Pharm Study Guide – Flashcards
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Focused Gram Positive Coverage
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1st generation cephalosporins antistaphylococcal penicillins clindamycin vancomycin
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Focused Gram Negative Coverage
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3rd generation cephalosporins aminoglycosides aztreonam quinolones
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Excellent Anaerobic Coverage
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2nd generation cephalosporins ß-lactamase inhibitor combos carbapenems clindamycin metronidazole tigecycline
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Broad Spectrum Therapy
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ß-lactamase inhibitor combos carbapenems tigecycline cefipime (no anaerobic coverage)
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Pseudomonal Coverage
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aminoglycosides antipseudomonal penicillins aztreonam cefipime ceftazidime (Fortaz) ciprofloxacin
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MRSA-inpatient therapy
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vancomycin linezolid (Zyvox)
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MRSA-community acquired
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bactrim clindamycin minocycline or doxycycline linezolid (Zyvox) rifampin
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Systemic Fungal Infections
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amphoteracin B & others flucanazole & other "azoles"
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Genital Herpes
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acyclovir, valacyclovir, or famciclovir
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Treat Clostridium difficile Diarrhea
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metronidazole oral vancomycin
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Atypical Pathogens
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macrolides quinolones tetracyclines
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Urinary Tract Infections
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bactrim quinolones nitrofurantoin
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Prostate Infections
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bactrim quinolones
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Chlamydia trachomatis (STD)
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doxycycline x 7 days azithromycin x 1 dose ofloxacin or levofloxacin x 7 days
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Pelvic Inflammatory Disease
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cefotetan or cefoxitin + doxycycline clindamycin + gentamicin + doxycycline ceftriaxone + doxycycline +/- metronidazole
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Bacterial Vaginosis
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metronidazole clindamycin
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Gonorrhea
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ceftriaxone (Rocephin) IM x 1 cefixime (Suprax) po x 1 cefpodoxime (Vantin) x 1
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Group A Strep Throat (Strep pyogenes)
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benzathine PCN G IM x 1 or oral PCN x 10 days amoxicillin macrolides if allergic to PCN
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Acute Sinusitis
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amoxicillin x 10 -14 days bactrim 2nd gen cephalosporins (cefuroxime, cefaclor) 3rd gen cephalosporins (cefpodoxime, cefixime) doxycycline macrolides moxifloxacin levofloxacin
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Otitis Media
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amoxicillin x 10 days erythromycin / sulfisoxazole macrolides 2nd gen cephalosporins (cefuroxime, cefaclor) 3rd gen cephatlosporins (cefpodoxime, cefixime, cefprozil)
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Community Acquired Pneumonia (outpatient)
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doxycycline macrolides quinolones (levofloxacin, moxifloxacin)
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Community Acquired Pneumonia (inpatient)
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add ceftriaxone or cefotaxime to CAP therapy
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Aspiration Pneumonia
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add clindamycin to CAP therapy add metronidazole to CAP therapy amoxicillin/clavulanate if very ill... carbapenems piperacillin/tazobactam ticarcillin/clavulanate
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Hospital Acquired Pneumonia
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ceftriaxone levofloxacin moxifloxacin
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Hospital Acquired Pneumonia (multi-drug resistant)
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piperacillin/tazobactam cefepime carbapenem + gentamicin + vancomycin if suspect MRSA
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Acne
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tetracyclines topical clindamycin topical macrolides
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Potential to lower seizure threshold
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carbapenems quinolones
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Nephrotoxicity
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aminoglycosides amphoteracin B bactrim vancomycin
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Cause Clostridium difficile Diarrhea
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any antibiotic can but especially those that are more broad spectrum and alter the GI flora to a greater extent clindamycin ampicillin 3rd gen cephalosporins
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Alterations in urine color
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nitrofurantoin rifampin
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Infusion-related reactions
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fever, chills, rigors: amphoteracin & caspofungin red man syndrome: vancomycin
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Issues with teeth & bone development
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quinolones ("quinolones go to the bones") tetracyclines (teeth) tigacycline
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Chelation interactions
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tetracyclines quinolones
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p450 metabolism interactions
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isoniazid macrolides (azithromycin less so) oral antifungal drugs quinolones rifampin several HIV antivirals synercid
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protein-binding interactions
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bactrim
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if anaphylactic PCN allergy
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no PCN no carbapenems no cephalosporins everything else is ok
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if non-anaphylactic PCN allergy
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no PCN no carbapenems everything else is ok
