Law Review GENERAL Clinical Flashcards

0
Q

Rivabirin and pregnancy? how long after can a patient get pregnant?

A

contraindicated in pregnancy , even a guy who is taking hep C cant have sex with a girl cuz she might have a baby with defects
-must wait 6 months after stopping therapy

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1
Q

Rivabirin and the kidney

A

Contraindicated at ClCR less than 50

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2
Q

Pegasys to generic

A

peginterferon 2g

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3
Q

What happens when a patient gets anemia or neutropenia with hepatitis C treatment?

A

doctor can prescribe epoetin for anemia

or filgastrim for neutropenia (neupogen)

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4
Q

Entecavir Brand

FOOD?

A

Baraclude

NO FOOD

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5
Q

peginterferon + rivabirin Brand

A

Rebetron

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6
Q

interferons and medguides

A

always dispense

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7
Q

Boceprivir/teleprivir

  • indication
  • MOA
  • frequency
  • pregnancy
A

Hepatitis C
protease inihibitors
-every 7 to 9 hours around the clock
-need negative pregnancy test before initial refill and before each refill
-must use two non hormonal contraceptives

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8
Q

NRTI class side effects

A

-lactic acidosis: muscle weakness, feet , cant move arms
-Headache fatigue, nausea, diarrhea
-skin rash
ALL possible

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9
Q

Epivir to Generic

Epivir HBV to generic

A

lamivudine for HIV

epivir HBV has a lower dose that is indicated for hepatitis

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10
Q

what meds cover bacteroides fragilis

A
tigecycline
metronidazole
Amp sulbactam 
cefoxitin, cefotetan 
ertapenem
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11
Q

nitrofurantoin

  • indication
  • Se
  • Serious side effect
  • renal adjustment
A

only for cystitis NOT systemic symptoms of UTI since does not reach good systemic concentraiton

  • causes yellow brown urine that sotpes when you DC
  • can cause serious lung problems
  • CI at ClCR less than 60
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12
Q

biaxin to generic
MOA/Class
SE
DDI

A

clarithromycin
macrolide inhibiting 50 s
GI abmnormalities
3A4 inhibitor

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13
Q

amphotericin B

  • compatibility
  • why use the lipid formulation
  • pregnancy
  • side effects
A

ONLY D5W

  • use lipid formulations to decrease infusion reactions and decrease nephrotoxicity
  • pregnancy category B
  • SE nephrotoxicity and electrolyte imbalances
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14
Q

what do you give to someone who has Cdiff but it it refractory to vancomycin and metronidazole?

A

Fidaxomicin

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15
Q

main rifampin side effects

A

hepatotoxicity and red orange urine

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16
Q

treatment for cytomegalovirus

A

cidofovir
valgancyclovir
foscarnet

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17
Q

clindamycin brand

spectrum

A

Cleocin
Covers gram + strept/staph but not enterococcus, gram + anaerobes
gram - anaerobes

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18
Q

daptomycin

  • type of killing
  • concentration or time dependent
  • renal
  • SE
  • compatibility
A
  • bacteriocidal
  • concentration dependent
  • Adjust renally
  • myopathy of adem… (?)
  • NS only
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19
Q

antibiotics with SLE - like side effects?

A

isoniazid

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20
Q

microdantin versus macrobid frequency

A

100 QID

100 BID

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21
Q

sinusitis doxycyline dose

A

100mg twice daily for 7-14 days

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22
Q

Does voriconazole cover aspergilis?

A

Yes

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23
Q

oseltamivir dose

A

75mg po twice daily for 5 days ( within the first 2 days of symptoms)

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24
Q

malaria prevention

main schedule

A

take the PO meds before and after traveling to an infected region

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25
Q

mefloquine dosing

A

2 weeks before travel and 4 weeks after travel

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26
Q

vivotif berna storage

A

fridge NOT freezer

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27
Q

primaquine

  • indication
  • test
  • pregancy
  • dose timing
A

for p vivax
make sure patient gets tested for G6PD deficiency
pregnancy X
take 1-2 days before travel and 7 days after travel

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28
Q

How is typhoid fever transmitted ? how is it prevented?

A

infected feces of people
make sure you eat safe food and water, wash hands
take the vaccine before traveling

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29
Q

Diamox generic

  • allergies
  • side effects
  • other recommendations
A

acetazolamide
CI in sulfa allergy
-photosensitivity
-remain well hydrated

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30
Q

possible side effects of valacyclovir

A

well tolerated but …

nausea and headache

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31
Q

common blood condition with Rivabirin?

A

within 1-2 weeks of starting, can cause hemolytic anemia

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32
Q

epivir dosing for hepatitis B vs HIV

A

HIV 300 po QD

HBV 100 po QD

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33
Q
Daytrana to generic
where to place 
can you swim in it
frequency
indication
A

methylphenidate patch
place on right hip on even days, left hip on odd days
yes can swim and bathe in it , make sure to hold patch in place for at least 30 seconds
place it once a day
it is for ADHD

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34
Q

Recommended criteria for starting ADHD medications

A

MUST have inattention and symptoms of hyperactivity/impulsivity
symptoms must impair the person it at least 2 settings : home, work, school

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35
Q

can patients take ADHD meds at night to decrease appetite suppression?

A

not a good idea! stimulants can lead to insomnia

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36
Q

which medications can be flushed down the toilet?

A
duragesic- fentanyl
nucynta
opana- oxymorphone
oxycontin 
butrans 
diastat- diazepam 
avinza - morphine sulfate 
Onsolis- fentanyl
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37
Q

Provigil to generic

  • indication
  • scheduled status
  • main adverse effects
A

modafinil
narcolepsy
CIV
severe rash

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38
Q

Med guides and when to give them

  • stimulants?
  • atomoxetine
  • provigil
A

give med guides for new prescriptions and for each refill

  • Yes for all stimulants because of psychiatric and heart problems
  • yes for atomoxetine because of risk of suicidal thoughts for children and teens, heart probles
  • yest but for sever rash
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39
Q

what to monitor in patients ADHD meds? when ?

A

Monitor Blood pressure & heart rate every month
height and weight every month or less often
ADHD symptoms and mood every month

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40
Q

ritalin to generic

A

methylphenidate

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41
Q

what is the starting dose of concerta?

concerta generic

A

18 m g once a day

methylphenidate ER

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42
Q

methylphenidate
stimulant side effects
usual schedule

A

-SE seeing, hearing non-real stuff, paranoia –> report
has an abuse potential
report chest pain, SOB or fainign
-usual schedule is start at low dose and increase dose with time

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43
Q

Nardil to generic

MOA

A

phenelzine

monoamine oxidase inhibitor

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44
Q

drug of choice for acute otitis media
dose
organism

A

amoxicillin 90mg/kg per day divided every 8 or 12 h

streptococcus pneumoniae

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45
Q

moxatag to generic

  • indication
  • how to take
  • kidney function
A

ER amoxicillin for pharyngitis by streptococcus pyogenes

  • take within an hour of finishing a meal
  • not for patient that has ClCr less than 30
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46
Q

treatment of giardiasis

A

diarrheal illness by a parasite

metronidazole po 250-500 TID or QID

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47
Q

Ceftin generic

A

cefuroxime

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48
Q

Extended dosing
gentamicin
tobramycin
amikacin

A

4 to 7 mg / kg/ dose

15mg/kg amikacin

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49
Q

penicillins and seizures

A

penicillins lower seizure threshold if they accumulate especially in renal impairment

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50
Q

Ketek generic

A

Telithromycin

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51
Q

minute time to infuse vancomycin

A

over two hours minimum

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52
Q

rifampin and urine

rifampin and food

A

orange red discoloration of body secretions

NO food! decreases absorption

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53
Q

treatment for syphillis based on duration of infection

A

penicillin G benzathine 2.4 million units x 1 for 3 weeks if unknown duration
if infection less than a year, just require one dose!

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54
Q

quinopristin-dalfopristing and VRE

A

IV covers only VRE faecium not faecalis. Also covers MRSA IV

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55
Q

ethambutol main side effects

A

optic neuritis and decrease in visual acuity

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56
Q

nitrofurantoin

  • role in treatment
  • when not to use
  • serious toxicity
  • food
A

for uncomplicated cystitis
NOT for less than 60 CL cr, not for systemic or complicated cystitis
pulmonary toxicity if used long term
take with food to increase absorption

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57
Q

Phenazopyridine

  • indication
  • OTC?
  • max day use
  • Food ? why?
A

to relieve pain from a UTI
yes OTC AZo and generics
maximum 2 day use because by then the antibiotics should be working by then so pain should be gone. If not gone, contact doctor cuz infection is not cured
-with food and 8 oz water because can cause stomach upset

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58
Q

vancomycin concentration dependent or time dependent?

A

time dependent

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59
Q

Drug of choice for ESBL bacteria

A

carbapenems

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60
Q

fidaxomicin

  • indication
  • effectiveness
A

clostridium dificille

as effective as vancomycin but less recurrence rates

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61
Q

zyban , Sexual dysfunction?

A

NO

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62
Q

adderall generic

A

dextroamphetamine / amphetamine

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63
Q

amphetamine toxicity treatment

A

if high blood pressure use BB
if super energetic give a sedative like lorazepam
if psychotic give an antipsychotic

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64
Q

what is the OROS system ?
what ADHD med takes advantage of this ?
Age limit?

A
  • the outer layer dissolved right away for quick delivery but the inner layer is extended release
  • concerta requires once daily dosing 18mg QAM
  • 6 to 12 yo
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65
Q

indication for dronedarone

A

maintaining sinus rhythm in recurrent Afib ad paroxismal Afib

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66
Q

max use of afrin - oxymetazline (days)

why?

A

3 days

cuz of risk of rebound congestion and rhinits medicamentosa

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67
Q

triamcinolone for allergic rhinitis

A

Nasacort AQ

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68
Q

Razadyne

A

Galantamine

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69
Q

Beclomethasone for allergic rhinitis brand?

which is for asthma?

A

Q Nasl and Beconase AQ for allergic rhinitis

Q Var for asthma

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70
Q

fluticasone for allergic rhinitis brands

A

Flonase

Veramyst

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71
Q

mometasone for asthma vs for allergies

A

Asmanex

Nasonex

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72
Q

percent of elemental iron in

  • ferrous fumarate
  • ferrous sulfate
  • ferrous sulfate exsiccated
A
  • 33 %
  • 20%
  • 30%
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73
Q

how long to taker iron for iron deficiency anemia

A

3 to 6 months after RBC, iron stores and other labs are normalized

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74
Q

what is the main indication for dabigatran

A

reduce the risk of stroke and blood clots in patients with non-valvular atrial fibrillation AKA: if you have irregular heart rhythm and not a prostesthetic valve, mitral valve repair or disease of mitral valve

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75
Q

Black box warning of dronaderone and WHY

A

class IV (4) heart failure and permanent heart failure , worse outcomes in these populations

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76
Q

where to inject aranesp?

where to inject darbopoetin?

A
  • abdomen (not 2 inches around belly button)
  • front of middle thighs
  • outer area of buttox
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77
Q

formulations of allergic rhinitis are? why?

A

oral tablets , eyedrops: itchy eyes, oral solution: pediatrics, nasal spray for nasal symptoms

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78
Q

class 3 antiarrhythmics

A

sotalol

amiodarone

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79
Q

what test to do to send a patient home on clindamycin if pt has MRSA

A

D-t est for resistance of MRSA to clindamycin

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80
Q

Intuniv to generic

  • MOA
  • indication
  • DDI
  • food?
  • SEs
A

Guanfancine ER

  • central alpha 2 adrenegic receptor agonist
  • ADHD
  • 34a substrate
  • no high fat food
  • somnolence, bradycardia, GI pain, nausea
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81
Q

drug of choice for perioperative prophylaxis

A
  1. first or second generation cephalosporins

2 if allergic: vancomycin

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82
Q

endocarditis prophylaxis drug of choice and second line

A
  1. 2 grams amoxicillin 30-60 minutes before dental procedure
  2. clindamycin 600mg po 1 hours before procedure if Beta lactam allergy
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83
Q

amphotericin B

  • potassium
  • magnesium
  • blood pressure
  • other side effects
A

decreases
decreases
decreases
chills and rigors, nephrotoxic

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84
Q

Nizoral A-D to generic

A

ketoconazole 1%

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85
Q

telithromycin main side effects

A

acute hepatic failure
visual problems
QTprolongation

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86
Q

rifaximin

  • indication
  • DDIs
A

treatment for Traveler’s diarrhea from non invasive ecoli

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87
Q

typhoid vaccine

  • route
  • storage
  • when to get vaccinated
A

4 capsules or IM injections
refrigerated
1 to 2 weeks before travel

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88
Q

vivotif generic

and dosing

A

typhoid vaccine

1 capsule 1 hour before a meal with cold, luke warm water

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89
Q

pediarix to generic

A

hepatitis b and DTAP and Polio vaccine

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90
Q

name of the tetanus booster

how frequent to take it

A

Td

every ten years

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91
Q

children Dtap schedule

A
DT is for children who cant tolerated the pertussis vaccine
start at 15- 18 months
2 years lold 
4 years old 
4-6 years old 
6 years old 

a total of 5 doses

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92
Q

who should use Tdap and who should be using TD

A

Tdap is to prevent a tetanus infection after a cut or a burn, also for people who have not gotten a dose previously
Td should be used if Tdap is not available
-a person who already got Tdap (a dose)
-or a person 65 years or older

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93
Q

MCV 4 vs MPSV4

  • route
  • age range
A

MCV 4 is given IM to patients 2 - 55 yo

MPSV4 is SC and 55 or older

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94
Q

which vaccine brands contain just hepatits B vaccine

A

engerix B

recombivax B

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95
Q

can you use acetaminophen during a vaccine

A

not before or after , but a while later is cool for mild pain or fever

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96
Q

in DTaP what do the captial versus the lower case letters mean

A

lower case d or p means a lower dose of diptheria or pertussi versus a capital D . The “a” means acellular

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97
Q

which vaccines go in the freezer and require reconstitution?

A

MMRV = Proquad
Zostavax
Varivax

98
Q
Herpes zoster vaccine brand 
what temperature to store 
how quick to use vaccine 
route
what needle
A

Zostavax
keep at -15 degrees celsius
use within 30 min of reconstitution or discard
SC with a 5/8” needle

99
Q

three main symptoms of tetanus

A

muscle rigidity
painful muscle spasms
high fever

100
Q

who should get the hpv vaccine

A

women 11 to 12 yo up to age 26

men up to age 21

101
Q
where are the following injected 
polio
Tdap/Td
TPV
Pnuemovax
Hep A/B
MCV 4
flu shot
HPV
A
polio: SC or IM
Td /Tdap IM
TPV SC or IM
Pneumovax SC or IM
HepA/B : IM 
MCV 4 IM
flu shot IM
HPV IM
102
Q

Flublok

  • age range and indication
  • how is it different from the normal flu vaccine
A

for 18 to 49 years old

can be used in egg allergies cuz not made in chickens, made with recombinant DNA techniques

103
Q

Comvax to generic

A

Hepatitis B and Hemaphilus influenza

104
Q

side effects of pegintron and indication

A

peginterferon plus rivabirin for hepatitis C
NV and loss of appetite
feeling of having the flu for 1 to 2 days after injections
fee low, worried, anxious
vision changes , hair
rash
IF SOB go to the doctor

105
Q

sandostatin to generic

indication and MOA

A

ocreotide for variceal bleeding in portal hypertension

vasoconstriction of splanchnic vessels

106
Q

itraconazole tabs vs oral solution FOOD

A

Tabs or capsules should be after a meal because they require acid
oral solution should be on an empty stomach

107
Q

in gentamicin and tobramycin dosing

what dosing parameter affects the peak versus the trough

A

peak: Mg of the dose
trought: dosing frequency

108
Q

one cephalosporin with anaerobic coverage

A

cefotetan

109
Q

clindamycin renal adjustment

A

NO

110
Q

moxifloxacin renal adjustment

A

NO

111
Q

VFEND

sun?

A

voriconazole

yes photosensitivity

112
Q

antibiotics with IV to PO 1 to 1 conversion

A
quinolones 
tetracycline 
smx tmp
linezolid 
rifampin
metronidazole
113
Q

lyme disease treatment

A

doxycycline

alternative amoxicillin

114
Q

what can be used for VRE

A

Tigacyl : tigecyline
Cubicin: daptomicin
Zyvox : linezolid

115
Q

levofloxacin tablets versus oral solution

food?

A

tablets are with or without food

but the oral solution is NO food

116
Q

risk factor to get tendonitis for fluoroquinolones

A

greater than 60 years old
transplant history
corticosteroid use

117
Q

ceftaroline coverage

A

really good gram positive coverage including MRSA and VRE

gram negative coverage is just like ceftriaxone

118
Q

oral candidiasis dosing for fluconazole IV

A

fluconazole IV 200mg IV qd for 7- 14 days

119
Q

what is tuloremia? treatment ?

A

infection by francicella tularensis after getting bitten by animals or other ways like breathing stuff
gentamicin / tobramycin 5mg/kg/ day divided every 8 hours for 7 to 14 days

120
Q

antibiotics that cover atypicals

A

Fluoroquinolones
doxycycline
azithromycin

121
Q

Y site administaration of Ceftriaxone: with what is it to be avoided

A

Calcium containing solutions use cefotaxime instead

122
Q

which cephalosporin has disulfuram like reaction with alcohol

A

cefotetan

123
Q

can patients use condoms /diaphragms / have sex when suing antifungal vaginal suppositories

A

NO because damage to the condom or diaphragm,

only sanitary napkins not tampons are ok

124
Q

rifaximin
indication
ddis

A

for travelers diarrhea from non invasive ecoli or for overt hepatic encephalopathy
doest not get absorbed systemically so not strong heaptic enzyme induction

125
Q

first line treatment for status epilipticus

A

lorazepam or diazepam

126
Q

side effects of depakote , generic

A

divalproex sodium
GI upset, nausea
weight gain
hair loss and thinnning

127
Q

can phenytoid cause SJS / TEN

A

YES if toxic levels occurs

Phenytoid needs to be separate 2 hours from tube feedings (AKA needs to be separated from meals)

128
Q

what diluent to use for phenytoin ONLY

A

normal saline

129
Q

topamax pregnancy category

A

pregancy D due to risk of cleft palate

130
Q

when to discontinue seizure treatment

A

if zero seizures within the last 2 to 4 years

if seizure from head injury , needs to be if zero seizures in 6 to 12 months can discontinue

131
Q

main indication for ethosuximide

A

absence seizures

132
Q

felbatol to generic

  • indication
  • Black box warning
A

felbamate for seizures

can cause hepatic failure, aplastic anemia

133
Q

valproate / valproic acid to brand
divalproex age limit
-brand dose
-main side effects

A

depakene
Depakote ER 125 to 150 BID
can cause liver damage

134
Q
oxcarbazine 
DDIs 
biggest risk 
normal side effects 
cross reactivity to carbamazepine sensitivity
A

CYP inducer
SJS
dizzy , sleepy, tired , nausea
yes can cross react

135
Q

starting dose of topamax for seizures

MAx dose

A

25mg BID

200mg BID

136
Q

primodone belongs to which drug class

A

barbiturate

137
Q

what is the biggest warning for anticonvulsants

A

increased risk of suicidal ideation

138
Q

lamotrigine starting dose

DDI with VPA

A

25 mg daily for 2 weeks

VPA will increase lamotrigine level

139
Q

long term treatment with phenytoin , what are the side effects
how to treat two of them

A
causes hirsutism and gingival hyperplasia
SLE
Hepatitis
macrocytic anemia: give folic acid 
osteoporosis: give calcium and vitamin D
140
Q

Keppra to generic

lamictal to generic

A

levotiracetam

lamotrigine

141
Q

WTF is oligohydrosis?
which anticonvulsants leand to oligohydrosis
who does it primarily affect

A

decreased sweating
topiramate/ zonisamide
children

142
Q

main indication for levitiracetam

A

first line for partial or generalized tonic clonic seizures

143
Q

if a patient got a rash with carbamazepine can they use oxcarbazine?

A

its not recommended cuz rish rash still there

144
Q

max infusion rate of phenytoin

A

50mg per min

145
Q

main toxicity from phenytoin overdose

A

ataxia : lack of coordination walking like you are drunk

146
Q

fosphenytoin

  • formulation
  • advantage
  • how long to work
A

injection IM with NS or D5W
thought to controll seizures faster cuz causes less hypdation than phenytoin
take 15 to 30 minutes to work so not really faster

147
Q

what is gabapentin FDA approved for

A

epilepsy and restless leg syndrome

also for post herpetic neuralgia

148
Q

carbamazepine testing

A

if asian descent HLA B1502

149
Q

BBW for valproate or divalproex

A

hepatic failure
pancreatitis
teratogenicity

150
Q

Gabitril to generic

A

tiagabine

151
Q

Hydrea
Droxia
to generic

A

hydroxyurea

152
Q

MOA of hydroxyurea with sickle cell disease

A

increases hemoglobin which blocks RBC sickling action

153
Q

exjade administration

A

drop- stir - drinkk tab must be dissolved
use OJ, AJ, H20
stir till even and then drink

154
Q

how is dabigatran cleared?

A

renally

155
Q

how is enoxaparin cleared

A

renally

156
Q

high potassium leads to what

A
muscle weakness
bradycardia 
chest pain 
arrythmias
paresthesias
157
Q

ACE inhibitors and kidney dysfunction

A

start if no contrainidications at stage 3 ClCR 30-59

158
Q

kidney disease stages

A
stage 1 is 120 or greater 
stage 2 is 60- 119
stage 3 is 30- 59
stage 4 is 15- 29
stage 5 is less than 15
159
Q

act FAST

A

face is droopy
arms don’t raise the same way
speech is slurred
time - actu quickly

160
Q

indication of nimodipine

only route of administration

A

for subarachnoid hemorrage
only PO max 21 days
BBW for IV (DO NOT USE IV)

161
Q

what is the maximum dose of alteplase

A

90 mg

162
Q

three approved regimens to prevents ischemic stroke

A
  1. ASA
  2. Clopidogrel
  3. ASA + dipyridamole
163
Q

phenytoin level in blood target

IM injection ?

A

10 to 20

AVOID

164
Q

number one reason patients get strokes

A

cuz they have hypertension and dont take their medicines regularly

165
Q

side effects of hydroxyurea

A

leukopenia and neutropenia
HA dizziness
hyper-pigmentation of nail or skin

166
Q

dose of folic acid for children

A

0.1mg to 0.4mg per day in 1 to 10 YO, can do 1mg a day, max 5mg a day

167
Q

hydroxyurea and pregnancy

A

use gloves when handling if pregnant and wash hands afterwards cuz this is category D

168
Q

why use deferasirox over deferoxamine

A

it Is PO vs the other is an injection . So it is better tolerated
it is less time consuming to administer

169
Q

buspar versus wellbutrin in terms of 3a4

A

buspirone is substrate of 3a4 while buproprion is not

170
Q

lithium and elderly patients

A

caution!

171
Q

nuvigil to generic
MOA
inidication

A

armodafinil
not known
narcolepsy

172
Q

tagamet to generic

A

cimetidine

173
Q

drug of choice if asthmatic and pregnant

A

budesonide plus albuterol
budesonide = pulmicort, flexhaler or respule
budesonide is also the drug of choice for infants with asthma but only the respules

174
Q

bacterial vaginosis and pregnancy treatment

A

DOC is clyndamycin PO and 2nd line is metronidazole PO

topical metronidazole and Clindamycin are not indicated in pregancy

175
Q

pregnancy and macrolides

A

azithromycin and erythromycin are category B, Clarithromycin is category C

176
Q

the folic acid name as a vitaimin name

A

vitamin B9

177
Q

do prenatal vitamins contain enough calcium for pregnancy?

A

no ! 200mg is not enough you need at least 1000mg

178
Q

chlor-trimeton

A

chlorpheniramine

179
Q

what to treat motion sickness, nausea in pregnancy

A

vitamin B6 which is pyridxime, you can also use an antihistamine

180
Q

trichomoniasis , metronidazole treatment dose?

pregnancy?

A

2G x 1 OR 500 BID x 7 OR 250 tid x 7 –ALL ok, even for pregnacy
Higher doses means higher side effects

181
Q

pregnancy and chlamydia

A

zithromax can be used at 1g x 1, but if also going to treat gonorrhea can use 2g x 1

  • Can also use amoxil
  • clarythromycin is not safe in pregnancy
182
Q

pregnancy and hyperthyroidism

A

can use PTU and methimazole but PTU is in the first trimester, then methemazole in 2nd and third trimester

183
Q

which anticonvulsants also can be used for migraine prophylaxis

A

topamax

depakote- divalproex

184
Q

drugs that increase the risk of seizures

A

demerol - meperidine
Ultram- tramadol
primaxin - imipenem/cylastin
zyban - bupoprion

185
Q

what need to supplement with carbamazepine?

biggest concern with CBZ

A

vitamin and folate levels

scared of SJS or TEN

186
Q

clindamycin renal dose adjustment

A

none MO-FO!

187
Q

vitamin D3
vitamin D2
why use doxercalciferol?
why use paricalcitol?

A

cholecalciferol = rocaltrol= calcitione
ergocalciferol
they decrease changes of hypercalcemia

188
Q

phosolo generic

A

calcium acetate

189
Q

at what Clearance createnine to avoid alendronate

A

less than 35

190
Q

tadalafil and severe renal impairment

A

less than 30 for prn use 5mg every 72 hours max

less than 30 for chronic daily treatment : DO NOT USE

191
Q

meperidine is cleared how?

A

renally and end metabolite is cleared renally too, so its metabolite can accumulate

192
Q

how is tigecycline cleared

A

50 % bile and 30 % urine

193
Q

how is metoclopramide cleared

A

renally

194
Q

pregabalin cleared

A

renally

195
Q

why do renal disease patients get problems with bones

A

increased phosphate levels leads to increased pth excretion which leads to breakdown of bone. Solution is to decrease phosphate intake

196
Q

rivaroxaban cleared?

A

renal cleared?

197
Q

how is voriconazole cleared

A

renally

198
Q

bicitra to generic
indication
cytra-z
SEs

A

sodium citrate/citric acid
for chronic metabolic acidosis
cytra z i s the same
SE are diarrhea

199
Q

xarelto to generic

DDIs

A

Rivaroxaban

3A4 substrate

200
Q

buspar DDI

A

cyp 3a4 substrate

201
Q

biaxin to generic

class

A

clarithromycin

macrolide inhibition of 50s ribosome

202
Q

what is the DDI of valproate with lamotrigine?

can you still give them together?

A

VPA inhibits metabolism of lamotrigine which increases the risk of rash
the lamictal dose titration can be used but need to use even lower doses

203
Q

demadex to generic

A

torsemide

204
Q

theophylline with respect to 3a4

A

subtrate

205
Q

dyazide to generic

MOA

A

triamterene and hydrochlorothiazide

inihitbs the sodium in the distal convoluted tubule, leading to decreased H2o and increased potassium retention

206
Q

inspra to generic

A

eplerenone

207
Q

MOA of tetracyclines

A

inhibit the 30s subunit of ribosome leading to decreased protein synthesis

208
Q

QT prolongation of

  • antibiotics
  • TCA
  • opoids
A

Quinolones and macrolides
amytryptiline
methadone

209
Q

can a patient on an MAOI take pseudophed?

alprazolam?

A

no pseudofed or analagos

yes alprazolam

210
Q

Grepefruit juice and transplant medications

A

Do not use due to tacrolimus/cyclosporine DDI

211
Q

common PGP substrates

A

cyclosporine/ TAC

dabigatran (pradaxa) /rivaroxaban (xarelto)

212
Q

which statin has least DDI risk

A

pravastatin

213
Q

meds that cause hearing damage

A
salicylate
vancomycin
tobramycin and gentamycin
ethacrynic acid
bumethanide
214
Q

neoral to generic

A

cyclosporine

215
Q

symptoms of serotonin syndrome

A

tremor, agitation, confusion, hallucination
tachycardia, sweating
diarrhea
muscle rigidity, shivering

216
Q

sustiva to generic
atripla to generic
emtriva to generic

A

efavirenz
efavirenz with tenofovir and emtricitabine
emtricitiabine

217
Q

kaletra to generic

food?

A

lopinavir and ritonavir

oral soluation must be with food but the tabs doesnt matter

218
Q

one preferred regimen for pregnant woman with HIV

A

ZDV/3TC + Lopinavir/RTV

219
Q

prophylaxis for toxoplasma in HIV, CD4 count

A
220
Q

pneumocystitis CD4 count to start prophylaxis

A

less than 200

221
Q

pregnancy category of efavirenz ?

A

D

222
Q

treatment for mycobacterium avium complex (MAC) opportunistic infection

A

azithromycin 1200 mg po every week

223
Q

epzicom to generic

A

ABC/3TC (abacavir/ lamivudine)

224
Q

Ziagen to generic

  • Bbw
  • test
  • class
A

abacavir
hypersensitivity if
positive for HLAB5701
NRTI

225
Q

class side effects of protease inhibitors

A

fat redistribution
dyslipidemia
insulin resistance

226
Q

tacrolimus

  • monitoring
  • DDIs
  • MOA
A

monitor trough levels
cyp 3A4 substrate and pgp substrate
calceneurin inhibitor

227
Q
cyclosporine to brands
common side effects
monitoring 
ddis
MOA
A
Neoral (caps and tabs), Sandimmune 
increase in blood glucose, nephrotoxicity, qt prolongation 
trough levels 
3a4 and pgp substrate 
calcineurin inhibitors
228
Q

renal transplant

blood pressure goal

A

less than 130 /80 (check JNC 8)

229
Q

belatacept bbw

A

post translplant lyphoproliferative disorder: lyphocytes grow out of control
only for EPV negative patients only

230
Q

what can cyclosporine solution be diluted with

A

apple juice or orange juice

231
Q
mycophenolate to brand
pregnancy category 
food interaction 
frequency 
common side effects
A

CellCept (mofetil) Myfortic (delayed release)
D fetal harm
empty stomach / separate from multivitamins /questra/
give every 12 hours exactly
diarrhea

232
Q

How are these transmitted

  • dengue
  • African sleeping sickness
  • Japanese encephalopathy
  • malaria
  • yellow fever
A

All through mosquito bites except African sickness

233
Q

Xenical should be separated from what ?

A

Separate from ADEK vitamins , take at different times of the day

234
Q

Lorcaserin to brand
Pregnancy
MOA
Phase IV trials

A

Belviq
Category x
Serotonin receptor agonist
Monitor cardiovascular effects using lorcaserin

235
Q

Most common side effects of orlistat

A

Flatulence with discharge

Fatty stool

236
Q

Xenical to generic

A

Orlistat

237
Q

Weight loss guidelines recommendation to have bariatric surgery

A

Yes if the Bmi is great than 40 or greater than 35 with obesity related conditions

238
Q

Lorcaserin side effects

A
Headache and dizziness 
Fatigue 
Dry mouth 
Constipation
Risk of hypoglycemia if diabetic
239
Q

Qsymia to generic
Contraindication
Scheduled?

A

Phetermine and topiramate
Contraindicated in pregancy, lactation, MAOI within14 days, hyperpathyroidosis
Scheduled IV

240
Q

Lorcaserin
Indication
Dose
DDI with serotonergic agents

A

Weight loss
Patients with bmi must be obese or overweight with at least one weight related condition
10mg bid
Increased risk of serotonin syndrome

241
Q

What kind of environment is required for atazanavir absorption

A

Acidic required

242
Q

Post exposure prophylaxis for HIV

A

Tenofovir emtricitabine to raltegravir for 4 weeks