EENT- Red info #1

Question 1

How do you treat Bacterial pharyngitis?

Answer 1

Penicillins (Beta-lactams)

Question 2

What is the most important adverse event/side effect of penicillins (Beta-lactams)?

Answer 2

Hypersensitivity rxn

Question 3

What is important for efficacy/monitoring when giving Penicillins (Beta-lactams)?

Answer 3

Opportunistic infection ( fever, chills, unhealed sores, white plaques in mouth or vagina, purulent vaginal discharge, fatigue).

Question 4

Drug interactions:

•Tetracycline Derivatives: May diminish the therapeutic effect of ________

• Bacteriostatic with bactericidal

•_______ may enhance the anticoagulant effect of Vitamin K Antagonist-warfarin

Answer 4

Penicillins (Beta Lactams)

Question 5

What is an alternative tx for Bacterial pharyngitis for a pt that has a PCN allergy?

Answer 5

Erythromycin (&Macrolides)

Question 6

Side effects:

• Abdominal pain, anorexia, diarrhea (GI disturbances)
• QTc prolongation

Answer 6

Important side effects for Erythromycin (macrolide)

Question 7

•Interactions

–Effects on CYP450

Answer 7

Erythromycin

Question 8

Gastrointestinal prokinetic (unlabeled use)

Answer 8

Erythromycin

Question 9

What is acute laryngitis usually caused by?

Answer 9

Usually viral

Question 10

•*Acyclovir:

–Within 3 days of onset–200mg 5x/day x 10 days

– 400mg TID x 7-10 days

Answer 10

Used to tx HSV 1 or 2

Question 11

What is Valacyclovir (prodrug of acyclovir) used to tx?

Answer 11

HSV 1 or 2

Question 12

Adverse events/Side Effects of _______:

• malaise
• headache

Answer 12

antiherpetics

Question 13

•Drug Interactions:

_____, ____, and ______may diminish the therapeutic effect of Zoster Vaccine

•discontinue antiviral agents with anti-zoster activity (i.e. ____, _____, ______) for at least 24 hours prior to and 14 days after receiving a live attenuated zoster vaccine

Answer 13

Acyclovir-Valacyclovir, Famciclovir

Question 14

What is a main treatment for aphthous ulcer treatment?

Answer 14

pain management

Question 15

First line- topicals: (less adverse events and drug interactions)

• Nystatin Suspension 1:100,000

Answer 15

First line topical for fungal-oral candidiasis

Question 16

What condition do you use the oral Prototype: Fluconazole to tx for?

Answer 16

Fungal oral candidiasis

Question 17

Adverse effects/side effects:

Increased Alkaline phosphatase, ALT, AST, hepatic failure (rare), hepatitis, jaundice

Answer 17

“azole” antifungal (Fluconazole)

Question 18

Efficacy/monitoring

–Periodic liver function tests (AST, ALT, alkaline phosphatase)

–Renal function tests: baseline SrCr

• Potassium levels

–QT prolongation

Answer 18

“Azole” antifungals (fluconazole)

Question 19

Interactions:

• Inhibits CYP1A2 (weak), CYP2C19 (strong), CYP2C9 (strong), CYP3A4 (moderate)
  
  • Increase the serum concentration of
    
    • Atorvastatin, simvastatin
    • Citalopram
    • Phenytoin
    • Proton Pump Inhibitors
    • Sulfonylureas
    • Vitamin K Antagonists
  • May decrease the metabolism of
    
    • Benzodiazepines
    • Carbamazepine
    • Losartan
  • May enhance the adverse/toxic effect of
    
    • Calcium Channel Blockers

Answer 19

“Azole” antifungals

Question 20

What bacteria is a special consideration for contact wearers who have conjunctivitis?

Answer 20

Pseudomonas aeruginosa

Question 21

Abx to tx what condition?

• Macrolides
• Trimethoprim-Polymyxin (Polytrim)
• Bacitracin-Polymyxin
• Bacitracin
• Fluroquinolones

“Trim Bac Bac Mom’s Flowers”

Answer 21

Bacterial conjunctivitis

Question 22

Treatment for which condition?

–Antibiotics: erythromycin or bacitracin ophthalmic (ophth) ointment

Answer 22

Acute blepharitis

Question 24

Tx for which condition?

–Amoxicillin/Amoxicillin-clavulanate

–Cefpodoxime

–Cefdinir

Answer 24

Preseptal cellulitis (periorbital)- *If MSSA

Question 25

Tx for which eye condition? –Trimethoprim-sulfamethoxazole –Clindamycin –Doxycycline

Answer 25

Preseptal cellulitis (periorbital)- \*If CA-MRSA suspected