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ENT > ENT Pharm > Flashcards

ENT Pharm Flashcards

1
Q

What bacteria cause 75% of bacterial sinusitis?

A

s.pneumo and h. flu

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2
Q

Abx used as first line tx for bacterial sinusitis in the past

A

Amoxicillin 500 mg po tid (appropriate sinus penetration) x 7-10 days. Ermergence of resistance

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3
Q

What should you also prescribe to a patient who needs abx but has tendency to get yeast infections?

A

diflucan one time PO med

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4
Q

What abx is recommended as initial empiric therapy in non PCN allergic patients with bacterial sinusitis?

A

Augmentin (Amoxicillin-clavulanate): 500mg/125mg

or 875mg/125mg bid x 7 days

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5
Q

CI to augmentin

A

severe renal impairment

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6
Q

CI to doxycycline

A

Pediatrics: tooth enamel hypoplasia or permanent tooth discoloration. Do not use during pregnancy a/w reduced bone growth

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7
Q

Abx that can be used for bacterial sinusitis in patients allergic to PCN despite emerging resistance

A

Azithromycin (Zithromax): 500mg every day x 3 days

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8
Q

Patient popn who should never be prescribed macrolide due to potentially fatal cardiac arrhythmias

A

pt with QT prolongation

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9
Q

Maximum does of pseudophedrine (Sudafed)

A

4 doses/24hr

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10
Q

Fancy name for Afrin and dosage

A

Oxymetazoline 0.05% two sprays each nostril q8 hours for 3 days only

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11
Q

Second line tx for bacterial sinusitis if patient has had abx tx in past 30 days or if patient doesn’t improve in 3-5 days

A

Amoxicillin/clavulanate 2000mg/125mg po bid
Levoflox 500mg 1 po every day
Moxifloxacin 400mg po every day

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12
Q

What is most common diagnosis in kids between age 1-3?

A

acute otitis media

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13
Q

T/F abx should be administered to any child younger than 6 months, regardless of the degree of diagnostic certainty

A

true

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14
Q

First line therapy of AOM if low risk for resistance

A

Peds: Amoxicillin 90mg/kg/d in divided doses BID x 10 day. Adults: 500 mg PO BID for 5-7 days

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15
Q

Therapy of AOM for patients allergic to PCN

A

Azithromycin (Zithromax) 10mg/kg/d. Max 500mg/day as day one dose. Max 250mg/day for days two through five
(dosing is for ped patients)

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16
Q

Recommended duration of treatment for otitis media

A

younger than 2: 10 days. older than 6: 5-7 days

17
Q

Indications for Auralgan (Antipyrine) drops in otitis media

A

reduce pain and swelling or to remove/soften cerumen

18
Q

Abx tx for malignant otitis externa/necrotizing external otitis

A

antipseudomonal antimicrobials- Ciprofloxin 750mg PO BID (first line), Levofloxin can be used 750mg po or IV every day

19
Q

Why are otic drops different in pH?

A

they are acidic because normal environment of EAC is acidic. these drops are painful if penetrate to middle ear because this environment is neutral

20
Q

First step in tx of otitis externa

A

Remove Cerumen, desquamated skin, and purulent material from ear canal

21
Q

What organisms do fluoroquinolones have no activity against?

A

anaerobes

22
Q

What drops shouldn’t be used in children < 1 yr?

A

Cipro HC Otic Suspension, Ciloxan (Ciprofloxin 0.2%/Hydrocrotisone 1%)

23
Q

What otic soln has been shown to have birth defects in animal studies and is not recommended during breastfeeding?

A

Ofloxin 0.3% solution (Floxin Otic Solution)

24
Q

What is the drug of choice when a perforated tympanic membrane cannot be ruled out?

A

Ofloxacin 0.3% Solution (Floxin Otic Solution)

25
Q

What is the otic that is very useful for prevention of ear infections and is good alternative to abx soln?

A

Acetic acid in aluminium acetate (Domeboro)

3-5 gtts q 4-8hr x 5-7 days (Adult and Pedi, >3y/o)

26
Q

What is an otic that is effective against both bacterial and fungal external otitis?

A

5% aluminum acetate (Burow’s Solution)

27
Q

Indication for debrox (OTC)?

A

Cerumen removal

28
Q

Purpose of an ear wick

A

helps topical medication penetrate a severely swollen ear canal

29
Q

Tx for labrynthitis for patient experiencing severe N/V (ie antiemetics)

A

Meclizine (Antivert)**: 25-100mg/day in divided dosages or Prochlorperazine (Compazine): 5-10mg po tid-qid

30
Q

How might diazepam help with labrynthitis?

A

Suppress the vestibular system

31
Q

CI to hydrochlorothiazide

A

sulfamide allergy

32
Q

Drug that can be used for Meniere’s as well as many other issues such as insomnia, anxiety, ETOH withdrawal, relief of pruritis

A

Atarax (Hydroxyzine)Start at 10mg every 4-6 hrs prn and work up if needed to 25-50mg every 4-6 hrs

33
Q

First line tx for allergic rhintis

A

intranasal glucocorticoids

34
Q

first gen intranasal glucocorticoids

A

Beclomethasone (Beconase AQ) 1 spray PN QD
Flunisolide (Nasalide) 1 spray PN BID
Budesonide (Rhinocort Aqua)

35
Q

second gen intranasal glucococorticoids

A

Fluticasone (Flonase) 2 sprays PN once daily or 1 spray bid. Mometasone (Nasonex) 2 sprays (100mcg) PN once daily

ENT (8 decks)

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