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141 Cards in this Set
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- Back
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Cell wall inhibitors AKA beta lactam inhibitors
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interrupt ability of bacteria to generate cell wall to it lyses and breaks apart
AKA beta lactam abx |
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Cell wall inhibitors AKA beta lactam inhibitors
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Penicillins
Cephalosporins (4 generations) Carbapenems Monobactams Vancomycin B-lactamase inhibitors (Added to one of the other abx) |
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Penicillins
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First group of B-lactams
Use over time has resulted in increased resistance Interfere with last step of cell wall synthesis Gram+ susceptible Gram- are not (exceptions) Synergistic with amino glycosides |
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Amoxicillin
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Most effective against gram - bacilli
Clavulanic acid helps amoxicillin get into cell TakenPO--one of 3 that is most used orally Kidney excretion |
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Ampicillin
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Extended spectrum
IV or IM Can add sublactam to help it get into cell Kidney excretion Gram + cocci: enterococci Gram + bacilli: Listeria monocytogenes Gram - rod: ecoli (resistant), hflu (resistant), salmonella typhi, proteus mirabilis |
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Dicloxacillin
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Antistaphylococcal penicillin
PO Kidney excretion One of 3 that is most used orally Penicillin G is a Dicloxacillin |
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Methicillin
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Antistaphylococcal penicillin
Kidney excretion Associated with nephritis Covers MSSA |
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Oxacillin
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Antistaphylococcal penicillin
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Penicillin G
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Natural penicillin
IM depot shot always Good for strep throat when pt not compliant with others Kidney excretion A Dicloxacillin |
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Penicillin V
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Natural penicillin
Oral Kidney excretion |
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Carbenicillin
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Antipseudomonal penicillin--against pseudomonas aeruginosa
Kidney excretion |
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Piperacillin
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Antipseudomonal penicillin
IV/IM Can be given with tazobactam to help it get into cell Used more for significant infix |
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Ticarcillin
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Antipseudomonal penicillin
Ticarcillin+claculanic acid helps it get into cell IV/IM Kidney excretion Used for more significant infix |
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Natural penicillins
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Penicillin G and Penicillin V
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Antistaphylococcal penicillins
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Methicillin
Oxacillin Dicloxacillin |
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Extended-Spectrum penicillins
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Ampicillin
Amoxicillin |
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Antipseudomonal penicillins
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Carbenicillin
Ticarcillin Piperacillin |
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Penicillins most used orally
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Penicillin V
Dicloxacillin Amoxicillin |
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Adverse reactions of penicillins
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Allergic reaction
Rash Anaphylaxis Diarrhea |
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Cephalosporins
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Similar to penicillins with regard to MOA but more resistance to B-lactamase activity
Divided into four generations based on spectrum of activity and resistance to B-lactamase activity Each generation has expanded spectrum and better B-lactamase resistance Not DOC for MRSA Serratia marcescens Resistance Cephalosporin cross-reactivity with penicillin so avoid only with hx of severe allergic reaction to PCN Elimination through kidneys |
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Cephalexin (Keflex)
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1st generation cephalosporin
skin, strep pharyngitis, cystitis, OM Covers MSSA-Methicillin sensitive staph aureus Proteus mirabilis, E.coli, Klebsiella pneumoniae Mnemonic: PEcK |
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Cefadroxil
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1st generation cephalosporin
OM, other Covers MSSA-Methicillin sensitive staph aureus Proteus mirabilis, E.coli, Klebsiella pneumoniae Mnemonic: PEcK Not DOC for abscess (MRSA) |
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Cefaclor
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2nd generation Cephalosporin
strep pharyngitis, skin, OM, sinusitis (if not responsive to penicillin. Second line) H. influenzae, Enterobacter aerogenes, some Neisseria, and Bacteroides fragilis Mnemonic: HENPEcK |
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Cefprozil (Cefzil)
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2nd generation Cephalosporin
strep pharyngitis, skin, OM, sinusitis (if not responsive to penicillin. These are second line) H. influenzae, Enterobacter aerogenes, some Neisseria, and Bacteroides fragilis Mnemonic: HENPEcK |
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Cefuroxime (Ceftin)
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2nd generation Cephalosporin
strep pharyngitis, skin, OM, sinusitis (if not responsive to penicillin. These are second line) H. influenzae, Enterobacter aerogenes, some Neisseria, and Bacteroides fragilis Mnemonic: HENPEcK |
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Cefotetan
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Second generation Cephalosporin
typically IV UTI, severe PID, prophylaxis surg/postcesarean H. influenzae, Enterobacter aerogenes, some Neisseria, and Bacteroides fragilis Mnemonic: HENPEcK |
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Cefoxitin
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Second generation Cephalosporin
typically IV UTI, severe PID, prophylaxis surg/postcesarean H. influenzae, Enterobacter aerogenes, some Neisseria, and Bacteroides fragilis Mnemonic: HENPEcK |
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Cefdinir (Omnicef)
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3rd generation cephalosporin
CAP, chronic bronchitis, maxillary sinusitis, strep pharyngitis, skin, OM H. influenzae, Enterobacter aerogenes, some Neisseria, and Bacteroides fragilis Mnemonic: HENPEcK |
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Ceftibutin
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3rd generation cephalosporin
CAP, chronic bronchitis, maxillary sinusitis, strep pharyngitis, skin, OM H. influenzae, Enterobacter aerogenes, some Neisseria, and Bacteroides fragilis Mnemonic: HENPEcK |
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Cefixime (Suprax)
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3rd generation cephalosporin
oral gonococcal infxns when ceftriaxone not available H. influenzae, Enterobacter aerogenes, some Neisseria, and Bacteroides fragilis Mnemonic: HENPEcK |
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Cefotaxime (Claforan)
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3rd generation cephalosporin
DOC for neonatal and peds meningitis gonococcal, prophylaxis H. influenzae, Enterobacter aerogenes, some Neisseria, and Bacteroides fragilis Mnemonic: HENPEcK |
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Ceftriaxone (Rocephin)
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3rd generation cephalosporin
DOC for neonatal and peds meningitis gonococcal, prophylaxis H. influenzae, Enterobacter aerogenes, some Neisseria, and Bacteroides fragilis Mnemonic: HENPEcK |
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Ceftazidime (Fortaz)
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neonatal infections, psuedomonas
H. influenzae, Enterobacter aerogenes, some Neisseria, and Bacteroides fragilis Mnemonic: HENPEcK |
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Cefepime (Maxipime)
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4th generation cephalosporin
febrile neutropenia, peds respiratory infections (cystic fibrosis), adult UTI |
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antibiograms
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Direct abx selection
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Carbapenems
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Synthetic B-lactam antibiotics with broad spectrum of activity
Imipenem (main drug of class), doripenem, ertapenem May contribute to increased resistance particularly with strains of pseudomonas |
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Imipenem (main drug of class), doripenem, ertapenem
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Carbapenems--synthetic beta lactam abx
Broad spectrum of activity |
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Monobactams
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Beta lactam abx
Aztreonam is only drug in the class Not used alone for empiric therapy due to limited spectrum of activity Gram negative Used in combo w/ drug that gives you gram + coverage Used in patients who are allergic to PCN and Cephalosporins |
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Aztreonam
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Only drug in monobactam class
Beta lactam abx Not used alone for empiric therapy due to limited spectrum of activity Gram negative Used in combo w/ drug that gives you gram + coverage Used in patients who are allergic to PCN and Cephalosporins |
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Vancomycin
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Abx
Useful for tx of MRSA and enterococci if Bactrim not effective Weakens bacterial cell wall by inhibiting synthesis of cell wall phospholipids Use should be limited due to resistance-Develops quickly Usually administered slow (d/t SE profile) IV infusion Can also be given orally Fever, chills, phlebitis at injection site, flushing (if given too quickly) Flushing may be mistaken for allergic reaction Ototoxicity, nephrotoxicity potential |
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Minimum Inhibitory Concentration
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Finds out what dose is required to inhibit growth of bacterium
if you have high MIC and low MIC, go with low MIC for better clinical outcome. |
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Fluoroquinolones
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Inhibits replication of bacterial DNA
Interferes with bacterial cell division Enters bacteria cell through protein channel Distribute well into bone, kidney, urine, prostatic tissue, and lung AE: 3% nausea, vomiting, diarrhea CNS: HA, dizziness, light-headedness Phototoxicity Tendinitis/tendon rupture- Black Box Warning QTc interval elongation Avoid drug interactions |
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Ciprofloxacin
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Second generation fluoroquinolone
Enterobacter species, E.coli, Pseudomonas, Bacillus anthracis, weak against Strep Pnemoniae Renally excreted |
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Levofloxacin (Levaquin)
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3rd generation fluoroquinolone
effective treatment of E.coli, gonnorhea, S. pneumoniae, Pseudomonas May be used for tx of UTI, skin, sinus, chronic bronchitis, CAP, nosocomial pneumonia Can be dosed once daily Renally excreted |
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Moxifloxacin (Avelox)
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4th generation fluoroquinolone
effective against S. pneumoniae and anaerobes Used for respiratory infections but not UTIs Not renally excreted like the others |
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Fluoroquinolones
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Ciprofloxacin
Levofloxacin Moxifloxacin |
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Bactrim AKA Cotrimoxazole, Trimethoprim + Sulfamethoxazole
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Synergistic activity
Combination has resulted in less resistance oral Trimethoprim concentrates well in acidic prostatic and vaginal fluids Respiratory infections caused by Haemophilis influenzae, Legionella pneumophilia, Pneumocystis Jiroveci pneumonia infection or prophylaxis (CD4+ count less than 200) Serious life-threatening infx for AIDS pts Can be cured with IV Bactrim Can be given PO prophylactically Septicemia or meningitis caused by Listeria monocytogenes Prostatitis or UTI GI: shigellosis, salmonella, carriers |
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Nitrofurantoin (Macrobid)
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Mechanism is enzyme inhibition that results in DNA damage
Most effective for E.coli but will cover other common gram negative pathogens (Staph saprophyticus, Klebsiella pneumoniae, Proteus mirabilis) Concentrates well in the urine |
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Antifungals
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Amphotericin B
Fluconazole Itraconazole Ketoconazole Voriconazole |
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Amphotericin B
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Antifungal
Life-threatening systemic mycoses, deep tissues (CSF and blood) Disrupts membrane function resulting in cell death IV or intrathecal administration AE: Test dose to check for anaphylaxis fever/chills--give steroid or antipyretic nephrotoxic--give IV NS Hypokalemia--give K supplement Thrombophlebitis--give heparin |
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Ketoconazole
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Antifungal
Blocks step in fungal membrane synthesis PO Second line due to limited spectrum Need to monitor LFTs--increases them Only one that causes endocrine problems (gynecomastia, decreased libido, etc) GI effects |
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Itraconazole
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Antifungal
Drug of choice for blastomycosis, sporotrichosis, paracoccidiomycosis, histoplasmosis Not therapeutic for CSF Metabolized in liver, no endocrine effects No renal dose adjustment needed Avoid in CHF patients |
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Voriconazole
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Antifungal
Newer broad spectrum antifungal Used in place of amphotericin B for invasive aspergillosis Used for candidiasis and candidemia Deep tissue , esophageal Visual and auditory hallucinations If dose is too high |
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Cutaneous antifungals
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Terbinafine
Griseofulvin Nystatin Miconazole, clomitrazole Ciclopirox Tolnaftate |
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Terbinafine (Lamisil)
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Cutaneous antifungal
Blocks the synthesis of ergosterol DOC for dermatophytoses or onychomycoses Fungicidal and useful for topical treatment of tinea pedis, tinea corporis, tinea cruris Can also be used orally for both skin and nails Nails: 6-12 weeks, tinea: 2 weeks Baseline LFTs for onychomycosis bc pt will be on this med for a longer period of time |
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Griseofulvin
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Cutaneous antifungal
Used for ringworm and dermatophytosis of skin and hair Requires long treatment duration so not used as frequently Disrupts fungal mitosis Not used much anymore. Covers same thing as Lamisil. Has to be used for long period of time |
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Nystatin
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Cutaneous antifungal
Topical treatment of candida infections Useful to treat oral candidiasis Adults with thrush are either immunocompromised or on inhaled corticosteroids |
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Clomitrazole/Miconazole
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Cutaneous antifungal
Wider spectrum of activity Epidermophyton, Microsporum, Trichophyton, Candida albicans, and Malassezia furfur Miconazole is a potent inhibitor of warfarin metabolism Even if applied topically Will increase INR |
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Ciclopirox
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Disrupts synthesis of DNA, RNA, protein
Similar coverage to terbinafine Treat tinea pedis, tinea corporis, seborrheic dermatitis, tinea versicolor, onychomycosis Can be used topically for certain types of onychomycosis If infx is more distal |
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Tolnaftate
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Distorts hyphae and stunts mycelial growth
Not effective against Candida Do not use for yeast infx Treat tinea pedis, tinea cruris, tinea corporis |
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Mebendazole
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Effective for treatment of whipworm, pinworm, hookworms, and roundworm
Causes the parasites to be expelled with feces Take with high fat meal for absorption Dosage varies with target organism Need to kill live worms and then go back and kill eggs |
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Pyrantel pamoate
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Effective against roundworms, pinworms, and hookworms
Paralyzes worms in the GI tract and expelled |
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Ivermectin
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Used to treat larva migrans, strongyloidiasis, and onchocerciasis
Look at 37.4 |
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Metronidazole (Flagyl)
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Antiprotozoal
Treatment of choice for E.histolytica (amoebic dysentery), pseudomembranous colitis (C. diff), Giardia lamblia, and Trichomonas vaginalis (found on wet prep) Combined with iodoquinol or paromomycin results in 90+% cure rates for amebiasis Adverse effects include GI (N/V), metallic taste, alcohol interaction within 72 hours (severe nausea and vomiting) |
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Tinidazole
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Antiprotozoal
Same use as metronidazole but more expensive Shorter course of treatment Similar SE |
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Primaquine
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Antiprotozoal
Eradicates primary exoerythrocytic forms of P. falciparum (fatal) and P. vivax and secondary P. vivax and P. ovale Radical cures of P. vivax and P. ovale In erythrocytic stage used with mefloquine May cause hemolytic anemia in glucose-6-phosphate dehydrogenase patients Used as tx, not prophylactic |
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Chloroquine
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Antiprotozoal
Drug of choice for treatment of erythrocytic P. falciparum Less effective versus P. vivax Side effects significant only at higher doses GI, pruritis, headaches, blurred vision No SE of hemolytic anemia like primaquine. |
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Mefloquine
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Antiprotozoal
Single agent used for prophylaxis and cure (distinguishes it from other 2) Effective against multidrug resistant P. falciparum Long half life with continuous circulation through the enterohepatic and enterogastric systems Prevents infx Adverse effects are similar to other agents but with ECG changes if administered with quindine or quinidine |
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Malaria regimen
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Doxycycline prophylaxis
Once a day dose Started a few days before person enters area of risk and continued 4 weeks after area is left Mefloquine prophylaxis Given for 14 days following Doxycycline prophylaxis Can also put pt on Mefloquine for the whole time and then follow w/ primaquine treatment daily for 14 days |
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Protein synthesis inhibitors
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Doxycycline
Minocycline Bind to 30S ribosomal subunit Broad spectrum Take PO Reduced absorption with dairy foods, antacids, and iron Discoloration and hypoplasia of teeth Temporary growth stunting in children Fatal hepatotoxicity in pg women Phototoxicity Superinfections (C.diff) Liver damage CI in renally compromised, pg, breast feeding, children <8yo |
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Doxycycline
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Protein synthesis inhibitor
Tetracycline Long acting Long half life Very high absorption rate Almost totally absorbed PO DOC for cholera, lyme disease, mycoplasma pneumoniae, chlamydia, rocky mountain spotted fever |
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Minocycline
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Protein synthesis inhibitor
Tetracycline Very high absorption--almost totally absorbed PO Long acting, long half life SE vestibular problems: dizziness, nausea, vomiting |
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Glycylcyclines
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Protein synthesis inhibitors
Tigecycline Derivative of minocycline with an added side chain |
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Tigecycline
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Protein synthesis inhibitor
Glycylcyclines Binds to 30S ribosomal subunit Broad spectrum including MRSA and VRE Developed to overcome resistance of tetracyclines Rapidly and extensively distributes into body tissues Significant N/V Discoloration in teeth and bone growth affected Overgrowth of nonsusceptible organisms Fetal harm CI in pg women, children, severe hepatic dysfunction |
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Aminoglycosides
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Protein synthesis inhibitors
Amikacin, Gentamicin, Neomycin, Streptomycin, Tobramycin Serious toxicities so replaced by safer abx Bacteriocidal--kill bacteria Bind to 30S subunit Given parenterally except Neomycin |
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Aminoglycosides AE
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Protein synthesis inhibitors: Amikacin, gentamycin, neomycin, streptomycin, Tobramycin
Ototoxicity (accumulate in endolymph/perilymph) Nephrotoxicity (accumulate in renal cortex) Neuromuscular paralysis (inhibits release of ACh from nerve endings) Cross placental barrier (CI in pg) |
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Aminoglycosides spectrum
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Protein synthesis inhibitors: Amikacin, gentamycin, neomycin, streptomycin, tobramycin
Gram + cocci tularemia PID UTI Sepsis Endocarditis |
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Macrolides
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Protein synthesis inhibitors: Azithromycin, Clarithromycin, Erythromycin, Telithromycin
Bind to 50S ribosomal subunit PO Caution in hepatic dysfunction AE: Cholestatic hepatitis, GI disturbance, interaction withP450, CI in arrhythmias |
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Erythromycin
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Protein synthesis inhibitor: Macrolide
AE: ototoxicity Diphtheria Used for syphilis if pcn allergy Mycoplasma pneumoniae |
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Azithromycin
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Protein synthesis inhibitor: Macrolide
Longest half life Zpack DOC for legionellosis Chalmydial infx as alternative to tetracycline--DOC for pg infx, possible anti-inflammatory |
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Telithromycin
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Protein synthesis inhibitor: macrolide
Prolongates QTc interval and can lead to Torsades de pointes |
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Chloramphenicol
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Protein synthesis inhibitor
Toxic so restricted to life-threatening infx w/o other alternative Inhibits transfer of amino acid to tRNA Bacteriostatic and bactericidal Broad spectrum abc Rickettsia AE: fatal aplastic anemia bone marrow suppression gray baby syndrome: CV collapse, cyanosis |
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Clindamycin
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Protein synthesis inhibitor
Bacteriostatic Binds to 50S subunit to inhibit translocation Anaerobic bacteria Gram+ cocci: MRSA AE: c. diff, agranulocytosis |
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Quinpritin/Dalfopristin
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Protein synthesis inhibitors
Bind to 50S ribosome Bactericidal MRSA Primarily for VRE Penicillin resistant pneumococci AE: venous irritation, inhibits CY P450 |
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Linezolid
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Protein synthesis inhibitor
Inhibits 50S ribosomal subunit Bacteriostatic AE: GI upset (N/D) |
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Isoniazid (INH)
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Anti-tuberculosis
DOC for TB. Most effective. Very potent. Low toxicity. Bactericidal in rapid growing bacteria Bacteriostatic in slow growing bacteria Inhibits synthesis of mycolic acid Needs to activated by KatG to form toxic metabolites AE: heptatitis and hepatotoxicity P450 inhibition Mental abnormalities Convulsions Optic neuritis |
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Rifamycins
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Rifampin
Rifabutin Rifabtin Rifapentine Anti-TB Block transcription by binding RNA polymerase |
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Rifampin
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Rifamycin--Anti TB
PO Most effective of the Rifamycins (lowest MIC) Least toxic fast onset of action AE: N/V, liver dysfunction, P450 drugs break down faster |
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Rifabtin
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Rifamycin--Anti TB
DOC for pt with TB and HIV Less potent p450 inducer |
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Rifapentine
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Rifamycin--anti TB
Longer half life than the others |
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Pyrazinamide
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Anti TB
Bactericidal Converted to pyrazinoid acid to be effective AE: liver dysfunction and urate retention |
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Ethambutol
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Anti-TB
Bacteriostatic Inhibits polymerization of arabinogalactal cell wall AE: optic neuritis, urate retention |
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Leprosy drugs
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Dapsone
Clofazimine |
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Dapsone
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Anti-leprosy
Bacteriostatic for M. leprae Inhibits folate synthesis PO AE: hemolysis, methemogobinemia, erythema nodosum leprosum |
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Clofazimine
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Anti-leprosy
Bactericidal to M. Leprae Inhibits DNA replication Phenazine dye Forms O2 radicals that harm the bacteria PO AE: skin discoloration and eosinophilic enteritis |
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Amphotericin B
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Antifungal
Disruption of membrane function Used for life threatening mycoses deep in body tissues, CSF or blood Given IV or intrathecal Need to test dose to check for anaphylaxis |
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Amphotericin B AE
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Ampho-terrible
F/C (premedicate with steroid or antipyretic) Nephrotoxic (give NS bolus prior) Hypokalemia (give K supplement) Thrombophlebitis (add heparin to prevent) |
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Ketoconazole
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Antifungal
Disrupts membrane structure and function PO and eliminated through liver (monitor LFTs) Tx: Histoplasma, blastomyces, candida, coccioides. Topical: tinea corpori, tinea cruris, tinea pedis, tinea versicolor |
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Ketoconazole AE
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Decrease testosterone and cortisol production-->gynecomastia, decreased libido, impotence, menstrual irregularities,
Inc in LFTs so CI in hepatitis GI (N/V) |
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Fluconazole/Diflucan (triazole)
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Inhibits synthesis of membrane
excellent penetration into CSF DOC for cryptococcus neoformans after tx with AmphB PO or IV Kidney Used prophylactically in BMT |
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Itraconazole (triazole)
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Antifungal
Not good for CSF Metabolized in liver Avoid in CFH pt's |
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Voriconazole
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Antifungal
Broad spectrum DOC for aspergillosis Given IV or PO Gets in tissues well--CSF and esophagus Visual and auditory hallucinations with high doses |
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Terbinafine (lamisil)
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Anti-fungal-topical
Primarily fungicidal DOC for dermatophytoses, onychomycoses increase in LFTs Oral tx nails 6-12 wks, tinea: 2 weeks |
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Griseofulvin
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Topical antifungal
Inhibition of fungal mitosis--fungiostatic Tx: ringworm, dermatophytosis Long tx duration 6-12m |
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Nystatin
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Topical tx of candida infx
Useful for thrush |
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Clotrimazole/Miconazole
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Wide spectrum of activity
Tx: Epidermophyton, microsproum, trichophyton, candida albicans, malassezia furfur, rashes Potent inhibitor of warfarin metabolism Fungal rash will worsen with steroids |
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Cyclopirox
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Inhibits transport mechanism of fungal cells
Tx: tinea pedis, tinea corporis, seborrheic dermatitis, tinea versicolor, onychomycosis on disal nail |
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Tolnaftate
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Distorts hyphae and stunts mycelial growth
Tx: tinea pedis, tinea cruris, tinea corporis Not effective against candida |
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Metronidazole (Flagyl)
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Anti-protozoal
DOC for E. histolytics (ameobic dysentry), giardia, trichomonas vaginalis, Results in 90% cure rate for amebiasis when combined with iodoquinol or paromycin AE: GI which makes people stop taking it, metallic taste, EtOH SE, DOC for C. diff Not a lot of resistance Tinidazole is a shorter acting version but more expensive |
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Primaquine
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Anti-malaria--tissue schizonticide
Used as tx, not prevention Used in combo with mefloquine Eradicates primary forms of P. falciparum and vivax. Eradicates secondary forms of P. vivax and P. oval AE: drug induced hemolytic anemia in G6PD patients Not effective against erythrocytic stage of malaria |
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Chloroquine
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Anti-malaria-blood schizonticide
DOC for erythrocytic P. falciparum malaria Less effective against P. vivax AE: at high doses, GI, pruritis, HA, blurred vision No G6PD problem |
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Mefloquine
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Anti-malaria-blood schizonicide
Used in multidrug resistant P. falciparum Also used as prophylaxis--standard of care, given 14d after completion of Doxy or by itself Can have EKG changes when given with quinine or quinidine Long half life (good preventive and cure) Continuous circulation through enterohepatic and enterogastric systems |
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Malaria prophylaxis
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Doxycycline Once daily dose started a few days before and 4wks after, Mefloquine prophylaxis given 14d after Doxy. Follwed by Primaquine x14d
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Mebendazole
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Anti-helmintic drug
Tx nematodes Affected parasites are expelled in feces Effective against hookworms, roundworms, pinworms, and whipworms Needs to be taken with high fat meal Stagger tx--first to kill adult, then to kill offspring Child itching around anus |
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Pyrantel Pamoate
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Anti-helmintic
Causes paralysis of organism, expels it in feces Roundworms, pinworms, hookworms |
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Ivermectin
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Anti-helmintic
DOC for tx of onchocerciasis (river blindness) common in Mexico, south america, and tropical africa ALso tx larva migrans and strongyloidiasis |
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Onchocerciasis (river blindness)
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Ivermectin
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Enterobiasis (pinworms)
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Mebendazole or pyrantel pamoate
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Ascariasis (roundworm disease)
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Pyrantel pamoate or mebendazole
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Hookworms
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Pyrantel pamoate or mebendazole
-unnecessary in asymptomatic without anemia |
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strongyloidiasis (threadworm)
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Thiabendazole or ivermectin
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Neuraminidase inhibitors
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Oseltamivir (Tamiflu) and Zanamivir (Relenza)
Prevents viral release Flu A and B |
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Oseltamivir (Tamiflu)
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Neuraminidase inhibitor
Prevents viral release Flu A and B PO AE: GI discomfort |
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Zanamivir (Relenza)
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Neuraminidase inhibitor
Prevents viral release Flu A and B Inhaled Bronchospasm |
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Amantadine and Rimantadine
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Prevents viral uncoating
Only Flu A 50% of pts will have resistance PO Amantadine penetrates CNS GI intolerance Amantadine AE: Insomnia, dizziness, hallucinations, sz |
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Ribavarin
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Prevents viral mRNA capping
Tx RSV Binds uracil or cytosine and causes viral mutations PO, IV, inhalation Doesnt cross BBB Appears in urine converted to phosphate derivatives AE: anemia CI in pg |
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Candida
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Amphotericin B
Ketoconazole Fluconazole (vaginal) Voriconazole Nystatin (thrush) |
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Histoplasmosis
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Amphotericin B
Ketoconazole Itraconazole (DOC for infx in AIDS) |
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Cryptococcus neoformans
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Amphotericin B
Fluconazole (DOC after Amph B) |
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Blastomycosis
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Amphotericin B
Ketoconazole Itraconazole (DOC) |
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Aspergillosis
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Amphotericin B
Voriconazole (DOC) |
|
|
Tinea corporis
|
Ketoconazole
Terbinafine (lamisil) Griseofulvin Ciclopirox Tolnafate |
|
|
Tinea cruris
|
Ketoconazole
Terbinafine (Lamisil) Tolnafate |
|
|
Tinea pedis
|
Ketoconazole
Terbinafine (Lamisil) Ciclopirox Tolnafate |
|
|
Tinea versicolor
|
Ketoconazole
Ciclopirox |
|
|
Onychomycosis
|
Fluconazole
Terbinafine (lamisil) Ciclopirox (if on distal nail) |
|
|
Sporotrichosis
|
Itraconazole (DOC)
|
|
|
Paracoccidiomycosis
|
Itraconazole (DOC)
|
|
|
Dermatophytosis
|
Terbinafine (DOC) (Lamisil)
Griseofulvin |
|
|
Malasessia furfur
|
Clotrimazole/Miconazole
|
|
|
Seborrheic dermatitis
|
Ciclopirox
|
