SD

Question 1

Pegfilgrastrim and Filgrastrim Dosing

Answer 1

Filgrastrim: 5 mcg/kg IV/SC daily (round to nearest 300 or 480 vial)

PEG: 6 mg SC once per chemo cycle
*PEGylated form of filgrastrim (extended half-life)

PPX TO REDUCE NEUTROPENIA (granulocyte colony stimulating factors)

Question 2

DOAC Q: No Injectables

Answer 2

Xarelto (correct dosing for DVT): 15 mg BID x21d then 20 mg QPM

-Warfarin (no MV)
-Edox (bridge?)
-Eliquis (wrong dosing)

Question 3

Meningitis: V or B

Answer 3

Neonate and 50+/IC: higher risk for Listeria bacteria

Dx: LP of CSF looking at WBC, protein, glucose etc

B: >= 1000 WBC and neutrophils

V: <100 WBC and lymphocytes

N. meningitides

No CTX in neonates due to biliary sludging and high bilirubin = brain damage

Question 4

UTI: Cystitis

Answer 4

For ESBL E. coli and Entero faecium

Fosfomycin 3g x1 (yes)
-Cipro (X - no in children, seizures, QTcP, tendinitis, BG)
-Beta lactam (no ESBL cov)
-Carbapenem (only ESBL not faecium cov)

Question 5

Psoriasis

Answer 5

Humira / Adalimumab
-80 mg on Day 1
-40 mg every other week thereafter (starting Day 8)

*Infections/malignancy risk

Treatment for candidates for systemic therapy or
phototherapy, and when other systemic therapies are medically less
appropriate

-Why not oral steroids: rebound effect (comes back worse) and serious AEs

Question 6

Sepsis

Answer 6

1. Norepi (Levophed) 0.5-50 mcg/min
2. Vasopressin 0.03 u/min
3. Epi 0.01-0.03 mcg/kg/min

Question 7

Folliculitis/Furcuncle or Abscess

Answer 7

-Bactrim 1-2 DS BID
-Doxycycline 100 mg BID

Question 8

Cellulitis

Answer 8

-Cephalexin 500 QID
-Clindamycin 300 QID

Question 9

Severe Purulent SSTI or Nec Fasc

Answer 9

-Vanco, dapto, linezolid

Nec Fasc: vanc or dapto + zosyn + clindamycin

Question 10

CAP IP and OP

Answer 10

OP
-H: Amox 1 g TID x5d (doxy or mac)
-C: Aug 875 mg BID x5d + Azithro 500 mg x3d (or levo 750 mg x5d)

IP
-GM: CTX + mac/doxy or RFQ
-ICU: CTX + mac/RFQ +/- vanco/line (PM zosyn instead of CTX)