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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
Q

Epivir

A

Lamivudine

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26
Q

NNRTI class ADEs

A

Rash, hepatotoxicity

CYP450 inducers

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27
Q

Efavirenz ADEs

A

QT prolongation, psychiatric/CNS symptoms, rash

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28
Q

Rilpivirine ADEs

A

depression/mood changes, insomnia

CI with strong CYP3A4 inducers

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29
Q

Nevirapine ADEs

A

hepatotoxicity, SJS/TEN

Nevirapine requires 14-day lead-in period (worst rash)

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30
Q

Which NNRTI needs to be with in acidic environment?

A

Rilpivirine (with food and NO H2RAs/PPIs)

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31
Q

Protease inhibitors ending

A

-navir

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32
Q

Protease inhibitors need boosted with what?

A

Ritonavir or cobicistat

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33
Q

ADEs of PI class

A 
hepatotoxicity
metabolic abnormalities
increased CVD risk (EKG changes)
GI upset (with food)
bleeding
rash
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34
Q

Darunavir counseling

A

Swallow whole

Sulfa allergy

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35
Q

Atazanavir ADEs

A

Nephrolithiasis, increased bilirubin, myalgia, depression

Caution with acid suppressants

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36
Q

Fosamprenavir ADEs

A

Caution with sulfa

NO FOOD

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37
Q

Lopinovir/Ritonovir counseling

A

42% alcohol

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38
Q

Nelfinavir special thing?

A

No boosting

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39
Q

Ritonavir/cobicistat need to be with or without food?

A

WITH

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40
Q

Class effects of integrase inhibitors?

A

increased CPK, HA, insomnia

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41
Q

Interaction with integrase?

A

Cations (separate by 2 hours)

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42
Q

Dolutegravir ADE

A

increased SCr

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43
Q

Raltegravir ADE

A

myopthay/rhabodymyolysis

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44
Q

Miraviroc MOA and ADE

A

CCR5 antagonist

Hepatotoxicity

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45
Q

Enfuviritide MOA and ADE

A

Fusion inhibitor

Local injection site reactions

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46
Q

Ibalizumab MOA and ADE

A

CD4directed post-attachment HIV-1 inhibitor

IV only

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47
Q

Selzentry

A

Miraviroc

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48
Q

Which class causes diarrhea?

A

PI

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49
Q

PrEP?

A

Truvada and testing every 3 months

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50
Q

PEP?

A

Truvada + raltegravir/dolutegravir - within 72 hours for 28 days

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51
Q

When to refer to doctor for GERD?

A

2 weeks of OTC
Painful swallowing
Frequent N/V
Dysphagia

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52
Q

How long is PPI treatment course (from doc)?

A

8 weeks

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53
Q

What antacid type is preferred in pregnancy?

A

Calcium

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54
Q

Who is at risk of confusion from H2RAs?

A

Elderly, ill, renally impaired (CrCl <50)

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55
Q

Which H2RAs are availablea s injection?

A

Ranitidine and famotidine

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56
Q

ADEs of cimetidine?

A

Gynecomastia, impotence, drug interactions

do not use

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57
Q

ADEs of PPIs

A

C dif, osteoporosis, hypomagnesemia, pneumonia

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58
Q

PPI drug interaction

A

CYP2C19 inhibitors

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59
Q

Which PPIs available IV?

A

Pantoprazole and esomeprazole

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60
Q

Which PPIs can be taken without regard to meals?

A

Dexlansoprazole

Pantoprazole

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61
Q

Pepcid

A

Famotidine

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62
Q

Zantac

A

ranitidine

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63
Q

Prilosec

A

omeprazole

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64
Q

Protonix

A

pantoprazole

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65
Q

Dexilant

A

dexlansoprazole

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66
Q

Prevacid

A

lansoprazole

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67
Q

Regland

A

metoclopramide

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68
Q

What is metoclopramide used for?

A

Gastroparesis (QID before meals)

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69
Q

Metoclopramide ADEs

A

Tardive dyskinesia, EPS, drowsiness; avoid in PD and decrease dose with renal impairment

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70
Q

What drugs are bound by antacids (5)?

A 
INSTIs
Steroids
Mycophenolate
Sotalol
isoniazid
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71
Q

How to diagnose H Pylori

A

Urea breath test

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72
Q

First-line therapy for H Pylori?

A

Quadruple therapy -

Bismuth + metronidazole + TC + PPI BID

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73
Q

Length of h pylori treatment?

A

10-14 days

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74
Q

Alternative H pylori treatment?

A

Amoxicillin + clarithromycn + PPI BID x 14 days

or replace amoxicillin with metronidazole

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75
Q

Prevpac

A

Amoxicillin + clarithromycin + lansoprazole

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76
Q

Pylera

A

Bismuth + metronidazole + tetracycline

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77
Q

Which NSAIDs are COX-2 selective?

A 
Meloxicam
Etodolac
Nabumetone
Diclofenac
Celecoxib
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78
Q

Vimovo

A

Naproxen/esomeprazole

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79
Q

Yosprala

A

Asa/omeprazole

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80
Q

Arthrotec

A

Diclofenac/misoprostol

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81
Q

Misoprostol MOA & ADEs

A

PGE analog

Diarrhea, abd pain, abortificant

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82
Q

Sucralfate ADE

A

constipation

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83
Q 
ISO air quality requirements in 
PEC
BUffer room
ante room
SCA
A

PEC: 5
Buffer room: 7
Ante room: 8 (7 if connected to negative pressure buffer)
SCA: none (unclassified air)

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84
Q

How long BUD in SCA?

A

12 hours

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85
Q

How often to clean PEC?

A

every 30 minutes

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86
Q

how often to perform gloved fingertip test? And how many samples?

A

3 samples on TSA plates

annually

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87
Q

How often to perform media fill test?

A

Annually

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88
Q

What do you use to clean?

A

Isopropyl alcohol 70%

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89
Q

How often to clean walls, ceilings, shelves?

A

Monthly

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90
Q

Bubble-point test?

A

Test filter integrity

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91
Q

How to sterilize glassware and utensils?

A

Dry-heat oven sterilization

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92
Q

What to use to clean hood?

A
  1. germicidal detergent

2. 70% IPA

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93
Q

Risk category of batch

A

Moderate

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94
Q

Risk category with 3+ ingredients

A

Moderate

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95
Q

Risk category with non-sterile ingredients

A

high

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96
Q

Risk categoy of TPN

A

moderate

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97
Q

BUD of low/medium/high risk components

A

Low: 14 days in fridge or 48h
Moderate: 30 hours not in fridge
High: 3 dyas in fridge

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98
Q

What is density factor used for?

A

Suppository molds

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99
Q

How is COPD diagnosed?

A

Fev1/FVC <0.70

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100
Q

What are used for symptom assessment?

A

MMRC and CAT

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101
Q

what is preferred treatment for copd?

A

Bronchodilators (laba/lama)

NOT ICS

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102
Q

Roflumilast MOA

A

PDE4 inhibitor (increases cAMP)

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103
Q

ADEs of roflumilast

A

Diarrhea, weight loss, CI with severe liver impairment

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104
Q

Treatment of exacerbation

A

azithromycn x 5-10 days

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105
Q

Combivent

A

Ipratropium/albuterol

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106
Q

Atrovent

A

Ipratropium

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107
Q

Spiriva

A

Tiotropium

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108
Q

Which Spiriva is DPI and which is MDI?

A 
HandiHaler = DPI
Respimat = MDI
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109
Q

Arcapta

A

Indacaterol

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110
Q

Arformoterol

A

Formoterol Ar isomer

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111
Q

LAMA ADEs

A

dry mouth

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112
Q

Inhaler counseling: Respimat

A 
TOP
Turn bottom
Open top
Push dose button
Breathe in
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113
Q

Inhaler counseling: Handihaler

A

Inhale two times to get full dose

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114
Q

Inhaler counseling: Tudorza Pressair

A

Press button and dose window should turn green, then red after dose inhaled

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115
Q

Pharmacogenomic testing: abacavir

A

HLAB*5701

HSR

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116
Q

Pharmacogenomic testing:

Azathiorpine

A

TPMT

Myelosppression

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117
Q

Pharmacogenomic testing:

Carbamazepine

A

HLAB*1502

SJS/TEN

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118
Q

Pharmacogenomic testing:

Cetuximab

A

KRAS negative only

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119
Q

Pharmacogenomic testing:

Panitumumab

A

TPMP

myelosuppression

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120
Q

Pharmacogenomic testing:

trastuzumab/pertuzumab

A

HER2

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121
Q

Pharmacogenomic testing:

Capecitabine/5-FU

A

DPD deficiency

Diarrhea/toxicity

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122
Q

Pharmacogenomic testing:

Allopurinol

A

HLAB*5801

SJS

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123
Q

Pharmacogenomic testing:

Oxcarbazepine, phenytoin

A

HLAB*1502

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124
Q

Pharmacogenomic testing:

Clopidogrel

A

CYP2C19 2/3 have faster metabolism

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125
Q

Pharmacogenomic testing:

Codeine

A

CYP2D6 (UR have increased toxicity)

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126
Q

Pharmacogenomic testing:

Warfarin

A

CYP2C9 2/3, VKORC1

Increased bleeding risk

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127
Q

Micro:

Bacteroides fragilis

A

Anaerobic Gram negative

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128
Q

H flu

A

gram negative rod

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129
Q

enteric rods

A 
Serratia
enterobacter
e coli
klebsiella
(SEEK)
citrobacter
proteus
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130
Q

Atypical bacteria

A

legionella
chlamydia
mycoplasma
mycobacterium TB

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131
Q

Which drug classes have synergy?

A

beta-lactams and aminoglycosides for G+

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132
Q

Which drugs are lipophilic (5)

A 
FQ
macrolids
tetracyclines
rifampin
linezolid
(good for atypicals, great bioavailability - 1:1)
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133
Q

ROA of PCN G benzathine

A

IM only

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134
Q

Which beta lactam is a vesicant?

A

nafcillin

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135
Q

Which bugs do cephalosporins NOT cover

A

enterococcus

Atypicals

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136
Q

Which cephalosporins cover anaerobes?

A

Cefotetan

Cefoxitin

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137
Q

Ceftriaxone CI

A

in neonates- biliary sludging

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138
Q

Cefotetan ADE

A

Disulfiram-like reaction

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139
Q

Which carbapenem does not cover pseudomonas?

A

Ertapenem

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140
Q

Which beta lactam okay in PCN alergy?

A

Aztreonam

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141
Q

Aztreonam spectrum?

A

Only gram-negatives

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142
Q

Which cephalosporin covers pseudomonas?

A

Ceftazidime

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143
Q

What beta-lactams cover enterococci?

A

PCN, amoxicillin, carbapenems

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144
Q

Aminoglycoside TDM goals

A

Trough <2
Peak 5-10
(for gram-negative)

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145
Q

What weight to dose aminoglcyoside?

A

IBW/AdjBW

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146
Q

ADE of aminoglycoside?

A

Neuromuscular blockade

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147
Q

FQ moa

A

Topoisomerase/gyrase inhibitor

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148
Q

Which FQ are respiratory?

A

levo, moxi, gemi

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149
Q

which FQ cover pseudomonas?

A

cipro, levo

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150
Q

Which FQ is NOT renally adjusted?

A

Moxifloxacin (not used for UTIs)

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151
Q

Which FQ covers MRSA?

A

Delafloxacin

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152
Q

ADEs of FQs?

A

Peripheral neuropathy
Seizures
BG (high or low)
Psychiatric disturbance

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153
Q

Macrolide MOA

A

50s ribosomal subunit inhibitor

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154
Q

ADEs of all macrolides

A

QT prolongation, hepatotoxicity

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155
Q

Which macrolide has most drug interactions

A

Clarithromycin

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156
Q

Which macrolide causes most GI upset

A

Erythromycin

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157
Q

Biaxin

A

Clarithromycin

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158
Q

Solodyn

A

Minocycline

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159
Q

Vibramycin

A

Doxycycline

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160
Q

Tetracycline MOA

A

30s ribosomal subunit

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161
Q

Dosing of Bactrim based on which component?

A

TMP

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162
Q

ADEs of Bactrim

A 
hyperkalemia
anemia (G6PD)
SJS/TEN
photosensitivity
crystalluria
increased INR with warfarin
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163
Q

Vancomycin MOA

A

blocks d-ala d-ala in cell wall synthesis

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164
Q

Goal vanc trough for serious infection

A

15-20

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165
Q

Daptomycin ADEs

A

Mytopathy/rhabdomyolysis

Falsely elevates INR

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166
Q

Linezolid ADEs

A

Thrombocytopenia
Optic neuropathy
Serotonin syndrome (no MOAIs)

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167
Q

Metronidazole CI

A

Pregnancy

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168
Q

Clindamycin - when to use?

A

use D-test for S aureus to see if R to erythromycin

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169
Q

Chloramphenicol ADEs

A

Gray Syndrome (circulatory collapse)

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170
Q

Polymyxin ADE

A

Nephrotoxicity
neurotoxicity
neuromuscular blockade

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171
Q

Tigecycline - why is it last line?

A

Increased risk of death

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172
Q

Quinupristin/dalfopristin ades

A

arthralgia, infusion reaction, hyperbili

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173
Q

Fidaxomicin use

A

c dif

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174
Q

Rifaximin use

A

E coli

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175
Q

Fosfomycin use

A

single dose for UTI

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176
Q

Nitrofurantoin ADEs

A

Not if CrCl <60
G6PD deficiency (hemolytc anemia)
brown urine

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177
Q

Which oral solution should NOT be refrigerated

A

Cefdinir (and non-beta lactams)

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178
Q

Which antibiotics need protection from light?

A

Doxycycline

Micafungin

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179
Q

What are the resistant candida strains?

A

Glubrata

Krusei

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180
Q

Which fungal infections are mold?

A

aspergillus and zygomycetes

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181
Q

Amphotericin B ADEs

A

Infusion reaction (fever, chills, HA, malaise, rigors) - premedicate!
Low K
Low Mg
Nephrotoxicity

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182
Q

What is the lipid formulation of amphotericin?

A

Ambisome

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183
Q

Amphotericin MOA

A

holes in cell membranes by binding to ergosterol

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184
Q

Ancobon

A

Flucytosin

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185
Q

Flucytosine MOA

A

Converted to FU inside cells

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186
Q

Flucytosine ADEs

A

Myelosuppression

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187
Q

Azole mechanism

A

Decrease ergosterol synthesis (no cell membrane)

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188
Q

Class effects of azoles

A

QT prolongation and increased LFTs

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189
Q

Which azole penetrates CNS?

A

fluconazole

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190
Q

Which azole is contraindicated in HF?

A

Itraconazole

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191
Q

Which azole covers aspergillus and resistant candidas?

A

Voriconazole

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192
Q

ADEs of voriconazole

A

Visual, increased SCr, hallucination
Photosensitivity
Avoid IV in CrCl <50

193
Q

Which azoles need acidic environment for absorption?

A

itraconazole and ketoconazole

194
Q

Which azole does not have qt prolongation?

A

isavuconazonium

195
Q

Echinocandins spectrum

A

resistnat candidas, aspergillosis

196
Q

ADEs of echinocandins

A

Histamin-mediated symptoms (rash, swelling, decreased BP)

197
Q

Cancidas

A

caspofungin

198
Q

Mycamine

A

micafungin

199
Q

Griseofulvin MOA

A

Binds to keratin precurosrs (good for hair/skin/nails)

200
Q

Griseofulvan ADEs

A

photosensitivity, increased LFTs, CI with pregnancy

201
Q

Terbinafine mechanism

A

Inhibits squalene epoxidase

202
Q

Mycelex

A

Clotrimazole

203
Q

Nystatin use

A

thrush

204
Q

DOC for aspergillus

A

voriconazole

205
Q

DOC for candida albicans

A

Nystatin/fluconazole

206
Q

DOC for candida glabrata/krusei

A

echincocandins

207
Q

DOC for cyptococcus

A

ampho B/flucytosine

208
Q

DOC for dermatophytes

A

itraconazole/terbinafine/fluconazole

nail infections

209
Q

Nizoral

A

Ketoconazole

210
Q

Sporanox

A

Itraconazole

211
Q

Vfend

A

Voriconazoe

212
Q

Noxafil

A

Posaconazole

213
Q

Neuraminidase inhibitors should be taken with __ days of symptom onset

A

2 days

214
Q

oseltamivir ade

A

neuropsychiatric events

215
Q

zanamavir ade

A

bronchospasm (inhaled)

216
Q

Rapivab

A

Peramavir

217
Q

Relenza

A

Zanamavir

218
Q

Which herpes virus causes oropharyngeal v genital disease?

A

HSV-1 - oropharyngeal

HSV-2 - genital

219
Q

What drugs to treat HSV?

A

valacyclovir
acyclovir
famiciclovir

220
Q

Herpes simplex treatment

A

docosanol (abreva)
acyclovir
or systemic treatment

221
Q

When to use antiviral for genital herpes?

A

within 1 day of legion

222
Q

Treatment for genital herpes?

A

valacyclovir

223
Q

Invasive HSV treatment

A

IV acyclovir

224
Q

Herpes zoster treatment within __ days of treatment and treated for __ days

A

3 days

7 days

225
Q

Drugs to treat BPH

A
  1. a1 blockers
  2. 5a reductase inhibitors
  3. phosphodiesterase-5 inhibitors
226
Q

Natural product to prevent prostate cancr

A

Lycopene

227
Q

a-1 blocker ADEs

A 
Floppy iris syndrome
Orthostatic hypotension
HA
Fatigue
Ejaculation
228
Q

How long do a1 blockers take to work?

A

4-6 weeks

229
Q

Which a1 blockers are non-selective?

A

terazosin and doxazosin

230
Q

ADE of alfuzosin

A

QT prolongation

231
Q

ADE of silodosin

A

Retrograde ejaculation

232
Q

5-alpha reductase inhibitors ADEs

A

Impotence
decreased libido
Ejaculation disfunction
gynecomastia

233
Q

Avodant

A

Dutasteride

234
Q

ProScar

A

Finasteride

235
Q

Which PDE5 can be used for BPH

A

Tadalafil

236
Q

5-alpha reductase CI

A

pregnancy

women of child-bearing age

237
Q

Ketorolac CI

A

liver failure

more than 5 days of use

238
Q

Relafen

A

Nabumetone

239
Q

Voltaren

A

Diclofenac

240
Q

Doans

A

Magnesium salicylate

241
Q

ASA ades

A

dyspepsia, heartburn tinnitus (from salicylates)

242
Q

Indomethacin ADE

A

CNS side effects

243
Q

Which opioids need to be avoided with alcohol (4)

A

Kadian
Embeda
Zohydro
Nucynta ER

244
Q

What schedule is codeine in combo with pan meds

A

CIII

245
Q

How often is fentanyl patch applied

A

3 days

246
Q

Fentanyl brand naems

A

Sublimaze

Duragesic

247
Q

Which opioids interact with CYP3A4 inhibitors

A

oxycodone

hydrocodone

248
Q

Zohydro

A

oxycodone ER

249
Q

Dilaudid

A

Hydromorphone

250
Q

Dolophine

A

Methadone

251
Q

Demerol

A

Meperidine

252
Q

Startng dose of dilaudid (PO and IV)

A

PO: 2-4mg q4-6h
IV: 0.2-1mg q2-3h

253
Q

Methadone ADEs

A

QT prolongation, variable half life

254
Q

Meperidine ADEs

A

Not in renal impairment (seizures)

serotonergic

255
Q

Kadian

A

Morphine

256
Q

Which opioid has to be taken on an empty stomach

A

oxymorphone

257
Q

Opioid conversions

A

Morphine: 10(IV) 30(PO)

Hydromorphone 1.5(IV) 7.5(PO)

258
Q

Which opioids cross-react?

A

Those with -morph and -cod

259
Q

What are the PAMORAs?

A

Methylnaltrexone (Relistor)
Naloxegel (Movantik)
Naldemedine (Symproic)
Lupiprostone (Amitzia)

260
Q

ADEs of PAMORAs

A

abdominal pain, N/D

261
Q

Lupiprostone MOA

A

Cl channel activator

262
Q

Centrally acting analgesics MOA

A

Tramadol and tapentadol

Central mu + NE uptake inhibitor

263
Q

ADEs of tramadol/tapentadol

A

serotonin syndrome, seizure risk

264
Q

tramadol drug interaction

A

CYP2D6

265
Q

Tx of opioid abuse

A

Naloxone, buprenorphine(+naloxone)

266
Q

How often is Butrans applied

A

weekly (buprenorphine patch)

267
Q

What is requirement to prescribe buprenorphine?

A

DATA 2000 (will have DEA that starts with x)

268
Q

ADEs of gabapentin

A

ataxia, edema, weight gain

269
Q

Pregabalin indications

A

fibromyalgia
PHN
neuropathic pain

270
Q

what is treatment for trigeminal neuralgia

A

carbamazepine

271
Q

Lioresal

A

Baclofen

272
Q

Fexmid

A

cyclobenzaprine

273
Q

Zanaflex

A

tizanidine

274
Q

Robaxin

A

Methocarbamol

275
Q

Soma

A

carisoprolol

276
Q

What are the analgesic antispasmodics

A

Baclofen
Tizanidine
cyclobenzaprine

277
Q

Cycobenzpaprine ade

A

dry mouth

serotonergic

278
Q

tizanidine ade

A

a-2 agonist
decreaed bp, dry mouth
weakness

279
Q

carisoprodol ade and schedule

A

CYP2C19 - would increase if poor metabolizer

CIV

280
Q

How many patches of lidocaine can be applied at once?

A

3

281
Q

Zostrix

A

Capsaicin

282
Q

OTC intranasal steroids?

A

Budesonide (Rhinocort)

Fluticasone (Flonase)

283
Q

Dose of benadryl

A

25-50mg q6h

284
Q

Which symptom do antihistamines not fix?

A

congestion

285
Q

Which 2nd gen AHs are preferred in pregnancy?

A

Cetirizine and loratadine

286
Q

Cetirizine notes on onset

A

fast onset and works well but higher sedation

287
Q

Patanase

A

Olaptadine (nasal spray)

288
Q

Afrin

A

Oxymetazoline (intranasal decongestant)

289
Q

Max treatment length of Afrin?

A

3 days

290
Q

Which allergy/cold meds are contraindicated with MAOIs

A

Sudafed and phenylephrine

Dextromethorphan

291
Q

T/F: Intranasal cromolyn is used as needed for mild allergy symptoms

A

FALSE - not PRN

292
Q

ADE of ipratropium

A

Drying

293
Q

Administration requirements of SL immunotherapy

A

monitored 30 minutes following the first dose

294
Q

How much Sudafed dispensed in one day and one month?

A

3.6g/day

9g/month

295
Q

Natural products for cold

A

Zinc, Vit C, echinacea

296
Q

Robafen

A

Guaifenasin

297
Q

Dayquil Cough

A

Dexromethorphine

298
Q

Tessalon

A

Benzonatate

299
Q

Bromfed DM

A

brompheniramine, pseudoephedrine, dextromethorphan

300
Q

How old should kids be with allergy meds?

A

2 years per FDA
6 years per AAP
Codeine not <12 years

301
Q

What mechanism calls dextromethorphan abuse potential?

A

NMDA blocker

302
Q

How long to rinse after topical/ocular exposure

A

Topical: 10 minutes
Ocular: 15 minutes

303
Q

What med is used for bradycardia

A

Atropine

304
Q

Dose of activated charcoal

A

1g/kg within 1 hr

305
Q

APAP antidoate and mechanism

A

NAT - increases glutathione in cells

306
Q

Dosing for NAC

A

Rumack-Matthew Nomogram

307
Q

Antiodate: anticholinergics

A

phyostigmine

308
Q

Antiodate: Benzos

A

Flumazenil

309
Q

Antiodate: Cyanide

A

Hydroxocobalamin

310
Q

Drug that can cause cyanide poisoning

A

nitroprusside (will turn blue)

311
Q

Antidote: ethanol

A

Vit b1 (to rpevent Wernicke’s)

312
Q

antidote: hydrocarbons/petroleum

A

Induce vomiting

313
Q

Iron antidote

A

deferoxamine

314
Q

Antidote: organophosphates

A

Atropine
Pralidoxime
(cause cholinergic effects)

315
Q

Antidote: Neostigmine

A

Pralidoxime

316
Q

Antidote: Rocuronium, vecuronium, panacuronium

A

Neostigmine

317
Q

Antiodte: salicylates

A

Sodium bicarbonate

318
Q

Antidote: Stimulants

A

benzos

319
Q

Antidote: Methanole

A

Fomepizole

320
Q

CroFab for what snake bites?

A

Rattle snake and copperhead

321
Q

Per-op Abx

A

cefazolin 60 minutes before surgery

322
Q

Pre-op for colorectal surgery

A

Amp/sul, cefotetan, cefoxitin

323
Q

Meningitis treatment (adults and neonates)

A

ceftriaxone/cefotaxime + vancomycin (amp if >50)

Neonates: ampicillin + cefotaxime

324
Q

AOM antibiotics

A

High-dose amoxicillin (80-90mg/kg/day)

*can use cephalosporins if PCN allergic

325
Q

Pharyngitis bug and treatment

A

S pyogenes

Amoxicillin or PCN

326
Q

Sinusitis tx

A

augmentin

327
Q

COPD exacerbation

A

augmentin, azithromycin, doxycycline

328
Q

Bordetella treatment

A

azithromycin
clarithromycin
bactrim

329
Q

CAP outpatient

A

macrolide/doxycycline

Beta-lactam + macrolide OR FQ (if comorbidities or recent abx0

330
Q

CAP inpatient

A

Beta-lactam + (ML or DC)

Respiratory FQ

331
Q

VAP/HAP

A

2 antipseudomonals + anti-MRSA

332
Q

Latent TB test

A

Rifampin x 4 months

ISN + Rifapentine x 12 weeks

333
Q

RIPE drugs

A

rifampin
Isoniazide
Pyrazanamide
Ethambutol

334
Q

Rifampin ADEs

A

Increased LFTs, positive Coombs test

335
Q

Isoniazid ADEs

A

DILE, positive Coombs test, inhibitor

336
Q

Pyrazanamide

A

Hyperuricemia, increased LFTs

337
Q

Ethambutol

A

Increased LFTs, optic neuritis, hallucinations, confusion

338
Q

Endocarditis tx

A

add gentamicin for prosthetic valve synergy

339
Q

Dental ppx

A

Amoxicillin

340
Q

Spontaneous bacterial peritonitis tx

A

Ceftriaxone

341
Q

What drugs cover anaerboes

A

cefoxitin
metronidazole
ertapenem

342
Q

Impetigo treatment

A

Mupirocin

343
Q

Follliculitis treatment

A

Cephalexin (probably MSSA)

344
Q

Non-purulent cellulitis

A

Cephalexin

345
Q

Severe purulent SSTI

A

Cover MRSA

346
Q

Necrotizing fasciitis

A

Vanc + beta lactam + another

347
Q

Diabetic foot infections

A

BROAD coverage (polymicrobial)

348
Q

UTI - in urinalysis

A

WBC and bacteria

349
Q

Treatment for UTI

A

Macrobid
Bactrim
Fosfamycin

350
Q

How long to use azo?

A

2 days

351
Q

Treatment for pyelonephritis/complicated UTI

A

Quinolones
Ceftriaxone
Bactrim
Beta-lactam

352
Q

Pregnancy UTI tx

A

Augmentin/cephalosporin
Bactrim/Macrobid
Fosfomycin

353
Q

Cdif

A
  1. Vanc or fidaxomicin
  2. Switch or pulse vanc
  3. Pulse vanc or rifaximin, fidaxomicin, transplant
354
Q

Traveler’s diarrha

A

Azithromycin

355
Q

Syphilis (early stage)

A

PCN G benzathine (2.4 mil IM)

356
Q

Syphilis (late stage)

A

PCN G benzathine (2.4 mil IM) x 3 doses

Late >1 year or unknown

357
Q

Second-line for syphilis

A

Doxycycline

358
Q

Neurosyphilis

A

PCN G aqueous

359
Q

Bicillin LA

A

PCN G benzathine

360
Q

Gonorrhea

A

ceftriaxone IM + azithromycin x1

361
Q

Chlamydia

A

Azithromycin 1gm

362
Q

Bacterial vaginosis

A

Metronidazole

363
Q

Trichomoniasis

A

Metronidazole

364
Q

Ricketts/lyme/rocky mountain spotted fever

A

Doxycycline

365
Q

ADHD diagnosis

A

Must have 5 symptoms in 2 settings appearing before 12 years old

366
Q

Natural product for ADHD

A

fish oil

367
Q

What neurotransmitters does stimulant increase?

A

dopamine and norepinephrine

368
Q

Which ACE is available IV?

A

enalaprilat

369
Q

Which beta blockers are available IV?

A

Esmolol
labetaolol
propranolol
metoprolol

370
Q

Which thiazide available IV?

A

Chlorathiazide

371
Q

Which CCB available IV?

A

Nicardipine
Clevidipine
Diltiazem
Verpamil

372
Q

Phenytoin administration requirements?

A
  • NS only
  • Separate 2 hours in NS tube
  • Use within 4 hours
  • Max 50ml/hr due to arrhythmias
373
Q

Kcal in lipid?

A

10%: 1.1kcal/mL
20%: 2kcal/mL
30%: 3kcal/mL

374
Q

kcal in carb?

A

3.4kcal/g

375
Q

kcal in protein?

A

4kcal/g

376
Q

Nitrogen in protein?

A

Divide protein by 6.25g

377
Q

Nucynta

A

Tapentadol

378
Q

What bug do carbapenems not cover?

A

acinetobacter

they DO cover anaerobes!

379
Q

Which HIV meds need to be with food? -3

A

protease inhibitors (except fosamprenavir suspension)
Rilpivirine
Etravirine

380
Q

Which HIV meds need to be on empty stomach? - 4

A

Efavirenz (Atripla, Symfi)
Fosamprenavir oral suspension
Didanosine
Indinavir

381
Q

Which HIV med causes nephrolithiasis?

A

Ataznavir

Indinavir

382
Q

What is the equation for mOsm?

A

mOsm/L = g/L/(MW) * valence * 1000

383
Q

What is the equation for mEq?

A

mEq = mg * valence / MW

384
Q

T/F: Stimulants must be dispensed with MedGuide

A

True

385
Q

ADEs of stimulants

A 
CV events
Mania episodes in BPD
decreased seizure threshold
serotnin syndrome
Erection >4 hours
Loss of appetite
Dry Mouth
Blurry vision
386
Q

Methylphenidate starting dose

A

5mg BID

387
Q

Ritalin

A

Methylphenidate IR

388
Q

Concerta

A

Methylphenidate ER - OROS tablet (ghost)

389
Q

Quillichew

A

Methylphenidate chewable tablet

390
Q

Quillivant

A

Methylphenidate oral suspension

391
Q

Contempla

A

Methylphenidate ODT

392
Q

Focalin

A

Dexmethylprednisolone

393
Q

Adderall

A

Dextroamphetamine/amphetamine IR

394
Q

Mydayis

A

Dextroamphetamine/amphetamine ER

395
Q

Daytrana

A

Methylphenidate patch

396
Q

Vyvanse

A

lisdexamfetamine - chewable tablet or opennable capsule

397
Q

Desoxyn

A

Methamphetamine

398
Q

Which stimulant has lowest abuse potential

A

Lisdexamfetamine (prodrug)

399
Q

Instructions for Daytrana

A

Apply 2 hours before needed to HIP; remove after 9 hours

400
Q

Atomoxetine MOA

A

Selective NE reuptake inhibitor

401
Q

ADEs of atomoxetine

A

hepatotoxicity, hypertension/increase HD

402
Q

Can atomoxetine be opened?

A

Nope

403
Q

Kapvay

A

Clonidine ER

404
Q

Can alpha 2 agonists be used with stimulants?

A

Yes

405
Q

Endings of drug classes:
NS3/4A protease inhibitor
NS5A replication complex inhibitor
NS5B Polymerase inhibitor

A

NS3/RA: Previr
NS5A: Asvir
NS5B: Buvir

406
Q

What drug class used for hepatitis C?

A

Direct acting antivirals

407
Q

ADEs of all DAAs

A

Reactivation of hep B

Bradycardia with amiodarone (especially sofosbuvir)

408
Q

Harvoni

A

Sofosbuvir/ledipasvir

409
Q

Epclusa

A

Sofosbuvir/velpatasvir

410
Q

Mavyret

A

Glecaprevir/pebrentasvir

411
Q

Which Hep C drug can be used for only 8 weeks?

A

Mavyret

412
Q

Which Hep C drugs can be used in all genotypes?

A

Epclusa and Mavyret

413
Q

Which Hep C drugs can be used with HIV?

A

Myravaret, Epclusa, Harvoni

414
Q

Which Hep C drug cannot be used with estradiol?

A

Viekira Pak

415
Q

Which Hep C drug cannot be used with antacids

A

Epclusa

416
Q

What drug interaction for all Hep C drugs?

A

Not with strong Cyp inducers

417
Q

Is ribavirin monotherapy or combination?

A

Combination

418
Q

ADEs of ribavirin

A

hemolytic anemia

CI with pregnancy

419
Q

Interferon alfa ADEs

A

Infusion reaction (pre-treat) myelosuppression, depression, increased LFTs, GI upset

420
Q

How to treat Hep B

A

IFN alfa

NRTIs

421
Q

Vemlidy

A

Tenofovir AF

422
Q

Entecavir administration requirement

A

Empty stomach

423
Q

What hepatitis drugs need original container?

A

TAF and Harvoni

424
Q

Natural product for liver

A

Misk thistle

425
Q

What vitamin deficiency for alcoholism

A

Vitamin B1 - thiamine

426
Q

How to treat portal HTN/variceal bleeding

A
  1. bands
  2. Octreotide/sandostatin
  3. Nadolol/propranolol (secondary prevention)
427
Q

What is hepatic encephalopathy caused by and major symptom?

A

Caused by build up of ammonia

Symptom is atsterexis

428
Q

Treatment of hepatic encephalopathy

A

Lactulose
Rifaxim
Neomycin
Metronidazole

429
Q

ADE of long-term metronidazole

A

Neuropathy

430
Q

ADE of neomycin

A

Neurotoxicity, GI upset

431
Q

How to treat ascites

A

Spironolactone monotherapy

Spironolactone/furosemide in 40:100 ratio

432
Q

How to reat SBP?

A

Ceftriaxone

433
Q

Uric acid goal in gout

A

<6

434
Q

Acute gout attack treatment

A

Steroids (injection in joints)
NSAIDs
Colchicine

435
Q

Which NSAIDs for gout?

A

Indomethacin
Celecoxib
Solindac

436
Q

Colchicine ADEs

A

neuropathy
myopathy
GI upset
myelosuppression

437
Q

Colchicine dose

A

2x 0.6mg dose, then 1x0.6mg

438
Q

Treatment of chronic gout

A
  1. allopurinol/febuxostat
  2. Probenecid/lesinurad
  3. Pegloticase
439
Q

Pegloticase MOA

A

uricase enzyme converts UA to allantoin

440
Q

How long should xanthine oxidase inhibitors be used with NSAIDs/colchicine?

A

first 3-6 months

441
Q

ADEs of allopurinol/febuxostat

A

Hepatotoxicity
Rash
Nausea
Thrombus (febuxostat)

442
Q

ADEs of lesinurad

A

Increased SCr

443
Q

Probenecid ADE

A

G6PD deficiency

444
Q

Probenecid drug interaction

A

increases beta-lactam levels

445
Q

Does probenecid or lesinurad have to be used with XOIs/colchicine?

A

Probenecid - colchicine

Lesinurad - XOIs

446
Q

Pegloticase administration requirements

A

IV - pre-medicate

447
Q

Should pegloticase be with or without XOIs?

A

WITHOUT

448
Q

What drugs can increase UA

A 
ASA
Niacin
Pyrazinamide
Calcineurin inhibitors
Chemos
449
Q

Drug classes used for glaucoma

A 
Beta-blockers
Prostaglandin analogs
cholinergics
Rho Kinase inhibitors
Carbonic anhydrase inhibitors
alpha-2 agonists
450
Q

Which beta-blocker is selective for glaucoma?

A

Betaxolol

451
Q

Which glaucoma med is preferred if for 1 eye only?

A

Beta-blocker

452
Q

What preservative can afffect contact lenses?

A

BAK

453
Q

What is zolamide?

A

Carbonic anhydrase inhibitor

454
Q

Which glaucoma meds decrease humor production?

A

Beta-blockers
a2 agonists
carbonic anhydrase inhibitors
(BP)

455
Q

Which glaucoma med increase humor outflow

A

Cholinergics
a2 agonists
Rho Kinase inhibitors

456
Q

Ophthalmic antibiotics

A

Maxitrol
Polytrim
Ofloxacin
Moxifloxacin

457
Q

What drugs can cause visual changes?

A 
Amiodarone
Linezolid
Isotretinoin
Vigabatrin
Hydroxychloroquine
Ablockers
digoxin
PDE-5 inhibitors
voriconazole
458
Q

What med is used for ear infection?

A

Ciprodex

459
Q

What med is used for ear wax blockage?

A

Debrox - carbamid eperoxide

460
Q

Ear drop counseling - direction to pull ear

A

Adults: up and back
Kids: Down and back
Then stay upright for 5 minutes

461
Q

Cosopt

A

Timolol/dorzolamide (carbonic anhydrase inhibitor)

462
Q

Drugs that cause constipation (4)

A

Sucralfate
Colesevelam
Anticholinergics
Aluminum

463
Q

Metamucil

A

Psyllium

464
Q

Citrucel

A

Methylcellulose

465
Q

Stool softener

A

Docusate

466
Q

Osmotics - 4

A

Milk of magnesium (Mg hydroxide) - caution with renal
PEG
Glycerin
Lactulose

467
Q

Stimulants

A

Senna

Bisacodyl (Colace)

468
Q

Lubricants

A

Mineral oil

469
Q

Which osmotic has risk of neuropathy

A

OsmoPrep

470
Q

What color food colorings to avoid before colonsocopy?

A

red/blue/purple

471
Q

Lupiprostone mechanism, use

A

Chloride channel activator for chonic constipation (IBS, OIC)

472
Q

Linaclotide mechanism, use

A

(linzessa)

Guanylate cyclase C agnost - IBS, CIC

473
Q

Alvimopan MOA, max dose, use

A

PAMORA
For post-surgery constipation (but not for more than 7 days of opioids)
MAX: 15 doses/day

474
Q

What drugs can cause diarrhea

A 
Magnesium
Colchicine
Antineoplastics
Metoclopramide
Misoprostol
Quinidine
475
Q

Pepto-Bismol ADEs

A

black tongue/stool
Tinnitus
Reye syndrome
CI: ulcer, coagulopathy

476
Q

Loperamide age limit and max dose

A 
>2 years old
Max 16 (Rx), 8 (OTC) for 2 days
477
Q

Diphenoxylate/atropine - max dose and age limit

A

> 13 yo

20mg/day

478
Q

Dicyclomine MOA and ADE

A

Anticholinergic/antispasmodic
Toxic mega-colon and paralytic ileus
Bentyl

479
Q

Eluxadoline MOA and CI

A

Peripherally-acting Mu agonist

C-IV

NAPLEX D: (3 decks)

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