Drugs of the day 2

Question 1

Doxycycline

Answer 1

B: Vibramycin
C: Tetracycline antibiotic
- DOC for Lyme or RMSI
- 2nd line for Community-acquired Pneumonia
- Used for Chlamydia / STD
- SE: Tooth discoloration, Not for use in <8yo
- Avoid Divalent & Trivalent cations (milk,calcium, magnesium)

Question 2

Enalaprilat

Answer 2

B: Vasotec
C: ACE inhibitor (Only IV agent in the class)
- Used for Hypertension
-Used for Heart Failure
- SE: Cough, Hyperkalemia, angioedema
- Not used in pregnancy

Question 3

Enoxaparin

Answer 3

B: Lovenox
C: Low molecular weight heparin
Use: Tx & Px of DVT, Pulmonary embolism
SE: Bleeding

Question 4

Epinephrine

Answer 4

B: N/A
C: Vasopressor
U: Cardiogenic shock, Anaphylaxis
SE: Headache, Tremors, Restless

Question 5

Epoetin Alfa

Answer 5

B: Epogen or Procrit (SA compared to Arnesep)
C: Colony stimulating factor
U: Anemia due to chemotherapy & chronic renal failure
SE: Hypertension, bone pain
BBW: Increased risk of mortality due to MI, Stroke, VTE

Question 6

Ertapenem

Answer 6

B: Invanz
C: Carbapenem Antibiotic
U: Gram +ve & -ve infections
SE: Cross Sensitivity to Pen, Ceph
Narrow spectrum
Not cover pseudomonas
IV only
Cidal

Question 7

Erythromycin

Answer 7

B: Erythrocin
C: Macrolide Antibiotic
U: Used for its side effects, Gastroparesis ( increase gut motility)
SE: Severe GI effects, QT prolongation
Many drug interactions
Major P450 inhibitor
Static

Question 8

Esomeprazole

Answer 8

B: Nexium
C: PPI
U: GERD, PUD, Prevent Stress Ulcers
SE: Well tolerated
Avoid Plavix and use Pantoprazole instead

Question 9

Famotidine

Answer 9

B: Pepcid
C: H2 histamine antagonist
U: GERD, PUD, Prevent Stress Ulcer
SE: Well tolerated

Question 10

Fentanyl

Answer 10

B: N/A
C: Opioid agonist
U: Moderate - Severe pain, pre & post Operation
SE: Constipation, Hypotension, Bradycardia, Respiratory depression < Morphine

Question 11

Filgrastim

Answer 11

B: Neupogen
C: Colony Stimulating Factor
U: ^ WBC production in (Neutropenia, Chemo/ Other sick patients)
SE: Bone pain, Fever, Thrombocytopenia( low platelets)

Question 12

Fluconazole

Answer 12

B: Diflucan
C: Antifungal
U: Tx Fungal infection by Candida, & (immunocompromised patients)
SE: ^LFTs, Nausea, Vomiting
Lower dose in PT with compromised kidney
P450 Inhibitor = Drug interactions
IV / PO HAVE >90% bioavailability

Question 13

Fosphenytoin

Answer 13

B: Cerebyx
Class: Anticonvulsant
U: status epilepticus
Conc. / Ro are expressed in PE
Levels need to be gotten
SE.Toxic: Nystagmus, ataxia, decrease mental status, Parasthesias
IV ONLY

Question 14

Furosemide

Answer 14

B: Lasix
C:Loop diuretic
U: Edema associated with heart, hepatic, & renal Faliure
SE: Hypokalemia,Hypotension
IV / PO

Question 15

Gentamycin

Answer 15

B: N/A
C: Aminoglycoside antibiotics
U: Tx Gram-ve infection (Pseudomonas)
SE: Ototoxixity, Nephrotox
Must draw peak and trough levels(narrow therapeutic window)
IV

Question 16

Haloperidol

Answer 16

B:Haldol
C:Typical antipsychotic agent
U: Schizophrenia, acute psychosis, aggressive/agitated behavior
SE: Extrapyramidal reactions ( tardive dyskinesia), hypotension, tachycardia, respiratory depression, QT
prolongation
Salt forms: Lactate (IVorIM) Decanoate(IM)

Question 17

Heparin

Answer 17

B: N/A
C: Anticoagulant
U: Tx & Px of clot (DVT, PE, IM)
SE: Bleeding HIT (Heparin Induced Thrombocytopenia
Monitor: aPPT, hemoglobin, hemotocrit
Narrow therapeutic window

Question 18

Hydralazine

Answer 18

B: N/A
C: Potent Vasodialator Antihypertensive
U: Hypertension, Preeclampsia
SE: Tachycardia, Hypotension, Reflex Tachycardia

Question 19

Hydrocortisone

Answer 19

B: Solu- Cortef
C: Glucocorticosteriod
U: Severe pulmonary disease, Septic shock, Addison disease
SE: Cushing, hyperglycemia, arrhythmia, psychosis
^WBC, Blood Sugar

Question 20

Hydromorphone

Answer 20

B: Dilaudid
C: Opiate analgesic
U: Severe Pain
SE: Respiratory Depression, Bradycardia, Hypotension, Sedation
Dilaudid > Morphin

Question 21

Imipenem- Cilastatin

Answer 21

B: Primaxin
C: Carbapenem Antibiotic
U: Infection by multidrug resistant organism + Pseudomonas
SE: Seizure, Pen & Ceph Sensitivity,
Cidal

Question 22

Infliximab

Answer 22

B: Remicade
C: Monoclonal antibody
U: Rheumatoid A, Crohn, Ulcerative colitis
SE: Headache, HTN, infusion related reactions, increased risk of infection

Question 23

Ketorolac

Answer 23

B: Toradol
C: NSAID
U: POST OP Pain
SE: N/V, abdominal pain( Ulcer, PUD)
Not > 5days. Increase risk of MI, STROKE, GI, BLEEDING

Question 23

Labetalol

Answer 23

B: N/A
C:Nonselective β blocker with α blocking ability
U:HTN, HTN crisis, angina
SE: Orthostatic hypotension, bradycardia, dizziness

Not for asthmatics & COPD

Question 23

Leucovorin

Answer 23

B: N/A C: Chemotherapy modulating agent U: rescue agent for methotrexate SE, Megaloblastic anemia due to folate deficiency SE: Thrombocytosis, allergic reaction

Question 24

Levofloxacin

Answer 24

B: Levaquin C: Fluroquinolone antibiotic U: Wide range of Gram -ve & +ve, UTI, Community acquired pneumonia SE: Tendon rupture, impaired cartilage development, QT prolongation, (ELDERLY: HTN, CVD, Aortic aneurysm) Avoid: <18yo(used in cystic fibrosis), pregnancy, divalent & trivalent cation CIDAl

Question 25

Levothyroxine

Answer 25

B: Synthroid C: Thyroid hormone U: Hypothyrodisim SE: Tachycardia, HTN, arrhythmia, flushing, weightloss, anxiety, feeling hot, hair loss Takes 6 weeks for result, take on empty stomach

Question 26

Lidocaine

Answer 26

B: Xylocaine C: Local anesthetic ( surgery), Ventricular arrhythmia (V.fib, v.tach) SE: Drowsiness, dizziness, confusion

Question 27

Linezolid

Answer 27

B: Zyvox (non-selective MAOI) C: Oxazolidinone antibiotic U: Gram +ve infection, DOC for Vancomycin Resistant Enterococcus(VRE), MRSA SE: Myelosuppression (>2wk), DI: Serotonin syndrome when used with SSRI, TCA, Triptan, DEMOROL

Question 28

Lorazepam

Answer 28

B: Ativan C: Benzodiaze4pine U: Status epilepticus, antiemetic adjunct, anxiety, preanesthetic, SE: CVD, Resp depressin, drowsiness, dizziness DI: Opioid

Question 29

Mannitol

Answer 29

B: Osmitrol C: Osmotic diuretic U: decrease intracranial pressure, TX/PX acute renal faliure SE: Heart faliure, Hyponatremia, hypokalemia Stability: Crystal form, so warm in bath & cool B4 administering

Question 30

Meperidine

Answer 30

B: Demerol C: Opiate agonist U: Post-op shivering, moderate - severe pain SE: Respiratory& Circulatory depression Only use for <48hr due to too much normeperidine metabolite(renal faliure) DI: Serotonin syndrome when used with SSRI, TCA, Triptan, Linezolid

Question 31

Meropenem

Answer 31

B: Merrem C: Carbapenem antibiotic U: Multi drug resistant infection + Pseudomonas SE: Pen & Ceph sensitivity

Question 32

Methylprednisone

Answer 32

B: Solu-Medrol C: Glucocorticosteroid U: Immunosuppressant ( transplant, autoimmune), Anti-inflammatory(pulmonary disease, cerebral edema, spinal cord injury) SE: Cushing, psychosis, hyperglycemia, osteoporosis(calcium +vitamin D supplement), ^WBC SUCCINATE(IV) ACETATE(IM, Depo-medrol)

Question 33

Metoclopramide

Answer 33

B: Reglan C: Prokinetic & Antiemetic (DA receptor Blocker) U: DM gastroparesis, GERD, CHEMO-Nausea, PX Vomiting SE: Drowsiness, EPS, Tardive dyskinesia DI: Anti-psychotic Avoid in Elderly & those in Renal Inssuficency