Exam 1 Flashcards

1
Q

Volume of distribution

A

Amount of drug in the body/plasma drug concentration

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2
Q

High volume of distribution

A

Means that the drug is not highly protein bound

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3
Q

Clearance of a drug

A

0.693(Vd)/half life

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4
Q

Bioavailability

A

How much of the drug will reach the blood after metabolism

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5
Q

What form of drug route will have greatest bioavailability

A

IV and sublingual

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6
Q

Fastest route of absorption

A

Inhalation

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7
Q

What will make urine more acidic

A

Cranberry juice, vitamin C, NH4Cl

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8
Q

What will make urine more basic

A

Aspirin

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9
Q

What types of drugs will cross placenta and blood brain barrier

A

Small, lipid soluble, non-protein bound

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10
Q

Inhibition of CYP450 leads to

A

Drug toxicity

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11
Q

General inducers of CYP450

A

GPCRABS

Glucocorticoids, phenytoin, carbamazepine, rifampin, alcohol, barbiturates, st johns wort

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12
Q

General inhibitors of CYP450

A

GPACMANS
Grapefruit, protease inhibitors, proton pump inhibitors, azoles, cimetidine, macrolides, amiodarone, non-dihydropyridines, SSRIs

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13
Q

Drugs that undergo zero order elimination

A

Phenytoin, salicylates, aspirin, alcohol

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14
Q

Drugs that have a small therapeutic index

A

Have a higher chance of toxicity–need to monitor drug levels

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15
Q

Water percentage in neonates

A

75-80%, less body fat

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16
Q

When do kidneys and liver reach maturation in infants

A

2 years old

Before this, drug toxicity can occur more frequently

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17
Q

When does gastric output levels reach adult levels in children

A

2 years old

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18
Q

Gastric emptying in infants/children

A

prolonged

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19
Q

Pulmonary absorption in children

A

Decreased due to increased RR and larger tidal volume

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20
Q

Volume of distribution in children

A

Larger due to increased total body water and less albumin

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21
Q

Body water and fat in elderly

A

Less body water and more body fat

Half life of drugs may increase if higher volume of distribution

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22
Q

Drugs that have increased CNS effects in elderly

A

Anticholinergics, TCAs, antihistamines, antispasmodics, benzodiazepines, analgesics

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23
Q

Allosteric site

A

A binding site for substrates not active in initiating a response; may induce a conformational change in the structure of the active site, rendering it more or less susceptible to response from a substrate

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24
Q

Downregulation

A

Decreased availability of drug receptors

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25
Q

Enterohepatic recirculation

A

Process by which a drug excreted in the bile flows into the GI tract, where it is reabsorbed and returned to the general circulation

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26
Q

Hepatic extraction ratio

A

A comparison of the percentage of drug extracted and the percentage of drug remaining active after metabolism of the liver

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27
Q

Pharmacodynamics

A

Process through which drugs affect the nody

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28
Q

Pharmacokinetics

A

process through which the body affects the drug

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29
Q

Prodrug

A

A drug that is transformed from an inactive parent drug to an active metabolite

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30
Q

Penicillin’s

  • Method of action
  • SE
  • Coverage
A

Bactericidal–interfere with cell wall synthesis
SE: hypersensitivity, GI distress, seizures, encephalopathy
Mostly G+ coverage
Some G- coverage

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31
Q

Cephalosporins

  • Method of action
  • SE
  • Coverage
A

Bactericidal–interfere with cell wall synthesis
SE: hypersensitivity, GI distress
As you progress from 1st to 4th generation, has more G- and less G+ coverage

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32
Q

Monobactams

  • Method of action
  • SE
  • Coverage
A

Bactericidal–interfere with cell wall synthesis
SE: GI distress, usually no cross-sensitivity with penicillin or cephalosporin
Primarily against G-

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33
Q

Carbapenems

  • Method of action
  • SE
  • Coverage
A

most broad spectrum agents available
Bactericidal–interfere with cell wall synthesis
SE: neurotoxicity, GI distress
G+ , G-,

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34
Q

Fluoroquinolones

  • Method of action
  • SE
  • Coverage
A

Bactericidal–Inhibit DNA gyrase and topoisomerase IV
SE: GI distress, dizziness, confusion, tendon rupture, QT prolongation
G+ and G-
DOC for UTI

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35
Q

Macrolides

  • Method of action
  • SE
  • Coverage
A

Erythromycin, azithromycin, clarithromycin
Bacteriostatic–binds to 50S
SE: GI distress, hepatotoxicity, ototoxicity
Broad spectrum: G+, G-, Atypical

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36
Q

Aminoglycosides

  • Method of action
  • SE
  • Coverage
A

Gentamicin, Neomycin, Streptomycin, Tobramycin
Bacteriostatic–binds to 30S
SE: Nephrotoxicity and ototoxicity
Mainly active against G-
Can combine with beta lactams for G+ coverage

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37
Q

Tetracyclines

  • Method of action
  • SE
  • Coverage
A

Bacteriostatic–binds to 50S
SE: GI distress, gray-brown discoloration of the teeth
Broad spectrum–G+, G-, atypical

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38
Q

Sulfonamides

  • Method of action
  • SE
  • Coverage
A

Bacteriostatic–inhibits folic acid
SE: GI distress, rash, fever, steven johnson syndrome and vasculitis
G+ and G- (except pseudomonas)

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39
Q

Vancomycin

  • Method of action
  • SE
  • Coverage
A

Bactericidal–inhibits d-alanyl-d-alanine portion of cell wall
SE: fever, chills, phlebitis, red man syndrome, nephrotoxicity
Active mostly against MRSA

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40
Q

Oxazolidinones

  • Method of action
  • SE
  • Coverage
A
Linezolid + Tedizolid
Oral tx for MRSA 
Bacteriostatic--bind to 50S 
se: GI distress, thrombocytopenia, leukopenia 
G+ only--MRSA, VRE
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41
Q

Clindamycin

  • Method of action
  • SE
  • Coverage
A

Bacteriostatic–binds to 50S
SE: diarrhea and C. DIff colitis
Active against G+ and G- anaerobic

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42
Q

Metronidazole

  • Method of action
  • SE
  • Coverage
A

Bactericidal–inhibition of DNA protein synthesis
SE: GI distress, seizures, peripheral neuropathy
G- coverage only
DOC for abdomen and GU system (H Pylori, C. Diff, bacterial vaginosis, trich)

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43
Q

Chloramphenicol

  • Method of action
  • SE
  • Coverage
A

Variably bactericidal–binds to 50S
SE: Gray baby syndrome, optic neuritis, fatal aplastic anemia
Broad spectrum: G+, G-, anaerobic

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44
Q

Rifampin

  • Method of action
  • SE
  • Coverage
A

Variably bactericidal–inhibits DNA
SE: GI distress, headache, fever, discolors body fluids to orange
Mostly against G+ with some G- coverage
DOC for TB

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45
Q

Nitrofurantoin

A

Variably bactericidal–interfers with cell wall synthesis
SE: N/V and pulmonary reactions, hepatotoxicity, peripheral neuropathy
G+ only
Only used for uncomplicated UTI

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46
Q

Dermatitis

A

Alteration in skin reactivity caused by exposure to external agent; usually on inflammatory process
Diaper dermatitis, atopic dermatitis, irritant dermatitis
Linear streaks of papules, vesicles, and blisters that are very pruritic

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47
Q

First line therapy for dermatitis

A

Low potency topical steroid 2x a day
Alclometasone, flucinolone, hydrocortisone, triamcinolone
Prolonged use can cause skin atrophy

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48
Q

Second line therapy for dermatitis

A

Increase protency of topical steroid or increase to oral steroid
-Use in tapering dose for 2-3 weeks

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49
Q

Topical immunosuppressants for dermatitis

A

Primecrolimus + Tacrolimus
Used if patient can not tolerate steroids
Decreases cytokine transcription

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50
Q

Relief of itching in dermatitis

A

Antihistamines

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51
Q

Tinea

A

Group of fungi infections on skin

Pruritus, burning, stinging

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52
Q

First line therapy for tinea capitis

A

Griseofulvin

Systemic terbinafine or itraconazole

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53
Q

First line therapy for tina corporis, cruris and pedis

A

Topical azoles first

Systemic terbinafine or fluconaozle if no relief

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54
Q

First line therapy for tinea uriguium

A

Systemic terbinafine or itraconazole

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55
Q

Griseofulvin

A

Fungistastic
May aggravate SLE
SE: N/V, diarrhea, headache, photosensitivity

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56
Q

Tinea versicolor

A

Opportunistic superficial yeast infection; chronic; asymptomatic
Well-demarcated scaling patches of varied color due to overgrowth of yeast

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57
Q

DOC for tinea versicolor

A

Selenium sulfide

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58
Q

Candidiasis

A

Superficial fungal infection of skin and mucus membranes

Found commonly in diaper area, oral cavity, nails, vagina, penis

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59
Q

First line therapy for oral thrush

A

Nystatin–swish and swallow 3x a day for 10-14 days

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60
Q

First line therapy for skin candidiasis

A

Cool soaks with burrow solution, topical azole

If no relief, can use a systemic azole

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61
Q

Topical antivirals

A

Acyclovir, Penciclovir

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62
Q

Systemic antivirals

A

Acyclovir, Famciclovir, Valacyclovir

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63
Q

First line treatment for HSV-1

A

Topical acyclovir or penciclovir

Can use systemic if no releif

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64
Q

First line treatment for VZV

A

Systemic antiviral if <72 hours from outbreak, patient >50 years old, or immunocompromised
7 day treatment

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65
Q

First line treatment of warts

A

Salicyclic acid

-Keratolytic peeling agent; leave patch on 5-6 days a week for 12 weeks

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66
Q

Salicyclic acid CI in

A

Patients with DM or impaired circulation

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67
Q

Skin infections are primarily due to

A

Staph aureus, GAS, GBS

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68
Q

Impetigo

A

Superficial skin infection due primarily to staph aureus

Spread between close quarter living environments, poor hygiene, schools, daycare centers

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69
Q

Treatment of impetigo

A
Topical Mupirocin (Bactraban) for 7-10 days 
If more major, can give a broad spectrum penicillin or 1st generation cephalosporin
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70
Q

Cellulitis

A

Infection involving skin and subcutaneous layers and can spread systemically
Mostly due to staph aureus or GAS

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71
Q

Erysipelas

A

Superficial form of cellulitis that occurs in children due to GAS

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72
Q

Treatment of cellulitis without systemic symptoms or purulence

A

Penicillin or Augmentin

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73
Q

Treatment of cellulitis with purulent infection

A

Bactrim, minocycline, clindamycin, linezolid (covers MRSA)

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74
Q

Folliculitis

A

Superficial infection of hair follicle usually due to staph aureus
May be due to pseudomonas in hot tubs

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75
Q

Treatment for superficial folliculitis

A

Warm compresses, topical mupirocin ointment or topical gentamicin

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76
Q

Treatment for deeper folliculitis

A

Oral dicloxacillin, cephalexin, clindamycin

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77
Q

Necrotizing fasciitis

A

Serious infection of subcutaneous tissues that can be life threatening
Usually polymicrobial

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78
Q

Bactrim is not active against

A

GAS

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79
Q

Mupirocin ointment active against

A

Staph aureus and some strep

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80
Q

Topical gentamicin active against

A

Staph aureus, GAS, pseudomonas

81
Q

Psoriasis

A

Autoimmune-mediated process driven by abnormally activated helper T cells
Well-demarcated, erythematous papules/plaques surrounded by silvery or whitish scales

82
Q

First line treatment for psoriasis

A

Moisturizers + topical steroids

If no relief, can add a vitamin D analog

83
Q

Topical corticosteroids for psoriasis

A

Hydrocortisone
Decreases redness, itching and scaling and promotes vasoconstriction
Rapid onset

84
Q

Coal tars for psoriasis

A

Decrease DNA synthesis and has anti-inflammatory and anti-pruritic properties
Adjunct therapy to steroids
Has an unpleasant odor, staining and photosensitivity

85
Q

Anthralin

A

Coal tar derivative used for psoriasis
Slow onset of action
Can irritate skin and stain clothing

86
Q

Topical Vitamin D analogs for psoriasis

A

Calcipotrient + Calcipotriol
Mild-moderate psoriasis
Decreases cell proliferation and is anti-inflammatory
Can cause dry skin, peeling and rash

87
Q

Retinoid

A
Vitamin D derivative 
Topical format for mild to moderate psoriasis 
Decreases inflammation 
Promotes longer remission
May get worse before it improves
88
Q

Systemic retinoids

A

Acitretin
Long term therapy for psoriasis
Decreases inflammation
Can cause liver and lipid problems, alopecia, skin peeling, dry skin and pruritus

89
Q

Methotrexate for psoriasis

A

Treats generalized psoriasis

Inhibits folic acid reductase

90
Q

Cyclosporine for psoriasis

A

Immunosuppressant
Used short term for exacerbation
May cause gingival hyperplasia, htn, nephrotoxicity, tremor

91
Q

Acne Vulgaris

A

Excess androgen causes increased sebum production

92
Q

Open comedones

A

Blackheads

93
Q

Closed comedones

A

White heads

94
Q

Comedolytics for Acne

A

Retinoic Acid (Tretinoin)
Adapalene Gel
Tazarotene Gel

95
Q

Comedolytic bactericidals for Acne

A

Benzoyl peroxide

Azelaic acid

96
Q

Topical antibiotics for acne

A

Clindamycin or erythromycin

97
Q

Oral antibiotics for acne

A

Tetracycline
Erythromycin
Indicated for inflammatory acne

98
Q

Isotretinoin

A

Reserved for severe nodulocystic acne when other treatments fail
Therapy usually occurs for 15-20 weeks
Severely teratogenic

99
Q

First line therapy for acne

A

Topical antibiotics of comedolytics

100
Q

Second line therapy for acne

A

Oral antibiotics and topical medications

Oral contraceptives

101
Q

Third line therapy for acne

A

Isotretinoin

102
Q

Who should not use tetracyclines

A

Children <12 years old

Pregnant women

103
Q

Rosacea

A

Acneiform disorder that begins in midlife

Symmetric rash on central part of face

104
Q

Treatment of rosacea

A

Topical metronidazole, sodium sulfacetamide, and acelaic acid first line
Oral doxycycline, erythromycin, bactrim for second line

105
Q

Blepharitis

A

Eyelid margin infections usually due to staph aureus

Irritated red eyes, burning sensation, increased tearing

106
Q

Treatment of blepharitis

A

Topical ophthalmic antimicrobials:

  • Erythromycin ointment
  • Bacitracin ointment
  • Fluoroquinolone solution
107
Q

Most common bacterial organisms of conjunctivitis

A

Staph, strep, moraxella, Haemophilus

N. gonorrhoeae and C. trach (for neonates)

108
Q

Conjunctivitis usually due to

A

Virus

Profuse watery discharge

109
Q

Treatment of bacterial conjunctivitis

A

Erythromycin or bacitracin ointment first line

ophthalmic fluoroquinolones for second line

110
Q

Treatment of seasonal conjunctivitis

A

Topical antihistamines first line
Low potency topical corticosteroids for second line
T

111
Q

Treatment of viral conjunctivitis

A

Topical antihistamines for first line

Low potency topical steroids for second line

112
Q

Topical antibiotics for bacterial conjunctivitis

A

Erythromycin or bacitracin-polymyxin B ointment

Ophthlamic fluoroquinolones

113
Q

Treatment of gonococcal conjunctivitis

A

IM ceftriaxone and oral azithromycin

114
Q

Treatment of chlamydial conjunctivitis

A

Azithromycin or 7 days of doxycycline

115
Q

Cromolyn for allergic conjunctivitis

A

Decreases inflammation and inhibits hypersensitivity

Mast cell stabilizer

116
Q

Dry eye syndrome

A

Bilateral disruption of tear film on ocular surface can be due to decreased tear production, increased tear evaporation or combination

117
Q

First line treatment for dry eye syndrome

A

Artificial tears 4x a day

If no relief, topical cyclosporine emulsion 2x a day

118
Q

Cholinergic agonists for dry eye

A

Pilocarpine

Increased secretions

119
Q

Glaucoma

A

Irreversible damage to optic nerve and retinal ganglion cells
Results in loss of visual sensitivity and field
Increased IOP due to increased aqueous humor

120
Q

Treatment of glaucoma

A

Topical prostaglandins first line
Topical beta blocker + prostaglandin second line
Carbonic anhydrase inhibitor third line

121
Q

Topical prostaglandins for glaucoma

A

-prost
Increases aqueous outflow
Can cause discoloration of iris

122
Q

Topica Beta blockers for glaucoma

A

Decreases production of aqueous humor

May be absorbed systemically and cause bradycardia, hypotension, heart block and bronchospasm

123
Q

Otitis media most frequent organisms

A

H. influenzae, S. pneumoniae, M. Catarrhalis

Less commonly due to s. aureus or GAS

124
Q

DX of otitis media

A

Fever, otalgia, irritability, tympanic membrane is red, bulging and immobile

125
Q

First line treatment for symptomatic otitis media

A

high dose amoxicillin or Augmentin

126
Q

Recurrent otitis media

A

> 3 episodes within 6 months of >4 episodes in 12 months

Antibiotic prophylaxis not recommended

127
Q

Vaccines important for prevention of acute otitis media

A

Pneumococcal, H. influenzae B, influenza

128
Q

Otitis externa treatment

A

Topical antibiotics usually adequate: Fluoroquinolone drops (first line due to anti-pseudomonal coverage), Neomycin/Polymyxin combo second line

129
Q

Do not use neomycin combo in otitis externa if

A

Tympanic membrane not in tact

130
Q

1st line treatment for viral or bacterial upper airway infection

A

Decongestant

131
Q

1st line treatment for allergic rhinitis

A

Antihistamines

Leukotriene inhibitors can also be used but they take longer

132
Q

Decongestants

A

Stimulate alpha adrenergic receptors and cause vasoconstriction
Pseudoephedrine–can also relax the bronchi by agonizing B2

133
Q

Do not give decongestants to

A

glaucoma patients, hypertension, CAD, BPH

134
Q

Antihistamines

A

Used to treat IgE mediated allergies
Decreases redness, swelling, mucus production
Anticholinergic properties
Do not use for lower respiratory infections

135
Q

Intranasal cromolyn

A

Decreases inflammation
Takes longer–not for acute cases
Does not have antihistamine, bronchodilator, vasoconstrictor or glucocoritcoid activity

136
Q

Montelukast

A

leukotriene receptor inhibitor

Effective when exposure not avoidable

137
Q

Antitussives

A

Codeine and dextromethorphan

Act on cough center of the medulla

138
Q

Tessalon Perles

A

Anesthetize stretch receptors in the respiratory passages reducing cough reflex

139
Q

Antitussives CI in

A

Productive cough, history of substance abuse, COPD

140
Q

SE of antitussives

A

Dizziness, nausea, drowsiness, sedation

141
Q

Expectorants

A

Guaifenesin
Increased respiratory tract fluid secretions
Loosen bronchial secretions

142
Q

70% of URI are

A

Viral
Educate about hand washing, increasing fluids
Can give benzonatate for antitussive

143
Q

First line treatment for cough

A

Decongestant and 1st generation antihistamine
Naproxen may decrease inflammation and cough
Do not use codeine for URI, only bronchitis

144
Q

First line therapy for bacterial rhinosinusitis

A

Augmentin for 14 days

If no relief in 8 days can change to doxycycline, or fuoroquinolone

145
Q

1st line treatment for URI

A

Topical decongestants for first 3 days, antipyretics, NSAIDS (naproxen)
If not better in 8-10 days, can try an antibiotic

146
Q

What medications should be avoided in children

A

Sustained release, cough medicine <6 years old, 1st generation antihistamines, intranasal corticosteroids

147
Q

What medications should be avoided in pregnant women

A

Decongestants, antitussives, expectorants

Antihistamines are category B

148
Q

Most common pathogen of common cold

A

Rhinovirus

149
Q

FEV1 concerning number

A

<80% treat

<50% emergency care

150
Q

What can exacerbate asthma

A

Inhaled allergens, food, NSAIDs, cold air, exercise, airway irritants

151
Q

Intermittent asthma

A

Symptoms <2 days per week

FEV >80%

152
Q

Mild persistent asthma

A

Symptoms >2 days per week

FEV >80%

153
Q

Moderate persistent asthma

A

Daily symptoms

FEV >60%

154
Q

Severe persistent asthma

A

Continuous daily

FEV <60%

155
Q

Initial treatment for asthma

A

inhaled corticosteroid

Then try leukotriene modifier or LABA

156
Q

When having an acute asthma attack,

A

Use SABA

157
Q

Long term control of asthma

A

inhaled corticosteroids
Lowest dose possible
2-4 inhalations 2-4 times per day
Takes 2 weeks of continuous therapy to achieve maximum effectiveness

158
Q

SE of inhaled corticosteroids

A

Oral candidiasis, dysphonia, hoarseness, headache

159
Q

Systemic corticosteroids

A

Used for severe exacerbations for 5 days-2 weeks

160
Q

Short acting Beta agonist

A

albuterol

161
Q

Long acting beta agonist

A

Formeterol, Aformeterol, salmeterol

162
Q

SE of systemic corticosteroids

A

Sodium and water retention, hyperglycemia, increased appetite, weight gain, fractures in elderly

163
Q

SE of leukotriene modifier drugs

A

Headache is common

164
Q

Methylxanthines

A

Theophylline + Aminophylline

Relaxes bronchial smooth muscle, anti-inflammatory

165
Q

Vaccines for patients with asthma

A

Annual influenza vaccine, 23 valent and 13 valent pneumococcal vaccine

166
Q

COPD s/s

A

Morning cough with yellow sputum, frequent URI, prolonged expiration with wheezes and may hear crackles

167
Q

Bronchodilators for COPD

A

SABA, LABA, Short acting anticholinergic (ipatropium), long acting anticholinergic (tiatropium)

168
Q

Medications for maintenance of COPD

A

Anticholinergics, beta agonists, methylxanthines, corticosteroids (last effort)

169
Q

Stage 1 COPD tx

A

Short acting bronchodilator

170
Q

Stage 2 COPD tx

A

Regular use of long acting bronchodilator in addition to SABA

171
Q

Stage 3 COPD tx

A

Add an ICS for frequent exacerbation

172
Q

Stage 4 COPD tx

A

Add long term oxygen

173
Q

Category B respiratory medications

A

Ipatropium, mast cell stabilizer, budesonide, montelukast, terbutaline

174
Q

When are antibiotics indicated for COPD

A

If increased dyspnea, increased sputum, purulent sputum

Most commonly due to H. influenzae, S. pneumoniae, m/ catarrhalis

175
Q

Acute bronchitis

A

95% due to virus
Edamatous mucus membranes, increase in bronchial secretions, crackles, rhonchi, wheezing, normal chest x ray
Treatment supportive

176
Q

Only give antibiotics for acute bronchitis if

A

COPD, purulent sputum, respiratory symptoms >4-6 days

177
Q

Chronic bronchitis

A

> 3 months every year in the past 2 years

178
Q

Tx of bacterial cause of exacerbation of uncomplicated chronic bronchitis

A

Ampicillin first line

179
Q

Tx of complicated chronic bronchitis

A

Augmentin, 2nd or 3rd generation cephalosporin, doxycycline

180
Q

Tx of severe chronic bronchitis

A

Levo or cipro

181
Q

Most common cause of community acquired pneumonia

A

S. Pneumoniae

182
Q

Empiric treatment for CAP

A

Should always cover S. Pneumoniae and treat for 7-14 days

183
Q

1st line treatment for CAP

A

Macrolide

Doxycycline or fluoroquinolone if recent antibiotic

184
Q

1st line treatment for influenza

A

Oseltamivir or Zanamivir

185
Q

Preventive measures for patients with asthma

A

Flu vaccine, pneumococcal vaccine, avoid smoking and allergens

186
Q

If patient comes in with influenza..

A

Appropriate to give antivirals within 48 hours

More than that time is ineffective

187
Q

SE of corticosteroids

A

Moon face, high blood pressure, high glucose, fractures, immunosuppression, growth issues in children

188
Q

DOC for bacterial rhinosinusitis

A

Amoxicillin or Augmentin

If allergies–Macrolide

189
Q

If you give a bronchodilator to an asthma patient, look out for

A

Tachychardia

190
Q

SE of a beta blocker

A

Bradycardia, bronchoconstriction

191
Q

How to distinguish viral from bacterial

A

Type of sputum, length of time, fever presence

192
Q

How long to treat bacterial sinusitis

A

14 days

193
Q

which drugs warrant monitoring drug levels due to narrow therapeutic index

A

Dilantin, warfarin, vancomycin, digoxin

194
Q

How many half lives are needed on average to get rid of a drug from the body

A

5

195
Q

If an elderly person has liver disease..

A

Concerned with drug toxicity due to less albumin so more free drug

196
Q

When should you treat otitis media

A

If purulent discharge, fever, getting worse

Don’t need to treat if no exudate, tympanic membrane visible, no fever

197
Q

Isoniazid SE

A

Neurotoxicity

Can give Vitamin B6 to prevent nerve damage

198
Q

Fluorescein test

A

Eye exam to look for foreign object

Use a wood lamp to look into the eye