415 Exam 4 Drugs Flashcards

1
Q

What is the DOC for uncomplicated gonorrhea infections of the cervix, urethra, and rectum

A

Ceftriaxone 250mg IM once
Plus
Azithromycin 1g PO once OR
Doxycycline 100mg PO BID for 7 days

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2
Q

DOC for chlamydia

A

Azithromycin 1g PO once OR

Doxycycline 100mg PO BID for 7 days

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3
Q

DOC for patient who has chlamydia AND gonorrhea

A

Azithromycin 2g PO once

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4
Q

DOC for treatment of chlamydia in pregnant patients

A

Erythromycin base 500mg QID for 7 days OR

Amoxicillin 500mg TID for 7 days

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5
Q

DOC for trichomoniasis treatment

A

Metronidazole (Flagyl)

  • short course: 2g PO once
  • extended course: 500mg PO BID for 7 days
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6
Q

DOC for outpatient PID patients

A

Ceftriaxone 250mg IM once
plus
Doxycycline 100mg BID for 14 days
+/- Metronidazole 500mg BID for 14 day

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7
Q

DOC for inpatient PID patients

A

Cefoxitin 2g IV q6h
plus
Doxycycline 100mg IV q12h

Continue for 24 hours after improvement then follow with:
Doxycycline 100mg PO BID to complete 14 days of treatment

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8
Q

DOC for primary, secondary, and early latent (<1 year duration with neg CSF) syphilis

A

Benzathine Penicillin G 2.4 MU IM once

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9
Q

DOC for latent (neg CSF >1 year or unknown duration) syphilis

A

Benzathine Penicillin G 2.4 MU IM weekly for 3 weeks

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10
Q

DOC for neuro/cardiovascular syphilis

A

Aqueous Penicillin G 3-4 MU IV q4h for 10-14 days

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11
Q

DOC for first episode of genital herpes

A

Acyclovir (Zovirax) 400mg TID or 200mg 5x/day OR
Valacyclovir (Valtrex) 1g BID OR
Famiciclovir (Famvir) 250mg TID
For 7-10 days

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12
Q

DOC for recurrent/episodic genital herpes

A

Acyclovir (Zovirax) 400mg TID or 200mg 5x/d or 800mg BID for 5 days (or 800mg TID for 2 days) OR

Valacyclovir (Valtrex) 500mg BID for 3 days or 1g QD for 5 days OR

Famiciclovir (Famvir) 125mg BID for 5 days or 1000mg BID for 1 day or 500mg once followed by 250mg BID for 2 days

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13
Q

DOC for suppressive therapy for genital herpes

A

Acyclovir (Zovirax) 400mg BID OR
Valacyclovir (Valtrex) 500mg QD or 1g QD OR
Famiciclovir (Famvir) 250mg BID daily

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14
Q

DOC for severe disseminated herpes simplex

A

Acyclovir (Zovirax) 5-10 mg/kg IV q8h until clinical improvement followed by oral for a total of at least 10 days

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15
Q

DOC for mild to moderate CDAD

A

Metronidazole 500mg TID for 10-14 days
OR
Vancomycin PO 125-500mg QID

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16
Q

DOC for severe CDAD

A

Vancomycin PO 125-500mg QID
plus
Metronidazole 500mg QID-TID for 10-14 days

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17
Q

DOC for patients who have toxic megacolon

A

Metronidazole 500mg IV QID for 10-14 days
OR
Vancomycin retention enema 500-1000mg in 1-2L of isotonic saline q4-12h

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18
Q

DOC for the first recurrent episode of CDAD

A

Vancomycin PO 125-500mg QID
plus
Metronidazole 500mg QID-TID for 10-14 days

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19
Q

DOC for the second recurrent episode of CDAD

A

Tapering dose of oral Vancomycin

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20
Q

DOC for the third recurrent episode of CDAD

A

Vancomycin 125mg QID for 14 days
following by
Rifixamin 400mg BID for 14 days

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21
Q

alternative (expensive) options for treating CDAD

A

Fidaxomicin (Dificid) 200mg BID

Bezlotoxumab (Zinplava)

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22
Q

DOC for folliculitis (if antibiotics needed)

A

Topical antibiotics: clindamycin, erythromycin, or mupirocin 2% ointment applied 3 times daily for 3-5 days

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23
Q

antibiotics recommended for persistent carbuncle treatment

A

Cephalexin 250-500mg q6h

Dicloxacillin 250-500mg q6h

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24
Q

DOC for erysipelas

A

Penicillin VK 250-500 PO q6h OR
Procaine Penicillin G 600,000 units IM q12h (or 1MU q4h)
Clindamycin 150-300 q6-8h
Erythromycin 250-500mg q6h

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25
Q

DOC topical treatment for impetigo

A

Mupirocin 2% (Bactroban) BID for 5 days

If MRSA: Retapamulin (Altabax) BID for 5 days

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26
Q

systemic treatment is given for MSSA or Strep impetigo

A

Dicloxacillin
Cephalexin
Erythromycin
Clindamycin (ONLY for PCN allergy)

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27
Q

systemic treatment is given for MRSA impetigo

A

Clindamycin
TMP/SMX
Doxycycline

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28
Q

DOC for cellulitis WITHOUT systemic manifestations (MRSA not suspected)

A

Cephalexin 500mg QID
Dicloxacillin 500mg QID
Clindamycin 300-450mg QID (last choice)
5-10 days

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29
Q

DOC for cellulitis WITHOUT systemic manifestations (MRSA suspected)

A

Doxycycline 100mg BID
Clindamycin 300-450mg QID
TMP/SMX DS 1 tab BID
5-10 days

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30
Q

DOC for cellulitis WITH moderate to severe infection (MRSA not suspected)

A

Cefazolin 1g IV q8h
Nafcillin or Oxacillin 1-2g IV q4h
Clindamycin 600mg IV q8h

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31
Q

DOC for cellulitis WITH moderate to severe infection (MRSA suspected)

A

Vancomycin 15-20mg/kg q12-8h (max dose 2g, goal trough 10-15)

Add Zosyn for anaerobes

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32
Q

DOC for cellulitis with moderate to severe infection and possible polymicrobial (including anaerobes)

A

Zosyn 3.375g q6h

Meropenem 1-2g q8h

Ceftazidime 1g q8h or Cefepime 2g q12h plus Metronidazole

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33
Q

DOC for type 1 necrotizing faciitis

A
Zosyn 3.375 IV q6h OR Meropenem 1-2g q8h 
*plus* 
Clindamycin 600-900mg IV q8h 
*plus* 
Vancomycin (daptomycin or linezolid)
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34
Q

DOC for type 2 necrotizing faciitis

A

Clindamycin and Penicillin G

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35
Q

DOC for mild diabetic foot ulcers

A
  • Amoxicillin/clavulanate
  • Clindamycin + cephalexin
  • Levofloxacin + Clindamycin
36
Q

DOC for moderate to severe diabetic foot ulcers

A

Zosyn 3.375g q6h
Meropenem 1-2g q8h
Ceftazidime 1g q8h or Cefepime 2g q12h
plus Metronidazole

37
Q

DOC for mild human/dog/cat bite treatment

A
  • Amoxicillin/clavulanate

- TMP/SMX + Clindamycin or Metronidazole

38
Q

Empiric therapy for primary SBP

A

Ceftriaxone
Ceftazadime
Cafotaxime
Cefepime

39
Q

anaerobic agent can be added to primary SBP therapy if absence of response

A

Clindamycin

Metronidazole

40
Q

treatment recommendations of secondary bacterial peritonitis (combinations)

A

Clindamycin or Metronidazole
plus
Antipseudomonal quinolone (Cipro) or Aminoglycoside

41
Q

treatments of secondary bacterial peritonitis that do not require a combination

A
*Zosyn* 
Unasyn 
Imipenem/cilastin 
Meropenem 
Ertapenem
42
Q

treatment recommendations for continuous ambulatory peritoneal dialysis-associated peritonitis

A

-Vancomycin (if G+) 30mg/L
-Aminoglycoside (8mg/L) or Cipro (if G-)
IV or intraperitoneal

43
Q

treatment recommendations for acute cholecystitis and cholangitis

A

Zosyn or Aminoglycoside plus Clindamycin or Metronidazole
Ceftazadime or cefepime plus Metronidazole or Clindamycin
Carbapenem

44
Q

single-dose therapy for UTIs

A
Fosfomycin tromethamine (Monurol) 
-single dose 3g powder packet dissolved in water (take on empty stomach)
45
Q

three day therapy for uncomplicated simple UTI

A

TMP/SMX DS (Bactrim DS) BID for 3 days

46
Q

seven day DOC therapy for UTI

A
  • TMP/SMX DS BID
  • Amoxicillin/clavulanate 875mg BID
  • Amoxicillin 500mg TID
  • Nitrofurantoin 100mg BID
47
Q

outpatient treatment recommendations for acute pyelonephritis (nonpregnant women)

A

-TMP/SMX BID for 14 days
-Cirpro 500mg BID for 7 days
-Ceftriaxone 1g IV/IM once plus TMP/SMX or beta lactam
Follow up with culture at completion of therapy

48
Q

empiric therapy for inpatient pyelonephritis

A
  • ceftriaxone 1g q24h
  • Zosyn 4.75g q8h
  • Ertapenem or Meropenem
  • Cipro IF local resistance <10%
49
Q

prophylaxis treatment should be given if recurrent UTI is related to intercourse

A

TMP/SMX 1 tab or
Nitrofurantoin 50-100mg or
Cephalexin 250mg
after intercourse

50
Q

prophylaxis treatment should be given if recurrent UTI is unrelated to intercourse

A

TMP/SMX 1/2 tab at bedtime or 1 tab 3x/week or
Nitrofurantoin 50-100mg at bedtime or
Cephalexin 250mg at bedtime

51
Q

DOC for bacterial prostatitis (when N. gonorrhea is NOT suspected)

A

TMP/SMX 10-14 days

do not give quinalones empirically

52
Q

DOC for athlete’s foot, ringworm, jock itch

A

OTC therapy—Antifungals

  • Clotrimazole
  • Miconazole
  • Butenafine
  • Terbinafine
  • Tolnaftate
53
Q

DOC for Interdigital tinea pedis, tinea cruris, tinea corporis

A

Naftifine (Naftin 1 or 2% cream and gel)

Luliconazole (Luzu 1% cream)

54
Q

DOC for onychomycosis

A

Terbinafine (Lamisil) 250mg/day 6-12 weeks

55
Q

DOC for uncomplicated vulvovaginal candidiasis

A

Topical: Clotrimazole (1, 2, 10%), Micronazole (2%), Miconazole supp, Ticonazole (2,6%)

Oral: Fluconazole 150mg daily

Nystatin 100,000unit daily intravaginally 14 days

56
Q

DOC for recurrent vulvovaginal candidiasis

A

Fluconazole 150mg qw x6 months

57
Q

DOC for oropharyngeal candidiasis in healthy uncomplicated, HIV pts on HAART w/mild OPC and minimal esophageal likelihood

A

Nystatin topical
Clotrimazole troches
Miconazole buccal

58
Q

DOC for oropharyngeal candidiasis in patients with refractory to topical OTC and cannot tolerate topical , moderate to severe disease and high risk for systemic disease

A

Systemic therapy
FLuconazole
Itraconazole solution

59
Q

DOC for systemic Candida in immunocompetent adults

A

Echinocandins or

Fluconazole 800mg load then 400mg (IF C. albicans)

60
Q

DOC for systemic Candida in Immunocompromised patients

A

Echinocandins

61
Q

DOC for esophageal candidiasis

A

Fluconazole 200-400mg PO QD for 14-21 days

62
Q

DOC symptomatic Candiduria

A

Fluconazole 200mg daily for 2 weeks

Alternative: AmB bladder irrigation

63
Q

DOC for Aspergillosis

A

Azoles

64
Q

DOC for invasive Aspergillosis

A

Voriconazole (start with IV, switch to PO) 6-12 weeks

65
Q

DOC for allergic bronchopulmonary aspergillosis

A

Itraconazole or Voriconazole plus steroid

66
Q

DOC for Aspergilloma

A

Surgery then Itraconazole or Voriconazole

67
Q

DOC Non-HIV patients for cryptococcosis

A

Fluconazole 6-12 months
Induction: AmB + Flucytosine 4weeks
Consolidation: Fluconazole 400-800mg for 8 weeks
Maintenance: Fluconazole 200mg for 6-12 months

68
Q

DOC for HIV patients with cryptococcosis

A

Fluconazole for life
Indication: AmB + Flucytosine for 4 weeks
Consolidation: Fluconazole 400mg for 8 weeks
Maintenance: Fluconazole 200mg for > 1year

69
Q

DOC for acute pulmonary histoplasmosis

A

Ampho B with steroid then Itraconazole for 12 weeks

70
Q

DOC for chronic pulmonary histoplasmosis

A

AmphoB then Itraconazole for 12-24 months

71
Q

DOC for non-AIDS disseminated histoplasmosis

A

AmphoB then ITZ for at least 12 months

72
Q

DOC AIDS disseminated histoplasmosis

A

AmphoB then Itraconazole for life

73
Q

DOC for pulmonary life-threatening blastomycosis

A

Lipid AmphB then Itraconazole 6-12 months

74
Q

DOC for pulmonary mild-moderate blastomycosis

A

Itraconazole 6-12 months

75
Q

DOC for disseminated CNS blastomycosis

A

Lipid AmphoB for 4-6weeks then Itraconazole or Voriconazole for 12 months

76
Q

DOC for Immunocompromised hosts with blastomycosis

A

Lipid AmphB then Itraconazole for life

77
Q

DOC for initial coccidioidomycosis

A

Fluconazole 400-1200mg daily for life

78
Q

DOC for influenza

A

Oseltamivir (Tamiflu)
Zanamivir (Relenza)
Peramavir (Rapivab)

79
Q

DOC for Herpes simplex virus

A
*Acyclovir (Zovirax)*
Valacyclovir (Valtrex) 
Famciclovir (Famvir) 
Penciclovir (Denavir) 
Foscarnet (Foscavir)
80
Q

DOC for herpes labialis primary disease

A

Acyclovir
Famciclovir
Valacyclovir

81
Q

DOC for Herpes labialis reactivation disease

A

Acyclovir
Famciclovir
Valacyclovir
Penciclovir 1% cream

82
Q

DOC for Varicella-Zoster virus

A

Acyclovir (Zovirax)
Valacyclovir (Valtrex)
Famciclovir (Famvir)
Penciclovir (Denavir)

83
Q

DOC for immunocompetent persons with herpes zoster

A

Acyclovir
Famciclovir
Valacyclovir

84
Q

DOC for immunocompromised persons with herpes zoster

A

Acyclovir (severe: IV, non-severe: PO)
Famciclovir
Valacyclovir
Foscarnet (acyclovir resistant)

85
Q

DOC for CMV antiviral therapy for treatment and prophylaxis

A
*Ganciclovir (Cytovene)* 
Valganciclovir (Valcyte) 
Foscarnet (Fascavir) 
Cidofovir (Vistide) 
CMV immune globulin (CytoGam)