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Practice Exam Questions Flashcards

1
Q

Why shouldn’t Cordarone be given with sofosbuvir-containing regimens?

A

Serious symptomatic bradycardia

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2
Q

How should patients take the Viekira Pak tablets?

A

2 pink tablets + 1 beige tablet in morning, 1 beige tablet in the evening
(Beige tablet is dasabuvir)

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3
Q

What medications are Viekira Pak contraindicated in combination with?

A

Ethinyl estradiol, lovastatin, simvastatin

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4
Q

What warnings are associated with interferons?

A

May cause or aggravate:

  1. Autoimmune disorders
  2. Psychiatric symptoms
  3. Ischemic disease
  4. Infections
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5
Q

What lab abnormalities are indicative of chronic liver disease?

A

Hypoalbuminemia and increased INR

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6
Q

ANC calculation

A

WBC x % neutrophils (segs + bands) x 10

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7
Q

Why should acetaminophen be used instead of NSAIDs in patients with cirrhosis?

A

NSAIDs can precipitate GI bleeding, blunt the diuretic response, and exacerbate renal dysfunction. APAP is safer if used sparingly at reduced doses.

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8
Q

Which natural product is used as a liver-protective agent?

A

Milk Thistle

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9
Q

What is a non-pharmacological recommendation for managing hepatic encephalopathy?

A

Restricting animal protein intake

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10
Q

What pharmacologic category is Transderm Scop?

A

Anticholinergic

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11
Q

Transderm Scop counseling points

A
  1. May cause dry mouth, dizziness and confusion
  2. Do not use alcohol
  3. Can make patient tired; don’t operate heavy machinery
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12
Q

Why can scopolamine worsen glaucoma?

A

anticholinergics can increase intraocular pressure and worsen glaucoma

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13
Q

Which BZDs are considered most safe in patients over the age of 65 based on Beers Criteria?

A

Lorazepam, oxazepam, temazepam

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14
Q

Which natural products can be used for anxiety?

A

Valerian, kava, St. John’s Wort, passionflower

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15
Q

USP chapter for non-sterile compounding

A

USP 795

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16
Q

What is Onzetra Xsail?

A

Intranasal sumatriptan

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17
Q

What treatment could be used for a 13-year old suffering from frequent migraines?

A

Maxalt (At least 6), Zolmiptriptin nasal and almotriptan and Treximet (at least 12)

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18
Q

How to take CellCept?

A

Twice daily on empty stomach, 12 hours apart

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19
Q

Common live vaccines that should be avoided in transplant patients

A

intranasal FluMist, MMR, Varivax (chicken pox), Zostavax (shingles)

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20
Q

Brand name(s) of everolimus

A

Afinitor, Zortress

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21
Q

Which cancers are transplant patients at higher risk for?

A

Melanoma, lymphoma

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22
Q

How often should the following be performed at minimum:

  1. glove fingertip testing
  2. air sampling
  3. temperature check
  4. air pressure check
A
  1. annually
  2. every 6 months
  3. daily
  4. daily
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23
Q

How often should media fill testing for technicians be performed?

A

Annually for medium- and low-risk compounding

Semiannually for high-risk compounding

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24
Q

What is considered high-risk compounding?

A

Making a CSP from non-sterile ingredients

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25
Q

Which reagent is used for the bacterial endotoxin test (BET)?

A

Limulus Amebocyte Lysate (LAL) is used for the BET to test for pyrogens

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26
Q

Brand name of calcium polycarbophil

A

Fibercon

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27
Q

Alvimopan

A

Entereg, opioid receptor antagonist for prevention of post-op ileus
(REMS drug, max 15 doses)

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28
Q

What are the peripherally acting mu-opioid receptor antagonists for constipation?

A

Methylnaltrexone (Relistor)
Naloxegol (Movantik)
Naldemedine (Symproic)

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29
Q

Lubiprostone

A

Amitiza for opioid induced constiption

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30
Q

Linaclotide (brand, MOA, tx)

A

Linzess, agonist of guanylate cyclase C, treats chronic idiopathic constipation (or IBS-C)

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31
Q

Eluxadoline

A

Viberzi for IBS-D

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32
Q

Drugs that worsen BPH

A
  1. Anticholinergics
  2. Antihistamines
  3. Caffeine
  4. Decongestants
  5. Diuretics
  6. SNRIs
  7. TCAs (and other drugs with anticholinergic properties)
  8. Testosterone products
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33
Q

Drugs that increase blood pressure

A
  1. Amphetamines or other ADHD drugs
  2. Cocaine
  3. Decongestants
  4. Erythropoietin-stimulating agents
  5. Immunosuppressants (eg tacrolimus)
  6. NSAIDs
  7. Systemic steroids
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34
Q

Lotrel

A

Benazepril/Amlodipine

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35
Q

Tenoretic

A

Atenolol/Chlorthalidone

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36
Q

Ziac

A

Bisoprolol/HCTZ

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37
Q

Byvalson

A

Nebivolol/Valsartan

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38
Q

Zestoretic

A

Lisinopril/HCTZ

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39
Q

First line agents for pregnant women with chronic HTN (>160/105)

A

Labetalol, nifedipine ER, methyldopa

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40
Q

Thiazide MOA

A

Inhibit Na reabsorption in DCT, causing increased excretion of Na, Cl, and water

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41
Q

Olmesartan warning

A

(Benicar); sprue-like enteropathy - severe chronic diarrhea with substantial weight loss

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42
Q

Spironolactone MOA

A

Non-selective aldosterone receptor blocker (also blocks androgen = endocrine SE, gynecomastia eg)

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43
Q

Which beta-blockers have intrinsic sympathomimetic activity (ISA)?

A

(do not decrease HR to the same degree as other beta-blockers)
Acebutolol, Penbutolol, Pindolol

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44
Q

Which beta blockers should be taken with food?

A

Metoprolol tartrate and succinate, carvedilol

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45
Q

Brevibloc

A

Esmolol (IV)

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46
Q

Beta-1 selective agents

A

(AMEBBA)

Atenolol, Metoprolol, Esmolol, Bisoprolol, Betaxolol, Acebutolol

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47
Q

Nebivolol classification

A

(Bystolic); beta-1 selective blocker and NO-dependent vasodilation

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48
Q

Which beta-blocker has high lipid solubility and crosses the BBB?

A

Propranolol (Inderal)

-more CNS SE but also useful for migraine ppx, essential tremor, etc

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49
Q

Which beta-blockers have a warning of causing hyperglycemia?

A

Beta-1 and -2 blockers (nonselective) - decrease insulin secretion

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50
Q

List the centrally-acting alpha-2 agonists

A
  1. Clonidine (Catapres) [Kapvay for ADHD]
  2. Guanfacine IR (Tenex) [ER - Intuniv for ADHD]
  3. Methyldopa
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51
Q

Warnings/SE for methyldopa

A 
Positive Coombs test (risk for hemolytic anemia)
Hypersensitivity reactions (DILE)
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52
Q

Clonidine patch counseling

A

Changed weekly; apply to upper outer arm or chest; remove before MRI to prevent burn
*do not stop clonidine suddenly - rebound HTN

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53
Q

darifenacin

A

Enablex - blocks M3 muscarinic acetylcholine receptor responsible for bladder muscle contractions (anticholinergic agent) for tx of OAB

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54
Q

tolterodine

A

Detrol LA - blocks M2 and M3 muscarinic acetylcholine receptors responsible for bladder muscle contractions (anticholinergic agent) for tx of OAB

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55
Q

desmopressin

A

Noctiva - reduces urine production for OAB (warning hyponatremia)

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56
Q

Exforge

A

Amlodipine/Valsartan

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57
Q

Ziac

A

Bisoprolol/HCTZ

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58
Q

Which antihypertensive agents have a risk of drug induced lupus erythematosus?

A

Methyldopa and Hydralazine

butterfly rash

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59
Q

IV agents available to treat hypertension

A

Chlorothiazide, nicardipine, Esmolol, Labetalol, hydralazine, enalaprilat, methyldopa, propanolol, metoprolol, celvidipine, diltiazem and verapamil

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60
Q

What are the GIIb/IIIa inhibitors?

A

eptifibatide (Integrelin), abciximab (ReoPro)

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61
Q

Name an IV P2Y12 inhibitor

A

cangrelor (Kengreal)

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62
Q

What is the MOA of tenecteplase?

A

(TNKase) Fibrinolytics bind to fibrin and convert plasminogen to plasmin. Plasmin then degrades the fibrin mesh leading to clot dissolution.

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63
Q

How long should patients continue BB and ACEi therapy after having an MI?

A

BB - 3 years (unless HF, Afib, eg)

ACEi - indefinitely

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64
Q

Symbyax

A

Fluoxetine/Olanzapine

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65
Q

Vilazodone

A

Viibryd

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66
Q

Drugs indicated to treat PMDD

A

Sarafem (contains fluoxetine), Yaz, and Zoloft

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67
Q

Medications that contribute to depression

A

lipophilic beta blockers, clonidine, methyldopa, certain types of hormones (including hormonal contraceptives), indomethacin, interferons, isotretinoin, some medications for ADHD

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68
Q

Side effects of bupropion

A

dry mouth, insomnia, tremors/risk of seizure

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69
Q

Live vaccines

A

MMR, MMRV, Varicella, Zoster, Yellow fever, influenza intranasal, rotavirus, cholera, typhoid (vivotif)

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70
Q

Necessary interval between and antibody-containing blood product and MMR or varicella-containing vaccine (except zoster)

A

minimum of 3 months and may be up yo 11 months; if vaccine given first, wait 2 weeks prior to giving Ab; if Ab given first, wait 3 months or longer prior to vaccine

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71
Q

Timing relationship between TB skin test and administration of a live vaccine

A

Administer both on the same day; if live vaccine has been given recently, but not on same day, wait 4 weeks prior to placing PPD test; or given PPD first and wait 48-72 hrs until its read prior to giving live vaccine

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72
Q

Vaccines in pregnancy

A

In season inactivated flu vaccine, Tdap x 1 with each pregnancy (optimal between 27-36 weeks; live vaccines are CI

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73
Q

HPV9 dosing

A

(Gardasil 9); if started before age 15: 2 doses (month 0 and 6-12 months later); if started after age 15 or if immunocompromised: 3 doses (month 0, 1-2, 6)

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74
Q

Which influenza vaccines are only indicated for patients at least 65 years of age?

A

Fluzone high-dose and Fluad

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75
Q

ProQuad

A

MMR + Varicella

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76
Q

Menactra vs Menveo

A

MCV4 Meningococcal Vaccines; Menactra is 9 months-55years; Menveo is 2 months-55 years

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77
Q

Pneumococcal vaccination in children <2 years of age

A

PCV13 (Prevnar) because they should not receive the polysaccharide vaccine (PPSV23)

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78
Q

Pneumococcal vaccination in adults at least 65 years of age

A

If never vaccinated: PCV13 followed by PPSV23 12 months later

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79
Q

Spacing between PPSV23 doses

A

At least 5 years

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80
Q

Pneumococcal vaccination in immunocompromised patients age 6-64

A

1 dose of Prevnar then 8 weeks later PPSV23, then 5 years later PPSV23, then at age 65 PPSV23

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81
Q

DTaP only indicated in what age

A

<7 years old

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82
Q

ACIP age recommendation vs FDA approval of Zostavax

A

Approved for 50+, recommended in 60+ years of age

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83
Q

Timing of antivirals in relation to varicella-containing vaccines

A

stop 24 hours before vaccine and do not administer for 14 days after vaccination

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84
Q

Administration of IM vaccines

A

deltoid muscle with 1” needle unless fat; 22-25 gauge needle at 90 degree angle

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85
Q

Administration of SQ vaccines

A

fatty tissue over triceps with a 5/8”, 23-25 gauge needle at a 45 degree angle

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86
Q

SQ Administered Vaccines

A

MMR, MPSV, varicella-containing, and PPSV (also IM)

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87
Q

Concentration-dependent (Cmax: MIC) antibiotics

A

aminoglycosides, quinolone, daptomycin

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88
Q

AUC:MIC Abx

A

vancomycin, macrolides, tetracyclines, colistimethate

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89
Q

Time> MIC (time-dependent)

A

Beta-lactams

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90
Q

First-line use of: Pen VK

A

Strep throat and mild non purulent skin infections

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91
Q

First-line use of: Amoxicillin

A

otitis media; infective endocarditis prophylaxis prior to dental procedures

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92
Q

First-line use of: Augmentin

A

otitis media and sinus infections; use lowest dose of clavulanate to reduce diarrhea

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93
Q

First-line use of: Pen G

A

syphilis (2.4 million units IM x 1)

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94
Q

First-line use of: Zosyn

A

pseudomonas infections; extended infusions can be used to maximize T>MIC

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95
Q

First-line use of: Nafcillin (IV) and dicloxacillin (PO)

A

MSSA

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96
Q

Common use of: Cephalexin

A

MSSA skin infections, strep throat

97
Q

Common use of: cefuroxime

A

Ceftin; 2nd gen; otitis media, CAP, sinus infection

98
Q

Common use of: cefdinir

A

Omnicef; 3rd gen; CAP, sinus infections

99
Q

Common use of: Cefazolin

A

1st gen; surgical prophylaxis, MSSA

100
Q

Common use of: Cefotetan and cefoxitin

A

2nd gen; anaerobe coverage (B. fragilis); surgical prophylaxis (colorectal procedures)

101
Q

Common use of: Ceftriaxone and cefotaxime

A

3rd gen; CAP, meningitis, SBP, pyelonephritis; do not use ceftriaxone in neonates

102
Q

Cephalosporins active against Pseudomonas

A

Ceftazidime (3rd gen) and Cefepime (4th), ceftolozane/tazobactam, ceftazidime/avibactam

103
Q

Cephalosporin active against MRSA

A

ceftaroline (5th gen)

104
Q

What bugs do Carbapenems not cover

A

MRSA, VRE, atypical, C. diff, stenothrophomonas

Ertapenem lacks coverage against pseudomonas, acinetobacter, and enterococcus

105
Q

Quinolone SE

A

tendon inflammation and/or rupture, peripheral neuropathy, seizures, QT prolongation, hypo/hyperglycemia, hepatotoxicity, photosensitivity

106
Q

Quinolone DDI

A

Multi-valent cations can chelate and inhibit absorption (antacids, didanosine, sucralfate, Mg, Al, Ca, Fe, Zinc, MVI, eg)

107
Q

Macrolide SE

A

QT prolongation, hepatotoxicity, GI upset

108
Q

Macrolide DDI

A

lovastatin/simvastatin (clarithromycin, erythromycin)

  • Erythromycin, Clarithromycin: major 3A4 substrates and inhibitors (more DDIs)
  • Azithromycin: minor 3A4 substrate, weak 1A2 and Pop inhibitor
109
Q

Macrolides use

A

CAP and beta-lactam alternatives for strep throat; good atypical coverage

110
Q

Azithromycin use

A

COPD exacerbations, mono therapy for chlamydia, combo therapy for gonorrhea, prophylaxis for MAC; DOC for dysentery

111
Q

Doxycycline use

A

RTIs, tick-borne/rickettsial diseases, spirochetes and chlamydia infections; less common: CA-MRSA in mild skin infections and VRE in UTIs

112
Q

Tetracycline warnings

A

children < 8 YOA, pregnancy and breastfeeding, photosensitivity, drug-induced lupus (DILE)

113
Q

Abx with absorption impacted by multivalent ion-containing drugs (antacids, sucralfate, Mg, Al, Ca,

A

quinolone, tetracyclines

114
Q

Bugs NOT covered by Sulfonamides

A

Pseudomonas, Enterococci, atypicals, or anaerobes

115
Q

Sulfonamides SE

A

N/V/D, anorexia, skin reactions, crystalluria (take with 8oz of water), photosensitivity, increased potassium, hypoglycemia, decreased folate, positive Combs test; significant increase in INR

116
Q

Sulfonamides common uses

A

CA-MRSA skin infections, UTI, pneumocystis pneumonia (PCP)

117
Q

Daptomycin SE

A

myopathy and rhabomyolysis; monitor CPK levels weekly; DO NOT use to treat pneumonia due to lung surfactant inactivating the drug

118
Q

Daptomycin coverage/usage

A

(Cubicin); most gram-positives including MRSA and enterococci; also VRE (E. faecium and E. faecalis); complicated SSTIs and MRSA blood-stream infections, including right-sided endocarditis

119
Q

Linezolid warnings/SE

A

(Zyvox); CI within 2 weeks of MAOIs, duration-related myelosuppression; decrease platelets, HA, nausea, diarrhea

120
Q

Synercid use

A

Quinopristin/Dalfopristin; VRE E. faecium infections

121
Q

Synercid SE

A

arthralgia/myalgia, infusion reactions, edema and pain at infusion site, phlebitis, hyperbilirubinemia, CPK elevations

122
Q

Tigecycline coverage

A

very broad spectrum; does not cover Pseudomonas, Proteus, or Providencia; boxed warning for increased risk of death

123
Q

Clindamycin coverage

A

most aerobic and anaerobic Gram-Positive bacteria, including some CA-MRSA;

124
Q

Clindamycin boxed warning

A

C. difficile colitis

125
Q

Metronidazole coverage/uses

A

anaerobes and protozoal infections; bacterial vaginosis, trichomoniasis, giardasis, amebiasis, C. difficile (although falling out of favor) and in combination for intra-abdominal infections

126
Q

Fidaxomicin use

A

Dificid; C. diff infections; shown benefit in preventing recurrence

127
Q

Drugs for: CA-MRSA SSTI

A

Bactrim DS, doxycycline, minocycline (clindamycin and linezolid)

128
Q

Drugs for: nosocomial MRSA

A

Vancomycin, linezolid, telavancin, daptomycin (not in PNA)

129
Q

Drugs for: VRE (E. faecalis)

A

Pen G or ampicillin, linezolid (daptomycin and tigecycline)

130
Q

Drugs for: VRE (E. faecium)

A

daptomycin, linezolid, synercid

131
Q

Drugs for: Pseudomonas

A

Zosyn, cefepime, ceftazidime, ceftazidime/avibactam, ceftolozane/tazobactam, carbapenems (except ertapenem), cipro, levo, aztreonam, aminoglycosides, Colistin, polymyxin B

132
Q

Drugs for: ESBL gram-negatives

A

Carbapenems

133
Q

Drugs for: Bacteroides fragilis

A

metronidazole beta-lactam/beta-lactamase inhibitor, cefotetan, cefoxitin, carbapenems

134
Q

Drugs for: C. Diff

A

metronidazole, vancomycin (oral), fidaxomicin

135
Q

Drugs for: Atypicals

A

azithromycin, doxycycline, quinolones

136
Q

Pediatric APAP dose

A

10-15 mg/kg Q4-6H PRN

137
Q

Preferred allergy medications in pregnancy

A

zyrtec, claritin, and budesonide nasal spray

138
Q

Natural products for Cold

A

echinacea, zinc, ascorbic acid

139
Q

Cough and cold medications CI within 14 days of MAOi therapy

A

Decongestants (Sudafed, Sudafed-PE) and dextromethorphan

140
Q

mOsmol/L Equation

A

mOsmol/L = (g/L)/MW * #particles * 1000

141
Q

AirDuo Respiclick

A

fluticasone/salmeterol

142
Q

Major side effects of inhaled beta-2 agonists

A

nervousness, tremor, cough, tachycardia, hyperglycemia, hypokalemia

143
Q

Acute bacterial meningitis treatment

A

<1 month: ampicillin + cefotaxime
1 month- 50 years: ceftriaxone + vancomycin
>50 years or immunocompromised: ceftriaxone + vancomycin + ampicillin

144
Q

Preferred allergy medications in pregnancy

A

zyrtec, claritin, and budesonide nasal spray

145
Q

Treatment: Outpatient CAP

A

Healthy and no Abx in last 3 months: macrolide or doxycycline
Abx in last 3 months, chronic disease, immunocompromised: beta-lactam (Augmentin, cefdinir, and cefpodoxime) + macrolide; or respiratory FQ monotherapy

146
Q

Cough and cold medications CI within 14 days of MAOi therapy

A

Decongestants (Sudafed, Sudafed-PE) and dextromethorphan

147
Q

AirDuo Respiclick

A

fluticasone/salmeterol

148
Q

Major side effects of inhaled beta-2 agonists

A

nervousness, tremor, cough, tachycardia, hyperglycemia, hypokalemia

149
Q

Treatment: HAP/VAP with high risk of mortality or high risk for MDR pathogens + MRSA risk

A

2 anti-pseudomonals + one anti-MRSA agent

150
Q

Treatment: Latent TB

A

isoniazid 300mg PO daily x 9 months (preferred in HIV+, pregnant women, and children);
rifampin 600mg daily x 4 months if isoniazid resistant or not tolerated

151
Q

Treatment: Outpatient CAP

A

Healthy and no Abx in last 3 months: macrolide or doxycycline
Abx in last 3 months, chronic disease, immunocompromised: beta-lactam (Augmentin, cefdinir, and cefpodoxime) + macrolide; or respiratory FQ monotherapy

152
Q

Treatment: Inpatient CAP

A

beta-lactam (ceftriaxone or cefotaxime) + macrolide or doxycycline; respiratory FQ monotherapy; 5 days of treatment

153
Q

IE dental prophylaxis

A

(for patients with artificial heart valves/conditions)
Amoxicillin 2g PO 30-60 minutes before dental procedure
–if pen allergy: Clinda 600mg or Azithro 500mg

154
Q

Treatment: HAP/VAP without risk of mortality with MRSA risk

A

One anti-pseudomonal + one anti-MRSA agent

155
Q

Treatment: HAP/VAP with high risk of mortality or high risk for MDR pathogens + MRSA risk

A

2 anti-pseudomonals + one anti-MRSA agent

156
Q

Treatment: Latent TB

A

isoniazid 300mg PO daily for 9 months (preferred in HIV+, pregnant women, and children); rifampin 600mg daily for 4 months if isoniazid resistant or not tolerated

157
Q

Treatment: Active TB; intensive phase

A

RIPE therapy (rifampin, isoniazid, pyrazinamide, and ethambutol) for 2 months

158
Q

Treatment: Cellulitis/Abscess, mild-moderate, purulent

A

CA-MRSA; Bactrim or Doxycycline; if cultures demonstrate MSSA, may switch to cephalexin

159
Q

IE dental prophylaxis

A

(for patients with artificial heart valves/conditions)
Amoxicillin 2g PO 30-60 minutes before dental procedure
–if pen allergy: Clinda 600mg or Azithro 500mg

160
Q

Treatment: SBP (primary peritonitis)

A

ceftriaxone 5-7 days; Bactrim or Cipro as primary or secondary prophylaxis

161
Q

Treatment: Impetigo

A

honey-colored crusts resulting from blisters; topical antibiotic such as mupirocin; or if numerous lesions, cephalexin

162
Q

Treatment: Folliculitis/Furuncle/Carbuncle

A

systemic signs: cephalexin; if non-responsive: Bactrim or doxycycline (CA-MRSA coverage)

163
Q

Treatment: Cellulitis non-purulent

A

Cephalexin or Clindamycin (if beta-lactam allergy) for 5 days

164
Q

Treatment: Cellulitis/Abscess, purulent

A

CA-MRSA; Bactrim or Doxycycline; if cultures demonstrate MSSA, may switch to cephalexin

165
Q

Treatment: Severe purulent SSTI

A

MRSA coverage; vancomycin 7-14 days

166
Q

Treatment: Syphilis, late latent (> 1 year duration) or tertiary

A

Pen G benzathine 2.4 million units IM weekly x 3 weeks

167
Q

Treatment: Diabetic Foot Infections, mod-severe, life-threatening

A

vancomycin + anti-pseudomonal 7-14 days; more severe, deeper: 2-4 weeks; severe, limb-threatening or bone/joint: 4-6 weeks

168
Q

Treatment: Acute uncomplicated cystitis

A

MacroBID x 5 days; Bactrim x 3 days or Fosfomycin as alternatives

169
Q

Treatment: Acute uncomplicated pyelonephritis

A

Quinolone resistance <10%: Cipro x 7 days; >10%: 1 dose of ceftriaxone then quinolone or Bactrim for 14 days

170
Q

Treatment: bacteruria in pregnant women

A

Augmentin or oral cephalosporins x 3-7 days; avoid quinolone and tetracyclines

171
Q

Treatment: Syphilis, primary, secondary or early latent

A

Pen G benzathine 2.4 million units IM x 1

172
Q

Treatment: Syphilis, late latent (> 1 year duration) or tertiary

A

Pen G benzathine 2.4 million units IM weekly x 3 weeks

173
Q

Treatment: Gonorrhea

A

ceftriaxone 250mg IM x 1 + Azithromycin 1g PO x 1 (preferred) or doxycycline 100mg BID x 7 days

174
Q

Treatment: Chlamydia

A

Azithromycin 1g x 1 or doxycycline 100mg BID x 7 days

175
Q

Treatment: Bacterial Vaginosis

A

fishy odor, pH>4.5

metronidazole 500mg BID x 7 days or metronidazole 0.75% gel (5g in that stinky vagina) x 5 days

176
Q

Treatment: Trichomoniasis

A

yellow-green vaginal discharge

Metronidazole 2g PO x 1

177
Q

Antibiotics that interfere with coagulation laboratory assays

A

Daptomycin, Oritavancin, Telavancin

178
Q

Synercid common toxicities

A

(Quinupristin-dalfopristin; treats VRE faecium)

arthralgias/myalgias, hyperbilirubinemia, infusion reactions

179
Q

Drug of choice for Acinetobacter

A

Meropenem

180
Q

Antibiotic that treats VRE E. faecalis

A

Daptomycin (Cubicin)

181
Q

Which cephalosporin should be avoided with extensive alcohol abuse

A

cefotetan; causes disulfiram reaction

182
Q

Which cephalosporins exhibit anaerobic activity?

A

cefotetan and cefoxitin

183
Q

Which antibiotic classes increase risk for seizures?

A

FQ and beta-lactams

184
Q

What test is used to confirm Clindamycin susceptibility in MRSA?

A

D-test

185
Q

What test detects carbapenemase production?

A

Hodge test

186
Q

Concentration-dependent Abx

A

aminoglycosides, FQs, daptomycins, others

187
Q

Third generation cephalosporins

A

cefpodoxime, cefdinir, cefotaxime, ceftriaxone

188
Q

Abx classes with atypical coverage

A

tetracyclines, macrolides, and anal beads, also FQs

189
Q

Which beta-lactams require refrigeration

A

all except cefdinir (omnicef)

190
Q

Which 2 PPIs should be avoided with clopidogrel?

A

omeprazole and esomeprazole

191
Q

What are the contents of Prevpac for H. Pylori

A

amoxicillin, clarithromycin, and lansoprazole

192
Q

Most susceptible Candida species

A

C. albicans

193
Q

Most difficult to treat Candida species

A

C. glabrata and C. krusei

194
Q

Which azole anti fungal requires renal dosage adjustment?

A

fluconazole

195
Q

Which azoles have pH-dependent absorption?

A

itraconazole and ketoconazole; space 2 hours from antacids; if PPI or H2RAs required, given with 8oz of that real coke

196
Q

Treatment: Candida albicans

  • Thrush
  • Esophageal infection
  • Bloodstream
A

Thrush: mild-disease- clotrimazole, nystatin; HIV+ or mod-severe- fluconazole PO preferred
Esophageal: fluconazole or echinocandin
Bloodstream: echinocandin preferred; or fluconazole

197
Q

Treatment: Candida glabrata or krusei

A

echinocandinds or amphotericin B

198
Q

Treatment: Aspergillus

A

voriconazole (preferred), amphotericin B, isavuconazonium

199
Q

Treatment: dermatophytes

A

nail bed infections: intraconazole, terbinafine, or fluconazole

200
Q

Treatment: histoplasma capsulatum

A

liposomal amphotericin B followed by itraconazole

201
Q

Oseltamivir dosing

A

Treatment (age >12): 75mg BID x 5 days

Prophylaxis (age>12): 75mg daily x 10 days

202
Q

Treatment of choice for CMV

A

Ganciclovir and Valganciclovir

203
Q

Prophylactic OI treatment: PCP

A

CD4+ count <200 or oropharyngeal candidiasis or other AIDS-defining illness; Bactrim DS or SS PO daily; D/C if CD4+ count >200 for >3 months on ART

204
Q

Prophylactic OI treatment: Toxoplasma gondii encephalitis

A

Toxoplasma IgG positive w/ CD4+ count <100; Bactrim DS tab PO daily; continue until >200 for >3 months on ART

205
Q

Prophylactic OI treatment: MAC

A

CD4+ <50; azithromycin 1200mg PO weekly; continue until CD4+ >100 for >3 months on ART

206
Q

Initial drug treatment of choice for GERD

A

8 week trial of PPI; then stop therapy and assess if symptoms return, which would require maintenance therapy

207
Q

MOA of H2RAs in GERD

A

REVERSIBLY inhibit H2 receptor, decreasing gastric acid secretion

208
Q

PPI warnings

A

C. diff infections, osteoporosis-related fractures, hypomagnesemia

209
Q

3 most common causes of PUD

A

H.pylori-positive ulcers, NSAID-induced ulcers, and stres ulcers

210
Q

First-line treatment of H.pylori ulcers

A

PPI BID + Bismuth subsalicylate 300mg QID + metronidazole 250-500mg QID + tetracycline 500mg QID for 10-14 days

211
Q

Alternative treatment options for H. pylori ulcers

A
  • PPI BID + Amoxicillin 1g BID + Clarithromycin 500mg BID + Metronidazole 250-500mg QID; 10-14 days
  • PPID BID + Amoxicillin 1g BID + Clarithromycin 500mg BID ( if never taken a macrolide) 14 days
212
Q

DOC for lyme disease

A

Doxycycline 10-21 days

213
Q

Antidote for heparin

A

Protamine

214
Q

Boxed warning for LMWHs

A

Spinal or epidural hematoma formation

215
Q

Anticoagulant that cannot be used in patients with CrCl > 95 d/t reduced efficacy

A

Edoxaban (Savaysa)

216
Q

A lower warfarin starting dose is recommended in which patient populations?

A
  1. elderly or debilitated
  2. liver disease
  3. HF
  4. high bleeding risk
217
Q

Duration of anticoagulation recommended after cardioversion for atrial fibrillation

A

minimum of 4 weeks

218
Q

How much heparin/enoxaparin will 1 mg of protamine reverse?

A

~100 units of heparin

1 mg of enoxaparin

219
Q

What type of valve requires INR goal of 2.5-3.5?

A

mechanical mitral valve

220
Q

Which natural products can increase INR?

A

“5 G’s”

  1. garlic
  2. ginger
  3. ginkgo
  4. ginseng
  5. glucosamine
221
Q

How to calculate relative risk (RR)

A

probability of event occurring in studied group divided by probability of event occurring in placebo group

222
Q

How to calculate absolute risk reduction (ARR)

A

probability of event occurring in studied group (%) minus probability of event occurring in placebo group (%)

223
Q

How to calculate relative risk reduction (RRR)

A

1 - relative risk (RR)

224
Q

How to calculate NNT

A

1/ARR

225
Q

Type I error

A

False positive (rejection of true null hypothesis); related to alpha value

226
Q

Type II error

A

False negative (retaining a false null positive); related to beta value (power = 1 - beta)

227
Q

Specificity

A

Percentage of time it’s a true negative

228
Q

Sensitivity

A

Percentage of time it’s a true positive

229
Q

torsemide

A

Demadex (more potent than furosemide; less than bumetanide)

230
Q

ethacrynic acid

A

Edecrin (least potent loop diuretic)

231
Q

bisoprolol

A

Zebeta

232
Q

Drugs that can raise BG

A
  1. beta-blockers
  2. diuretics (thiazides/loops)
  3. immunosuppressants
  4. niacin
  5. protease inhibitors
  6. quinolones
  7. 2nd gen antipsychotics
  8. statins
  9. systemic steroids
233
Q

Antidote for iron overdose

A

deferoxamine (Desferal)

234
Q

INFeD

A

Iron dextran (IV); test dose

235
Q

Ferrlecit

A

Sodium ferric gluconate (IV)

236
Q

Venofer

A

Iron sucrose (IV)

237
Q

Feraheme

A

ferumoxytol (IV); risk of fatal anaphylactic reaction

238
Q

FeroSul

A

ferrous sulfate (PO) 325mg (65mg elemental) daily-TID

NAPLEX Flashcards (3 decks)

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