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1
Q

What is the difference between Reclast and Zometa which are both zolendronic acid?

A

Same ingredient, different uses: Reclast - osteo, pager’s disease; Zometa - cancer

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2
Q

What is the brand for Fidaxomicin and what is this medication used for?’

A

Dificid. Used to treat C.diff. Used as first line agents in patients with no fulminant infection.
*reduces risk for recurrent infection, has GI side effects, expensive

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3
Q

What is the brand name for bezlotoxumab? And what is it used for?

A

Zinplava. C.diff. Recommendation is to be used for recurrent infections and patients who has had infection in the last 6 months.

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4
Q

What two lab values show kidney injury?

A

Creatinine and BUN. They are waste products that are eliminated by the kidney. As their levels rise in the blood, it can be indicated that the kidney is not functioning properly. BUN/Creatinine ratio tends to go up as GFR falls.

*BUN (Blood Urea Nitrogen) can be falsely low in patients with liver impairment since liver is unable to adequately convert ammonia to urea

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5
Q

What are the two types of acute kidney injuries?

A

Intrinsic: damage to function units of kidney (nephrons), caused by infection, toxic agents, drugs (aminoglycosides, vancomycin, chemotherapy, etc)

Postrenal: obstruction (stone, BPH, tumor), drugs that can form crystals and stones (acyclovir, Indian or, methotrexate)

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6
Q

What medications treat AKI?

A

None. Dialysis in emergency situation to filter blood.
Otherwise treat underlying cause and/or remove offending agent: infection with a/b, dehydrations with fluid replacement etc
Fluid overload with diuretics
Treat electrolyte imbalances caused by AKI: hyperkalemia with SPS (GI side effects), or in emergency situations insulin can be used to push K+ out of cells.
Severe acidosis: sodium bicarbonate

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7
Q

What drugs are known to cause/contribute to AKI?

A

Aminoglycosides
Vancomycin
NSAIDS
ACEI/ARB
Contrast dye
Amphotericin B
Chemo agents (platinum compounds)
Diuretics via dehydration risks
Anti rejection agents

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8
Q

What is Addison’s disease?

A

Opposite of Cushing. Too little cortisol. Aldosterone could be in short supply.

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9
Q

How do you treat Addison’s disease?

A

Steroid replacement: hydrocortisone, prednisone
Mineralcorticoid replacement may be necessary to help hyponatremia: fludrocortisone, avoid spironolactone which can exacerbate hyperkalemia and hyponatremia as well as oppose effects of mineralcorticoid
Adrenal crisis management through fluid and electrolyte replacement, monitor blood glucose and give dextrose as needed, IV hydrocortisone, fludrocortisone as needed

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10
Q

What medications can likely cause angioedema?

A

ACEI/ARB
NSAIDS
Penicillins

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11
Q

What is and how do you treat angioedema?

A

Swelling of the loose tissue like lips, mouth, throat, and genitals etc.

Epi-pen 0.3mg (response may be blunted by being on Betablockers)
Glucagon for patients on beta-blockers
Antihistamines
Glucocorticoids
Respiratory bronchodilators

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12
Q

What organisms are targeted for a/b prophylaxis and what medications are used?

A

Gram (+) mostly, staph and strep (mostly using 1st or 2nd generation cephalosporins (ie. cefazolin), penicillin type (ampicillin)
Concerns for MRSA, use vancomycin or Clindamycin for resistant gram (+)
GI surgery may need to cover gram (-) and anaerobes (use metronidazole or clindamycin for anaerobes), quinolones for gram (-)
Urologic procedure use quinolones (levo, cipro); smz/tmp

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13
Q

What is the max dose of Zyrtec for patients >77yo?

A

5mg QD

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14
Q

What are some side effects associated with common systemic decongestants like pseudoephedrine and phenylephrine?

A

Increase in blood pressure, contribute to urinary retention in patients with BPH, increases anxiety/insomnia

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15
Q

What is the black box warning for montelukast?

A

Psychiatric events such as aggression, suicide, and depression

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16
Q

When do you increase or decrease dose for ESAs?

A

Monitor Hb, if increases more than 1g/dL in two weeks, decrease dose by 25%.
If no increase of Hb of 1g/dL in 4 weeks, then increase dose by 25%.
*black box of cardiovascular events

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17
Q

What is the most potent for of oral iron supplementation?

A

Ferrous fumurate (33%), sulfate (22%), gluconate (12%)
*constipation stomach upset dependent on dose and iron content
*watch for cation interaction with other meds
*take with vitamin C to help with absorption
*polyscaccharide iron complex can be option is absorption not enough from standard therapy

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18
Q

How do you treat pernicious anemia?

A

Supplement with B12, oral not readily absorbed
Injection = 1,000mcg weekly until goal is reached, then maintain with monthly injection

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19
Q

Hemoglobin and hematocrit ranges for male and female

A

Hemoglobin
Female: 12-16 g/dL
Male: 14-18 g/dL

Hematocrit
40-54%
36-48%

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20
Q

What should you ask burn patients before using silver sulfadiazine?

A

Are you allergic to sulfa?

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21
Q

Why shouldn’t burn patients use topical corticosteroids?

A

It can possibly increase infection risk and healing may be impaired

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22
Q

What is the order of potency in corticosteroid creams?

A

Lowest to highest
Hydrocortisone —> fluocinonide, betamethasone valerate —> triamcinolone —> clobetasol, betamethasone diproprionate
*skin thinning
*enlarged blood vessels

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23
Q

What are topical calcineurin inhibitors?

A

Tacrolimus (Protopic) pimecrolimus (Elidel)

*adverse effects profile better than topical corticosteroids for atopic dermatitis
*boxed warning of rare cases of malignancy

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24
Q

What is bacterial peritonitis and what are common agents to treat it?

A

Infection of the peritoneum, occurs in patients with portal hypertension which is typically as a result of cirrhosis, lupus
*Target gram (-), 3rd gen cephalosporins = cetriaxone, cefotaxime
*If gram (+) concerns, ampicillin can be used
*ProphylaxisL cipro, Bactria

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25
Q

What are common eye drops for bacterial/viral eye infections?

A

Gentamicin
Erythromycin
Polymixin/trimethoprim
Moxifloxacin
Sulfacetamide
*adenovirus most common cause of viral infection
*most common bacteria: staph, strep, m.cat, h.flu

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26
Q

What is cholelithiasis and what medication treats it?

A

Gallstones; Ursodiol (Actigall), dissolves cholesterol which can be important component in gallstones, monitor liver function
*Allopurinol for prevention if Uric acid based stones
*pain in upper right quadrant, commonly associated with fatty meals

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27
Q

What is a sign of cirrhosis that involves INR?

A

Elevation on INR due to liver making clotting factors even when patient is not on anti coagulation

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28
Q

Why is bleeding a risk in cirrhosis?

A

If liver is damaged, clotting factors may not be properly made causing thin blood, esp in even there is esophageal varies that rupture due to portal hypertension

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29
Q

What happens when liver can not break down waste products?

A

Hepatic encephalopathy. Build of of ammonia causing risk of confusion, sedation, seizure, delirium
*drugs that can cause this - carbamazepine, valproic acid
*Treat underlying causes, obesity, hepatitis, alcoholism
*Portal hypertension: non-selective beta blocker- propranolol, Nadia lol
Encephalopathy: lactulose, rifaximin (Xifaxen)
*Manage ascites: aldosterone antagonist, spironolactone (may be used with loops to remove excess fluid), appropriate target is
40mg furosemide to 100mg spironolactone to maintain stable K+

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30
Q

When is red man syndrome not a concern when taking Vanc?

A

When given orally. Only indication for oral vanc is c.diff since systemic absorption is poor, infection in GI so not an issue

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31
Q

What are medications and disease states that can cause constipation?

A

Opioids, anticholinergics, calcium channel blockers, iron supplements, calcium supplements
Parkinson’s, MS, diabetes, hypothyroidism, stroke

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32
Q

What is the CIWA-AR test for?

A

Scale for withdrawal scored up to 67, the higher the score the more likely the patient needs meds for the withdrawal

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33
Q

Alcoholics are usually deficient in what vitamins?

A

B12, thiamine (B1), folic acid

In Wernicke’s encephalopathy patients can have delirium and typically due to lack of dietary thiamine (B1)

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34
Q

What meds are used for alcohol withdrawal?

A

Naltrexone (monthly injection, once daily tablet): GI sides effects, inc LFTs *pt should be opioid free for 7-14 days
Acamprosate: *rec to start after abstaining from alcohol, Contraindicated in CrCl <30, diarrhea is predominant side effect, dosing TID
Disulfiram: mechanism is disulfram reaction causing dysphoric, headache, flushing, and GI symptoms when alcohol is ingested, need to take med for it to work

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35
Q

What meds are used for opioid use disorder?

A

Methadone, suboxone, naltrexone
Methadone, full mu agonist, very long half life, will cause sedation and other opioid like effects, Qtc interactions, has to be dispensed via special treatment program, sched 2
Suboxone, combo of partial mu agonist and opioid mu antagonist, prevents reward from opioid agonists, sched 3
Naltrexone: mu antagonist, needs to be taken regularly, monthly injection, or once daily tab, can precipitate withdrawal so maintenance therapy must not be started until withdrawal is finished

Naltrexone can precipitate withdrawal, suboxone may precipitate withdrawal, methadone can be started prior to full withdrawal

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36
Q

Why is it usually not recommended to give elderly patients mineral oil?

A

Increase risk for pneumonitis (aspiration risk)

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37
Q

What are the normal levels of uric acid?

A

2.5-6 mg/dL

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38
Q

What are some risk factors for gout?

A

Alcohol
Metabolic disease/obesity
Seafood (foods high in purine)
Family history
Male gender
Loop/thiazide diuretics can decrease uric acid excretion
Niacin, cyclosporine, and tacrolimus can raise uric acid levels

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39
Q

What are some important things to note about allopurinol?

A

Reduces the PRODUCTION of uric acid, prevents making more does not remove what’s already there
Side effects of rash and GI
Test for HLA-B5801 in AA and SE asians descent prior to starting
Can raise azathioprine levels
Loop/thiazide and PCN use may increase risk for allergic reaction
Dose adjust with worsening kidney function

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40
Q

What is a major limiting factor with using colchicine?

A

Side effect of diarrhea (low does has similar efficacy to high does in acute treatment of flares with reduced side effects)

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41
Q

Is colchicine used for prevention or treatment?

A

Both. Watch for CYP3A4 inhibitors like grapefruit juice which will increase serum levels.
May inc risk of myopathy/rehab do in patients on statins

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42
Q

Is indomethacin the only NSAID for gout flares?

A

No, can use other NSAIDs. Indomethacin has high incidence of GI side effects, possibly will see GI protection with its use
Needs to watch with patients that have CHF, renal impairment, or on anticoagulants

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43
Q

What can be used for pain in gout flares if NSAIDs and colchicine can not be used?

A

Corticosteroids. Acute flare management only, first line alternative.

44
Q

What is febuxostat used for?

A

Uloric or febuxostat is very similar to allopurinol. Meant for prophylaxis as well, FDA warning for cardiovascular death, so only used last line.

45
Q

What does probenecid do?

A

Removes uric acid in the body by increasing kidney excretion. Need adequate renal function for this medication to work.

46
Q

What is the main side effect of probenecid?

A

GI upset.

47
Q

The serum levels of which medications can be raised by taking probenecid?

A

PCN, quinolones, cephalosporins, NSAIDs, nitrofurantoin, methotrexate
Thus, probenecid can be seen used with PCNs to prolong plasma-life and increase serum concentrations.

48
Q

What is a GAD-7 scale used for?

A

7 questions about ANXIETY
Each question scored from 0-3, total max score of 21
0-4 minimal anxiety, 15-21 severe

49
Q

What is flumazenil?

A

The reversal agent for benzos

50
Q

What is the shortest acting benzo? Longest?

A

Triazolam
Diazepam, flurazepam, chlordiazepoxide

51
Q

What is the advantage of using buspirone for anxiety? And disadvantage?

A

Non-controlled.
Multiple times a day dosing

52
Q

What medications can exacerbate GERD?

A

Corticosteroids,bisphosphonates, NSAIDs

53
Q

What medications must be look out for that interact with antacids?

A

Quinolones, tetracyclines, levothyroxine

54
Q

Do we dose adjust H2 blockers for GERD?

A

Yes. Also watch for possible accumulation that could cause rare CNS problems that are more likely in CKD
Avoid cimetidine due to many interactions CYP3A4, also carries gynecomastia risk

55
Q

How many hours do you have to separate sulcralfate and other medications?

A

Take sucralfate 2 hours after other meds

56
Q

What are eye vitamins usually composed of?

A

Vitamin A, C, E, Lutein, copper, zinc, zeanthin

57
Q

What VEGF inhibitor is used for macular degeneration and what does it do?

A

Cancer med Avastin, bevacizumab, can be injected into the eye to reduce the growth of abnormal blood vessels

58
Q

What are the outpatient treatments for COVID-19?

A
  1. Paxlovid (nirmatrelvir/ritonavir): mild to moderate patients
    oral admin, initiate within 5 days of symptom development
    Strong CYP3A4 inhibitor so can interact with many medications (be careful with polypharmacy geriatric patients)
  2. Remdesivir: alternative to paxlovid, IV admin for 3 days
  3. Bebtelovimab: (best against omicron strains), single IV Inj
  4. Lagevrio (Molnupiravir): oral med, 50% reduction in hospitalization and death
59
Q

What are inpatient options for COVID-19?

A

In patients that do not need oxygen: remdesivir

In patients that need oxygen: Dexamethasone + remdesivir

In patients that have worsening condition and inc oxygen requirements: dexamethasone + baricitinib or tocilizumab (can also consider adding remdesivir as supplies allow)

60
Q

What is flumazenil?

A

Benzo reversal
Black box warning or seizure risk

61
Q

What are the routes of halo one?

A

IV
IM
SC
Intranasal

62
Q

How do you treat diverticulitis?

A

Treat infection + Pain management

Look for infection, if so, gram (-) and anaerobic coverage is primary initial focus
Cipro or Bactrim + metronidazole
Plus pain management, use acetaminophen as opioids and NSAIDs can exacerbate condition

63
Q

What are medications for “failure to thrive”?

A

No medication to treat FTT.
Treat underlying disease state
Avoid minimize medications that can contribute

64
Q

What are some environmental conditions to help prevent falls in the older patients?

A

Poor lighting
Hazardous object in hallways etc
Bathroom bedroom conditions
Avoid steps and stairs
Support rails as appropriate

65
Q

What can we do to help prevent fails with patients with diabetes and HTN?

A

Relax doses of BP meds (hypotension) and diabetic meds (hypoglycemia)

66
Q

What are some risk factors for diabetic ketoacidosis?

A

Non-adherence to insulin
Poor management of blood sugars
Type-1 diabetes

67
Q

How to treat diabetic ketoacidosis?

A

Fluid replacement, electrolyte abnormalities (ie potassium), insulin, NaBicarb (reserved for severe acidosis state)

Fluid replacement as often hypovolemic (ie. normal saline)
Identify and address electrolyte abnormalities: K should be given BEFORE insulin if low K+ (<3.3-3.5), K can be given with insulin if normal K+
-Insulin causes an intracellular shift of K+ out of cells that could lead to potential profound hypokalemia if potassium stores are already low

68
Q

What is first line and second line treatment for PAD?

A

Lack or inadequate blood flow to legs, extremities caused by claudication with symptoms of pain and cramping in legs, atherosclerosis is usually the cause

First line: statins, treat HTN, manage diabetes, anti platelet therapy aspirin or clopidogrel (if ASA contraindicated)
2nd: cilostazol, take on empty stomach, contraindicated in heart failure, pentoxifylline, give with food, might not be beneficial
3rd: bypass surgery

69
Q

How do you treat valvular heart disease?

A

Control HTN, lipids
ABx if needed
Valve replacement
*Anticoag afterwards, bridge with LMWH and then long term warfarin
* Warfarin goal for MITRAL MECHANICAL valve 2.5-3.5 with aspirin
* Warfarin goal for AORTIC MECHANICAL valve 2.0-3.0 with aspirin unless with risk factor goal = 2.5-3.5 (prev clot, LV dysfunction, hypercoaguable state, older type valve)
*Warfarin goal for BIOPROSTHETIC mitral or aortic valves 2-3 with aspirin

70
Q

What medications are used to treat VERTIGO?

A

Symptomatic management with:
Meclizine, benzos, ondansetron, promethazine/metoclopramide/procloperazine

71
Q

When do you use midodrine?

A

For orthostasis.
Opposite of alpha blocker, clamps on vessels to cause pressure
Should not be used in BPH, can cause exacerbation

72
Q

What is CAD?

A

CAD IS PLAQUE BUILDUP WITHIN THE WALLS OF THE CORONARY ARTERIES CORONARY HEART DISEASE

73
Q

What are some common drugs associated with SJS?

A

allopurinol
lamotrigine
carbamazepine
barbituates
pheytoin
nsaids, APAP
sulfa, pcn

74
Q

What genetic testing shows increase risk for SJS from antiseizure medicaitons? gout medications like allopurinol?

A

HLA-B 1502
inc risk for sjs from carbamazepine, phenytoin, and phenobarbital, more common in asian descent (chinese, indian)

HLA-B*5801
inc risk for severe cutaneous reactions in asian descent (korean, han chinese, and thai) and also african

75
Q

What can sleep apnea cause?

A

Resistant HTN, must rule out before increasing antihypertensive meds

76
Q

T/F: no meds treat sleep apnea?

A

True, Treat underlying cause
nasal steroids for nasal congestion
nasal saline for nasal dryness

CPAP, weight loss, smoking cessation

77
Q

What medications can exacerbate sleep apnea?

A

Opioids, Benzos
Seizure meds
Older anticholinergics/antihistamines
Drugs that can contribute to weight gain (SU, mirtazapine, etc)

78
Q

What are the 5 As for reviewing readiness for smoking cessation?

A
  1. Ask about smoking at each visit
  2. Advise the patient to quit
  3. Assess readiness to quit
  4. Assist those patient who are ready to quit (counseling and medication management)
  5. Arrange follow-up visits, contact, phone calls as the patient begins their smoking cessation journey
79
Q

What does the American Thoracic Society recommend for smoking cessation?

A

Chantix (Varenicline) recommends over other therapy
but can use nicotine replacement, varenicline, buproprion are all considered primary options based on cost, coexisting conditions, patient preference etc

2nd line options: clonidine, nortriptyline

80
Q

What is varenicline?

A

Chantix
Partial nicotine agonist, 12 week course which can be doubled to 24 for certain patients
*patients can still smoke in first week
*notorious adverse affect of vivid dreams
*possible risk of psych changes
* insomnia
*nausea/vomitting

81
Q

What are the types of nicotine replacement products?

A

Patch, Gum, inhaler, lozenge, nasal spray

82
Q

What are the different dosages for NRT patches?

A

21, 14, and 7 mg
start with 21mg for patients using 10 or more cig per day and 14 mg patch for those using less than 10 cig per day

83
Q

What are the doses for NRT gum options? lozenge?

A

2 mg and 4 mg (max 24 pieces a day, q2h)
4 mg dose for patient that has their first cigarette within the first 30 min of awakening

Lozenge: same as gum strengths (max 20 pieces a day)

84
Q

What is the limiting factor of the inhaler type NRT?

A

Must puff inhaler for 20 minutes for best relief of craving (max of 16 cartridges per day)

85
Q

How do you use the nasal spray for NRT?

A

2 sprays (1 in each nostril) = 1 dose, 1mg of nicotine (Max 40 doses per day, 80 individual sprays)

86
Q

What are some symptoms of serotonin syndrome?

A

CNS changes, neuromuscular overactivity
HTN, Tachycardia
Tremor, fever
Diarrhea
Ataxia (impaired balance or coordination)

87
Q

What are some offending drugs for serotonin syndrome?

A

SSRI, SNRI, TCA, MAOI, buspirone
Tramadol
Triptans
Linezolid

88
Q

How to treat serotonin syndrome?

A

Remove offending agent, can use benzo to help agitation and tremor
Cyproheptadine, first generation antihistamine, typically reserved for moderate to severe cases (has antiserotonergic activity)

*Patient will likely need inpatient management, fluids, cardiac status, oxygen

89
Q

What are the two GLP-1s used for weight loss?

A

Saxenda (Liruglatide) and Wegovy (Semaglutide), larger doses for weight loss than for diabetes

90
Q

What are the cutoffs for obesity with BMI?

A

normal is 18.5-25
overweight is 25-30
moderate obesity 30-35
severly obese 35-40
very severyly obese 40+

91
Q

Which equation is now used for eGFR that excludes race as a risk factor?

A

CKD EPI 2021

92
Q

What are some risk associated with menopause?

A

Osteoporosis, CV disease, UI, and sexual dysfunction (dec libido, vaginal dryness)

93
Q

What are the risk for hormone replacement therapy?

A

Breast cancer
DVT/PE
Heart disease
Stroke

94
Q

T/F: for patients with intact uterus, they will need to use progestin if estrogen is going to be used to lower the risk of uterine cancer

A

True.

95
Q

What is duavee?

A

Bazedoxifene/estrogen combination “Tissue selective estrogen complexes” TSEC
SERM combined with estrogen
Potential option to avoid progestin risks/side effects

96
Q

What are non-hormonal therapy for menopausal symptoms?

A

SNRI: velafaxine
SSRI: paroxetine, citalopram
Anticonvulsants: Gabapentin

97
Q

How do you calculate ANC?

A

ANC = WBC * ((Segs/100) + (Bands/100)) ANC = 1.0 k/uL x (0.32 + 0.42) = 740

98
Q

Explain time dependent vs concentration depended pharmacokinetics

A

-T>MIC: the pharmacodynamics outcome that is correlated with efficacy for time dependent drugs; increased bacterial killing is based on the percentage of time the concentration exceeds the MIC. Drugs reach a saturable killing rate, therefore, increasing drug concentrations more will not affect the bacterial activity. Example of drugs: Penicillins, cephalosporings, monobactmas, clindamycin, macrolides, linezolid, tetracyclines.

-Peak/MIC: the pharmacodynamics outcome that is correlated with efficacy for concentration depend drugs. The rate and extend of killing of bacteria will increase with increased drug concentrations relative to the MIC. Administer higher doses with a decreased frequency of administration. Examples of drugs: aminoglycosides, floroquinolones, ketolide, metronidazole, oritavancin.

-AUC/MIC: the pharmacodynamics outcome that is correlated with efficacy for concentration depend drugs. It measures the AUC relative to the MIC of the organisms. Administer higher doses with a decreased frequency of administration. Example of drugs: floroquinolones, macrolides, tetracyclines, vancomycin.

99
Q

T/F: the CAGE questionnaire is used to assess alcohol use

A

True

100
Q

What is associated with Wernicke’s encephalopathy?

A

B1 thiamine deficiency

101
Q

What happens if you do not treat the reversible disorder fo Wernicke encephalopathy?

A

It can evolve to a non reversible disorder called Korsakoff syndrome

memory loss, amnesia, confabulation

Treatment IV thiamine 500mg bid-tid

102
Q

What is CIWA used to assess?

A

Clinical Institute withdrawal assessment for alcohol scale

scored up to 67 higher the score, the more the patient need medication for withdrawal

to be decided —> monitor or benzo indicated

103
Q

What is the assessment scale used for opiate withdrawal?

A

Clinical opiate withdrawal scale COWS

104
Q

What are some medications used to manage opioid withdrawal symptoms?

A

Clonidine: helps overall symptoms, sweats, tearing, piloerction

trazodone, loperamide
ondandsetron
ibuprofen
dicyclomine: GI cramping

105
Q

What medications are best for isolated systolic elevated bp?

A

CCB and thiazide diuretics

106
Q

What drug is primidone metabolized to?

A

Phenobarbital.

BCGP (26 decks)

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