ABX review

• Extremely resistant TB

  Resistant to all Fluoroquinolones, Isoniazid (INH) and rifampin, and at least one of the injectable second line drugs
• Multidrug resistant TB

  Resistant to both Isoniazid (INH) and Rifampin
• Medications that create problematic interactions with other HIV antiviral drugs

  • Rifampin
  • Rifabutin
• Adverse effect of isoniazid therapy

  Peripheral neuropathy, which can be reversed with pyridoxine
• Medication that can be used for both prevention and treatment of malaria in chloroquine-resistant areas

  Atovaquone-proguanil
• Effect of rifampin

  Can change the color of body fluids to reddish orange
• TB medication that can cause decrease in vision

  Ethambutol
• Treatment for onychomychosis (toenail fungus)

  Terbinafine daily for 3 months
• Lab to monitor when taking terbinafine for toenail fungus

  Liver enzymes baseline and monthly
• Initial treatment for athlete's foot

  Terbinafine topical
• Treatment for vaginal Candidiasis

  Fluconazole 150 mg by mouth once
• Treatment for tinea capitis

  Griseofulvin by mouth daily
• Treatment for bacterial vaginosis

  Metronidazole gel 0.75%, one full applicator intravaginally once daily for 5 days
• Treatment for chlamydia

  Doxycycline 100 mg by mouth twice daily for 7 days
• Suppressive therapy for genital herpes

  Valacyclovir 500 mg by mouth daily for 1 year
• Treatment for uncomplicated cervical infection with gonorrhea and chlamydia

  Ceftriaxone 500 mg IM plus Doxycycline 100 mg by mouth twice daily for 7 days
• Treatment for primary syphilis

  Benzathine penicillin G (Bicillin LA) IM
• Treatments for trichomoniasis

  • Metronidazole 500 mg by mouth twice daily for 7 days
  • Tinidazole 2 gram by mouth in a single dose
• Instructions for patient taking metronidazole

  • Metronidazole can cause a disulfiram-like reaction if taken with alcohol
  • Alcohol must be avoided completely during treatment and for 72 hours after treatment
• Lab test to order prior to starting antivirals for shingles in a 70 year old diabetic

  BUN/Cr
• Medication used for herpes labialis

  Penciclovir
• Antivirals that can be given if started within 48 hours of onset of flu symptoms


  • Oseltamivir
  • Zanamivir
• Antiviral that the CDC no longer recommends for flu due to resistance

  Amantadine
• Mechanism of action of penicillins and cephalosporins

  Weakening the cell wall and promoting lysis and death
• Bactericidal drugs

  Directly lethal to bacteria at achievable concentrations
• Reason narrow spectrum antibiotics are preferred over broad spectrum

  Broad spectrum antibiotics do the most to facilitate emergence of resistance
• Mechanisms of bacterial resistance to penicillins

  • Production of penicillin binding proteins that have low affinity for penicillins
  • Inability of penicillins to reach their target
  • Inactivation of penicillins by bacterial enzymes
• Appropriate antibiotic for patient with penicillin allergy and strep throat

  Azithromycin
• Penicillinases

  Beta-lactamases that act selectively on penicillins
• Penicillinase-Resistant Penicillins

  • Nafcillin
  • Dicloxacillin
  • Oxacillin
• Broad-spectrum Penicillins (aminopenicillins)

  • Amoxicillin
  • Ampicillin
• Extended-Spectrum Penicillins (antipseudomonal)

  Piperacillin
• Beta-lactamase Inhibitors

  • Clavulanic acid
  • Sulbactam
  • Tazobactam
• Antibiotic that should not be prescribed for an alcoholic patient

  Cefazolin
• Cephalosporins that are rarely used for active infections

  First generation
• Cephalosporin that should not be prescribed for a patient on coumadin

  Ceftriaxone
• Condition that third generation cephalosporins are good to treat

  Meningitis
• Condition that fourth generation cephalosporins are good to treat

  Pneumonia
• Mechanism of action of vancomycin

  Inhibiting cell wall synthesis
• Mechanism of action of fluoroquinolones

  Disrupting DNA replication and cell division