Vector-Borne Diseases & GU Infections

Nitrofurantoin brand name:

Macrobid

Macrobid class:

Nitrofuran

Macrobid monitoring:

CBC, LFT, pulmonary rxn

Macrobid adverse reactions:

C. diff, drug-induced liver injury, peripheral neuropathy, pulmonary toxicity, nausea, increased phosphate, brown urine

Main pathogen(s) Macrobid covers:

Some G+: Staphylococcus saprophyticus

Some G-: E. coli

Macrobid renal/hepatic adjustments:

CrCl <30: contraindicated

Macrobid dosage for acute uncomplicated cystitis:

100 mg po bid

female: x5 days

male: x7 days

Macrobid dosage for cystitis prophylaxis:

100 mg po qhs

Phenazopyridine brand name:

Pyridium

Pyridium class:

Analgesic

Pyridium monitoring:

serum glucose if pt has diabetes

Pyridium adverse reactions:

rash, headache, urine discoloration (orange or red)

Pyridium renal/hepatic adjustments:

CrCl <50: contraindicated

Pyridium dosage for dysuria:

200 mg po tid x2 days

Fosfomycin brand name:

Monurol

Monurol class:

Phosphonic

Monurol monitoring:

sodium, potassium, phosphate, hypersensitivity

Monurol adverse reactions:

C. diff, electrolyte disturbances, GI disturbances, hypersensitivity

Monurol renal/hepatic adjustments:

CrCl 30-40: 2.25 g po in 2-3 doses

CrCl 20-30: 1.8 g po in 2-3 doses

CrCl 10-20: 1.2 g po in 2-3 doses

CrCl <10: 0.6 g po in 1-2 doses

Main pathogen(s) Monurol covers:

Some G+: Staphylococcus saprophyticus

Some G-: E. coli, Serriata

Monurol dosage for uncomplicated cystitis:

3 g po once

Monurol dosage for cystitis prophylaxis:

3 g po qd x7-10 days

Quinine brand name:

Qualaquin

Qualaquin class:

Antimalarial

Qualaquin black box warning:

Hematologic reactions

Qualaquin monitoring:

ECG, CBC and platelets, LFT, blood glucose, ophthalmologic exam

Main pathogen(s) Qualaquin covers:

Plasmodium falciparum

Qualaquin renal/hepatic adjustments:

Severe chronic renal impairment: 648 mg po once then 324 mg po q12h

Qualaquin adverse reactions:

arrhythmia, hypoglycemia, hematologic abnormalities, hepatitis, vision loss

Qualaquin dosage for malaria treatment:

648 mg po q8h x7 days

Atovaquone brand name:

Mepron

Mepron class:

Antiprotozoal

Mepron monitoring:

hepatic fxn, CD4 count, hypersensitivity

Mepron adverse reactions:

headache, insomnia, v/d, increased LFT

Mepron renal/hepatic adjustments:

None

Main pathogen(s) Mepron covers:

Plasmodium falciparum

Mepron dosage for babesiosis:

750 mg po bid with azithromycin x7-10 days

Chloroquine class:

Aminoquinoline

Chloroquine monitoring:

CBC with differential, ophthalmologic exam at baseline

Chloroquine adverse reactions:

anemia, retinopathy, psoriasis exacerbation

Chloroquine renal/hepatic adjustments:

None

Main pathogen(s) Chloroquine covers:

Plasmodium falciparum

Chloroquine dosage for malaria prophylaxis:

500 mg po once weekly x1-2 weeks before exposure - 4 weeks after

Chloroquine dosage for malaria treatment:

1 g po as a single dose, 500 mg po 6h, 24h, 48h after 1st dose

Hydroxychloroquine brand name:

Plaquenil

Plaquenil class:

Antimalarial

Plaquenil monitoring:

ECG, CBC with differential, blood glucose, ophthalmologic exam at baseline

Plaquenil adverse reactions:

cardiomyopathy, hemolytic anemia, hypersensitivity, hypoglycemia, neuromuscular, neuropsychiatric, QTc prolongation, retinal toxicity

Plaquenil renal/hepatic adjustments:

None

Main pathogen(s) Plaquenil covers:

Plasmodium falciparum

Plaquenil dosage for malaria prophylaxis:

400 mg po once weekly 1-2 weeks before exposure - 4 weeks after

Plaquenil dosage for malaria treatment:

800 mg po once then 400 mg po at 6h, 24h, 48h after initial dose

Artemether-lumefantrine brand name:

Coartem

Coartem class:

Antimalarial

Coartem monitoring:

ECG

Coartem adverse reactions:

QTc prolongation

Coartem renal/hepatic adjustments:

None

Main pathogen(s) Coartem covers:

Plasmodium falciparum

Coartem dosage for malaria treatment:

80 mg artemether/480 mg lumefantrine po bid x3 days

Atovaquone-proguanil brand name:

Malarone

Malarone class:

Antimalarial

Malarone monitoring:

LFT, SCr, BUN, v/d

Malarone adverse reactions:

n/v, increasing LFT

Malarone renal/hepatic adjustments:

CrCl <30: contraindicated for prophylaxis

Main pathogen(s) Malarone covers:

Plasmodium falciparum

Malarone dosage for malaria prophylaxis:

250 mg atovaquone/100 mg porguanil po qd 1-2 days before exposure - 7 days after

Malarone dosage for malaria treatment:

1000 mg atovaquone/400 mg porguanil po qd x3 days

Mefloquine class:

Antimalarial

Mefloquine black box warning:

neuropsychiatric effects

Mefloquine monitoring:

LFT, neuropsychiatric effects, ocular exam

Mefloquine adverse reactions:

abnormal dreams, insomnia, vomiting

Mefloquine renal/hepatic adjustments:

None

Main pathogen(s) Mefloquine covers:

Plasmodium falciparum

Mefloquine dosage for malaria prophylaxis:

250 mg po once weekly starting 2 weeks before exposure - 4 weeks after

Mefloquine dosage for malaria treatment:

750 mg po as a single dose then 500 mg po once 6-12 hrs after

Primaquine class:

Antimalarial

Primaquine monitoring:

ECG, CBC, Hgb, Hct, G6PD deficiency

Primaquine adverse reactions:

QTc prolongation, anemia, leukopenia

Primaquine renal/hepatic adjustments:

None

Main pathogen(s) Primaquine covers:

Plasmodium falciparum

Primaquine dosage for malaria prophylaxis:

30 mg po qd starting 1-2 days before - 7 days after

Primaquine dosage for malaria treatment:

30 mg po qd x14 days

Tafenoquine brand name:

Arakoda

Arakoda class:

Antimalarial

Arakoda monitoring:

pregnancy testing and G6PD deficiency before initiation, psychiatric effects, methemoglobinemia, hypersensitivity

Arakoda adverse reactions:

diarrhea, methemoglobinemia

Arakoda renal/hepatic adjustments:

None

Main pathogen(s) Arakoda covers:

Plasmodium falciparum

Arakoda dosage for malaria prophylaxis:

200 mg po qd x3 days before travel

200 mg po weekly x7 days while in the region

200 mg po as a single dose 7 days after leaving

Acyclovir brand name:

Zovirax

Zovirax class:

Antiviral

Zovirax monitoring:

BUN, SCr, CBC, neurotoxicity

Zovirax adverse reactions:

acute kidney injury, neurotoxicity, thrombotic microangiopathy, neutropenia

Zovirax renal/hepatic adjustments:

None

Main pathogen(s) Z ovirax covers:

HSV-1, HSV-2

Zovirax dosage for primary herpes simplex:

400 mg po/IV tid x7-10 days

Zovirax dosage for episodic herpes simplex:

800 mg po/IV bid x5 days

Zovirax dosage for severe herpes:

5-10 mg/kg IV q8h x2-7 days