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NAPLEX 2021 > Cram Deck > Flashcards

Cram Deck Flashcards

1
Q

ml in 1 gal

A

3785ml per gallon

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2
Q

Gram positive in clusters

A

Staph!

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3
Q

Gram positive in chains/pairs

A

Strep

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4
Q

What organisms do penicillins work well against?

A

Gram positive!

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5
Q

When can you use a penicillin against gram negatives and anaerobes?

A

If it’s combined with a beta lactamase inhibitor (sulbacyam, clavulanate, tazobactam)

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6
Q

Penicillins CIs

A

Kidney failure (Crcl<30)

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7
Q

What are cephalosporins not active against?

A

Enterococcus or atypical

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8
Q

Ceftriaxone CI

A

Neonate!

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9
Q

How to renally adjust ceftriaxone

A

You don’t!

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10
Q

Pseudomonas coverage

A

Pip/tazo
Cefepime
Meropenem
Doripenem

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11
Q

Carbapenems can NOT be used for….

A

atypical
MRSA
C. Diff
VRE

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12
Q

Can you use aztreonam with PCn allergy?

A

Yes!!!

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13
Q

What antibiotics do you need to avoid with lovastatin/simvastatin

A

Clarithromycin and erythromycin.

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14
Q

Vanc systemic infection dosing

A

15-20mg/Kg q 8-12h

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15
Q

Vanco AUC/Trough goals for serious MRSA infections

A

Auc/mic 400-600

Trough 15-20

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16
Q

Which abx suspensions do you NOT refrigerate?

A 
Cefdinir 
Azithro 
Clarithro 
Cipro 
Clinda
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17
Q

Meningitis empiric treatment

A

Neonates: amp And cefotaxime or gent
1 month-50 years old:
Ceftriaxone and Vanc

> 50 or immunocomp:
Amp, ceftriaxone, and Vanc

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18
Q

Abx of acute bacterial exacerbation of chronic bronchitis (ABECB)

A

5-7 days of augmentin if sputum volume and puryulence and difficulty breathing

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19
Q

CAP treatment if no comorbidities

A

Amoxicillin or doxycycline or azithromyicn if resistance is low

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20
Q

CAP tx with comirbidities present

A

Cephalosporin or augmentin + doxy

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21
Q

HAP tx for low risk of MRSA

A

Cefepime or pip/tazo

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22
Q

HAP tx for MRSA risk high but low MDR risk

A

Cefepime + vanco

Meropenem + linezolid

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23
Q

If a patient on warfarin starts taking rifampin, what would you expect their INR to do and why?

A

INR would decrease because rifampin is a potent 3A4 inducer

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24
Q

What to use for bacteriuria in a pregnant patient

A

Augmentin!

Can use nitrofuratoin and Bactrim if beta lactam allergy

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25
Q

When to use azithromycin in travelers diarrhea

A

Fever, blood in stool, pregnant or peds

Otherwise use a floxacin!

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26
Q

Tx options for c. Diff

A

Oral vanco

Or metronidazole

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27
Q

What can amphotericin B cause a risk of with other agents that can cause this?

A

Nephrotox!

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28
Q

Issues with Azoles

A

Increase LFTs
QT prolongation
Interactions!!!!

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29
Q

What azole needs renal adjustment?

A

Fluconazole

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30
Q

What azole can cause heart failure

A

Itraconazole

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31
Q

Cyp consideration with Azoles

A

3A4 inhibitors!

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32
Q

One pill once daily HIV treatment for treatment naive

A

Biktarvy
Triumeq
Dovato

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33
Q

HIV: what’s the difference between TDF and TAF

A

TDF has a higher risk of fractures and should not be used in renal impairment

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34
Q

What’s special about abacavir?

A

HLA-B*5701 testing before use: hypersensitivity reactions

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35
Q

What drugs have abacavir?

A

Triumeq
Epzicom
Ziagen

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36
Q

What drug has TDF? (Fracture warning)

A

Truvada

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37
Q

What’s special with Maraviroc?

A

CCR5 receptor must be present and CXXR4 cannot be present

Assay test called Trofile used to test!

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38
Q

HIV PEP regimen!

A

Truvada + (Tivicay or Isentress)

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39
Q

What two hiv meds can be used for PrEP

A

Truvada or Descovy

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40
Q

What are HIV drug boosters?

A

Cobicistat and Ritonavir

Not interchangeable!

41
Q

Major CYP inhibitors

A 
G-PACMAN 
Grapefruit
Protease Inhibitors (especially ritonavir)
Azoles 
C - cyclosporine, cimetidine, and cobicistat 
Macrolides (clarithro and erythro) 
Amiodarone
Non/DHPs (diltiazem and verapamil)
42
Q

CYP inhibitor effect on non-pro drugs

A

Decreased metabolism > increased effects/ADRs/toxicities

43
Q

CYP inducers

A 
PS PORCS 
Phenytoin
Smoking
Phenobarbital
Oxcarbazepine 
Rifampin
Carbamazepine 
St Johns Wort
44
Q

Which statins interact with CYP?

A

SAL
Simva
Atorva
Lovastatin

45
Q

Ear drop instructions for adults

A

Pull earlobe up and back

46
Q

Ear drop directions for children

A

Pull earlobe down and back (if less than 3yo)

47
Q

Drugs that leach with PVC

A 
Leach Absorbs To Take In Nutrients 
Lorazepam
Amoidarone 
Tacrolimus 
Taxanes
Insulin
Nitroglycerin
48
Q

What drugs require Saline as a diluent

A 
A DIAbetic Can’t Eat Pie 
Ampicillin
Daptomycin 
Infiximab - Remicade 
Amp/sulbactam 
Capsofungin 
Ertapenem 
Phenytoin
49
Q

What drugs require dextrose as a diluent?

A

BOAS will strangle you if you don’t put these in Dextrose

Bactrim
Oxaliplatin
Amphotericin B
Synercid

50
Q

Other than phosphate what drug cannot be mixed with calcium with IV such and such

A

Ceftriaxone! Do not mix with LRs!

51
Q

Particles in an ISO class 5

A

3520

52
Q

BUD for CSPs made in an isolator

A

12 hours

53
Q

What does an HLB value of 4 mean

A

Low value for hydrophilic/lipophilic balance.

Product is more lipid soluble - aka typically for topical emulsions

54
Q

BUD nonaqueous formulations

A

6 months! Room temp

55
Q

BUD water containing oral forms

A

14 days - store in fridge

56
Q

BUD water containing topicals

A

30 days - room temp

57
Q

True or false: live attenuated vaccines can replicate?

A

True!

58
Q

Who cannot receive live attenuated vaccines

A

Pregnant and immunocompromised

59
Q

Common live vaccines

A 
COZY IV RM 
Cholera
Oral typhoid
Zostavax 
Yellow fever
Intranasal flu 
Varicella 
Rotavirus 
MMR
60
Q

Age for DTaP

A

<7 years old

61
Q

Which flu shot is egg free and what are the age requirements for it

A

Flublock

Must be >18yo

62
Q

What is type II error?

A 
Null hypothesis is accepted when it should have been rejected 
*remember the picture in class with the doctor telling the man he’s pregnant
63
Q

What factors does warfarin inhibit?

A

II, VII, IX, X

64
Q

Which anticoagulant should be used: stroke prophylaxis with mitral stenosis

A

Warfarin!

65
Q

Which anticoagulant should be used: stroke prophylaxis with mechanical heart valve

A

Warfarin

66
Q

Which anticoagulant: VTE treatment in cancer patient

A

LMWH

67
Q

Dose adjustment with Eliquis

A

For a fib, if patient has two of the following: 80yo or older, body weight less than 60kg, or SCr greater than 1.5mg/dL

Reduce dose to 2.5mg bid

68
Q

At what creatinine clearance value would you not use Xarelto

A

<30

69
Q

Which doac can’t be used if crcl is too good (>95)

A

Edoxaban

70
Q

Warfarin color order

A 
Please 
Let 
Grandma 
Brown 
Bring 
Peaches 
To 
Your 
Wedding

Pink, lavender, green, brown, blue, peach, teal, yellow, white

71
Q

What type of anemia McV<80

A

Microlytic - iron deficiency

Rbcs are small

72
Q

What type of anemia MCV 80-100

A

Normocytic

Blood loss, malignancy, CKD, hemolysis

73
Q

Type of anemia MCV >100

A

Macrolytic

B12 or folate deficiency

74
Q

Recommended dose of elemental iron

A

100-200mg/day

75
Q

% elemental iron in gluconate

A

12%

76
Q

% elemental iron in sulfate

A

20%

77
Q

% elemental iron in fumarate

A

33%

78
Q

Which IV iron needs a test dose?

A

Dextran!

79
Q

Where do loop diuretics work?

A

Ascending loop of henle at Na-K pump

80
Q

Where do thiazides work?

A

Na-Cl pump in distal convoluted tubule

81
Q

Crcl equation

A

=(140- (age) / 72 x SCr ) x wt (kg) x0.85(female)

82
Q

Patient has albuminuria, what should they be put on for kidney protection?

A

Acei or arb

83
Q

Drugs CI in CKD

A 
<60
Nitrofuratoin 
<50 
TDF
Voriconazole 
<30
TAF
NSAIDs 
Dabigatran 
Rivaroxban

Gfr- metformin and SGLT2

84
Q

What’s sevelamer?

A

Renvela
Phosphate binder thats non-ca, non-Al based
Not systemically absorbed
N/v/d

Can lower Total Cholesterol

85
Q

Hyperkalemia treatment

A

Give calcium gluconate to stabilize the heart

Shift it : dextrose, insulin, sodium bicarbonate, albuterol neb

Remove it: diuretics, hemodialysis

86
Q

Metabolic acidosis lab value

A

Sodium bicarbonate <22

Replace

87
Q

Different mechanisms of HCV drugs

A

Ns3/4a PI: -previr
ns5a replication Inhibitor: -asvir
Ns5b PI: -buvir in

88
Q

CYP considerations with DAAs (HepC drugs)

A

All are CI with strong 3A4 inducers

89
Q

HepB preferred treatment

A

Interferon Alfa

90
Q

Non-selective beta blockers for portal HTN

A

Nadolol

Propranolol

91
Q

Allergy medication that is safe in children

A 
>2yo
Flonase 
Cetirizine: 2.5-5mg qd 
Allegra: 30mg bid 
Claritin 5mg qd

Benadryl if >6yo
Xyzal: if >6 months

92
Q

What drugs can decrease IOP

A

Beta blockers (timolol)
Prostaglandins (lantanoprost)
Alpha 2 agonists (brimonidine)

93
Q

1 drop daily eye drops

A

Bimatoprost (Lumigan)
Latanoprosy
Travoprost (Travatan Z)
Bimatoprost (Latisse)

94
Q

Dosing frequency for timolol

A

Once daily to twice daily

95
Q

What’s a risk with steroid eye drops?

A

They can increase IOP long term

96
Q

Alopecia tx options

A

Finasteride

Minoxidil (rogaine)

97
Q

List of topical steroid potency from high to low

A 
Clobetasol
Fluocinonide 
Betamethasone
Mometasone 
Triamcinolone
98
Q

LDL equations

A

Tc-HDL - (TG/5)

99
Q

What is error of commission?

A

Something was done incorrectly versus being left out

NAPLEX 2021 (28 decks)

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