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Pharmacology > Mouth/ Throat > Flashcards

Mouth/ Throat Flashcards

1
Q

bacterial pharyngitis bacteria that causes

A

Group A Beta hemolytic streptococcal infection

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2
Q

bacterial pharyngitis patient presents with

A

Fever over 38 degrees C
Tender anterior cervical adenopathy
lack of a cough
Pharyngotonsillar exudate

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3
Q

bacterial pharyngitis symptoms and likelihood

A

1 symptom unlikely it is bacterial pharyngitis

and 3 symptoms it is about 90% likely that it is bacterial pharyngitis

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4
Q

bacterial pharyngitis treatment

A

Penicillins/Cephalosporins 1st gen

Erythromycins/Macrolides

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5
Q

Is gray furry tongue likely seen in bacterial or viral pharyngitis?

A

bacterial

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6
Q

Are red swollen tonsils seen in bacterial or viral pharyngitis?

A

both

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7
Q

Penicillin adverse evetns / side effects

A

hypersensitivity

mild diarrhea, vomitingn nausea, oral candidiasis

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8
Q

describe the hypersensitivity experienced by some patients taking penicillins

A

rash, hives, itching, swelling of lips, tongue, mouth, or throat

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9
Q

describe the hypersensitivity experienced by some patients taking penicillins

A

rash, hives, itching, swelling of lips, tongue, mouth, or throat

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10
Q

what should you monitor in patients taking penicillin for bacterial pharyngitis

A

monitor for signs of anaphylaxis during first dose

also monitor for opportunistic infections

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11
Q

opportunistic infections associated with penicillin and bacterial pharyngitis

A

fever, chills, unhealed sores, white plaques in mouth or vagina, purulent vaginal discharge, fatigue

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12
Q

Penicillin drug interactions Probenecid

A

Probenecid may increase the serum concentration of Penicillins

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13
Q

Penicillin drug interactions Tetracycline Derivatives

A

Tetracycline Derivatives: May diminish the therapeutic effect of Penicillins
Bacteriostatic with bactericidal

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14
Q

Penicillin drug interactions Warfarin

A

Penicillin may enhance the anticoagulant effect of Vitamin K Antagonist-warfarin

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15
Q

Erythromycin, Macrolides mechanism

A

Inhibitor of translation and transcription

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16
Q

what drug is given to patients with bacterial pharyngitis that have a penicillin allergy

A

Erythromycin, Macrolides

17
Q

Erythromycin, Macrolides adverse events and side effects

A 
hypersensitivity 
abdominal pain, anorexia, diarrhea (GI disturbances)
Qt prolongation
pruritus, rash 
ototoxicity, hearing loss 
cholestatic jaundice
18
Q

What should you monitor in patients taking Erythromycin, Macrolides?

A

ask patients to report immediately any unusual malaise, nausea, vomiting, abdominal colic, or fever; skin rash or itching; easy bruising or bleeding

19
Q

Erythromycin, Macrolides drug interactions

A

Effects on CYP450

20
Q

Macrolides unlabeled use

A

serve as a gastrointestinal pro kinetic, which serve to increase the movement of ingested material through the GI tract

21
Q

Acute Laryngitis cause

A

usually a viral cause

possible bacterial causes are M catarrhalis and H influenzae

22
Q

Treatment for acute Layngitis

A

erythromycin (macrolide)
cefuroxime
amoxicillin-clavulanate (Augmentin)

23
Q

RIH or RAS
few to several vesicles that are shallow with punctate ulcers, attached to the gingiva and hard palate, lasting 1 to 3 weeks, due to a virus

A

Recurrent Intraoral Herpes (RIH)

24
Q

RIH or RAS
one to a few ulcers with erythematous halo on the burial mucosa, floor of the mouth, oropharynx, vitiable, tongue lasting one to two weeks

A

Recurrent Aphthous Stomatitis (RAS) (canker sores)

25
Q

off label treatment for Viral-Herpes Simplex

A

Acyclovir, Valacyclovir, Famciclovir

26
Q

Acyclovir

A

Viral-Herpes Simplex treatment needs to be used within 3 days of onset for 10 days

27
Q

Valacyclovir

A

Viral-Herpes Simplex treatment prodrug of acyclovir

28
Q

Famciclovir

A

used for Viral-Herpes Simplex treatment with no randomized control trials

29
Q

Pain and fluid management for Viral-Herpes Simplex treatment

A

ice, popsicles, or rinse and expectorate every two hours with diphenhydramine mixed with magnesia-aluminum 1:1
Topical lidocaine
Fluids as tolerated

30
Q

Adverse events/Side Effects of antiherpetic

A

malaise, headache

31
Q

Drug Interactions of antiherpetic

A

Acyclovir-Valacyclovir, Famciclovir may diminish the therapeutic effect of Zoster Vaccine
discontinue antiviral agents with anti-zoster activity for at least 24 hours prior to and 14 days after receiving a live attenuated zoster vaccine

32
Q

Fungal-Oral Candidiasis First line treatment

A

topical due to less adverse events and drug interactions ystatin Suspension 1:100,000 first choice

33
Q

Fungal-Oral Candidiasis oral prototype

A

Fluconazole

Binds to sterols in fungal cell membrane, changing the cell wall permeability allowing for leakage of cellular contents

34
Q

Fungal-Oral Candidiasis adverse effects

A

Increased Alkaline phosphatase, ALT, AST, hepatic failure (rare), hepatitis, jaundice
Angioedema (rare)

35
Q

What should you monitor in patents with Fungal-Oral Candidiasis treatment

A

Periodic liver function tests (AST, ALT, alkaline phosphatase)
Renal function tests: baseline SrCr
Potassium levels
QT prolongation

36
Q

Fungal-Oral Candidiasis treatment interactions

A 
Inhibits CYP1A2 (weak), CYP2C19 (strong), CYP2C9 (strong),  CYP3A4 (moderate)
Increase the serum concentration of 
Atorvastatin, simvastatin
Citalopram
Phenytoin
Proton Pump Inhibitors
Sulfonylureas
Vitamin K Antagonists

May decrease the metabolism of
Benzodiazepines
Carbamazepine
Losartan

May enhance the adverse/toxic effect of
Calcium Channel Blockers

37
Q

Fungal-Oral Candidiasis Treatment in pregnancy

A

Pregnancy category C (single dose for vaginal candidiasis)/D (all other indications)

38
Q

Ketaconazole

A

used for Fungal-Oral Candidiasis needs to be taken with breakfast Treatment requires acidic gastric environment

Pharmacology (9 decks)

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