take WITH FOOD
DON'T refrigerate suspension |
|
|
Azithromycin dosing for kids?
|
Otitis media or CAP
- 10mg/kg up to 500mg 1st day, then 5mg/kg up to 250mg day 2-5 |
|
|
What are the Tetracyclines?
|
Doxycycline (Adoxa, Vibramycin, Oracea, Periostat)
Minocycline (Minocin, Dynacin, Solodyn) Tetracycline (Sumycin) |
|
|
Dosing for Sumycin?
|
Tetracycline
250 - 500mg PO QID on EMPTY STOMACH 250 - 500mg BID for acne bulgaris ***Al, Mg, Ca, & Fe impair absorption. |
|
|
What is Fanconi's Syndrome?
|
Excessive urination due to intake of expired tetracycline
|
|
|
Tetracycline SE?
|
Photosensitivity
Avoid in children (<8 YO) and pregnant women Renal patients can't be given any tetracycline EXCEPT for DOXYCYCLINE |
|
|
What is Oracea? Indication?
|
Doxycycline, for rosacea
Dose: 40mg Qam |
|
|
What is Solodyn? Dose?
|
Minocycline ER for moderate to severe acne
Dose: QD |
|
|
Chloramphenicol SE?
|
Hemolytic anemia
Gray baby syndrome |
|
|
Clindamycin coverage? Clinical use?
|
Gram (+) and anaerobes
***Don't give with erythromycin due to antagonistic effect. Use: dental prophylaxis for PCN allergic patients |
|
|
What is Lincocin?
|
Lincomycin, similar to Clindamycin
***Don't give with erythromycin due to antagonistic effect. |
|
|
What is Flagyl? Spectrum? DoC?
|
Metronidazole
Spectrum: anaerobes, B. fragilis, giardia DoC: C. difficile & giardia (250mg TID x 7 days) |
|
|
Flagyl ER strength? How do you take it?
|
ER: 750mg
Take on EMPTY STOMACH |
|
|
What is Macrobid?
|
Nitrofurantoin
Don't use if CrCl<60 |
|
|
What is Monurol?
|
Fosfomycin, similar to Macrobid
Dose: 3g packet |
|
|
What is Linezolid? Dose? Spectrum?
|
Zyvox
Dose: 600mg PO/IV Q12H Spectrum: VRE, MRSA, Gram + |
|
|
Linezolid comes in what forms?
|
Tabs: 600mg
Susp: 100mg/5mL : RT, stable for 21 days : Don't shake IV |
|
|
Zyvox SE?
|
Linezolid
SE: Thrombocytopenia MAO inhibitor Peripheral & optic neuropathy |
|
|
What is Synercid? Spectrum? Dose?
|
Quinupristine/dalfopristin, IV ONLY!!!!!!!!!! D5W!!!!!!!!!!!!!!
Spectrum: VRE, MRSA, Gram + Dose: 7.5mg/kg IV Q8H |
|
|
What is Tygacil?
|
Tygecycline, similar to Tetracycline
************* LD: 100mg IV MD: 50mg IV Q12H |
|
|
Age range for Tygacil?
|
>18 yo
|
|
|
What is Televancin? Indications?
|
Vibativ, IV ONLY!!!!!!!!!!!
Indication: complicated skin & skin structure infections (cSSSI) caused by GRAM (+) organisms |
|
|
What are the SE of Telavancin?
|
Fetal Risk
Nephrotoxicity QTc Prolongation Renal, respiratory & cardiac events Foamy urine |
|
|
Vibativ dosing? Dose? Age range?
|
Telavancin
Dose: 10mg/kg IV infusion over 1H x 7-14 days Age: >18 yo |
|
|
Can you give Vibativ to renal patients?
|
Dose adjustment required
CrCl 30 - 50 mL/min ==== 7.5mg/kg QD CrCl <30 === 10mg/kg Q48H |
|
|
What is Bactrim? SE? Okay to use with renal patients?
|
Sulfamethoxazole - Trimethoprim
SE: Bone Marrow Suppression CrCl 15-30mL/min = 50% of dose DON'T USE WITH CrCl <15mL/min |
|
|
Indications for Bactrim?
|
Gram (-) and PCP
Dose UTI 800-1600 Q12H x 10-14 days PCP Tx: 15-20mg/kg PCP Px: 1 DS qd |
|
|
Bactrim IV method of preparation?
|
Each 5mL should be added to 125mL of D5W.
Do NOT refrigerate after dilution and use within 6H |
|
|
What is Xifaxan?
|
Rifaximin
Dose: 200mg PO TID x 3 days |
|
|
What is Mepron?
|
Atovaquone, for PCP in patients with Sulfa allergy
Tx: 750mg BID x 21 days with meals Px: 1500mg QD |
|
|
Abx that SHOULD be kept at room temperature?
|
Biaxin (Clarithromycin)
Cleomycin (Clindamycin) |
|
|
Abx that doesn't need to be refrigerated (&)?
|
Amoxicillin, Zithromax, EES Liquid or EryPed
Suprax, Duricef, Ceftin, Omnicef |
|
|
What is Dotrecogin?
|
Xigris, to reduce mortality in sepsis. It is a recombinant verson of human activated protein C, that decreases inflammation and coagulation and increases fibrinolysis
|
|
|
List the NNRTI's
|
Delavirdine (Rescriptor) (DLV)
Efavirenz (Sustiva) (EFV) Nevirapine (Viramune) (NVP) Etravirine (Intelence) Rilpivirine (Endurant) - NEW!!!! |
|
|
What is Endurant?
|
Endurant (Rilpivirine) is an NNRTI
Dose: 25mg QD WITH FOOD SE: Depression, Insomia, HA |
|
|
List the Protease Inhibitors
|
Amprenavir (Agenerase)
Indinavir (Crixivan) Lopinavir + Ritonavir (Kaletra) Nelfinavir (Viracept) Ritonavir (Norvir) Saquinavir (Invirase) Tiprinavir (Aptivus) Fosamprenavir (Lexiva) Atazanavir (Reyataz) Darunavir (Prezista) |
|
|
List the NRTI's
|
Abacavir (Ziagen)
Didanosine (Videx, Videx EC) Lamivudine (Epivir, Epivir HBV) Stavudine (Zerit) Emtricitabine (Emtriva) Zidovudine (Retrovir) |
|
|
What are the antifungals used for Aspergillosis?
|
***VIPAC
Voriconazole (V-Fend) Itraconazole (Sporanox) Posaconazole (Noxafil) Ampho B Caspofungin (Cancidas) |
|
|
What is the Herpes drug approved for daily use?
|
Valcyclovir (Valtrex) is FDA approved for daily use to prevent transmission and flair ups
|
|
|
What is the 5th Generation cephalosporin?
|
Teflaro (Ceftaroline)
Indications: CAP and skin infections Dose: >18 YO 600mg IV Q12H over 1H |
|
|
Max final concentration of Primaxin?
|
Should not exceed 5mg/mL
DON'T INTERCHANGE IV/IM |
|
|
What is Ciloxan? Dosing?
|
Ciloxan (ciprofloxacin for the eye) is for bacterial conjunctivitis.
Dose: 1-2 gtts Q2H x 2 days then 1-2 gtts Q4H x 5 days |
|
|
What is the DoC for systemic fungal infection?
|
Ampho B
|
|
|
What do you premedicate with when using Ampho B?
|
Acetaminophen
Diphenhydramine Hydrocortisone Meperidine (shaking & chills) |
|
|
What is the max daily dose for Ampho B?
|
1.5mg/kg
|
|
|
Brand names for Ampho B in lipid formulation. Max dose?
|
Abelcet
Ambisome Amphotec Max: 3-5mg/kg/day |
|
|
List the 3 criteria for using Ampho B lipid formulation
|
Significant renal impairment
Patient is unable to tolerate the infusion-related reactions to regular Ampho B Transplant recipients. |
|
|
Reconstitution and storage of Ampho B?
|
Protect from MOISTURE, LIGHT & REFRIGERATED.
Reconstitute with sterile water then mix with D5W ONLY!!! After reconstitution: Protect from light and stable at RT: 24H or Fridge: 1 week. |
|
|
General points to remember with antifungals?
|
Check LFT's
Take with empty except for V-Fend |
|
|
What is Itraconazole? Forms?
|
Itraconazole (Sporanox) comes IV/PO
|
|
|
What is V-Fend? Comes in what forms? How do you take it?
|
Voriconazole (V-Fend) comes in ***TIS tabs (50mg, 200mg), injection (200mg), suspension (40mg/mL)
EMPTY STOMACH!!!! |
|
|
What do you need to check when using V-Fend?
|
LFT's
QT prolongation Check the eyes. |
|
|
What is Cancidas? Indication and dosing?
|
Cancidas (CaspfungiNS) is for invasive aspergillosis.
Dose: 70mg IV first day then 50mg IV QD |
|
|
What is Eraxis? Indication and dosings?
|
Eraxis (Andilafungin is for serious Candida fungal infections)
IV ONLY!!! Candidemia: 200mg on day 1 then 100mg QD x 14 days Esophageal candidiasis: 100mg on 1st day then 50mg x 14 days |
|
|
What is Posaconazole? Dose?
|
Posaconazole (Noxafil)
Dose: 200mg (1 tsp) TID with FOOD |
|
|
What is used for 1st trimester trichomonas vaginitis?
|
Clotrimazole (OTC Gyne-lotrimin) for vaginal yeast infection
|
|
|
Nystatin dosing for thrush?
|
Dose: 5mL swish and swallow
Infants: 2mL QID |
|
|
What is Ancobon?
|
Flucytosine (Ancobon) is synergistic with Ampho B or Fluconazole in cryptococcal meningitis
|
|
|
What are the medications for Influenza A?
|
Amantadine (Symmetrel) --- 10mg BID x 5 days --- anticholinergic and increases dopamine
Rimantadine (Flumadine) --- 100mg BID x 5 days |
|
|
Medications for Influenza B?
|
Oseltamiir (Tamiflu) --- start within 48 hours of symptoms
Zanamavir (Relenza) --- Shelf; 10mg BID |
|
|
What is Vistide? Form? Premedicate with what?
|
Cidofovir (Vistide) comes IV.
Watch for renal failure. Premedicate with PROBENECID 2 grams PO 3H before and then 1 gram 2H and 8H after. |
|
|
What is Foscarnet? Stored in what container after dilution?
|
Foscavir (Foscarnet) must be diluted in D5W or NS and transferred to PVC containers.
|
|
|
List the meds for Hepatitis B
|
Lamivudine (Epivir HBV)
Telbuvidine (Tyzeka) --- 600mg QD Interferon alpha-2B (Intron - renal) Adefovir (Hepsera - renal) Entecavir (Baraclude - renal) |
|
|
List the meds for Hepatitis C
|
Interferon Alfacon-1 (Infergen)
Peginterferon alfa-2a (Pegasys) Peginterferon alfa-2b (PEG-Intron) Ribavirin (Rabetrol, Copegus, Ribasphere) |
|
|
Px counseling for Ribavirin?
|
Pregnancy Category X
Advice of symptoms for hemolytic anemia: palpitation & shortness of breath |
|
|
What is Synagis? Dose?
|
Synagis (Palivizumab) is for RSV prevention
Dose: 15mg/kg IM every month |
|
|
List some brand names for Probiotic and their dosing?
|
***V-CLAF
VCL #3: FRIDGE; RT for 1 weekCulturelle - 1 cap BID Lactinex Acidophilus Florastro - 2 caps BID; NEVER REFRIGERATE!!!! |
