Midterm #1 605 review Flashcards
Why is pregabalin (Lyrica) NOT recommended in the elderly?
Risk of falls
What is duloxetine?
Cymbalta
delayed release capsule 30-60mg OD
Tx: fibromyalgia, DPN, chronic lower back pain, OA of the knee
Max dose= 60mg OD
What is Lamotrigine?
Anti-epileptic drug
Mood stabilizer
Tx: bipolar, schizophrenia
First line tx for cystitis?
Nitrofurantoin (Macrobid) 100mg po bid
Nitrofurantoin 50mg-100mg po QID (96% effective, low resistance potential*)
CrCl < 40ml - 60/min, intolerance/allergy to nitrofurantoin= Fosfomycin 3g PO
Drugs to avoid in pyelonephritis?
Nitrofurantoin: doesn’t achieve high enough tissue or renal concentrations
Foscomycin: (same as above)
Moxifloxacin: inadequate urinary levels
Amoxicillin and cephalexin: high e. coli resistance.
E. coli is most likely the culprit!
Acne treatment options:
Improvement can take 2-3 months with topical and systemic tx. If better, consider stopping the systemic tx.
- Benzoyl peroxide and clindamycin= topical choices
doxycycline, minocycline (drug induced lupus/ hepatitis) and tetracycline are effective first-line options when systemic antibiotics are indicated
Due to increased resistance macrolides and SMX should be reserved
Can take 6 weeks to work
Oral abx x 3 months and topical benzylperoxide = decreased drug resistance
Oral contraceptive =effective
Treatment for inflammatory pustules in Rosacea?
In practice, treatment is often started with metronidazole, as it is less irritating; however, using moisturizer before or after azelaic acid may lessen any associated irritation. Treatment duration will depend upon the severity of symptoms, but improvement can generally be expected in 4–6 wk. Counsel patients that topical treatment may need to be continued indefinitely;
topical ivermectin improves rosacea by decreasing the number of Demodex mites present. The exact mechanism of action in rosacea has not been elucidated but is thought to involve an immunomodulatory effect. Topical ivermectin has shown continued improvement in papulopustular lesions and long-term safety with up to 1 y of therapy
Abx that react with cations?
Fluoroquinolones
Tetracyclines
Treatment for group A Pharyngitis?
PCN VK 600mg PO bid x 10 days
PCN VK 300mg PO tid x 10 days
malaria drug tx options?
- Mefloquine
- Quinine
- Primaquine
- Doxycycline
- Hydroxychloroquine
• pyrimethamine
- Chloroquine (Aralen)
Nikolsky sign
is a skin finding in which the top layers of the skin slip away from the lower layers when rubbed
Characteristics of Gram -
Stains RED
Outer lipopolysaccharide LPS membrane (outer membrane that blocks the passage of PCN, lysosomal abx).
Thin Peptidoglycan layer
Inner cytoplasmic membrane
characteristics of Gram +
Stains Blue/Violet
Thick outer peptidoglycan cell wall (doesn’t block Abx from passing through their cytoplasmic membranes)
Inner cytoplasmic membrane
Vulnerable to lysosomal and PCN attacks
Isoniazid (INH):
Treats TB Give Pyridoxine (Vit B6) to reduce peripheral neuropathy.
What is dapsone?
A nucleic acid synthesis inhibitor
Sulfonamide abx
