E2 liver Pharm & UTI review

Question 1

Lactulose class

Answer 1

Hyperosmotic laxative

Question 2

Indication of lactulose

Answer 2

Reduction of ammonia absorption in heptic encephalopathy

Question 3

MOA of lactulose

Answer 3

Reduced blood urea levels by converting it to ammonium which is water soluble & gets trapped in intestines for excretion

Question 4

How is lactulose given

Answer 4

PO, Enema, rectal

Question 5

How is lactulose titrated?

Answer 5

by number of stools or by ammonia levels

Not just given for high ammonia level must be showing s/s of encephalopathy

Question 6

Before giving lactulose make sure the pt isn’t

Answer 6

Hypokalemic

Question 7

Rifaximin is given ________

Answer 7

2nd line if lactulose isn’t working or as preventative

Question 8

MOA of rifaximin

Answer 8

Inhibits bacterial RNA synthesis by binding to bacterial DNA

Question 9

Side effects of rifaximin

Answer 9

Abdominal pain
Anemia
Ascites
dizziness
fatigue
Nausea
Peripheral edema
pruritis
skin rash

Question 10

rifaximin has been associated with

Answer 10

an increased risk of C.diff

Question 11

What class is ciprofloxacin?

Answer 11

Fluroquinolone

Question 12

What does ciprofloxacin treat?

Answer 12

• Mostly Gram - Broad spectrum
  -UTIs
  (-Some STIs, resp infections, Gonorrhea)

Question 13

MOA of ciprofloxacin

Answer 13

-Destroy bacteria by altering DNA

Question 14

Who would you not give ciprofloxacin to?

Answer 14

-Avoid in pts <18 or >60 yrs
-Do NOT give if bone pain

Question 15

1st abx prescribed for uncomplicated UTIs

Answer 15

Sulfamethoxale + trimethoprim

Question 16

Sulfamethoxale + trimethoprim class

Answer 16

Sulfonamines

Question 17

Who should not take Sulfamethoxale + trimethoprim and Side effects

Answer 17

-Do not take if sulfa allergy
-Adverse reactions more likely in HIV pts
-Photosensitivity