Cram Deck

Question 1

ml in 1 gal

Answer 1

3785ml per gallon

Question 2

Gram positive in clusters

Answer 2

Staph!

Question 3

Gram positive in chains/pairs

Answer 3

Strep

Question 4

What organisms do penicillins work well against?

Answer 4

Gram positive!

Question 5

When can you use a penicillin against gram negatives and anaerobes?

Answer 5

If it’s combined with a beta lactamase inhibitor (sulbacyam, clavulanate, tazobactam)

Question 6

Penicillins CIs

Answer 6

Kidney failure (Crcl<30)

Question 7

What are cephalosporins not active against?

Answer 7

Enterococcus or atypical

Question 8

Ceftriaxone CI

Answer 8

Neonate!

Question 9

How to renally adjust ceftriaxone

Answer 9

You don’t!

Question 10

Pseudomonas coverage

Answer 10

Pip/tazo
Cefepime
Meropenem
Doripenem

Question 11

Carbapenems can NOT be used for….

Answer 11

atypical
MRSA
C. Diff
VRE

Question 12

Can you use aztreonam with PCn allergy?

Answer 12

Yes!!!

Question 13

What antibiotics do you need to avoid with lovastatin/simvastatin

Answer 13

Clarithromycin and erythromycin.

Question 14

Vanc systemic infection dosing

Answer 14

15-20mg/Kg q 8-12h

Question 15

Vanco AUC/Trough goals for serious MRSA infections

Answer 15

Auc/mic 400-600

Trough 15-20

Question 16

Which abx suspensions do you NOT refrigerate?

Answer 16

Cefdinir 
Azithro 
Clarithro 
Cipro 
Clinda

Question 17

Meningitis empiric treatment

Answer 17

Neonates: amp And cefotaxime or gent
1 month-50 years old:
Ceftriaxone and Vanc

> 50 or immunocomp:
Amp, ceftriaxone, and Vanc

Question 18

Abx of acute bacterial exacerbation of chronic bronchitis (ABECB)

Answer 18

5-7 days of augmentin if sputum volume and puryulence and difficulty breathing

Question 19

CAP treatment if no comorbidities

Answer 19

Amoxicillin or doxycycline or azithromyicn if resistance is low

Question 20

CAP tx with comirbidities present

Answer 20

Cephalosporin or augmentin + doxy

Question 21

HAP tx for low risk of MRSA

Answer 21

Cefepime or pip/tazo

Question 22

HAP tx for MRSA risk high but low MDR risk

Answer 22

Cefepime + vanco

Meropenem + linezolid

Question 23

If a patient on warfarin starts taking rifampin, what would you expect their INR to do and why?

Answer 23

INR would decrease because rifampin is a potent 3A4 inducer

Question 24

What to use for bacteriuria in a pregnant patient

Answer 24

Augmentin!

Can use nitrofuratoin and Bactrim if beta lactam allergy

Question 25

When to use azithromycin in travelers diarrhea

Answer 25

Fever, blood in stool, pregnant or peds Otherwise use a floxacin!

Question 26

Tx options for c. Diff

Answer 26

Oral vanco | Or metronidazole

Question 27

What can amphotericin B cause a risk of with other agents that can cause this?

Answer 27

Nephrotox!

Question 28

Issues with Azoles

Answer 28

Increase LFTs QT prolongation Interactions!!!!

Question 29

What azole needs renal adjustment?

Answer 29

Fluconazole

Question 30

What azole can cause heart failure

Answer 30

Itraconazole

Question 31

Cyp consideration with Azoles

Answer 31

3A4 inhibitors!

Question 32

One pill once daily HIV treatment for treatment naive

Answer 32

Biktarvy Triumeq Dovato

Question 33

HIV: what’s the difference between TDF and TAF

Answer 33

TDF has a higher risk of fractures and should not be used in renal impairment

Question 34

What’s special about abacavir?

Answer 34

HLA-B*5701 testing before use: hypersensitivity reactions

Question 35

What drugs have abacavir?

Answer 35

Triumeq Epzicom Ziagen

Question 36

What drug has TDF? (Fracture warning)

Answer 36

Truvada

Question 37

What’s special with Maraviroc?

Answer 37

CCR5 receptor must be present and CXXR4 cannot be present Assay test called Trofile used to test!

Question 38

HIV PEP regimen!

Answer 38

Truvada + (Tivicay or Isentress)

Question 39

What two hiv meds can be used for PrEP

Answer 39

Truvada or Descovy

Question 40

What are HIV drug boosters?

Answer 40

Cobicistat and Ritonavir Not interchangeable!

Question 41

Major CYP inhibitors

Answer 41

``` G-PACMAN Grapefruit Protease Inhibitors (especially ritonavir) Azoles C - cyclosporine, cimetidine, and cobicistat Macrolides (clarithro and erythro) Amiodarone Non/DHPs (diltiazem and verapamil) ```

Question 42

CYP inhibitor effect on non-pro drugs

Answer 42

Decreased metabolism > increased effects/ADRs/toxicities

Question 43

CYP inducers

Answer 43

``` PS PORCS Phenytoin Smoking Phenobarbital Oxcarbazepine Rifampin Carbamazepine St Johns Wort ```

Question 44

Which statins interact with CYP?

Answer 44

SAL Simva Atorva Lovastatin

Question 45

Ear drop instructions for adults

Answer 45

Pull earlobe up and back

Question 46

Ear drop directions for children

Answer 46

Pull earlobe down and back (if less than 3yo)

Question 47

Drugs that leach with PVC

Answer 47

``` Leach Absorbs To Take In Nutrients Lorazepam Amoidarone Tacrolimus Taxanes Insulin Nitroglycerin ```

Question 48

What drugs require Saline as a diluent

Answer 48

``` A DIAbetic Can’t Eat Pie Ampicillin Daptomycin Infiximab - Remicade Amp/sulbactam Capsofungin Ertapenem Phenytoin ```

Question 49

What drugs require dextrose as a diluent?

Answer 49

BOAS will strangle you if you don’t put these in Dextrose Bactrim Oxaliplatin Amphotericin B Synercid

Question 50

Other than phosphate what drug cannot be mixed with calcium with IV such and such

Answer 50

Ceftriaxone! Do not mix with LRs!

Question 51

Particles in an ISO class 5

Answer 51

3520

Question 52

BUD for CSPs made in an isolator

Answer 52

12 hours

Question 53

What does an HLB value of 4 mean

Answer 53

Low value for hydrophilic/lipophilic balance. | Product is more lipid soluble - aka typically for topical emulsions

Question 54

BUD nonaqueous formulations

Answer 54

6 months! Room temp

Question 55

BUD water containing oral forms

Answer 55

14 days - store in fridge

Question 56

BUD water containing topicals

Answer 56

30 days - room temp

Question 57

True or false: live attenuated vaccines can replicate?

Answer 57

True!

Question 58

Who cannot receive live attenuated vaccines

Answer 58

Pregnant and immunocompromised

Question 59

Common live vaccines

Answer 59

``` COZY IV RM Cholera Oral typhoid Zostavax Yellow fever Intranasal flu Varicella Rotavirus MMR ```

Question 60

Age for DTaP

Answer 60

<7 years old

Question 61

Which flu shot is egg free and what are the age requirements for it

Answer 61

Flublock | Must be >18yo

Question 62

What is type II error?

Answer 62

``` Null hypothesis is accepted when it should have been rejected *remember the picture in class with the doctor telling the man he’s pregnant ```

Question 63

What factors does warfarin inhibit?

Answer 63

II, VII, IX, X

Question 64

Which anticoagulant should be used: stroke prophylaxis with mitral stenosis

Answer 64

Warfarin!

Question 65

Which anticoagulant should be used: stroke prophylaxis with mechanical heart valve

Answer 65

Warfarin

Question 66

Which anticoagulant: VTE treatment in cancer patient

Answer 66

LMWH

Question 67

Dose adjustment with Eliquis

Answer 67

For a fib, if patient has two of the following: 80yo or older, body weight less than 60kg, or SCr greater than 1.5mg/dL Reduce dose to 2.5mg bid

Question 68

At what creatinine clearance value would you not use Xarelto

Answer 68

<30

Question 69

Which doac can’t be used if crcl is too good (>95)

Answer 69

Edoxaban

Question 70

Warfarin color order

Answer 70

``` Please Let Grandma Brown Bring Peaches To Your Wedding ``` Pink, lavender, green, brown, blue, peach, teal, yellow, white

Question 71

What type of anemia McV<80

Answer 71

Microlytic - iron deficiency | Rbcs are small

Question 72

What type of anemia MCV 80-100

Answer 72

Normocytic | Blood loss, malignancy, CKD, hemolysis

Question 73

Type of anemia MCV >100

Answer 73

Macrolytic | B12 or folate deficiency

Question 74

Recommended dose of elemental iron

Answer 74

100-200mg/day

Question 75

% elemental iron in gluconate

Answer 75

12%

Question 76

% elemental iron in sulfate

Answer 76

20%

Question 77

% elemental iron in fumarate

Answer 77

33%

Question 78

Which IV iron needs a test dose?

Answer 78

Dextran!

Question 79

Where do loop diuretics work?

Answer 79

Ascending loop of henle at Na-K pump

Question 80

Where do thiazides work?

Answer 80

Na-Cl pump in distal convoluted tubule

Question 81

Crcl equation

Answer 81

=(140- (age) / 72 x SCr ) x wt (kg) x0.85(female)

Question 82

Patient has albuminuria, what should they be put on for kidney protection?

Answer 82

Acei or arb

Question 83

Drugs CI in CKD

Answer 83

``` <60 Nitrofuratoin <50 TDF Voriconazole <30 TAF NSAIDs Dabigatran Rivaroxban ``` Gfr- metformin and SGLT2

Question 84

What’s sevelamer?

Answer 84

Renvela Phosphate binder thats non-ca, non-Al based Not systemically absorbed N/v/d Can lower Total Cholesterol

Question 85

Hyperkalemia treatment

Answer 85

Give calcium gluconate to stabilize the heart Shift it : dextrose, insulin, sodium bicarbonate, albuterol neb Remove it: diuretics, hemodialysis

Question 86

Metabolic acidosis lab value

Answer 86

Sodium bicarbonate <22 Replace

Question 87

Different mechanisms of HCV drugs

Answer 87

Ns3/4a PI: -previr ns5a replication Inhibitor: -asvir Ns5b PI: -buvir in

Question 88

CYP considerations with DAAs (HepC drugs)

Answer 88

All are CI with strong 3A4 inducers

Question 89

HepB preferred treatment

Answer 89

Interferon Alfa

Question 90

Non-selective beta blockers for portal HTN

Answer 90

Nadolol | Propranolol

Question 91

Allergy medication that is safe in children

Answer 91

``` >2yo Flonase Cetirizine: 2.5-5mg qd Allegra: 30mg bid Claritin 5mg qd ``` Benadryl if >6yo Xyzal: if >6 months

Question 92

What drugs can decrease IOP

Answer 92

Beta blockers (timolol) Prostaglandins (lantanoprost) Alpha 2 agonists (brimonidine)

Question 93

1 drop daily eye drops

Answer 93

Bimatoprost (Lumigan) Latanoprosy Travoprost (Travatan Z) Bimatoprost (Latisse)

Question 94

Dosing frequency for timolol

Answer 94

Once daily to twice daily

Question 95

What’s a risk with steroid eye drops?

Answer 95

They can increase IOP long term

Question 96

Alopecia tx options

Answer 96

Finasteride | Minoxidil (rogaine)

Question 97

List of topical steroid potency from high to low

Answer 97

``` Clobetasol Fluocinonide Betamethasone Mometasone Triamcinolone ```

Question 98

LDL equations

Answer 98

Tc-HDL - (TG/5)

Question 99

What is error of commission?

Answer 99

Something was done incorrectly versus being left out