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NAPLEX D: > Clinical Crap Part 2 > Flashcards

Clinical Crap Part 2 Flashcards

1
Q

How long until HIV becomes detectable?

A

Up to 3-6 months

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2
Q

How long after exposure should take-home antiboy screening test be used?

A

3 months

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3
Q

What requirements to confirm HIV?

A

Antigen test + Antibody test

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4
Q

Initial treatment regimen for HIV

A

Integrase inhibtor + 2 NRTIs (backbone)

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5
Q

Biktarvy

A

bictegravir + emtricitabine + TAF

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6
Q

Triumeq

A

dolutegravir + abacavir + lamivudine

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7
Q

Tivicay

A

Dolutegravir

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8
Q

Truvada

A

Emtricitabine + TDF

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9
Q

Descovy

A

Emtricitabine + TAF

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10
Q

Stribild

A

Elvitegravir + TDF + Emtricitabine + cobicistat

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11
Q

Genvoya

A

Elvitegravir + cobicistat + TAF + Emtricitabine

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12
Q

Isentress

A

Raltegravir

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13
Q

Preferred initial treatment for pregnancy

A

2 NRTIs + PI

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14
Q

What are the NRTIs

A 
Lamivudine
Emtricitabine
Abacavir
TDF/TAF
Zidovudine
Stavudine
Didanosine
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15
Q

BBW of NRTIs

A

Hepatomegaly w/ steatosis; lactic acidosis

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16
Q

Abacavir ADE

A

HSR with HLA-B*5701

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17
Q

Lamivudine ADE

A

HA

N/V/D

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18
Q

Emtricitabine ADEs

A 
N/V/D
Rash
Dizziness
HA
Insomnia
Hyperpigmentation
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19
Q

TDF/TAF

A

Osteoporosis, renal syndrome/Fanconi syndrome

TAF has less

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20
Q

Zidovudine

A

Macrocytic anemia

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21
Q

Stavudine

A

Peripheral neuropathy, lipoatrophy, hyperbilirubinemia

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22
Q

Didanosine

A

Pancreatitis, peripheral neuropathy, increased amylase, pruritus/rash

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23
Q

Which HIV drug classes have CYP interactions?

A

NOT integrase inhibitors
NNRTIs = CYP inducers
PIs = CYP inhibitors

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24
Q

Viread

A

TDF

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25
Epivir
Lamivudine
26
NNRTI class ADEs
Rash, hepatotoxicity | CYP450 inducers
27
Efavirenz ADEs
QT prolongation, psychiatric/CNS symptoms, rash
28
Rilpivirine ADEs
depression/mood changes, insomnia | CI with strong CYP3A4 inducers
29
Nevirapine ADEs
hepatotoxicity, SJS/TEN | Nevirapine requires 14-day lead-in period (worst rash)
30
Which NNRTI needs to be with in acidic environment?
Rilpivirine (with food and NO H2RAs/PPIs)
31
Protease inhibitors ending
-navir
32
Protease inhibitors need boosted with what?
Ritonavir or cobicistat
33
ADEs of PI class
``` hepatotoxicity metabolic abnormalities increased CVD risk (EKG changes) GI upset (with food) bleeding rash ```
34
Darunavir counseling
Swallow whole | Sulfa allergy
35
Atazanavir ADEs
Nephrolithiasis, increased bilirubin, myalgia, depression | Caution with acid suppressants
36
Fosamprenavir ADEs
Caution with sulfa | NO FOOD
37
Lopinovir/Ritonovir counseling
42% alcohol
38
Nelfinavir special thing?
No boosting
39
Ritonavir/cobicistat need to be with or without food?
WITH
40
Class effects of integrase inhibitors?
increased CPK, HA, insomnia
41
Interaction with integrase?
Cations (separate by 2 hours)
42
Dolutegravir ADE
increased SCr
43
Raltegravir ADE
myopthay/rhabodymyolysis
44
Miraviroc MOA and ADE
CCR5 antagonist | Hepatotoxicity
45
Enfuviritide MOA and ADE
Fusion inhibitor | Local injection site reactions
46
Ibalizumab MOA and ADE
CD4directed post-attachment HIV-1 inhibitor | IV only
47
Selzentry
Miraviroc
48
Which class causes diarrhea?
PI
49
PrEP?
Truvada and testing every 3 months
50
PEP?
Truvada + raltegravir/dolutegravir - within 72 hours for 28 days
51
When to refer to doctor for GERD?
2 weeks of OTC Painful swallowing Frequent N/V Dysphagia
52
How long is PPI treatment course (from doc)?
8 weeks
53
What antacid type is preferred in pregnancy?
Calcium
54
Who is at risk of confusion from H2RAs?
Elderly, ill, renally impaired (CrCl <50)
55
Which H2RAs are availablea s injection?
Ranitidine and famotidine
56
ADEs of cimetidine?
Gynecomastia, impotence, drug interactions | do not use
57
ADEs of PPIs
C dif, osteoporosis, hypomagnesemia, pneumonia
58
PPI drug interaction
CYP2C19 inhibitors
59
Which PPIs available IV?
Pantoprazole and esomeprazole
60
Which PPIs can be taken without regard to meals?
Dexlansoprazole | Pantoprazole
61
Pepcid
Famotidine
62
Zantac
ranitidine
63
Prilosec
omeprazole
64
Protonix
pantoprazole
65
Dexilant
dexlansoprazole
66
Prevacid
lansoprazole
67
Regland
metoclopramide
68
What is metoclopramide used for?
Gastroparesis (QID before meals)
69
Metoclopramide ADEs
Tardive dyskinesia, EPS, drowsiness; avoid in PD and decrease dose with renal impairment
70
What drugs are bound by antacids (5)?
``` INSTIs Steroids Mycophenolate Sotalol isoniazid ```
71
How to diagnose H Pylori
Urea breath test
72
First-line therapy for H Pylori?
Quadruple therapy - | Bismuth + metronidazole + TC + PPI BID
73
Length of h pylori treatment?
10-14 days
74
Alternative H pylori treatment?
Amoxicillin + clarithromycn + PPI BID x 14 days | or replace amoxicillin with metronidazole
75
Prevpac
Amoxicillin + clarithromycin + lansoprazole
76
Pylera
Bismuth + metronidazole + tetracycline
77
Which NSAIDs are COX-2 selective?
``` Meloxicam Etodolac Nabumetone Diclofenac Celecoxib ```
78
Vimovo
Naproxen/esomeprazole
79
Yosprala
Asa/omeprazole
80
Arthrotec
Diclofenac/misoprostol
81
Misoprostol MOA & ADEs
PGE analog | Diarrhea, abd pain, abortificant
82
Sucralfate ADE
constipation
83
``` ISO air quality requirements in PEC BUffer room ante room SCA ```
PEC: 5 Buffer room: 7 Ante room: 8 (7 if connected to negative pressure buffer) SCA: none (unclassified air)
84
How long BUD in SCA?
12 hours
85
How often to clean PEC?
every 30 minutes
86
how often to perform gloved fingertip test? And how many samples?
3 samples on TSA plates | annually
87
How often to perform media fill test?
Annually
88
What do you use to clean?
Isopropyl alcohol 70%
89
How often to clean walls, ceilings, shelves?
Monthly
90
Bubble-point test?
Test filter integrity
91
How to sterilize glassware and utensils?
Dry-heat oven sterilization
92
What to use to clean hood?
1. germicidal detergent | 2. 70% IPA
93
Risk category of batch
Moderate
94
Risk category with 3+ ingredients
Moderate
95
Risk category with non-sterile ingredients
high
96
Risk categoy of TPN
moderate
97
BUD of low/medium/high risk components
Low: 14 days in fridge or 48h Moderate: 30 hours not in fridge High: 3 dyas in fridge
98
What is density factor used for?
Suppository molds
99
How is COPD diagnosed?
Fev1/FVC <0.70
100
What are used for symptom assessment?
MMRC and CAT
101
what is preferred treatment for copd?
Bronchodilators (laba/lama) | NOT ICS
102
Roflumilast MOA
PDE4 inhibitor (increases cAMP)
103
ADEs of roflumilast
Diarrhea, weight loss, CI with severe liver impairment
104
Treatment of exacerbation
azithromycn x 5-10 days
105
Combivent
Ipratropium/albuterol
106
Atrovent
Ipratropium
107
Spiriva
Tiotropium
108
Which Spiriva is DPI and which is MDI?
``` HandiHaler = DPI Respimat = MDI ```
109
Arcapta
Indacaterol
110
Arformoterol
Formoterol Ar isomer
111
LAMA ADEs
dry mouth
112
Inhaler counseling: Respimat
``` TOP Turn bottom Open top Push dose button Breathe in ```
113
Inhaler counseling: Handihaler
Inhale two times to get full dose
114
Inhaler counseling: Tudorza Pressair
Press button and dose window should turn green, then red after dose inhaled
115
Pharmacogenomic testing: abacavir
HLAB*5701 | HSR
116
Pharmacogenomic testing: | Azathiorpine
TPMT | Myelosppression
117
Pharmacogenomic testing: | Carbamazepine
HLAB*1502 | SJS/TEN
118
Pharmacogenomic testing: | Cetuximab
KRAS negative only
119
Pharmacogenomic testing: | Panitumumab
TPMP | myelosuppression
120
Pharmacogenomic testing: | trastuzumab/pertuzumab
HER2
121
Pharmacogenomic testing: | Capecitabine/5-FU
DPD deficiency | Diarrhea/toxicity
122
Pharmacogenomic testing: | Allopurinol
HLAB*5801 | SJS
123
Pharmacogenomic testing: | Oxcarbazepine, phenytoin
HLAB*1502
124
Pharmacogenomic testing: | Clopidogrel
CYP2C19 *2/*3 have faster metabolism
125
Pharmacogenomic testing: | Codeine
CYP2D6 (UR have increased toxicity)
126
Pharmacogenomic testing: | Warfarin
CYP2C9 *2/*3, VKORC1 | Increased bleeding risk
127
Micro: | Bacteroides fragilis
Anaerobic Gram negative
128
H flu
gram negative rod
129
enteric rods
``` Serratia enterobacter e coli klebsiella (SEEK) citrobacter proteus ```
130
Atypical bacteria
legionella chlamydia mycoplasma mycobacterium TB
131
Which drug classes have synergy?
beta-lactams and aminoglycosides for G+
132
Which drugs are lipophilic (5)
``` FQ macrolids tetracyclines rifampin linezolid (good for atypicals, great bioavailability - 1:1) ```
133
ROA of PCN G benzathine
IM only
134
Which beta lactam is a vesicant?
nafcillin
135
Which bugs do cephalosporins NOT cover
enterococcus | Atypicals
136
Which cephalosporins cover anaerobes?
Cefotetan | Cefoxitin
137
Ceftriaxone CI
in neonates- biliary sludging
138
Cefotetan ADE
Disulfiram-like reaction
139
Which carbapenem does not cover pseudomonas?
Ertapenem
140
Which beta lactam okay in PCN alergy?
Aztreonam
141
Aztreonam spectrum?
Only gram-negatives
142
Which cephalosporin covers pseudomonas?
Ceftazidime
143
What beta-lactams cover enterococci?
PCN, amoxicillin, carbapenems
144
Aminoglycoside TDM goals
Trough <2 Peak 5-10 (for gram-negative)
145
What weight to dose aminoglcyoside?
IBW/AdjBW
146
ADE of aminoglycoside?
Neuromuscular blockade
147
FQ moa
Topoisomerase/gyrase inhibitor
148
Which FQ are respiratory?
levo, moxi, gemi
149
which FQ cover pseudomonas?
cipro, levo
150
Which FQ is NOT renally adjusted?
Moxifloxacin (not used for UTIs)
151
Which FQ covers MRSA?
Delafloxacin
152
ADEs of FQs?
Peripheral neuropathy Seizures BG (high or low) Psychiatric disturbance
153
Macrolide MOA
50s ribosomal subunit inhibitor
154
ADEs of all macrolides
QT prolongation, hepatotoxicity
155
Which macrolide has most drug interactions
Clarithromycin
156
Which macrolide causes most GI upset
Erythromycin
157
Biaxin
Clarithromycin
158
Solodyn
Minocycline
159
Vibramycin
Doxycycline
160
Tetracycline MOA
30s ribosomal subunit
161
Dosing of Bactrim based on which component?
TMP
162
ADEs of Bactrim
``` hyperkalemia anemia (G6PD) SJS/TEN photosensitivity crystalluria increased INR with warfarin ```
163
Vancomycin MOA
blocks d-ala d-ala in cell wall synthesis
164
Goal vanc trough for serious infection
15-20
165
Daptomycin ADEs
Mytopathy/rhabdomyolysis | Falsely elevates INR
166
Linezolid ADEs
Thrombocytopenia Optic neuropathy Serotonin syndrome (no MOAIs)
167
Metronidazole CI
Pregnancy
168
Clindamycin - when to use?
use D-test for S aureus to see if R to erythromycin
169
Chloramphenicol ADEs
Gray Syndrome (circulatory collapse)
170
Polymyxin ADE
Nephrotoxicity neurotoxicity neuromuscular blockade
171
Tigecycline - why is it last line?
Increased risk of death
172
Quinupristin/dalfopristin ades
arthralgia, infusion reaction, hyperbili
173
Fidaxomicin use
c dif
174
Rifaximin use
E coli
175
Fosfomycin use
single dose for UTI
176
Nitrofurantoin ADEs
Not if CrCl <60 G6PD deficiency (hemolytc anemia) brown urine
177
Which oral solution should NOT be refrigerated
Cefdinir (and non-beta lactams)
178
Which antibiotics need protection from light?
Doxycycline | Micafungin
179
What are the resistant candida strains?
Glubrata | Krusei
180
Which fungal infections are mold?
aspergillus and zygomycetes
181
Amphotericin B ADEs
Infusion reaction (fever, chills, HA, malaise, rigors) - premedicate! Low K Low Mg Nephrotoxicity
182
What is the lipid formulation of amphotericin?
Ambisome
183
Amphotericin MOA
holes in cell membranes by binding to ergosterol
184
Ancobon
Flucytosin
185
Flucytosine MOA
Converted to FU inside cells
186
Flucytosine ADEs
Myelosuppression
187
Azole mechanism
Decrease ergosterol synthesis (no cell membrane)
188
Class effects of azoles
QT prolongation and increased LFTs
189
Which azole penetrates CNS?
fluconazole
190
Which azole is contraindicated in HF?
Itraconazole
191
Which azole covers aspergillus and resistant candidas?
Voriconazole
192
ADEs of voriconazole
Visual, increased SCr, hallucination Photosensitivity Avoid IV in CrCl <50
193
Which azoles need acidic environment for absorption?
itraconazole and ketoconazole
194
Which azole does not have qt prolongation?
isavuconazonium
195
Echinocandins spectrum
resistnat candidas, aspergillosis
196
ADEs of echinocandins
Histamin-mediated symptoms (rash, swelling, decreased BP)
197
Cancidas
caspofungin
198
Mycamine
micafungin
199
Griseofulvin MOA
Binds to keratin precurosrs (good for hair/skin/nails)
200
Griseofulvan ADEs
photosensitivity, increased LFTs, CI with pregnancy
201
Terbinafine mechanism
Inhibits squalene epoxidase
202
Mycelex
Clotrimazole
203
Nystatin use
thrush
204
DOC for aspergillus
voriconazole
205
DOC for candida albicans
Nystatin/fluconazole
206
DOC for candida glabrata/krusei
echincocandins
207
DOC for cyptococcus
ampho B/flucytosine
208
DOC for dermatophytes
itraconazole/terbinafine/fluconazole | nail infections
209
Nizoral
Ketoconazole
210
Sporanox
Itraconazole
211
Vfend
Voriconazoe
212
Noxafil
Posaconazole
213
Neuraminidase inhibitors should be taken with __ days of symptom onset
2 days
214
oseltamivir ade
neuropsychiatric events
215
zanamavir ade
bronchospasm (inhaled)
216
Rapivab
Peramavir
217
Relenza
Zanamavir
218
Which herpes virus causes oropharyngeal v genital disease?
HSV-1 - oropharyngeal | HSV-2 - genital
219
What drugs to treat HSV?
valacyclovir acyclovir famiciclovir
220
Herpes simplex treatment
docosanol (abreva) acyclovir or systemic treatment
221
When to use antiviral for genital herpes?
within 1 day of legion
222
Treatment for genital herpes?
valacyclovir
223
Invasive HSV treatment
IV acyclovir
224
Herpes zoster treatment within __ days of treatment and treated for __ days
3 days | 7 days
225
Drugs to treat BPH
1. a1 blockers 2. 5a reductase inhibitors 3. phosphodiesterase-5 inhibitors
226
Natural product to prevent prostate cancr
Lycopene
227
a-1 blocker ADEs
``` Floppy iris syndrome Orthostatic hypotension HA Fatigue Ejaculation ```
228
How long do a1 blockers take to work?
4-6 weeks
229
Which a1 blockers are non-selective?
terazosin and doxazosin
230
ADE of alfuzosin
QT prolongation
231
ADE of silodosin
Retrograde ejaculation
232
5-alpha reductase inhibitors ADEs
Impotence decreased libido Ejaculation disfunction gynecomastia
233
Avodant
Dutasteride
234
ProScar
Finasteride
235
Which PDE5 can be used for BPH
Tadalafil
236
5-alpha reductase CI
pregnancy | women of child-bearing age
237
Ketorolac CI
liver failure | more than 5 days of use
238
Relafen
Nabumetone
239
Voltaren
Diclofenac
240
Doans
Magnesium salicylate
241
ASA ades
dyspepsia, heartburn tinnitus (from salicylates)
242
Indomethacin ADE
CNS side effects
243
Which opioids need to be avoided with alcohol (4)
Kadian Embeda Zohydro Nucynta ER
244
What schedule is codeine in combo with pan meds
CIII
245
How often is fentanyl patch applied
3 days
246
Fentanyl brand naems
Sublimaze | Duragesic
247
Which opioids interact with CYP3A4 inhibitors
oxycodone | hydrocodone
248
Zohydro
oxycodone ER
249
Dilaudid
Hydromorphone
250
Dolophine
Methadone
251
Demerol
Meperidine
252
Startng dose of dilaudid (PO and IV)
PO: 2-4mg q4-6h IV: 0.2-1mg q2-3h
253
Methadone ADEs
QT prolongation, variable half life
254
Meperidine ADEs
Not in renal impairment (seizures) | serotonergic
255
Kadian
Morphine
256
Which opioid has to be taken on an empty stomach
oxymorphone
257
Opioid conversions
Morphine: 10(IV) 30(PO) | Hydromorphone 1.5(IV) 7.5(PO)
258
Which opioids cross-react?
Those with -morph and -cod
259
What are the PAMORAs?
Methylnaltrexone (Relistor) Naloxegel (Movantik) Naldemedine (Symproic) Lupiprostone (Amitzia)
260
ADEs of PAMORAs
abdominal pain, N/D
261
Lupiprostone MOA
Cl channel activator
262
Centrally acting analgesics MOA
Tramadol and tapentadol | Central mu + NE uptake inhibitor
263
ADEs of tramadol/tapentadol
serotonin syndrome, seizure risk
264
tramadol drug interaction
CYP2D6
265
Tx of opioid abuse
Naloxone, buprenorphine(+naloxone)
266
How often is Butrans applied
weekly (buprenorphine patch)
267
What is requirement to prescribe buprenorphine?
DATA 2000 (will have DEA that starts with x)
268
ADEs of gabapentin
ataxia, edema, weight gain
269
Pregabalin indications
fibromyalgia PHN neuropathic pain
270
what is treatment for trigeminal neuralgia
carbamazepine
271
Lioresal
Baclofen
272
Fexmid
cyclobenzaprine
273
Zanaflex
tizanidine
274
Robaxin
Methocarbamol
275
Soma
carisoprolol
276
What are the analgesic antispasmodics
Baclofen Tizanidine cyclobenzaprine
277
Cycobenzpaprine ade
dry mouth | serotonergic
278
tizanidine ade
a-2 agonist decreaed bp, dry mouth weakness
279
carisoprodol ade and schedule
CYP2C19 - would increase if poor metabolizer | CIV
280
How many patches of lidocaine can be applied at once?
3
281
Zostrix
Capsaicin
282
OTC intranasal steroids?
Budesonide (Rhinocort) | Fluticasone (Flonase)
283
Dose of benadryl
25-50mg q6h
284
Which symptom do antihistamines not fix?
congestion
285
Which 2nd gen AHs are preferred in pregnancy?
Cetirizine and loratadine
286
Cetirizine notes on onset
fast onset and works well but higher sedation
287
Patanase
Olaptadine (nasal spray)
288
Afrin
Oxymetazoline (intranasal decongestant)
289
Max treatment length of Afrin?
3 days
290
Which allergy/cold meds are contraindicated with MAOIs
Sudafed and phenylephrine | Dextromethorphan
291
T/F: Intranasal cromolyn is used as needed for mild allergy symptoms
FALSE - not PRN
292
ADE of ipratropium
Drying
293
Administration requirements of SL immunotherapy
monitored 30 minutes following the first dose
294
How much Sudafed dispensed in one day and one month?
3.6g/day | 9g/month
295
Natural products for cold
Zinc, Vit C, echinacea
296
Robafen
Guaifenasin
297
Dayquil Cough
Dexromethorphine
298
Tessalon
Benzonatate
299
Bromfed DM
brompheniramine, pseudoephedrine, dextromethorphan
300
How old should kids be with allergy meds?
2 years per FDA 6 years per AAP Codeine not <12 years
301
What mechanism calls dextromethorphan abuse potential?
NMDA blocker
302
How long to rinse after topical/ocular exposure
Topical: 10 minutes Ocular: 15 minutes
303
What med is used for bradycardia
Atropine
304
Dose of activated charcoal
1g/kg within 1 hr
305
APAP antidoate and mechanism
NAT - increases glutathione in cells
306
Dosing for NAC
Rumack-Matthew Nomogram
307
Antiodate: anticholinergics
phyostigmine
308
Antiodate: Benzos
Flumazenil
309
Antiodate: Cyanide
Hydroxocobalamin
310
Drug that can cause cyanide poisoning
nitroprusside (will turn blue)
311
Antidote: ethanol
Vit b1 (to rpevent Wernicke's)
312
antidote: hydrocarbons/petroleum
Induce vomiting
313
Iron antidote
deferoxamine
314
Antidote: organophosphates
Atropine Pralidoxime (cause cholinergic effects)
315
Antidote: Neostigmine
Pralidoxime
316
Antidote: Rocuronium, vecuronium, panacuronium
Neostigmine
317
Antiodte: salicylates
Sodium bicarbonate
318
Antidote: Stimulants
benzos
319
Antidote: Methanole
Fomepizole
320
CroFab for what snake bites?
Rattle snake and copperhead
321
Per-op Abx
cefazolin 60 minutes before surgery
322
Pre-op for colorectal surgery
Amp/sul, cefotetan, cefoxitin
323
Meningitis treatment (adults and neonates)
ceftriaxone/cefotaxime + vancomycin (amp if >50) | Neonates: ampicillin + cefotaxime
324
AOM antibiotics
High-dose amoxicillin (80-90mg/kg/day) | *can use cephalosporins if PCN allergic
325
Pharyngitis bug and treatment
S pyogenes | Amoxicillin or PCN
326
Sinusitis tx
augmentin
327
COPD exacerbation
augmentin, azithromycin, doxycycline
328
Bordetella treatment
azithromycin clarithromycin bactrim
329
CAP outpatient
macrolide/doxycycline | Beta-lactam + macrolide OR FQ (if comorbidities or recent abx0
330
CAP inpatient
Beta-lactam + (ML or DC) | Respiratory FQ
331
VAP/HAP
2 antipseudomonals + anti-MRSA
332
Latent TB test
Rifampin x 4 months | ISN + Rifapentine x 12 weeks
333
RIPE drugs
rifampin Isoniazide Pyrazanamide Ethambutol
334
Rifampin ADEs
Increased LFTs, positive Coombs test
335
Isoniazid ADEs
DILE, positive Coombs test, inhibitor
336
Pyrazanamide
Hyperuricemia, increased LFTs
337
Ethambutol
Increased LFTs, optic neuritis, hallucinations, confusion
338
Endocarditis tx
add gentamicin for prosthetic valve synergy
339
Dental ppx
Amoxicillin
340
Spontaneous bacterial peritonitis tx
Ceftriaxone
341
What drugs cover anaerboes
cefoxitin metronidazole ertapenem
342
Impetigo treatment
Mupirocin
343
Follliculitis treatment
Cephalexin (probably MSSA)
344
Non-purulent cellulitis
Cephalexin
345
Severe purulent SSTI
Cover MRSA
346
Necrotizing fasciitis
Vanc + beta lactam + another
347
Diabetic foot infections
BROAD coverage (polymicrobial)
348
UTI - in urinalysis
WBC and bacteria
349
Treatment for UTI
Macrobid Bactrim Fosfamycin
350
How long to use azo?
2 days
351
Treatment for pyelonephritis/complicated UTI
Quinolones Ceftriaxone Bactrim Beta-lactam
352
Pregnancy UTI tx
Augmentin/cephalosporin Bactrim/Macrobid Fosfomycin
353
Cdif
1. Vanc or fidaxomicin 2. Switch or pulse vanc 3. Pulse vanc or rifaximin, fidaxomicin, transplant
354
Traveler's diarrha
Azithromycin
355
Syphilis (early stage)
PCN G benzathine (2.4 mil IM)
356
Syphilis (late stage)
PCN G benzathine (2.4 mil IM) x 3 doses | Late >1 year or unknown
357
Second-line for syphilis
Doxycycline
358
Neurosyphilis
PCN G aqueous
359
Bicillin LA
PCN G benzathine
360
Gonorrhea
ceftriaxone IM + azithromycin x1
361
Chlamydia
Azithromycin 1gm
362
Bacterial vaginosis
Metronidazole
363
Trichomoniasis
Metronidazole
364
Ricketts/lyme/rocky mountain spotted fever
Doxycycline
365
ADHD diagnosis
Must have 5 symptoms in 2 settings appearing before 12 years old
366
Natural product for ADHD
fish oil
367
What neurotransmitters does stimulant increase?
dopamine and norepinephrine
368
Which ACE is available IV?
enalaprilat
369
Which beta blockers are available IV?
Esmolol labetaolol propranolol metoprolol
370
Which thiazide available IV?
Chlorathiazide
371
Which CCB available IV?
Nicardipine Clevidipine Diltiazem Verpamil
372
Phenytoin administration requirements?
- NS only - Separate 2 hours in NS tube - Use within 4 hours - Max 50ml/hr due to arrhythmias
373
Kcal in lipid?
10%: 1.1kcal/mL 20%: 2kcal/mL 30%: 3kcal/mL
374
kcal in carb?
3.4kcal/g
375
kcal in protein?
4kcal/g
376
Nitrogen in protein?
Divide protein by 6.25g
377
Nucynta
Tapentadol
378
What bug do carbapenems not cover?
acinetobacter | they DO cover anaerobes!
379
Which HIV meds need to be with food? -3
protease inhibitors (except fosamprenavir suspension) Rilpivirine Etravirine
380
Which HIV meds need to be on empty stomach? - 4
Efavirenz (Atripla, Symfi) Fosamprenavir oral suspension Didanosine Indinavir
381
Which HIV med causes nephrolithiasis?
Ataznavir | Indinavir
382
What is the equation for mOsm?
mOsm/L = g/L/(MW) * valence * 1000
383
What is the equation for mEq?
mEq = mg * valence / MW
384
T/F: Stimulants must be dispensed with MedGuide
True
385
ADEs of stimulants
``` CV events Mania episodes in BPD decreased seizure threshold serotnin syndrome Erection >4 hours Loss of appetite Dry Mouth Blurry vision ```
386
Methylphenidate starting dose
5mg BID
387
Ritalin
Methylphenidate IR
388
Concerta
Methylphenidate ER - OROS tablet (ghost)
389
Quillichew
Methylphenidate chewable tablet
390
Quillivant
Methylphenidate oral suspension
391
Contempla
Methylphenidate ODT
392
Focalin
Dexmethylprednisolone
393
Adderall
Dextroamphetamine/amphetamine IR
394
Mydayis
Dextroamphetamine/amphetamine ER
395
Daytrana
Methylphenidate patch
396
Vyvanse
lisdexamfetamine - chewable tablet or opennable capsule
397
Desoxyn
Methamphetamine
398
Which stimulant has lowest abuse potential
Lisdexamfetamine (prodrug)
399
Instructions for Daytrana
Apply 2 hours before needed to HIP; remove after 9 hours
400
Atomoxetine MOA
Selective NE reuptake inhibitor
401
ADEs of atomoxetine
hepatotoxicity, hypertension/increase HD
402
Can atomoxetine be opened?
Nope
403
Kapvay
Clonidine ER
404
Can alpha 2 agonists be used with stimulants?
Yes
405
Endings of drug classes: NS3/4A protease inhibitor NS5A replication complex inhibitor NS5B Polymerase inhibitor
NS3/RA: Previr NS5A: Asvir NS5B: Buvir
406
What drug class used for hepatitis C?
Direct acting antivirals
407
ADEs of all DAAs
Reactivation of hep B | Bradycardia with amiodarone (especially sofosbuvir)
408
Harvoni
Sofosbuvir/ledipasvir
409
Epclusa
Sofosbuvir/velpatasvir
410
Mavyret
Glecaprevir/pebrentasvir
411
Which Hep C drug can be used for only 8 weeks?
Mavyret
412
Which Hep C drugs can be used in all genotypes?
Epclusa and Mavyret
413
Which Hep C drugs can be used with HIV?
Myravaret, Epclusa, Harvoni
414
Which Hep C drug cannot be used with estradiol?
Viekira Pak
415
Which Hep C drug cannot be used with antacids
Epclusa
416
What drug interaction for all Hep C drugs?
Not with strong Cyp inducers
417
Is ribavirin monotherapy or combination?
Combination
418
ADEs of ribavirin
hemolytic anemia | CI with pregnancy
419
Interferon alfa ADEs
Infusion reaction (pre-treat) myelosuppression, depression, increased LFTs, GI upset
420
How to treat Hep B
IFN alfa | NRTIs
421
Vemlidy
Tenofovir AF
422
Entecavir administration requirement
Empty stomach
423
What hepatitis drugs need original container?
TAF and Harvoni
424
Natural product for liver
Misk thistle
425
What vitamin deficiency for alcoholism
Vitamin B1 - thiamine
426
How to treat portal HTN/variceal bleeding
1. bands 2. Octreotide/sandostatin 3. Nadolol/propranolol (secondary prevention)
427
What is hepatic encephalopathy caused by and major symptom?
Caused by build up of ammonia | Symptom is atsterexis
428
Treatment of hepatic encephalopathy
Lactulose Rifaxim Neomycin Metronidazole
429
ADE of long-term metronidazole
Neuropathy
430
ADE of neomycin
Neurotoxicity, GI upset
431
How to treat ascites
Spironolactone monotherapy | Spironolactone/furosemide in 40:100 ratio
432
How to reat SBP?
Ceftriaxone
433
Uric acid goal in gout
<6
434
Acute gout attack treatment
Steroids (injection in joints) NSAIDs Colchicine
435
Which NSAIDs for gout?
Indomethacin Celecoxib Solindac
436
Colchicine ADEs
neuropathy myopathy GI upset myelosuppression
437
Colchicine dose
2x 0.6mg dose, then 1x0.6mg
438
Treatment of chronic gout
1. allopurinol/febuxostat 2. Probenecid/lesinurad 3. Pegloticase
439
Pegloticase MOA
uricase enzyme converts UA to allantoin
440
How long should xanthine oxidase inhibitors be used with NSAIDs/colchicine?
first 3-6 months
441
ADEs of allopurinol/febuxostat
Hepatotoxicity Rash Nausea Thrombus (febuxostat)
442
ADEs of lesinurad
Increased SCr
443
Probenecid ADE
G6PD deficiency
444
Probenecid drug interaction
increases beta-lactam levels
445
Does probenecid or lesinurad have to be used with XOIs/colchicine?
Probenecid - colchicine | Lesinurad - XOIs
446
Pegloticase administration requirements
IV - pre-medicate
447
Should pegloticase be with or without XOIs?
WITHOUT
448
What drugs can increase UA
``` ASA Niacin Pyrazinamide Calcineurin inhibitors Chemos ```
449
Drug classes used for glaucoma
``` Beta-blockers Prostaglandin analogs cholinergics Rho Kinase inhibitors Carbonic anhydrase inhibitors alpha-2 agonists ```
450
Which beta-blocker is selective for glaucoma?
Betaxolol
451
Which glaucoma med is preferred if for 1 eye only?
Beta-blocker
452
What preservative can afffect contact lenses?
BAK
453
What is zolamide?
Carbonic anhydrase inhibitor
454
Which glaucoma meds decrease humor production?
Beta-blockers a2 agonists carbonic anhydrase inhibitors (BP)
455
Which glaucoma med increase humor outflow
Cholinergics a2 agonists Rho Kinase inhibitors
456
Ophthalmic antibiotics
Maxitrol Polytrim Ofloxacin Moxifloxacin
457
What drugs can cause visual changes?
``` Amiodarone Linezolid Isotretinoin Vigabatrin Hydroxychloroquine Ablockers digoxin PDE-5 inhibitors voriconazole ```
458
What med is used for ear infection?
Ciprodex
459
What med is used for ear wax blockage?
Debrox - carbamid eperoxide
460
Ear drop counseling - direction to pull ear
Adults: up and back Kids: Down and back Then stay upright for 5 minutes
461
Cosopt
Timolol/dorzolamide (carbonic anhydrase inhibitor)
462
Drugs that cause constipation (4)
Sucralfate Colesevelam Anticholinergics Aluminum
463
Metamucil
Psyllium
464
Citrucel
Methylcellulose
465
Stool softener
Docusate
466
Osmotics - 4
Milk of magnesium (Mg hydroxide) - caution with renal PEG Glycerin Lactulose
467
Stimulants
Senna | Bisacodyl (Colace)
468
Lubricants
Mineral oil
469
Which osmotic has risk of neuropathy
OsmoPrep
470
What color food colorings to avoid before colonsocopy?
red/blue/purple
471
Lupiprostone mechanism, use
Chloride channel activator for chonic constipation (IBS, OIC)
472
Linaclotide mechanism, use
(linzessa) | Guanylate cyclase C agnost - IBS, CIC
473
Alvimopan MOA, max dose, use
PAMORA For post-surgery constipation (but not for more than 7 days of opioids) MAX: 15 doses/day
474
What drugs can cause diarrhea
``` Magnesium Colchicine Antineoplastics Metoclopramide Misoprostol Quinidine ```
475
Pepto-Bismol ADEs
black tongue/stool Tinnitus Reye syndrome CI: ulcer, coagulopathy
476
Loperamide age limit and max dose
``` >2 years old Max 16 (Rx), 8 (OTC) for 2 days ```
477
Diphenoxylate/atropine - max dose and age limit
>13 yo | 20mg/day
478
Dicyclomine MOA and ADE
Anticholinergic/antispasmodic Toxic mega-colon and paralytic ileus Bentyl
479
Eluxadoline MOA and CI
Peripherally-acting Mu agonist | C-IV

NAPLEX D: (3 decks)

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