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105 Cards in this Set

  • Front
  • Back
how treat C dif
metronidazole or vanc
ceph of choice for B fragiles
Cefoxitin
Ceftazidime
3rd gen ceph
cefpodox
3rd gen oral ceph
ceftibuten
3rd gen oral ceph
cefazolin
1st gen IV ceph
what DOC for gonorrhea
Ceftriaxone
what are limitations of ceftriax
no MRSA, no Entero
coverage of Ceftazidime
(3rd gen) general +/- with Pseudo, no MRSA or Entero
RMSF tx
in adult tetracycline, in child/preg chloramphenicol
tx NGU
doxycycline or azithro (good coverage chlamydia)
tx CAP, (1 agent and coverage, this also covers...)
azithromycin, covers H flu, Legionella, M pneu, and C pneu. also covers MAIC and N mening, also used for NGU
tx brucella
tetracyclines (ie doxycycline)
tx atypical PNA (3)
tetracyclines (covers Legionella, Chlamydia Pneu, M Pneu, as well as H Flu) and azithro (DOC for CAP), FQ (good GNR, H Flu, atypicals)
general properties of AG
positives:
negatives:
positives: GNR including Pseudo, expanded w b-lactam,
negatives: toxicities, not useful N mening, atypicals, anaerobes,
prophylaxis meningo
rifampin
recurrent UTI
TMP/SMZ
Are Carbenicillin, Piperacillin, and Ticarcillin penicillinase resistant?
no
coverage aztreonam
only GNR, including Pseudo
coverage imipenem
general +/-, Pseudo, anaerobes, DOC for enterobacter (NOT MRSA, VRE)
coverage Cipro
general +/- and atypicals, including Pseudo, NOT MRSA or entero
coverage Zosyn
GNR including Pseudo, general + (not MRSA), not atypicals,
does gatofloxacin cover M Pneu
yes
Name fluoroquinolones and general coverage
Ciprofloxacin, Gatifloxacin, "floxacin"
coverage: general +/- and atypicals, Cipro covers Pseudo, NOT MRSA or entero
Name Macrolides
Erythromycin, Azithromycin, Clarithromycin (NOT Gentamicin, Tobramycin)
name aminoglycosides
Gentamicin, Tobramycin (NOT Erythromycin, Azithromycin, Clarithromycin (macrolides), macrolides all end in "thromycin")
how aminoglycosides and macrolides difft
macrolides much safer, also cover atypicals and some anaerobes, but not Pseudo, whereas AG almost all gram - incl Pseudo
tx Pseudo
-anti pseudo PCN (Zosyn, Pipera/Tazo)
-Imipenem or aztreonam
-3/4 Cephalo
-cipro
-AG (gent)
(not macrolides)
per First Aid-gent+piperacillin
tx anaerobes (4)
-clinda
-chloramphenicol
-metronidazole
-vanc
tx MRSA
-linezolid
-daptomycin
-rifampin
-vanc
tx VRE
-linezolid
-daptomycin
-aminoPCN
tx GNR enterics
-aztreonam/imipenem
-FQ
-AG
-3rd ceph
(not macrolides, tetracyclines)
tx H Flu
-some PCN
-aztreonam/imip
-FQ
-Ceph
-AG
-macrolides
-tetracyclines
-rifampin
bactericidal
PCN and FQ,
ceph, AG, vanc, metronidazole
toxicity Griseofulvin
Teratogenic, Carcinogenic, Confusion, Headaches, incr wafarin metabolism
interferons MOA
gycoproteins from luekocytes that block viral RNA/DNA syn
use of interferons
Hep B, C, Kaposi's sarcoma
Hep C also ribavirin
tx worms
mebendazole
tx flukes
praziquantel
tx tapeworm
niclosamide
cestode
tapeworm
nematode
round worm
trematode
fluke
UTI tx (2)
sulfa or FQ (cipro or norflox)
name bug naturally resist to Pen G
enterococci
SE imipenem/cilast
GI distress
slom rash
sz
vanc SE
in general well tolerated
Nephrotoxic
Ototoxis
Thromophlebitis
red man syndrome
if person PCN allergic what could you use for a GNR PNA
aztreonam
SE macrolides
GI, acute cholestatic hepatitis, eosinophilia, skin rashes
"GHER"
macrolide in combo: beware when used w
T de pointes:
ketoconazole, flucanzole, clarithro, nefazadine, indinavir, cisapride
Fanconi syn can be seen with what Abx
tetracyclines
which tetracycline useful in RF
what other Rx useful in RF
doxycycline, also aztreonam
toxicity AG
nephrotoxic (esp w cephalo)
ototoxic (esp w loop)
vestibular toxicity
AG: gent, tobra, strepto
tetracycline: minocycline
what tetracycline can be used to tx siADH
demeclocycline
what can be used in pt with PCN allergy with more atypical
macrolide, tetracycline
sulfonamides inhib? trimeth/pyr?
sulfonamide=dihydropteroate synthase
termieth/pyr=dihydrofolate reductase
SE trimethoprim
megaloblastic anemia, leukopenia, granulocytopenia (can supplement with folic)
SE FQ
GI, superinfxns, skin rashes, HA, dizziness, tendonitis/tendon rupture. NOT in preg or KIDS
INH toxicity
hemo G6PD, neuro, hepato, SLE
for neuro give B6
fast v. slow acetylators
Think My Fair Lady "GHANS"=G6PD, hepato, acetylators, neuro (B6), SLE and H in INH for Hepburn
SE metronidazole
disulfram rxn w EtOH, HA
be careful with cefamandole
disulfiram rxn w ETOH
SE amantadine
ataxia, dizzy, slurred speech
mech amantadine
blockes viral penetration/uncoating may buffer pH endosome
(also rel DA)
SE ribavirin
hemo anemia, TERATOGEN
SE rifampin
minor, exc red/or body fluids, incr P450
how do macrolides resist Abx
methyl of rRNA near erythro RNA binding site
AG resistance
modification, ie acetylation, adenylation, or phosphorylation
chloramphenicol resist
modification via acetylation
tetracycline resist
decr uptake or incr transport out
think t for "transport"
sulfonamide resist
altered enzyme, decr uptake or incr PABA syn
where specifically macrolides act
bind to 23s rRNA of 50S and block translocation
where specific does chloramphenicol act
inhibit 50S peptidyltrxs
where Clinda specif act
blocks peptide bond formation at 50S
how specific AG act
inhibit formation of initiation and cause misreading of mRNA---remember need O2 for uptake
what does aztreonam bind to
PBP3
mech Metron
forms toxic metabolites
mech griseofulvin
disrupt microtubules
mech INH
inhibit mycolic acid
mech ribavirin
inhib guanine, inhib IMP dehydrogenase
inhibit viral polymerase
rifampin, acyclovir, gancic, fosa
bacteriocidal
PCN, FQ, Ceph, AG, vanc, metron
polymyxins-action, toxicity
cationic basic proteins that act as detergent, disrupting bac cell mem
use: resist gram - infxns
neurotoxicity, renal ATN
SE amph B
F/C (shake and bake), hypotension, nephrotoxic, arrhyth
SE "azoles"
gynecomastia, induce P450, F/C
flucytosine SE
(for systemic fungal, converted to fluorouracil and competes w uracil)

N/V, diarrhea, BM suppression
caspofungin SE
(for invasive aspergillosis, inhibits cell wall synthesis)

GI, flushing
terbinafine mech, use
mech: inhib fungal enz squalene epoxidase
dermatophytes, esp onychomycosis
compare antivirals Ayclovir, Ganc, Foscarnet
Ayclovir=needs P, less toxic, use for HSV, VZV, EBV
Ganciclovir=needs P, toxic, use CMV
Foscarnet=no P, use if CMV tx with ganciclovir fails
SE Foscarnet
nephrotoxicity
SE Ganciclovir
Leuko, neuto, thrombocyto -penia,
renal toxicity
SE acyclovir
delirium, tremoe, nephrotoxic
name Protease Inhib for HIV
saquinavir, ritonavir, "-avir"
BUT abacavir is NRTI
SE PI for HIV
GI, hypergly, dislipidemia, (indinavir thrombocytopenia)
name NRT
Zidovudine (AZT), didanosine (ddI), zalcitabine (ddC), stavudine (d4T), lamivudine (3TC), abacavir
didanosine
NRT (aka ddI)
zalcitabine
NRT (aka ddC)
stavudine
NRT (aka d4T)
toxic specific to NRT
lactic acidosis,
AZT=mega anemia
toxic specific to NNRT
rash
name NNRT
nevirapine, delavirdine, efavirenz
delavirdine
an NNRT
nevirapine
an NNRT
general toxicities of HAART
BM suppression (neutropenia, anemia), peripheral neuropathy
generally start HAART
CD4<500 or hi viral load