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Pharmacology > EENT > Flashcards

EENT Flashcards

1
Q

GABHS Treatment

A
  1. Penicillin VK x10 days

2. Erythromycin

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2
Q

What may increase PCN serum concentration? when would we want to use this?

A

Probenecid= prevents excretion from kidneys

–>give this when you want to conserve PCN

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3
Q

Whats is the effect of tetracylcine derivatives on PCN?

A

Diminish therapeutic effect because of bacteriostatic (tetracycline) and bactericidal (PCN)

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4
Q

What will drug will PCN enhance?

A

Anticoagulant effect of Vitamin K antagonist (Warfarin)

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5
Q

Side effects of erythromycin

A
  1. Prokinetic agent: Diarrhea, GI upset
  2. QT prolongation
  3. Ototoxicity
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6
Q

erythromycin drug interactions

A

Effects on CYP450

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7
Q

What is a good drug combination to treat in bacterial pharyngitis in chronic carriers?

A

PCN V + Rifampin

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8
Q

When is the ideal time to start antiviral therapy (acyclovir) in HSV1 or 2 outbreak?

A

Prodome period, within 3 days of onset

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9
Q

List pain and fluid management for HSV

A
  1. Diphenhydramine (Benadryl) liquid mixed with magnesia-aluminum (Maloxx): Rise and spit
  2. Topical Lidocaine
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10
Q

Side effects of antiherpetics

A
  1. Malaise

2. HA

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11
Q

When would you want to discontinue antiviral therapy?

A

With Zoster Vaccine (shingles)

-D/C @ least 24 hrs prior and 14 days after receiving live attenuated vaccine

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12
Q

What is first line treatment for oral candidiasis (“flush”)? Drug name? And why?

A

Topicals: Nystatin Suspension 1:100,000

  • Less adverse events
  • Less drug interactions
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13
Q

What is the fungal oral prototype for tx of oral thrush?

A

Fluconazole

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14
Q

Fluconazole MOA

A

Binds to sterols in funga cell membrane–>changing the cell wall permeability, allowing for a leakage of cellular contents

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15
Q

What is the major side effect to of -azoles?

A

Liver function: Increased alkaline phosphates, increase ALT/AST, hepatitis

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16
Q

What is a rare side effect to of -azoles?

A

Angioedema

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17
Q

What is the most common cause of conjunctivitis?

A

Viral: Adenovirus

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18
Q

bacterial conjunctivitis organisms

A 
Her Majestic Secret Service 
H- H. influenza
M- Moraxella catarrhalis
S- S. aureus
S- S. pneumoniae
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19
Q

What is the most common organism that causes bacterial conjunctivitis in adults?

A

S.aureus

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20
Q

What population is at an increased risk for bacterial conjunctivitis? Organism? Tx?

A
  1. Contact wearers
  2. Pseudomonas aeruginosa
  3. Aminoglycosides (more gram negatives)
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21
Q

Abx treatment for bacterial conjunctivitis

A
  1. Macrolides: Erythromycin ointment

2. Polymixin-Trimethoprim (Polytrim) drops (anti-folate)

22
Q

What is the most common organism that causes blepharitis?

A

S. aureus

23
Q

blepharitis tx?

A

Topical abx: Erythromycin ointment

24
Q

Periorbital cellulitis treatment if MSSA

A
  1. Amoxicillin-Clavulanate
  2. Cefpodoxime
  3. Cefdinir
25
Q

Periorbital cellulitis treatment if MRSA

A
  1. Trimethropim-Sulfamethoxazole (Bactrim)
  2. Clindamycin: long term= C.diff
  3. Doxycycline: Contraindicated in child < 8 y.o.
26
Q

Orbital cellulitis treatment

A

Empiric Vancomycin (covers MRSA) + Ceftriaxone (3rd generation covers CNS infection)

27
Q

Corneal abrasion treatment

A

Ophthalmic abx: Eryhtromycin ointment

28
Q

What should you AVOID using with a corneal abrasion?

A

Aminoglycosides

  • Toxic to epithelium
  • Exception: Contact-lens related abrasions
29
Q

What is CONTRAINDICATED with a corneal abrasion?

A

Steroids

-Slows epithelial healing

30
Q

Corneal ulcer (keratitis) tx

A

Ophthalmic fluroquinolones

31
Q

HSV Keratitis tx

A
  1. Topical antivirals:
    - Ganciclovir opth. gel
    - Trifluridine opth solution
  2. Corticosteroids ONLY by ophthalmologist
32
Q

Herpes zoster tx (eye)

A
  1. Ophthalmic antivirals and abx

2. Corticosteroids ONLY by ophthalmologist

33
Q

Viral conjunctivitis tx

A
  1. OTC topical antihistamines/decongestants
  2. Eye lubricant drops
  3. Abx if requires by school: Erythromycin ointment
34
Q

ADE’s in Macrolides (Erythromycin, Azithromycin)

A

Hypersensitivity rxn

35
Q

Topical NSAIDs name and indication

A

Ketorlac 0.5% Ophthalmic solution

-Tx for postop inflammation following cataract/laser corneal surgery

36
Q

ADEs of corticosteroids

A

Cataract formation, glaucoma

37
Q

Otitis externa treatment

A
  1. Aminoglycosides

2. Fluroquinolones: Ciprofloxacin

38
Q

What MUST you do before administering Aminoglycosides** ? Why?

A

Visualize TM to make sure TM is not perforated= IRREVERSIBLE OTOTOXICITY

39
Q

Most common otits externa organism infection?

A

Pseudomonas

40
Q

Most common otits media organism infection?

A

S. pneumoniae

41
Q

What is first line treatment in otitis media?

A

High dose Amoxicillin

=80-90 mg/kg/day DIVIDED BY 12 HRS

42
Q

What is second line therapy in otits media?

A

Amoxicillin-Clauvulanate

43
Q

otits media treatment with PCN allergy, but NO type 1 hypersensitivity rxn

A

Cephalosporin

44
Q

otits media treatment with PCN allerg with type 1 hypersensitivity rxn

A
  1. Macrolides: Azithromycin, Erythromycin
  2. Clindamycin
  3. Trimethoprim-sulfamethoxazole (TMP-SMX)
45
Q

What are two major adverse effect with TMP-SMX?

A
  1. Steven-Johnson Syndrome (rash on face)

2. Sulfa allergy

46
Q

First line treatment for bacterial sinusitis?

A

Amoxicillin: 1000 mg TID 7-10 days

47
Q

Second line treatment for bacterial sinusitis?

A

Amoxicillin-clavulanate

-If not responding to 1st line treatment after 3 days

48
Q

What may decrease risk of acute otitis media?

A

Vaccination against influenza and pneumococcus

49
Q

1st line treatment Glaucoma

A

Increase aqueous drainage:

  1. PG analogues
  2. Topical alpha adrenergic: constrict blood vessels
  3. Topical alpha cholinergic: Parasympathetics= constrict pupil (myosis)
50
Q

2nd line treatment Glaucoma

A

Decrease aqueous production

1. Topical B-blockers (Timolol)= absorbed systemically¥

51
Q

PG analogues ADEs

A

Increased pigmentation of iris

-Blue eyes (lack pigmentation) might become brown

52
Q

Topical alpha cholinergics side effects?

A 
SLUDGE
S-salvation
L-Lacrimation
U-urination
D-Defecation
G-Gastric
E-Emesis

Pharmacology (9 decks)

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