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NAPLEX
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136
Other
Professional
07/08/2012

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Term
CAP smokers organisms
Definition
H. flu, M catarrhalis
Term
What population of CAP are GNRs seen?
Definition
ICU, pts with underlying illness
Term
Risk factors for Pen-resistance?
Definition
<2 or >65. B-lactam use within 3 m, alcoholism,comorbidities, immunosuppressed, child in day care
Term
Quinopristin/dalfopristin
Definition
Synergid, binds 50s subunit, not active versus enterococcus faecium
Term
Cefdiroten
Definition
Spectracef, 3rd gen ceph, pen resistant strept pneumo, H. flu and MMSA. Take with high fat meal
Term
Tekithromycin
Definition
Ketek, mild to mod CAP. HEPATOTOXIC!Not for pts with liver problems! QTc prolongation
Term
Moxifloxacin
Definition
Avelox. QTc prolongation (don't use with class Ia/IV antiarrthythmics)Tendonitis + tendon rupture risk
Term
Ceftaroline
Definition
Teflaro. IV 5th gen ceph. MRSA coverage
Term
tx CAP Outpatient therapy
Definition
macrolide OR doxy OR FQ OR Augmenin if suspected aspiration
Term
tx CAP Inpatient non-ICU
Definition
CefTRI, OR Cefotax + macrolide OR B-lactam with B-lactamase inh. + macrolide OR Resp FQ
Term
tx CAP Inpatient ICU
Definition
Ceftri, OR cefotax OR B-lactam with B-lactamase inh.(ie Zosyn) + macrolide or FQ
Pen allergy: FQ + aztreonam
Term
UTI relapse vs reinfection
Definition
relapse: same organism, <14 days after completion of antibiotics
Reinfection: same OR diff organism, >14 days after antibiotics
Term
UTI: When and with what to prophylax
Definition
2_ infections within 6 months or 3+ infectiosn within a year. 1/2 DS Bactrim q hs or 3x/week OR Nitrofurantoin 50-100 q hs
Term
Tx UTI in pregnancy
Definition
Nitrofurantoin up to 3rd trimester. Bactrim in 2nd trimester only, 2nd gen cephs are safe
Term
Zidovudine
Definition
Retrovir NRTI. anemia, NVD, LFT inc
Term
Didanosine
Definition
Videx NRTI. pancreatitis, inc SCr
Term
Lamivudine
Definition
Epivir NRTI.
Term
Abacavir
Definition
Ziagen NRTI. HYPERSENSITIVITY, NVD
Term
Tenofovir
Definition
Viread NRTI
Term
Emtricitabine
Definition
Emtriva NRTI
Term
Lamivudine/Zidovudine
Definition
Combivir 2NRTIs
Term
Abacavir/Lamivudine/Zidovudine
Definition
Trizivir 3 NRTIs
Term
Abacavir/Zidovudine
Definition
Epzicom 2 NRTIs
Term
Emtricitabine/Tenofovir
Definition
Truvada
Term
Emtricitabine/Tenofovir/Efavirenz
Definition
Atripla (2 NRTIs + 1 NNRTI)
Term
Nevirapine
Definition
Viramune (NNRTI)CYP3A4 Inducer
Term
Efavirenz
Definition
Sustiva (NNRTI) CNS SE (dizziness, somnolence, insomnia, confusion)
Term
Etravirine
Definition
Intelence NNRTI
Term
Rilpivirine
Definition
Edurant (NNRTI)
Term
Indinavir
Definition
Crixivan PI. Must drink >1.5L water daily to prevent kidney stones
Term
Nelfinavir
Definition
Viracept PI
Term
Ritonavir
Definition
Norvir PI
Term
Saquinavir
Definition
Fortovase PI take w high fat meal
Term
Lopinavir/Ritonavir
Definition
Kaletra PI
Term
Darunavir
Definition
Prezista PI, used later when resistance develops
Term
Enfuvirtide
Definition
Fuzeon (fusion inhibitor)
Term
Raltegravir
Definition
Isentress (Integrase inhibitor)
Term
Maraviroc
Definition
Selzentry (CCR5 antagonist)
Term
HIV: PI side effects
Definition
NVD, gynecomastia and METABOLIC:abnormal fat distribution, inc. cholesterol, insulin resistance
Term
HIV: P.Jiroveci Prophx and Tx
Definition
Proph: when CD<200 1 Bactrim DS daily
Tx: 15-20 mg/kg/day Bactrim x 21 days
Term
HIV: CMV Tx
Definition
Tx: Ganciclovir OR valganciclovir OR cidofovir+ probenecid
Term
HIV: Varicella Tx
Definition
Tx: Acyclovir
Term
HIV: Toxoplasmosis Prophx and Tx
Definition
Proph: when CD<100 1 Bactrim DS daily
Tx: Pyrimethamine + folinic acid + sulfadiazene
Term
HIV: MAC Prophx and Tx
Definition
Proph: when CD<50 1200mg azithromycin q weekly
Term
HIV: Cryptococcal meningitis Tx
Definition
Amphotericin B + flucytosine x 2 weeks, then fluconazole x 8-10 weeks
Term
HIV: Pregnancy Tx
Definition
Regimen must have zidovudine. Avoid: efavirenz, stavudine, amprenavir
Term
TB: Prophx for exposed pts
Definition
Isoniazid (INH) x 6-9 m
Term
Isoniazid
Definition
Neuropathy:Vit B 6 deficiency, Inh CYP450
Term
Rifampin
Definition
Discolors bodily fluids to orange/red/strong inducer 3A4, 1A2, 2C19
Term
Pyrizinamide
Definition
(PZA) inc Uric acid, hepatotoxic
Term
Ethambutol (ETH)
Definition
inc Uric acid, Optic neuritis! don;t use in very young/old with visual problems. ONLY TB drug that's renally eliminated, all other through liver!
Term
Ketoconazole
Definition
Nizoral
Term
Fluconazole
Definition
Diflucan. Best bioavailability and CSF penetration, renal excretion (ALL others through liver!)
Term
Itraconazole
Definition
Sporonox
Term
Voriconazole
Definition
Vfend SE- vidual changes, photosensitivity) DOC for Aspergillus
Term
Posaconazole
Definition
Noxafil
Term
AZOLES MOA and side effects
Definition
MOA : inh ergosterol synthesis
SE: LFT elevations, GI, endocrine (ketoconazole only)
Term
Capsofungin
Definition
Cancidas, echinocandin (inh. beta glucan synthetase)
Term
Micafungin
Definition
Mycamine. Infuse slowly to avoid histamine reaction. can use in pts with bad kidneys/liver
Term
Anidulafungin
Definition
Eraxis
Term
Amphotericin B
Definition
Nephrotoxic(but reversible, give NS bolus before and after)! Infusion site reactions (premed with hydrocortisonem meperidine and ibuprofen)HypoKalemia, hypoMagnesemia
Term
Tigecycline
Definition
Tygacil MRSA, strept, e. coli, klebsiella
Term
Televancin
Definition
Vibativ. MRSA, teratogenic
Term
Daptomycin
Definition
Cubicin. Staph, Strept, enterococcus. not for PNA
Term
HIV: Which agents to avoid in peripheral neuropathy?
Definition
didanosine, stavudine, zalcitabine
Term
Renal threshold for glucose
Definition
>180 mg/dL
Term
Sulfonylurea of choice in RF
Definition
Glipizide (Glucotrol)
Term
Glimepiride, Glipizide, Glyburide
Definition
Glimepiride -Amaryl,Glipizide- Glucotrol, Glyburide- Micronase. Sulfonylureas - enhance insulin secretion and sensitivity
Term
Repaglinide, Nateglinide
Definition
Repaglinide-Prandin, Nateglinide-Starlix. Meglitanides - promote insulin secretion
Term
Miglitol
Definition
Glyset alpha-glucosidase inh.
Term
Exenatide, liraglutide
Definition
Byetta, Victoza. GLP-1 agonists, enhance insulin synthesis and secretion, decrease glucagon
Term
Sitagliptin, Saxagliptin, Linagliptin
Definition
Januvia, Onglyza, Trajenta. DPP-4 Inh --> inc GLP-1--> enhance insulin synthesis and secretion, decrease glucagon
Term
Pramlintide
Definition
Symlin. Amylin analog. suppresses glucagon
Term
Tx for PUD
Definition
1) Helidac (Bismuth subsalicylate, metronidazole, tetracycline) + H2 antag OR PPI x 2 weeks
2)Amoxicillin + Clarithromycin + PPI
3)If PCN ALL: metronidazole + clarithrpmycin + PPI
Term
Tamoxifen, Tamorifene
Definition
Nolvadex and Fareston. SERM start after chemo for 5 years in pts for at high risk for breast cancer reccurence. not beneficial in women >60 (high risk of complications)
Term
Anastrozole, letrozole, exemestane
Definition
Anastrozole (Arimidex), letrozole (Femara), exemestane (aromastin) - aromatase inhibitors- suppress estroge production. for postmenopausal women not responding to tamoxifen
Term
goserelin
Definition
Zoladex - stops estrogen production in premenopausal women with estrogen sensitive breast CA
Term
raloxifene
Definition
Evista. SERM for post menopausal women in their 60s to prevent breast CA
Term
Trichomonas Sx and Tx
Definition
sx: discharge, frothy/foamy/yellow-green, fould smelling. vaginal itching, swelling,pain, strawberry spots on cervix
tx: metronidazole 2g po x 1 OR Tinidazole (tindamax) 2g po x 1
Term
Chlamydia sx and tx
Definition
sx: mucopurulent discharge, painful urination, urinary frequency, PID
Tx: Azithromycin 1g po x 1 OR
Doxycycline 100mg po BID x 7 days
Term
Gonorrhea sx and tx
Definition
abnormal discharge, painful urination, frequency
tx: ceftriaxone 250 mg IM x 1 OR cefixime 400 po x 1 OR
cipro 500 po x 1
Term
Syphilis (treponema pallidum) sx and tx
Definition
primary: single painless ulcer - benzathine pen G 2.4MU IM x 1
secondary: widespread rash (palms and soles), enlarged lymph nodes- benz penG 2.4 MU IM q week x 3
Tertiary:cardiac, neurologic, opthalmic, and auditory complications. tx: aq crystalline penG 18-24MU/day in 6 div doses or cont. infusion x10-14days
Term
HBV: drugs used to treat
Definition
adefovir, tenofovir, emtricitabine, entecavir
Term
methotrexate
Definition
Rheumatrex - 1st line therapy for RA, 7.5-20mg/week SE- rash, pruritits, thrombocytopenia, leuokopenia, liver/pulm fibrosis
Term
Hydroxychloroquine
Definition
plaquenil
Term
Leflunamide
Definition
Arava. inhibits progression of structural damage in RA SE - NVD, alopecia, HTN, HA, inc LFTs
Term
RA: What agents to use for severe unresponsive cases?
Definition
Cyclophosphamide, cyclosporine (neoral/gengraf), azathioprine (Imuran)
Term
Etanercept
Definition
Enbrel. TNF a and b inhibitor. injection. SE: infection!
Term
Infliximab
Definition
Remicade. TNFa inh used w methotrexate. injections.
Term
Adalimumab
Definition
Humira. TNFs inhibitor. SQ injection. SE: infections. NEED TB TEST PRIOR TO INITIATION
Term
Anakinra
Definition
Kineret. IL-1 antagonist. DO NOT COMBINE with TNF inh!
Term
Abatacept
Definition
Orencia. T-cell modulator for RA
Term
Golimumab
Definition
Simponi. TNF-a inh. injection
Term
Certolizumab
Definition
Cimzia. TNFa inh. for RA and Crohn's
Term
Tocilizumab
Definition
Actemra, Genentech. Used when TNF-a arent working. NOT to be combined with live vaccines. IF ANC<2000 or PLT<100, or elevetaed LFTs do not start!
Term
Rituximab
Definition
Rituxan. modulates B-cell activation. Used for ppl unresponsive to TNF-a inh. infused with steroids. SE: severe infusion reactions!
Term
Formula for adjusted calcium
Definition
Ca (corrected) = Ca (serum) + 0.8(4-albumin)
Term
Calories per mL in 10% and 20% lipids
Definition
10% - 1.1kcal/mL 20% 2kcal/mL
Term
Max carbohydrates and fat/ day that liver can handle
Definition
carbs - 4mg/kg/min or 7g/kg/day
lipids - 2.5 g/kg/day
Term
? g protein for 1 g nitrate
Definition
6.25g protein for 1 g N
Term
how much insulin to add to TPN bag?
Definition
1/2 previous day's sliding scale
Term
Formula for E (NaCl equivalent)
Definition
E=[(58.5)(i)]/(MW x 1.8)
i=1, 1.8,2.6,3.4,4.2 (1= doesn't dissociate 1.8 dissociates into 2 etc)
Term
formula for mEq
Definition
mEq= (mg x valence)/MW
Term
mOsm/L formula
Definition
(g/L)/MW x valence x 1,000
Term
Amoxicillin
Definition
Amox, Moxatag
Term
Ampicillin
Definition
Principen
Term
Ampicillin/sulbactam
Definition
Unasyn
Term
Piperacillin/tazobactam
Definition
Zosyn!
Term
Ticarcillin/clavulanic acid
Definition
Timentin
Term
Cephalexin
Definition
Keflex 1st gen
Term
Cefprozil
Definition
Cefzil 2nd gen
Term
Cefdinir
Definition
Omnicef 3rd gen
Term
Ceftazidime
Definition
Fortaz, Tazicef
Term
Ceftriaxone
Definition
Rocephin
Term
Cefepime
Definition
Maxipime
Term
Imipenem/cilastin
Definition
Primaxin
Term
Meropenem
Definition
Merrem
Term
Ertapenem
Definition
Invanz
Term
Doripenem
Definition
Doribax
Term
Clarithromycin
Definition
Biaxin
Term
doxycycline
Definition
Vibramycin
Term
Minocycline
Definition
Solodyn
Term
Sulfamethoxazole/trimethoprim
Definition
Bactrim/Spetra. 800 mg SMZ/160 mg TMP - DS 5:1 ratio =)
Term
Linezolid
Definition
Zyvox. MAOI effect! avoid tyramine, things that inc serotonin, and stimulants (amphetamines, dextromethorphan, meperidine)
Term
Aztreonam
Definition
Azactam
Term
Clindamycin
Definition
Cleocin
Term
Nitrofurantoin
Definition
Macrobid, Macrodantin not for pts with renal impairment (<60ml/min)
Term
Surg Proph: CABG/vascular/hip/knee suregries
Definition
Cefazolin, cefuroxime, or Vanc
Term
Surg Proph: Colon
Definition
Have to cover for anaerobes! cefotetan, cefoxitin, Unasyn, or ertapenem OR either cefuroxime or cefazolin with metronidazole.
Term
Surg Porph: Hysterectomy
Definition
cefotetan, cefoxitin,cefuroxime or cefazolin, or unasyn
Term
Tx: Otitis media
Definition
amox 90mg/kg/day in BID or TID
amox/clav or 2nd gen cef
Pn allergy: macrolide/clinda or SMX/TMP
severe : 10d
mild-mod: 5-7 days
Term
Tx: Endocarditis : MSSA
Definition
oxacillin/nafcillin +/- gent OR Vanc +/- gent if PEN allergy
Term
Tx: Endocarditis: Strept
Definition
PenG +gent x 2 weeks OR
PenG x 4 weeks OR CefTRI x 4 weeks
Term
Tx: Endocarditis: Enterococcus
Definition
PenG OR Ampicillin + Gent
If Gent resistant: Use Streptomycin instead
IF Pen resistant: Vanc + Gent
If Vanc resistant: Linezolid or Synergid
Term
Tx: Ricketsia
Definition
Doxycycline for most things!
Term
Tx: Meningitis
Definition
Empiric: 3rd gen Cef + Dexamethasone + vanc (If listeria susoected <1m >50 add ampicillin)
Pen allergy: Chlorphenocol + Vanc
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