Pharmacology

Question 1

What are treatments for head lice and scabies?

Answer 1

Permethrin is preferred for children and infants. Another treatment, lindane (gamma benzene hexachloride), is available but it is rarely used in children because of neurotoxicity due to percutaneous absorption, especially in small infants and those with abnormal skin (impetigo, etc)

Question 2

What are the effects on an newborn if a mother took propranolol throughout pregnancy?

Answer 2

Propranolol, which may cause growth retardation when given
throughout pregnancy, diminishes the ability of an asphyxiated infant to increase heart rate and cardiac output. It has also been associated with hypoglycemia and apnea.

Question 3

Why is erythromycin generally discouraged as prophylaxis in neonates for chlamydial pneumonia infections?

Answer 3

Erythromycin is associated with idiopathic hypertrophic pyloric stenosis in neonates

Question 4

What medication should be given as prophylaxis against pertussis?

Answer 4

Macrolide (e.g. azithromycin)

Question 5

What medication should be given prophylactically in patients with sickle cell anemia with frequent pain crises?

Answer 5

Hydroxyurea - leads to increased fetal hemoglobin (main side effect is myelosuppression)

Question 6

What medication is recommended for superficial hemangiomas (aka strawberry hemangiomas) that are at risk for causing severe complications (e.g. tracheal, eyelid)?

Answer 6

Propranolol

Question 7

What antibiotics should be administered to a patient with sickle cell anemia with osteomyelitis?

Answer 7

A third-generation cephalosporin for Salmonella and Staph coverage as well as a more targeted anti-staphylococcal agent (e.g. oxacillin, vancomycin)

Question 8

Why do 20% of patients with cystic fibrosis develop sensorineural hearing loss?

Answer 8

Frequent treatment with aminoglycosides for gram negative infections (e.g. Pseudomonas)

Question 9

What medication prophylaxis should patients with a splenectomy receive?

Answer 9

Penicillin

Question 10

What medications are often responsible for serum sickness-like reactions and how does the reaction present?

Answer 10

Beta-lactams (e.g. penicillins, cephalosporins) and trimethoprim-sulfamethoxazole. Classic manifestations include fever, urticaria, and polyarthralgia. Due to a type III hypersensitivity reaction

Question 11

What are alternatives to penicillin antibiotics for treating Strep throat in a patient with a penicillin allergy?

Answer 11

Cephalosporins (if allergy not severe) or clindamycin or a macrolide (e.g. azithromycin)