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64 Cards in this Set

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Penicillin G
IV
1. (group A, B, C, F, G strep)
2. must give larger doses to cover strep pneumo (susceptible strains)
3. syphilis, strep pneumo
4. very effective against susceptible bugs
5. Do NOT use for staph aureus b/c 95% of strains are resistant

s/e: Immediate = anaphylaxis, angioedema

Bactericidal/β-lactams
Procaine penicillin G
Benzathine penicillin G
IM
*used prophylactically to prevent group A β strep infections in military recruits
*used to treat syphilis (NOT neurosyphilis)


s/e: Immediate = anaphylaxis, angioedema

Bactericidal/β-lactams
Oxacillin
Nafcillin
Beta-lactamase resistant PCNs
IV
TX soft tissue infections c/b PCN-producing staph infections and infections c/b susceptible strains of strep.

s/e: Immediate = anaphylaxis, angioedema

Bactericidal/β-lactams
Cloxacillin
Dicloxacillin
Beta-lactamase resistant PCNs
PO
TX soft tissue infections c/b PCN-producing staph infections and infections c/b susceptible strains of strep.
DOC: for susceptible staph aureus (MSSA) (cellulitis (dicloxacillin)

s/e: Immediate = anaphylaxis, angioedema

Bactericidal/β-lactams
Ampicillin
Aminopenicillins
IV
*extended spectrum antibiotic that covers gram neg E. coli & H. flu
*b/c better penetration of outer membrane of gram neg bugs*NOT active against MRSA
*DOC for infections caused by Listeria & Enterococcus
Do NOT give PO b/c it causes diarrhea

s/e: Immediate = anaphylaxis, angioedema

Bactericidal/β-lactams
Amoxicillin
Aminopenicillins
1. DOC for OM in children
2. cellulitis (MSSA) b/c dose is BID

s/e: Immediate = anaphylaxis, angioedema

Bactericidal/β-lactams

Give w/ β-lactamase inhibitor if no success with drug alone
Clavulanate
Piperacillin
TX Pseudomonas aeruginosa give w/ tazobactam, can also use ceftazidime, or cefepime (BUT must add an aminoglycoside like GENT w/all)
3rd choice for anaerobic infections (penetrating GI trauma, appendicitis, PID, lung abscess); give w/ tazo
***never use a single drug to tx pseudomonas
(i.e. serious GNB infections beta-lactam + an aminoglycoside like GENT)


s/e: Immediate = anaphylaxis, angioedema

Bactericidal/β-lactams
Clavulanate
Sulbactam
tazobactam
Beta-lactamase inhibitors
Co-administration with certain PCNs that are destroyed by β-lactamase so that the β-lactam can do its job
Imipenem/cilastatin
Carbapenems
*Must give with Cilastatin (DHP inhibitor) b/c imipenem is metabolized by renal DHP

*broad spectrum β-lactam antibiotic
*good tissue penetration

Seizure (caution with renal and neurosurgical pts.)
Bactericidal/ β-lactams
Aztreonam
Monobactams
IV only
TX pts w/ severe gram (-) infection w/ PCN allergy
Bactericidal/ β-lactams
Cefazolin
1st generation Cephalosporins
IV
DOC: for surgical prophylaxis (not intraabdominal);good for SSTI if not c/b MRSA
*cross reactivity in pts w/ PCN allergy
*superinfections is more common
Bactericidal β-lactams
Cephalexin
1st generation Cephalosporins
Safe to use in pregnant women
Cellulitis (MSSA)
*cross reactivity in pts w/ PCN allergy
*superinfections is more common
Bactericidal β-lactams
Cefoxitin
Cefotetan
2nd generation cephalosporins
IV
Only 2 cephalosporins that cover anaerobic bugs
1. anaerobic infections (penetrating GI trauma, appendicitis, PID, lung abscess)
2. DOC for prophylaxis for intraabdominal surgery
*cross reactivity in pts w/ PCN allergy
*superinfections is more common

Bactericidal β-lactams
Cefotaxime
Ceftriaxone
3rd generation cephalosporins
1. CAP (h.flu, strep pneumo, and moraxella) inpatient, strep pneumo, bacterial meningitis (h.flu, strep pneumo or neisseria spp. Give w/ or w/out ampicillin; depending on age)
2. CAP inpt (ceftriaxone + macrolide)

Only ceftriaxone: gonorrhea (IV, IM), syphilis (IM) b/c these ppl usually do not come back for f/u
*cross reactivity in pts w/ PCN allergy
*superinfections is more common

Bactericidal β-lactams

1. NH pt w/ PNA & freq UTI: tx w/ cefotaxime or ceftriaxone
2. TX strep pneumo only if resistant to PCN G
Ceftazidime
3rd generation cephalosporins
Pseudomonas arg. and give w/ an aminoglycoside
*cross reactivity in pts w/ PCN allergy
*superinfections is more common

Bactericidal β-lactams
Cefdinir
3rd generation cephalosporins
OM after 2 failures of amox or amox + clav
*cross reactivity in pts w/ PCN allergy (more in 1st generation, less in 3rd & 4th )
*thrombophlebitis (uncommon)
*superinfections is more common when pts are treated w/ ceph (4>3>2>1) w/ a broad spectrum

Bactericidal β-lactams
Cefepime
4th generation cephalosporins
IV
-Pseudomonas arg (GNR) and give with an aminoglycoside
-febrile neutropenic, ICU pts
*cross reactivity in pts w/ PCN allergy (more in 1st generation, less in 3rd & 4th )
*thrombophlebitis (uncommon)
*superinfections is more common when pts are treated w/ ceph (4>3>2>1) w/ a broad spectrum

Bactericidal β-lactams
Doxycycline
Tetracyclines
IV & PO
TX against intracellular pathogens: mycoplasma spp, Chlamydia spp, Rickettsia spp, borrelia burgdorferi (Lyme’s ds)

DOC for pts w/ renal dysfunction
-reduce GI problems by taking w/ food
-do NOT give to tx pregnant females or children <15 b/c it can cause discoloration in newly forming teeth
-photosensitization: use Bacteriostatic
Minocycline
Tetracyclines
TX of acne
-reduce GI problems by taking w/ food
-do NOT give to tx pregnant females or children <15 b/c it can cause discoloration in newly forming teeth
-photosensitization:
bacteriostatic
Tigecycline
Tetracyclines
IV
TX of infections c/b MDR acinebactor, MRSA,
-reduce GI problems by taking w/ food
-do NOT give to tx pregnant females or children <15 b/c it can cause discoloration in newly forming teeth
-photosensitization: use Bacteriostatic
Macrolides
CAP outpatient, URI inpt w/ PCN allergy, mycoplasma, Chlamydia, mycobacterium avium (AIDS pts), legionella
Bacteriostatic
-if PCN allergy give PO macro
Erythromycin
Macrolides
Acne (topical pads)
GI upset and cramping
Bacteriostatic
Azithromycin
Macrolides
Bacteriostatic
Large doses will stimulate motilin receptors and cause emesis
use for chlamydia
Clarithromycin
Macrolides
Bacteriostatic
PO
DOC for outpt CAP b/c excellent intracellular
concentrations
GI upset and metallic taste
Telithromycin
Macrolides(synthetic macrolide)
Bacteriostatic
c/b used for outpt URI
Lethal hepatic damage!
Ciprofloxacin
Gemifloxacin
Levofloxacin
Moxifloxacin
Bactericidal
FQ’s
1. MDR S. pneumo (including PCN resistant) all except CIPRO
2. Legionella
3. complicated- UTI
4. diarrhea (salmonella, shigella, e. coli or campylobacter)

Levo and moxi: CAP inpts
s/e: Q-T prolongation
1. Cipro: do NOT use for G (+)
2. Do NOT use FQ’s for MRSA
3. FQ’s F is 90% so PO=IV
4. Do Not use FQ on NH pts. w/ CAP
5. can TX MDR S.pneumo w/ high dose levofloxacin + vanco
Vancomycin
IV,PO
1. MDR strep pneumo (including PCN resistant) & can also be used with IV levofloxacin
2. empiric therapy for bacterial meningitis and add it with ceftriaxone
3. MRSA in the hospital
4. Ampicillin-resistant enterococcal infections
5. Gram (+) bacteremia (empirically until cx)
6. empiric therapy for febrile neutropenia
PO
1. C. Diff (second line tx use after 2 courses of PO metronidazole)
1. ototoxicity (deafness)
2. renal toxicity
3. “red-man” syndrome (given to fast)
4. allergic rxns and rash

1. remember PO vanco is not absorbed by the GI tract
2. Bactericidal
Clindamycin
IV, PO
1. Aspiration PNA (anaerobic bugs)
2. Cellulitis (MSSA) in pt w/ PCN allergy
3. Cellulitis (MRSA)
4. topical for acne
s/e:
1. Rash
2. Diarrhea
3. C. Diff
if after cx and comes back (MSSA) d/c clinda and start amoxicillin
2. Bacteriostatic
Trimethoprim-sulfamethoxazole
PO (excellent F)
1. DOC for PCP (PJP)
2. cellulitis (MRSA)
3. uncomplicated UTI
s/e:
1. Skin: rash, photosensitivity, erhythema multiforme, steven-johnson syndrome (wicked rash)Bacteriostatic and sometimes bactericidal against certain orgs
Nitrofurantoin
1. uncomplicated UTI (pregnant ♀)
2. frequent UTI’s and N.H. residents
1. urine color ∆ (brown)Bactericidal
Gentamicin
Aminogylcosides
IV
1. Pseudomonas (GNB) give w/ a beta lactam
2. Serious GNB give w/ a beta lactam
s/e:
1. Nephrotoxicity
2. Ototoxicity (irreversible)
Bactericidal
Amikacin
Aminogylcosides
Bactericidal
1. is the ace in the hole for bacteria resistant to gent and tobra
s/e:
1. Nephrotoxicity
2. Ototoxicity (irreversible)
Neomycin
Aminogylcosides
Bactericidal
1. gut decontamination prior to GI surgery (day before)
s/e:
1. Nephrotoxicity
2. Ototoxicity (irreversible)
Acyclovir
Antiviral
PO, IV, topical
1. HSV and VZV
Valacyclovir
Antiviral
PO
1. DOC: HSV and VZV
2. higher F b/c it has a higher plasma concentration
Trifluridine
Antiviral
Ophthalmic solu
1. herpes keratitis (occular herpes)
Ganciclovir
Antiviral
1. tx of CMV (AIDS)
Valganciclovir
Antiviral
1. DOC tx of CMV (AIDS)
2. higher F
Metronidazole
Antiprotozoal
1. DOC for C. Diff (pseudomembranous colitis)
2. DOC tx of trichomoniasis
3. DOC for giardia (beaver fever)
4. DOC for amebiasis
s/e:
1. HA
2. Metallic taste
3. Xerostomia
4. dysguesia
Nitazoxanide
Antiprotozoal
1. cryptosporidiosis (daycare)
Chloroquine
Antimalarial
PO
1.treat malaria (if not resistant)
2. to kill RBC from
3. safe to use in children
Mefloquine
Antimalarial
PO
1. Treat malaria (if resistant to chloroquine)
s/e
1. Dizziness
2. dysphoria
Primaquine
Antimalarial
1. Treat Malaria
2. to kill liver hypnozoites
Primaquine 1. Treat Malaria
2. to kill liver hypnozoites
s/e
1. do NOT use if pregnant
2. methemoglobinemia
Doxycyline
Antimalarial
1. TX MDR malaria
Atovaquone-proguanil
Antimalarial
1. prophylaxis of malaria
2. tx of drug resistant p. falciparum
3. best tolerated
Pyrimenthamine-sulfadiazine
1. DOC of toxoplasmosis
Pentamidine
1. second choice TX of PCP after trim-sulfa
Albendazole
Antihelmintic-**TX the entire FAMILY**
1. DOC mixed infections c/b roundworms and tapeworms
s/e:
1. reversible alopecia
2. increase LFT’s
Mebendazole
Antihelmintic-**TX the entire FAMILY**
1. kills round and tape worms
Pyrantel pamoate
Antihelmintic-**TX the entire FAMILY**
1. kills round worms
Ivermectin
Antihelmintic-**TX the entire FAMILY**
1. TX of scabies (PO admin)
2. given to livestock: kills all round worms and arthropods (ticks, mites, and other insects)
Praziquantel
Antihelmintic-**TX the entire FAMILY**
1. DOC for trematodes (flukes)
Permethrin
TX of ectoparasites
Topical
1. DOC for scabies
2. tx lice
Nystatin
Antifungal
PO
1. tx of oral candida
2. swish and swallow solution
3. has an offensive taste
Fluconazole
Antifungal
PO
1. candidal vulvovaginitis (C.V.V.)
2. Ringworm of scalp and hair
Itraconazole
Antifungal
PO
1. Ringworm of scalp and hair
Miconazole
Antifungal
PV
1. C.V.V.
Clotrimazole
Antifungal
PV and PO
1. C.V.V. (PV)
2. replacing nystatin b/c less offensive taste in tx of oral candida
Ketoconazole
Antifungal
PO and topical
1. TX Seborrheic dermatitis
2. adjunct therapy of ringworm of scalp and hair
Griseofulvin
Antifungal
1. DOC for ringworm of scalp and hair
Terbinafine
Antifungal
1. DOC Onychomycosis (fungal infection of the nails)
2. tx of athlete’s foot and jock itch
Tolnaftate
Antifungal
1. tx of dermatophytes (MET) and P. orbiculare
RIPE
Rifampin, isoniazid, pyrazinamide, ethambutol
Anti-TB (sputum positive)

s/e:
1. INH: hepatotoxicity (NO alcohol), neurotoxicity, peripheral neuropathy (give B6)
INH or rifampin
TB prophylaxis in pt w/ (+)ppd, but negative CXR and sputum (-)