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64 Cards in this Set
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Penicillin G
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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 |
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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 |
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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 |
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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 |
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Ampicillin
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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 |
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Amoxicillin
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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 |
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Piperacillin
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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 |
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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 |
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Imipenem/cilastatin
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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 |
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Aztreonam
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Monobactams
IV only TX pts w/ severe gram (-) infection w/ PCN allergy Bactericidal/ β-lactams |
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Cefazolin
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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 |
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Cephalexin
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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 |
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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 |
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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 |
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Ceftazidime
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3rd generation cephalosporins
Pseudomonas arg. and give w/ an aminoglycoside *cross reactivity in pts w/ PCN allergy *superinfections is more common Bactericidal β-lactams |
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Cefdinir
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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 |
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Cefepime
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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 |
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Doxycycline
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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 |
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Minocycline
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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 |
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Tigecycline
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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 |
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Macrolides
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CAP outpatient, URI inpt w/ PCN allergy, mycoplasma, Chlamydia, mycobacterium avium (AIDS pts), legionella
Bacteriostatic -if PCN allergy give PO macro |
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Erythromycin
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Macrolides
Acne (topical pads) GI upset and cramping Bacteriostatic |
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Azithromycin
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Macrolides
Bacteriostatic Large doses will stimulate motilin receptors and cause emesis use for chlamydia |
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Clarithromycin
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Macrolides
Bacteriostatic PO DOC for outpt CAP b/c excellent intracellular concentrations GI upset and metallic taste |
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Telithromycin
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Macrolides(synthetic macrolide)
Bacteriostatic c/b used for outpt URI Lethal hepatic damage! |
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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 |
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Vancomycin
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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 |
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Clindamycin
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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 |
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Trimethoprim-sulfamethoxazole
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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 |
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Nitrofurantoin
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1. uncomplicated UTI (pregnant ♀)
2. frequent UTI’s and N.H. residents 1. urine color ∆ (brown)Bactericidal |
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Gentamicin
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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 |
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Amikacin
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Aminogylcosides
Bactericidal 1. is the ace in the hole for bacteria resistant to gent and tobra s/e: 1. Nephrotoxicity 2. Ototoxicity (irreversible) |
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Neomycin
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Aminogylcosides
Bactericidal 1. gut decontamination prior to GI surgery (day before) s/e: 1. Nephrotoxicity 2. Ototoxicity (irreversible) |
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Acyclovir
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Antiviral
PO, IV, topical 1. HSV and VZV |
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Valacyclovir
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Antiviral
PO 1. DOC: HSV and VZV 2. higher F b/c it has a higher plasma concentration |
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Trifluridine
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Antiviral
Ophthalmic solu 1. herpes keratitis (occular herpes) |
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Ganciclovir
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Antiviral
1. tx of CMV (AIDS) |
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Valganciclovir
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Antiviral
1. DOC tx of CMV (AIDS) 2. higher F |
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Metronidazole
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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 |
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Nitazoxanide
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Antiprotozoal
1. cryptosporidiosis (daycare) |
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Chloroquine
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Antimalarial
PO 1.treat malaria (if not resistant) 2. to kill RBC from 3. safe to use in children |
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Mefloquine
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Antimalarial
PO 1. Treat malaria (if resistant to chloroquine) s/e 1. Dizziness 2. dysphoria |
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Primaquine
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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 |
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Doxycyline
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Antimalarial
1. TX MDR malaria |
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Atovaquone-proguanil
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Antimalarial
1. prophylaxis of malaria 2. tx of drug resistant p. falciparum 3. best tolerated |
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Pyrimenthamine-sulfadiazine
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1. DOC of toxoplasmosis
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Pentamidine
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1. second choice TX of PCP after trim-sulfa
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Albendazole
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Antihelmintic-**TX the entire FAMILY**
1. DOC mixed infections c/b roundworms and tapeworms s/e: 1. reversible alopecia 2. increase LFT’s |
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Mebendazole
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Antihelmintic-**TX the entire FAMILY**
1. kills round and tape worms |
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Pyrantel pamoate
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Antihelmintic-**TX the entire FAMILY**
1. kills round worms |
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Ivermectin
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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) |
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Praziquantel
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Antihelmintic-**TX the entire FAMILY**
1. DOC for trematodes (flukes) |
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Permethrin
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TX of ectoparasites
Topical 1. DOC for scabies 2. tx lice |
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Nystatin
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Antifungal
PO 1. tx of oral candida 2. swish and swallow solution 3. has an offensive taste |
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Fluconazole
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Antifungal
PO 1. candidal vulvovaginitis (C.V.V.) 2. Ringworm of scalp and hair |
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Itraconazole
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Antifungal
PO 1. Ringworm of scalp and hair |
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Miconazole
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Antifungal
PV 1. C.V.V. |
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Clotrimazole
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Antifungal
PV and PO 1. C.V.V. (PV) 2. replacing nystatin b/c less offensive taste in tx of oral candida |
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Ketoconazole
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Antifungal
PO and topical 1. TX Seborrheic dermatitis 2. adjunct therapy of ringworm of scalp and hair |
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Griseofulvin
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Antifungal
1. DOC for ringworm of scalp and hair |
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Terbinafine
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Antifungal
1. DOC Onychomycosis (fungal infection of the nails) 2. tx of athlete’s foot and jock itch |
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Tolnaftate
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Antifungal
1. tx of dermatophytes (MET) and P. orbiculare |
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RIPE
Rifampin, isoniazid, pyrazinamide, ethambutol |
Anti-TB (sputum positive)
s/e: 1. INH: hepatotoxicity (NO alcohol), neurotoxicity, peripheral neuropathy (give B6) |
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INH or rifampin
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TB prophylaxis in pt w/ (+)ppd, but negative CXR and sputum (-)
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