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EENT Flashcards

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1
Q

GABHS Treatment

A
  1. Penicillin VK x10 days

2. Erythromycin

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2
Q

What may increase PCN serum concentration? when would we want to use this?

A

Probenecid= prevents excretion from kidneys

–>give this when you want to conserve PCN

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3
Q

Whats is the effect of tetracylcine derivatives on PCN?

A

Diminish therapeutic effect because of bacteriostatic (tetracycline) and bactericidal (PCN)

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4
Q

What will drug will PCN enhance?

A

Anticoagulant effect of Vitamin K antagonist (Warfarin)

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5
Q

Side effects of erythromycin

A
  1. Prokinetic agent: Diarrhea, GI upset
  2. QT prolongation
  3. Ototoxicity
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6
Q

erythromycin drug interactions

A

Effects on CYP450

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7
Q

What is a good drug combination to treat in bacterial pharyngitis in chronic carriers?

A

PCN V + Rifampin

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8
Q

When is the ideal time to start antiviral therapy (acyclovir) in HSV1 or 2 outbreak?

A

Prodome period, within 3 days of onset

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9
Q

List pain and fluid management for HSV

A
  1. Diphenhydramine (Benadryl) liquid mixed with magnesia-aluminum (Maloxx): Rise and spit
  2. Topical Lidocaine
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10
Q

Side effects of antiherpetics

A
  1. Malaise

2. HA

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11
Q

When would you want to discontinue antiviral therapy?

A

With Zoster Vaccine (shingles)

-D/C @ least 24 hrs prior and 14 days after receiving live attenuated vaccine

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12
Q

What is first line treatment for oral candidiasis (“flush”)? Drug name? And why?

A

Topicals: Nystatin Suspension 1:100,000

  • Less adverse events
  • Less drug interactions
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13
Q

What is the fungal oral prototype for tx of oral thrush?

A

Fluconazole

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14
Q

Fluconazole MOA

A

Binds to sterols in funga cell membrane–>changing the cell wall permeability, allowing for a leakage of cellular contents

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15
Q

What is the major side effect to of -azoles?

A

Liver function: Increased alkaline phosphates, increase ALT/AST, hepatitis

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16
Q

What is a rare side effect to of -azoles?

A

Angioedema

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17
Q

What is the most common cause of conjunctivitis?

A

Viral: Adenovirus

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18
Q

bacterial conjunctivitis organisms

A 
Her Majestic Secret Service 
H- H. influenza
M- Moraxella catarrhalis
S- S. aureus
S- S. pneumoniae
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19
Q

What is the most common organism that causes bacterial conjunctivitis in adults?

A

S.aureus

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20
Q

What population is at an increased risk for bacterial conjunctivitis? Organism? Tx?

A
  1. Contact wearers
  2. Pseudomonas aeruginosa
  3. Aminoglycosides (more gram negatives)
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21
Q

Abx treatment for bacterial conjunctivitis

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A
  1. Macrolides: Erythromycin ointment

2. Polymixin-Trimethoprim (Polytrim) drops (anti-folate)

22
Q

What is the most common organism that causes blepharitis?

23
Q

blepharitis tx?

Study These Flashcards
A

Topical abx: Erythromycin ointment

24
Q

Periorbital cellulitis treatment if MSSA

Study These Flashcards
A
  1. Amoxicillin-Clavulanate
  2. Cefpodoxime
  3. Cefdinir
25
Periorbital cellulitis treatment if MRSA
1. Trimethropim-Sulfamethoxazole (Bactrim) 2. Clindamycin: long term= C.diff 3. Doxycycline: Contraindicated in child < 8 y.o.
26
Orbital cellulitis treatment
Empiric Vancomycin (covers MRSA) + Ceftriaxone (3rd generation covers CNS infection)
27
Corneal abrasion treatment
Ophthalmic abx: Eryhtromycin ointment
28
What should you AVOID using with a corneal abrasion?
Aminoglycosides - Toxic to epithelium * Exception: Contact-lens related abrasions
29
What is CONTRAINDICATED with a corneal abrasion?
Steroids | -Slows epithelial healing
30
Corneal ulcer (keratitis) tx
Ophthalmic fluroquinolones
31
HSV Keratitis tx
1. Topical antivirals: - Ganciclovir opth. gel - Trifluridine opth solution 2. Corticosteroids ONLY by ophthalmologist
32
Herpes zoster tx (eye)
1. Ophthalmic antivirals and abx | 2. Corticosteroids ONLY by ophthalmologist
33
Viral conjunctivitis tx
1. OTC topical antihistamines/decongestants 2. Eye lubricant drops 3. Abx if requires by school: Erythromycin ointment
34
ADE's in Macrolides (Erythromycin, Azithromycin)
Hypersensitivity rxn
35
Topical NSAIDs name and indication
Ketorlac 0.5% Ophthalmic solution | -Tx for postop inflammation following cataract/laser corneal surgery
36
ADEs of corticosteroids
Cataract formation, glaucoma
37
Otitis externa treatment
1. Aminoglycosides | 2. Fluroquinolones: Ciprofloxacin
38
What MUST you do before administering Aminoglycosides** ? Why?
Visualize TM to make sure TM is not perforated= IRREVERSIBLE OTOTOXICITY
39
Most common otits externa organism infection?
Pseudomonas
40
Most common otits media organism infection?
S. pneumoniae
41
What is first line treatment in otitis media?
High dose Amoxicillin | =80-90 mg/kg/day DIVIDED BY 12 HRS
42
What is second line therapy in otits media?
Amoxicillin-Clauvulanate
43
otits media treatment with PCN allergy, but NO type 1 hypersensitivity rxn
Cephalosporin
44
otits media treatment with PCN allerg with type 1 hypersensitivity rxn
1. Macrolides: Azithromycin, Erythromycin 2. Clindamycin 3. Trimethoprim-sulfamethoxazole (TMP-SMX)
45
What are two major adverse effect with TMP-SMX?
1. Steven-Johnson Syndrome (rash on face) | 2. Sulfa allergy
46
First line treatment for bacterial sinusitis?
Amoxicillin: 1000 mg TID 7-10 days
47
Second line treatment for bacterial sinusitis?
Amoxicillin-clavulanate | -If not responding to 1st line treatment after 3 days
48
What may decrease risk of acute otitis media?
Vaccination against influenza and pneumococcus
49
1st line treatment Glaucoma
Increase aqueous drainage: 1. PG analogues 2. Topical alpha adrenergic: constrict blood vessels 3. Topical alpha cholinergic: Parasympathetics= constrict pupil (myosis)
50
2nd line treatment Glaucoma
Decrease aqueous production | 1. Topical B-blockers (Timolol)= absorbed systemically¥
51
PG analogues ADEs
Increased pigmentation of iris | -Blue eyes (lack pigmentation) might become brown
52
Topical alpha cholinergics side effects?
``` SLUDGE S-salvation L-Lacrimation U-urination D-Defecation G-Gastric E-Emesis ```

Pharmacology (9 decks)

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