Pharmacotherapy Exam 2 (Cases 8-13)

Question 1

buprenorphine/naloxone

Answer 1

Film: start 2/0.5, target 8/2, max 16/4
Tablet: start 1.4/0.36, target 11.4/2.9
concern of interaction with depressants
headache, anxiety, constipation, perspiration, fluid retention in lower extremities, urinary hesitancy, and sleep disturbance.

Question 2

doxepin

Answer 2

3-6 mg
take 30 min qhs

Question 3

methadone

Answer 3

first day 10-30 mg, max 40
target usually 80-120 mg
arrhythmia/QT prolongation

Question 4

naltrexone

Answer 4

7-10 days w/o opioids first
25-50 mg qd PO
380 mg IM q3-4 weeks
optional: naloxone challenge
insomnia, lack of energy/
sedation, anxiety, nausea, vomiting, abdominal pain/cramps, headache, cold symptoms, joint and muscle pain,

Question 5

ramelteon

Answer 5

8 mg
take 30 min qhs

Question 6

eszopiclone

Answer 6

1-3 mg
take immediately qhs

Question 7

zolpidem

Answer 7

IR: 5-10 mg
ER: 6.25-12.5 mg
requires 7-8 hrs before waking

Question 8

apixaban

Answer 8

tx: 10 bid for 7 days, then 5 bid
ppx: 2.5(-5) bid

Question 9

rivaroxaban

Answer 9

tx: 15 bid for 21 days, then 20 qd
ppx: 10(-20) qd

Question 10

edoxaban

Answer 10

60 mg qd
can use after at least 5 days IV

Question 11

dabigatran

Answer 11

150 bid
can use after 7-10 days IV

Question 12

warfarin

Answer 12

2-10 mg qd, titrated to INR

Question 13

levofloxacin (for UTI)

Answer 13

250-750 mg q24-48h
duration: 3-7 days

Question 14

nitrofurantoin

Answer 14

100 mg bid
duration: 5 days
contraindicated with renal insufficiency

Question 15

trimethoprim/sulfamethoxazole

Answer 15

160/800 (DS) q12-24h
duration: 3 days

Question 16

fosfomycin

Answer 16

3 g once

Question 17

amoxicillin/clavulanic acid (for UTI)

Answer 17

500/125 or 875/125 mg q12-24h
duration: 7 days

Question 18

dexamethasone

Answer 18

12 mg first day for HEC, then 8 mg

Question 19

aprepitant

Answer 19

125 mg first day, then 80 mg

Question 20

fosaprepitant

Answer 20

150 mg IV

Question 21

ondansetron

Answer 21

8-16 mg IV
8-24 mg PO

Question 22

prochlorperazine

Answer 22

all routes: 5-10 mg/dose
max 40 mg/day

Question 23

palonosetron

Answer 23

0.25(-0.75) mg IV

Question 24

olanzapine

Answer 24

5-10 mg PO

Question 25

ceftriaxone

Answer 25

1-2 g q24h
max 4 g/day

Question 26

azithromycin

Answer 26

500 mg day 1, then 250 day 2-5

Question 27

levofloxacin (for CAP)

Answer 27

500 qd for 7-14 days
OR
750 mg for 5 days

Question 28

oseltamivir

Answer 28

75 mg bid
duration: 5 days tx, or 7-10 ppx

Question 29

semaglutide

Answer 29

2.4 mg weekly

Question 30

phentermine

Answer 30

15-37.5 mg qd

Question 31

liraglutide (Saxenda)

Answer 31

0.6 titrated up to 3.0 mg SQ qd
increased weekly for 4 weeks

Question 32

phentermine/topiramate

Answer 32

3.75/23 qd
Qsymia

Question 33

orlistat

Answer 33

Xenical: 120 mg tid
Alli: 60 mg tid

Question 34

ibuprofen

Answer 34

200-800 mg q6-8h

Question 35

acetaminophen

Answer 35

325-500 q4-6h
max 3 g/day