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Pharmacology > EENT Pharmacology > Flashcards

EENT Pharmacology Flashcards

1
Q

What is the tx to GABHS pharyngitis?

A
  • 1st line: Penicillin, 1st generation cephalosporin

- macrolides/erythromycin

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2
Q

Name the four symptoms present in GABHS?

A
  • absent cough
  • tender anterior cervical lymphadenopathy
  • tonsillar exudate
  • fever greater than 38C
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3
Q

Name penicillin susceptible narrow spectrum drugs

A
  • Penicillin VK

- Penicillin G

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4
Q

T/F Narrow spectrum penicillins cover gram pos bacteria while broad spectrum cover both gram pos and gram neg?

A

True

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5
Q

What is drug that is narrow spectrum and penicillinase resistant?

A

Nafcillin

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6
Q

What class drug is amoxicillin?

A

-broad spectrum penicillin

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7
Q

What are examples of penicillinase inhibitors (2)?

A
  • sulbactam

- clavulanic acid

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8
Q

What are adverse effects of penicillins(4)?

A
  • hypersensitivity rxn’s/maculopapular rash
  • c diff colitis
  • hemolytic anemia
  • overgrowth of opportunistic infections
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9
Q

What are drug interactions with penicillins (3)?

A
  • reduces Vitamin K/warfarin anticoagulation function
  • probenecid-penicillin stops clearance from kidneys
  • tetracycline is bacteriostatic and penicillin is bactericidal so don’t combine
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10
Q

Name 1st generation and 2nd generation cephalosporin?

A
  • cephalexin

- cefuroxime

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11
Q

name 3rd and 4th gen cephalosporin?

A
  • ceftriaxone
  • cefixime
  • cefipime 4th
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12
Q

name 5th gen cephalosporin?

A

ceftaroline?

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13
Q

1st gen cephalosporin clinical use?

A

-skin, soft tissue, UTI

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14
Q

2nd gen cephalosporin clinical use?

A

-more active against Strep pneumo, H. flu, and B fragilis

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15
Q

3rd gen cephalosporin clinical use?

A
  • pneumoniae, meningitis, and gonorrhea

- broad spectrum, beta lactamase stable

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16
Q

4th gen cephalosporin clinical use?

A

pseudomonas coverage

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17
Q

5th generation?

A

skin soft tissue

-CAP

18
Q

Why don’t you give ceftriaxone to infants?

A

-this increases serum bilirubin that can deposit in tissues

19
Q

If patient has IgE hypersensitivity rxn to penicillin, which cephalosporin should you avoid?

A

–all of them, they only one that has partial cross reactivity is 1st generation ceph

20
Q

What is MOA of penicillins?

A

cell wall synthesis inhibitors

-they act as substrate for penicillin binding protein and inhibit NAG+NAM linking

21
Q

What is MOA of macrolides?

A

Protein synthesis inhibitors (stop translation and transcription)
-affect 50S subunit/ribosome

22
Q

When would you give macrolides to patient with GABHS?

A

if patient has true allergic rxn to penicillin

23
Q

What are side effects of macrolides?

A
  • QT prolongation
  • abdominal pain
  • diarrhea/GI disturbances
  • Ototoxicity
24
Q

Name two macrolide drugs?

A

erythromycin

azithromycin

25
Q

What is an “off label use” of macrolides?

A

-GI prokinetic

26
Q

Drug interactions of macrolides?

A

-affects CYP450

27
Q

What viruses cause acute laryngitis?

A
  • M. catarrhalis

- H. flu

28
Q

Name two antivirals?

A
  • acyclovir

- valacyclovir

29
Q

What is MOA of antivirals?

A

-stop DNA synthesis and viral replication by competing for viral DNA polymerase

30
Q

T/F Valacyclovir is a prodrug and is more expensive than acyclovir

A

true

31
Q

How do you manage fluid and pain in patients with herpes or aphthous ulcers?

A
  • topical lidocaine
  • rinse and expectorate with 12.5/5 diphenhydramine and mixed with magnesium and aluminum 1:1.
  • ice popsicles
32
Q

What are side effects of antiherpetic drugs?

A
  • headaches

- malaise

33
Q

What is a drug interaction of antivirals?

A

-valacyclovir and acyclovir can diminish therapeutic effect of zoster vaccine. Don’t give it 24 hrs before receiving vaccine and wait 2 weeks after vaccine has been given to administer the antivirals.

34
Q

What is clinical presentation of oral candidiasis?

A
  • painful creamy white curd like patches that brush off

“Thrush will brush”

35
Q

What is MOA of antifungal?

A

Nystatin-binds sterols in fungal cell membrane and increase permeability of cells; cells leak contents and die
Azoles: inhibit cell membrane synthesis by stopiping Cytochrome P450 and thus stop ergosterol synthesis

36
Q

What is 1st line tx for oral candidiasis?

A

Nystatin oral soln: 1:100,000

  • 5 ml swish, hold and swallow QID x 7-10 days
  • Clotrimazole troches
37
Q

What is 2nd line tx for oral candidiasis?

A

Fluconazole PO

itraconazole suspension

38
Q

What are some adverse side effects of antifungals?

A
  • increased ALP, ALT, AST, jaundice, hepatitis, hepatic failure
  • angioedema (rare)
39
Q

What should you monitor in patients taking antifungals?

A
  • LFT
  • Qt prolongation
  • baseline serum creatinine
40
Q

What are drug interactions with antifungals?

A
  • enhances toxic effects of calcium channel blockers
  • increases serum concentrations of Vitamin K antagonists, proton pump inhibitors, atorvastatin and simvastatin
  • decrease metabolism of benzos and losartan
41
Q

What is pregnancy category for antifungals?

A

Category C

-give single dose for vaginal candidiasis

Pharmacology (47 decks)

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