Pharmacology

Question 1

First line abx for acute sinusitis.

Answer 1

Amoxacillin 500mg PO TID x 7-10
or
** Augmentin 500mg PO qd for 7 days

Question 2

Augmentin SE

Answer 2

GI upset, urticaria, rash, stevens johnson, yeast infection.

Question 3

Augmentin CI

Answer 3

Severe renal impairment

Question 4

Can augmentin be used in pregnancy?

Answer 4

Yes, category B.

Question 5

Other abx for acute sinusitis?

Answer 5

Doxycycline 100mg PO bid x 7 days

Zithromax (high resistance)

Question 6

Doxy SE

Answer 6

Hepatotoxicity
Photosensitivity
Rash, urticaria
Tissue hyperpigmentation

Question 7

Which drug turns teeth brown?

Answer 7

Tetracyclines (doxy)

Question 8

Doxy CI

Answer 8

Pregnancy (D)

Pediatrics

Question 9

What should be given to a PCN allergic pregnant patient with acute sinusitis?

Answer 9

Zithromax dose pack

Question 10

Zithromax SE

Answer 10

Potentially fatal arrhythmias

N/V/D, acute renal failure, vaginitis

Question 11

Non-abx tx for acute sinusitis?

Answer 11

Pseudoephedrine (sudafed) 30mg
1-2 tabs q 4-6
Oxymetazoline (not longer than 3 days)
NS spray

Question 12

Sudafed CI

Answer 12

HTN, CVD, DM, Thyroid

Question 13

What is the most frequent diagnosis in children btw ages 1 and 3

Answer 13

AOM

Question 14

Symptomatic tx of AOM

Answer 14

Ibuprofen / Motrin
Topical aqueous lidocaine
Auralgan drops

Question 15

AOM Abx recommendations by age

Answer 15

• Younger than 6 mo: Administer to all
• 6 mo to 2 yrs: Recommended for severe s/s, uncertain dx
• over 2 yrs: use abx for certian dx and severe illness

Question 16

First line for AOM for peds

Answer 16

Augmentin 90mg/kg/day q8 x 10 days
or
Amoxacillin 90mg/kg/day BID x10

Question 17

First line for peds with AOM who are PNC allergic

Answer 17

Zithromax 10mg/kg/day
or
Clarithromycin 15 mg/kg/day
or
Pediazole

Question 18

Other AOM alternative Abx

Answer 18

Cefdinir (omnicef)

Cefuroxime (Ceftin)

Question 19

Amoxacillin reduces the efficacy of?

Answer 19

BCP

Question 20

Auralgan (Antipyrine) Drops

Answer 20

Ear drops
reduce pain and swelling
Removes or softens cerumen
Fill ear canal every 1-2 hrs
Contra in kids younger than 2

Question 21

1st line therapy for adult AOM

Answer 21

Amoxacillin 500mg TID x 5-7 days
or
Augmentin 500mg BID x 5-7 days

Question 22

2nd line tx for adult AOM with PCN allergy

Answer 22

If mild allergy: 3rd gen ceph: cefdinir

If severe: Macrolide abx (azithro)

Question 23

Malignant Otitis Externa 1st line abx

Answer 23

Antipseodomonas (flouro)
Ciprofloxacin 750mg BID
or
Levofloxacin 750 mg po or IV

Question 24

What is the pH of the EAC?

Answer 24

Acidic

Question 25

What must be done before ear drops are applied?

Answer 25

Clean the ear, remove cerumen.

Question 26

OE Otic abx tx

Answer 26

Corticosporin Otic Suspension
Polymixin, Neomycin and Hydrocortisone
3-4 drops to affected ear for 5-7 days

Question 27

Cipro HC Otic Suspension (Ciloxan)

Answer 27

Ciprofloxacin .2%/Hydrocortisone 1%
Activity against pseudomonas
Do not use in kids <1 yr

Question 28

Ciprodex Otic Solution

Answer 28

Ciprofloxacin .3% / Dexamethasone .1%

Same as Ciloxan

Question 29

Tobradex

Answer 29

Tobramycin and Dexamethasone

Opthalmic, but used off label as otic

Question 30

Domeboro

Answer 30

Acetic acid in aluminum acetate
Acidifies ear canal
Baceriacidal and fungacidal activity

Question 31

Domeboro dose

Answer 31

3-5 drops q4-8 for 5-7 days

Not recommended in kids < 3 yo

Question 32

5% aluminum acetate

Answer 32

Burow’s solution
good against bacteria and fungus
OTC

Question 33

Home remedy for OE

Answer 33

50% rubbing alcohol
25% white vinegar
25% distilled water
4-6 drops BID

Question 34

Debrox OTC

Answer 34

Carbamide peroxide
Cerumen removal
5-10 drops in ear canal, keep in for several mins, irrigate with warm water

Question 35

Labrynthitis Rx Tx

Answer 35

Prochlorperazine (Compazine)
Meclizine (Antivert)
Diazepam

Question 36

Prochlorperazine (Compazine)

Answer 36

For severe N/V
5 and 10mg tabs
SE: somnolence, dizziness, anticholinergenic, lowered seizure threshold.

Question 37

Meclizine (Antivert)

Answer 37

for N/V, vertigo of vestibular origin
25 - 100mg/day
SE: drowsiness, sedation, dry mouth, blurred vision

Question 38

Diazepam (Valium)

Answer 38

Suppreses the vestibular system
2-10 mg 2-4 times/day prn
Interacts w/ ETOH, synergistic w/ opioids
SE: CNS depression, ataxia, memory impairment

Question 39

Meniere’s Tx

Answer 39

Diuretics (reduce salt intake)
Antiemetics (compazine, antivert)
Valium (diazepam), Atarax

Question 40

Atarax (Hydroxyzine)

Answer 40

Antihistamine and antianxiolytic
Drowsiness, dry mouth
Used for meniere’s