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CUMULATIVE > PHARM FINAL > Flashcards

PHARM FINAL Flashcards

1
Q

ANTIBIOTIC TREATMENT FOR DACRYOCYSTITIS

A
  • augmentin
  • clindamycin
  • vancomycin + ceftriaxone
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2
Q

ANTIBIOTICS TREATMENT FOR BLEPHARITIS

A
  • anterior blepharitis = can use azithromycin solution or erythromycin ointment (on top of eyelid hygiene / warm compresses)
  • posterior blepharitis = more systemic antibiotics if eyelid hygiene / Meibomian gland massage doesn’t work = Tetracyclines or Azithromycin
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3
Q

ANTIBIOTICS TREATMENT FOR BLEPHARITIS

A
  • anterior blepharitis = can use azithromycin solution or erythromycin ointment (on top of eyelid hygiene / warm compresses)
  • posterior blepharitis = more systemic antibiotics if eyelid hygiene / Meibomian gland massage doesn’t work = Tetracyclines or Azithromycin
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4
Q

ANTIBIOTICS TO TREAT HORDEOLUM

A
  • MC caused by staph aureus
  • mainstay of treatment = warm compresses
  • ABX = azithromycin or Bactroban ointment
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5
Q

UNASYN

A

ampicillin + sulbactam (beta lactamase inhibitor)

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6
Q

beta lactamase inhibitors

A

clavulanate (augmentin)

sulbactam (unasyn)

tazobactam (Zosyn)

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7
Q

antibiotics used to treat blowout fracture if infection develops/needed

A

Unasyn (ampicillin + sulbactam)

or clindamycin

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8
Q

treatment for lyme disease

A

doxycycline = adults

amoxicillin in children < 8 & pregnancy

if doxy is CI or if allergic to PCN = give azithro or erythro

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9
Q

treatment for RSMF

A

doxycycline, even in kids < 8

2nd line = Chloramphenicol - if pregnant….however chloramphenicol in 3rd trimester = associated with Grey Baby Syndrome

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10
Q

AUGMENTIN

A

amoxicillin + clavulanate

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11
Q

Treatment for WILSON’S DISEASE

A

D-Penicillinase = chelates copper

Zinc = increases fecal excretion of copper, and decreases intestinal absorption of copper

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12
Q

TREATMENT FOR H.PYLORI

A

CAP

Clarithromycin + Amoxicillin + PPI (omeprazole)

if allergic to PCN = give metronidazole instead (with clarithromycin + PPI)

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13
Q

TREATMENT FOR WET MACULAR DEGENERATION

dry = drusen; gradual vision loss, more common
wet = neovascularization; less common, more rapid loss
A

BEVACIZUMAB = intra-vitreal anti-angiogenic = inhibits VEGF (vascular endothelial growth factor) to reduce neovascularization

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14
Q

TREATMENT FOR PROLIFERATIVE DIABETIC RETINOPATHY

A

VEGF INHIBITOR = BEVACIZUMAB

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15
Q

ACETAZOLAMIDE (diuretic) IS USED FOR

A
  • altitude sickness
  • papilledema
  • glaucoma (1st line for acute angle closure glaucoma, but not 1st line for chronic (open angle) glaucoma - latanoprost/prostaglandin analogs = 1st line)
  • epilepsy
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16
Q

eye drops for contact lens wearers

A

CIPROFLOXACIN (protects against pseudomonas)

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17
Q

antibiotics to avoid with corneal abrasions

A

AMINOGLYCOSIDES = toxic to corneal epithelium

STEROIDS = slows epithelial healing & predisposed to further infection

never prescribe topical anesthetics for the eyes
- can prescribe cycloplegics though

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18
Q

GONORRHEA

A

CEFTRIAXONE (ROCEPHIN)

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19
Q

CHLAMYDIA

A

AZITHROMYCIN OR DOXYCYCLINE

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20
Q

AMINOGLYCOSIDE DRUGS

A 
streptomycin
gentamycin
tobramycin
amikacin
neomycin
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21
Q

medication for bacterial conjunctivitis

A

erythromycin
can also use azithromycin, fluoroquinolones (moxifloxacin), sulfonamides, aminoglycosides (can be toxic to cornea).

if contact lens wearer = fluoroquinolones (cipro)

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22
Q

medication for viral conjunctivitis

A

supportive therapy - cool compresses, artificial tears

can give topical antihistamines for itching / redness
- H1 blocker topical antihistamine = Olopatadine (Patanol = antihistamine / mast cell stabilizer)

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23
Q

medication for allergic conjunctivitis

A
  • topical antihistamines: H1 blockers = Olopatadine (Patanol), Pheniramine/Naphazoline (Naphcon A)
  • can give topical NSAID - ketorolac
  • topical steroids
  • (se of long term steroid use on eyes = glaucoma, cataracts, and HSV keratitis)
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24
Q

medication that can cause optic neuritis

A

ETHAMBUTOL

also chloramphenicol

25
Q

treatment for orbital cellulitis

A
  • IV abx: Vancomycin, Clindamycin, Cefotaxime, Ampicillin/sulbactam (unasyn)
26
Q

HSV keratitis treatment

A
  • treat with topical antivirals = trifluridine, vidarabine, ganciclovir ointment, PO acyclovir
27
Q

Bacterial keratitis treatment

A

Treat with fluoroquinolone drops (moxifloxacin) - do NOT patch!

28
Q

cataracts are a SE of

A

steroids

29
Q

TREATMENT FOR ACUTE ANGLE CLOSURE GLAUCOMA

A
  • 1st line = ACETAZOLAMIDE - decreases aqueous humor production –> decreases IOP
  • BB - Timolol - reduces IOP pressure without affecting visual acuity
  • Miotics (constricts) / cholinergics = Pilocarpine, Carbachol = acetylcholine induced papillary constriction –> reduces IOP by increasing aqueous humor drainage through pupil constriction
  • Alpha 2 agonists - apraclonidine , brimonidine - suppresses aqueous humor production, and increases outflow
30
Q

TREATMENT FOR CHRONIC OPEN ANGLE GLAUCOMA

A

1st line = prostaglandin analogs = Latanoprost –> reduces IOP

  • Timolol (BB)
  • Brimonidine (alpha-2 agonist) - decreases production and increases outflow
  • acetazolamide (carbonic anhydrase inhibitor - reduces IOP by decreases production of aqueous humor)
31
Q

TREATMENT FOR PAPILLEDEMA

A

ACETAZOLAMIDE = decreases production of aqueous humor

32
Q

optic neuritis treatment

A
  • IV methylprednisolone followed by oral steroids

- vision usually returns with treatment

33
Q

EPIDIDYMITIS TREATMENT

A
  • in younger men < 35 = consider GC & Chlamydia = give Ceftriaxone 250mg IM + Doxy 100mg BID x 10 days (if septic = hospitalize for IV hydration & IV antibiotics)
  • in older men or hx of BPH, urethral stricture, or chronic UTI = consider enteric gram negative bacteria = fluoroquinolones!
  • Levaquin 500mg qday x 10 days: outpatient management

SYMPTOMATIC TREATMENT
⦁ NSAIDS
⦁ Scrotal elevation
⦁ Ice

lot of symptomatic relief while waiting for ABX to work

34
Q

MEDS THAT CAN CAUSE PRIAPISM

A

PDE-5 inhibitors

antidepressants (especially Trazodone)

antipsychotics

anticonvulsants

alpha blockers

35
Q

PHENYLEPHRINE

A

alpha agonist used for PRIAPISM (1st line!)

causes vasoconstriction - will increase venous outflow of blood / contract smooth muscle

CONTRAINDICATIONS = cardiac or CV history

36
Q

TREATMENT FOR PRIAPISM

A

TREATMENT FOR LOW FLOW (ISCHEMIC PRIAPISM)
1st line = PHENYLEPHRINE = alpha agonist intracavernous injection - causes contraction of smooth muscle - will increase venous outflow

TERBUTALINE = PO or SQ - constricts cavernosal artery - decreases arterial inflow; may be used if < 4 hrs

Needle Aspiration of corpora to remove blood; especially if > 4 hours duration - can also give phenylephrine in addition to aspiration

surgery if not responsive to medication / aspiration

TREATMENT FOR HIGH FLOW (NON-ISCHEMIC)

  • observation
  • can do arterial embolization or surgical ligation if refractory
37
Q

reversal of methotrexate

A

Leucovorin

38
Q

medication to treat EPS (extrapyramidal symptoms)

A

Cogentin (Benztropine)

39
Q

BBW of anti-depressants

A

suicidal thinking / behavior

40
Q

SNRI indicated for DPN & Fibromyalgia

A

Duloxetine (Cymbalta)

41
Q

SNRI DRUGS

A

VENLAFAXINNE (EFFEXOR)

DESVENLAFAXINE (PRISTIQ)

DULOXETINE (CYMBALTA)

LEOMILNACIPRAN (FETZIMA)

42
Q

URINARY RETENTION MEDICATION

A

ALPHA-1 BLOCKERS

  • Prazosin (Minipress)
  • Tamsulosin (Flomax)
  • Doxazosin (Cardura)
43
Q

PYELONEPHRITIS MEDICATION

A

FLUOROQUINOLONES** if resistance is low
cipro or Levaquin

if resistance is high = give Bactrim or augmentin

if in hospital = give IV ceftriaxone, then discharge on fluoroquinolones

44
Q

TREATMENT FOR GOUT

A

ALLOPURINOL

45
Q

PHENOZOPYRIDINE

A

anesthetic agent (pill) in urogenital tract - can give for symptoms of dysuria. Turns urine dark orange. Will stain clothes permanently

46
Q

CYSTITIS TREATMENT

A 
WOMEN
nitrofurantoin (Macrobid)
Bactrim
can give phenozopyridine (pyridium)
reserve fluoroquinolones (for pyelonephritis and more severe cases due to resistance)

MEN
Bactrim
fluoroquinolone

47
Q

PDE-5 INHIBITORS

A

SILDENAFIL (VIAGRA)
TADALAFIL (CIALIS)
VARDENAFIL (LEVITRA)

MOA = increases nitric oxide levels and increases cGMP –>

48
Q

BPH TREATMENT

A

⦁ Alpha-1 blockers
⦁ 5 alpha-reductase inhibitors
⦁ Combo = Dutasteride-Tamsulosin (Jalyn)
⦁ Tadalafil (Cialis) = 5PDE-inhibitor

49
Q

ALPHA-1 BLOCKERS

A 
⦁	Tamsulosin (Flomax)
⦁	Terazosin (Hytrin)
⦁	Doxazosin (Cardura)
⦁	Alfuzosin (Uroxatrol)
⦁	Silodosin (Rapaflo)

Alpha-1 blockers = more effective than 5-alpha reductase inhibitors for short & long term symptom management

MOA = relaxes smooth muscle in bladder neck, prostatic capsule, and prostatic urethra

Alpha-1 receptors = located in the base of the bladder and in the prostate

SE OF ALPHA-1 BLOCKERS
***MOST COMMON SE = DIZZINESS & ORTHOSTATIC HYPOTENSION

OTHER SE
⦁ problems with ejaculation - found primarily with Tamsulosin (flomax) - this is a problem with all alpha blockers, but more so with Tamsulosin

  • retrograde ejaculation in Silodosin (Rapaflo)

⦁ Doxazosin (Cardura) & Terazosin (Hytrin) = cause more BP lowering than others

⦁ Tamsulosin (Flomax), Alfuzosin (Uroxatrol) & Silodosin (Rapaflo) = less BP effects

⦁ ***Alpha-1 blockers = can cause severe hypotension if used with PDE-5 inhibitors

50
Q

5 ALPHA REDUCTASE INHIBITORS

A

⦁ Finasteride (Proscar)
⦁ Dutasteride (Avodart)

Combo: 5-ARI + alpha-1 blocker
⦁ Dutasteride (Avodart) + Tamsulosin (Flomax) = Jalyn

The only agents that provide LONG TERM DECREASE IN PROSTATE SIZE and decreased need for prostatic surgery

MOA

  • 5- alpha reductase converts testosterone to dihydrotestosterone
  • by inhibiting 5-alpha-reductase = blocks conversion of testosterone to dihydrotestosterone = suppresses serum dihydrotestosterone levels
  • This decreases prostate size
  • may take up to a year to notice reduction in symptoms
  • decreased need for surgery
  • decreased development of acute urinary retention
  • the larger the prostate volume, the more effective the medication**
  • Dutasteride (Avodart) may be more potent than Finasteride (Proscar)

SE
⦁ decreased libido
⦁ ejaculatory or erectile problems (ED)
- may only have these SE for the first year of therapy

⦁ **decreases serum PSA by 50%****

- in the first 24 months of therapy = multiply PSA by 2 when interpreting results
- after 24 months of therapy = multiply PSA by 2.5 when interpreting results
- There is decreased development of prostate cancer, but concern of possible 	increased incidence of high grade lesions
51
Q

5-PDE INHIBITORS

A

⦁ Tadalafil (Cialis)
⦁ Vardenafil (Levitra)
⦁ Sildenafil (Viagra)
⦁ Avanafil (Stendra)

MOA
- For an erection to occur, nitric oxide (NO) is released in the corpus cavernosum during sexual stimulation

  • Nitric Oxide (NO) then activates the enzyme guanylate cyclase –> results in increased levels of cGMP (cyclic guanosine monophosphate) –> produces smooth muscle relaxation and inflow of blood to the corpus cavernosum
  • PDE-5 degrades cGMP (erection goes away) in the corpus cavernosum, so PDE-5 inhibitors enhance the effect of NO by inhibiting PDE-5 from degrading cGMP = leads to maintained erection
  • PDE-5 inhibitors do not directly cause penile erections…they enhance erections (still need arousal)

CONTRAINDICATIONS TO PDE-5 INHIBITORS
⦁ men taking nitrates
⦁ caution with alpha-1 blockers due to risk for severe hypotension

ADVERSE REACTIONS
⦁ severe hypotension (with nitrates or alpha-1 blockers)
⦁ common = flushing, headaches, dyspepsia
⦁ visual effects = transient blue vision with sildenafil (viagra), may increase risk for nonarteritic ischemic optic neuropathy
⦁ Hearing loss
⦁ Priapism

52
Q

FLUOROQUINOLONES

A

MOA = inhibits DNA topoisomerase

Pregnancy category = C

Black box warnings (2) = tendon rupture; may exacerbate myasthenia gravis

Adjust dose based on renal function

Urologic indications
⦁ Cystitis
⦁ UTI (pyelonephritis)*
⦁ Prostatitis

53
Q

BACTRIM

A

Class = Sulfonamides
MOA = inhibits folic acid synthesis - avoid in pregnancy!
- effective against gram negative and staph; not active against group A strep
Pregnancy category = X
- 2nd best coverage for MRSA after Vanco
- oral tx for MRSA

can be used for UTIs - cystitis / pyelonephritis

54
Q

drug given to terminate ectopic pregnancy fetus prior to rupture

A

METHOTREXATE

55
Q

drug given to allow quick passage of spontaneous abortion/miscarriage rather than expectant and surgery

A

MISOPROSTOL (CYTOTEC)

56
Q

drug given to stop contractions with pre-term labor

A

magnesium sulfate

57
Q

drug given in preterm labor to help fetal baby’s lungs mature

A

betamethasone or dexamethasone

58
Q

drug given for hypercalcemia oncologic emergency

A

IV PAMIDRONATE

59
Q

drug given for spinal cord compression due to malignancy

A

decadron (dexamethasone)

CUMULATIVE (3 decks)

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