Practice Exam Questions Flashcards
1
Q
Why shouldn’t Cordarone be given with sofosbuvir-containing regimens?
A
Serious symptomatic bradycardia
2
Q
How should patients take the Viekira Pak tablets?
A
2 pink tablets + 1 beige tablet in morning, 1 beige tablet in the evening
(Beige tablet is dasabuvir)
3
Q
What medications are Viekira Pak contraindicated in combination with?
A
Ethinyl estradiol, lovastatin, simvastatin
4
Q
What warnings are associated with interferons?
A
May cause or aggravate:
- Autoimmune disorders
- Psychiatric symptoms
- Ischemic disease
- Infections
5
Q
What lab abnormalities are indicative of chronic liver disease?
A
Hypoalbuminemia and increased INR
6
Q
ANC calculation
A
WBC x % neutrophils (segs + bands) x 10
7
Q
Why should acetaminophen be used instead of NSAIDs in patients with cirrhosis?
A
NSAIDs can precipitate GI bleeding, blunt the diuretic response, and exacerbate renal dysfunction. APAP is safer if used sparingly at reduced doses.
8
Q
Which natural product is used as a liver-protective agent?
A
Milk Thistle
9
Q
What is a non-pharmacological recommendation for managing hepatic encephalopathy?
A
Restricting animal protein intake
10
Q
What pharmacologic category is Transderm Scop?
A
Anticholinergic
11
Q
Transderm Scop counseling points
A
- May cause dry mouth, dizziness and confusion
- Do not use alcohol
- Can make patient tired; don’t operate heavy machinery
12
Q
Why can scopolamine worsen glaucoma?
A
anticholinergics can increase intraocular pressure and worsen glaucoma
13
Q
Which BZDs are considered most safe in patients over the age of 65 based on Beers Criteria?
A
Lorazepam, oxazepam, temazepam
14
Q
Which natural products can be used for anxiety?
A
Valerian, kava, St. John’s Wort, passionflower
15
Q
USP chapter for non-sterile compounding
A
USP 795
16
Q
What is Onzetra Xsail?
A
Intranasal sumatriptan
17
Q
What treatment could be used for a 13-year old suffering from frequent migraines?
A
Maxalt (At least 6), Zolmiptriptin nasal and almotriptan and Treximet (at least 12)
18
Q
How to take CellCept?
A
Twice daily on empty stomach, 12 hours apart
19
Q
Common live vaccines that should be avoided in transplant patients
A
intranasal FluMist, MMR, Varivax (chicken pox), Zostavax (shingles)
20
Q
Brand name(s) of everolimus
A
Afinitor, Zortress
21
Q
Which cancers are transplant patients at higher risk for?
A
Melanoma, lymphoma
22
Q
How often should the following be performed at minimum:
- glove fingertip testing
- air sampling
- temperature check
- air pressure check
A
- annually
- every 6 months
- daily
- daily
23
Q
How often should media fill testing for technicians be performed?
A
Annually for medium- and low-risk compounding
Semiannually for high-risk compounding
24
Q
What is considered high-risk compounding?
A
Making a CSP from non-sterile ingredients
25
Which reagent is used for the bacterial endotoxin test (BET)?
Limulus Amebocyte Lysate (LAL) is used for the BET to test for pyrogens
26
Brand name of calcium polycarbophil
Fibercon
27
Alvimopan
Entereg, opioid receptor antagonist for prevention of post-op ileus
(REMS drug, max 15 doses)
28
What are the peripherally acting mu-opioid receptor antagonists for constipation?
Methylnaltrexone (Relistor)
Naloxegol (Movantik)
Naldemedine (Symproic)
29
Lubiprostone
Amitiza for opioid induced constiption
30
Linaclotide (brand, MOA, tx)
Linzess, agonist of guanylate cyclase C, treats chronic idiopathic constipation (or IBS-C)
31
Eluxadoline
Viberzi for IBS-D
32
Drugs that worsen BPH
1. Anticholinergics
2. Antihistamines
3. Caffeine
4. Decongestants
5. Diuretics
6. SNRIs
7. TCAs (and other drugs with anticholinergic properties)
8. Testosterone products
33
Drugs that increase blood pressure
1. Amphetamines or other ADHD drugs
2. Cocaine
3. Decongestants
4. Erythropoietin-stimulating agents
5. Immunosuppressants (eg tacrolimus)
6. NSAIDs
7. Systemic steroids
34
Lotrel
Benazepril/Amlodipine
35
Tenoretic
Atenolol/Chlorthalidone
36
Ziac
Bisoprolol/HCTZ
37
Byvalson
Nebivolol/Valsartan
38
Zestoretic
Lisinopril/HCTZ
39
First line agents for pregnant women with chronic HTN (>160/105)
Labetalol, nifedipine ER, methyldopa
40
Thiazide MOA
Inhibit Na reabsorption in DCT, causing increased excretion of Na, Cl, and water
41
Olmesartan warning
(Benicar); sprue-like enteropathy - severe chronic diarrhea with substantial weight loss
42
Spironolactone MOA
Non-selective aldosterone receptor blocker (also blocks androgen = endocrine SE, gynecomastia eg)
43
Which beta-blockers have intrinsic sympathomimetic activity (ISA)?
(do not decrease HR to the same degree as other beta-blockers)
Acebutolol, Penbutolol, Pindolol
44
Which beta blockers should be taken with food?
Metoprolol tartrate and succinate, carvedilol
45
Brevibloc
Esmolol (IV)
46
Beta-1 selective agents
(AMEBBA)
| Atenolol, Metoprolol, Esmolol, Bisoprolol, Betaxolol, Acebutolol
47
Nebivolol classification
(Bystolic); beta-1 selective blocker and NO-dependent vasodilation
48
Which beta-blocker has high lipid solubility and crosses the BBB?
Propranolol (Inderal)
| -more CNS SE but also useful for migraine ppx, essential tremor, etc
49
Which beta-blockers have a warning of causing hyperglycemia?
Beta-1 and -2 blockers (nonselective) - decrease insulin secretion
50
List the centrally-acting alpha-2 agonists
1. Clonidine (Catapres) [Kapvay for ADHD]
2. Guanfacine IR (Tenex) [ER - Intuniv for ADHD]
3. Methyldopa
51
Warnings/SE for methyldopa
```
Positive Coombs test (risk for hemolytic anemia)
Hypersensitivity reactions (DILE)
```
52
Clonidine patch counseling
Changed weekly; apply to upper outer arm or chest; remove before MRI to prevent burn
*do not stop clonidine suddenly - rebound HTN
53
darifenacin
Enablex - blocks M3 muscarinic acetylcholine receptor responsible for bladder muscle contractions (anticholinergic agent) for tx of OAB
54
tolterodine
Detrol LA - blocks M2 and M3 muscarinic acetylcholine receptors responsible for bladder muscle contractions (anticholinergic agent) for tx of OAB
55
desmopressin
Noctiva - reduces urine production for OAB (warning hyponatremia)
56
Exforge
Amlodipine/Valsartan
57
Ziac
Bisoprolol/HCTZ
58
Which antihypertensive agents have a risk of drug induced lupus erythematosus?
Methyldopa and Hydralazine
| butterfly rash
59
IV agents available to treat hypertension
Chlorothiazide, nicardipine, Esmolol, Labetalol, hydralazine, enalaprilat, methyldopa, propanolol, metoprolol, celvidipine, diltiazem and verapamil
60
What are the GIIb/IIIa inhibitors?
eptifibatide (Integrelin), abciximab (ReoPro)
61
Name an IV P2Y12 inhibitor
cangrelor (Kengreal)
62
What is the MOA of tenecteplase?
(TNKase) Fibrinolytics bind to fibrin and convert plasminogen to plasmin. Plasmin then degrades the fibrin mesh leading to clot dissolution.
63
How long should patients continue BB and ACEi therapy after having an MI?
BB - 3 years (unless HF, Afib, eg)
| ACEi - indefinitely
64
Symbyax
Fluoxetine/Olanzapine
65
Vilazodone
Viibryd
66
Drugs indicated to treat PMDD
Sarafem (contains fluoxetine), Yaz, and Zoloft
67
Medications that contribute to depression
lipophilic beta blockers, clonidine, methyldopa, certain types of hormones (including hormonal contraceptives), indomethacin, interferons, isotretinoin, some medications for ADHD
68
Side effects of bupropion
dry mouth, insomnia, tremors/risk of seizure
69
Live vaccines
MMR, MMRV, Varicella, Zoster, Yellow fever, influenza intranasal, rotavirus, cholera, typhoid (vivotif)
70
Necessary interval between and antibody-containing blood product and MMR or varicella-containing vaccine (except zoster)
minimum of 3 months and may be up yo 11 months; if vaccine given first, wait 2 weeks prior to giving Ab; if Ab given first, wait 3 months or longer prior to vaccine
71
Timing relationship between TB skin test and administration of a live vaccine
Administer both on the same day; if live vaccine has been given recently, but not on same day, wait 4 weeks prior to placing PPD test; or given PPD first and wait 48-72 hrs until its read prior to giving live vaccine
72
Vaccines in pregnancy
In season inactivated flu vaccine, Tdap x 1 with each pregnancy (optimal between 27-36 weeks; live vaccines are CI
73
HPV9 dosing
(Gardasil 9); if started before age 15: 2 doses (month 0 and 6-12 months later); if started after age 15 or if immunocompromised: 3 doses (month 0, 1-2, 6)
74
Which influenza vaccines are only indicated for patients at least 65 years of age?
Fluzone high-dose and Fluad
75
ProQuad
MMR + Varicella
76
Menactra vs Menveo
MCV4 Meningococcal Vaccines; Menactra is 9 months-55years; Menveo is 2 months-55 years
77
Pneumococcal vaccination in children <2 years of age
PCV13 (Prevnar) because they should not receive the polysaccharide vaccine (PPSV23)
78
Pneumococcal vaccination in adults at least 65 years of age
If never vaccinated: PCV13 followed by PPSV23 12 months later
79
Spacing between PPSV23 doses
At least 5 years
80
Pneumococcal vaccination in immunocompromised patients age 6-64
1 dose of Prevnar then 8 weeks later PPSV23, then 5 years later PPSV23, then at age 65 PPSV23
81
DTaP only indicated in what age
<7 years old
82
ACIP age recommendation vs FDA approval of Zostavax
Approved for 50+, recommended in 60+ years of age
83
Timing of antivirals in relation to varicella-containing vaccines
stop 24 hours before vaccine and do not administer for 14 days after vaccination
84
Administration of IM vaccines
deltoid muscle with 1" needle unless fat; 22-25 gauge needle at 90 degree angle
85
Administration of SQ vaccines
fatty tissue over triceps with a 5/8", 23-25 gauge needle at a 45 degree angle
86
SQ Administered Vaccines
MMR, MPSV, varicella-containing, and PPSV (also IM)
87
Concentration-dependent (Cmax: MIC) antibiotics
aminoglycosides, quinolone, daptomycin
88
AUC:MIC Abx
vancomycin, macrolides, tetracyclines, colistimethate
89
Time> MIC (time-dependent)
Beta-lactams
90
First-line use of: Pen VK
Strep throat and mild non purulent skin infections
91
First-line use of: Amoxicillin
otitis media; infective endocarditis prophylaxis prior to dental procedures
92
First-line use of: Augmentin
otitis media and sinus infections; use lowest dose of clavulanate to reduce diarrhea
93
First-line use of: Pen G
syphilis (2.4 million units IM x 1)
94
First-line use of: Zosyn
pseudomonas infections; extended infusions can be used to maximize T>MIC
95
First-line use of: Nafcillin (IV) and dicloxacillin (PO)
MSSA
96
Common use of: Cephalexin
MSSA skin infections, strep throat
97
Common use of: cefuroxime
Ceftin; 2nd gen; otitis media, CAP, sinus infection
98
Common use of: cefdinir
Omnicef; 3rd gen; CAP, sinus infections
99
Common use of: Cefazolin
1st gen; surgical prophylaxis, MSSA
100
Common use of: Cefotetan and cefoxitin
2nd gen; anaerobe coverage (B. fragilis); surgical prophylaxis (colorectal procedures)
101
Common use of: Ceftriaxone and cefotaxime
3rd gen; CAP, meningitis, SBP, pyelonephritis; do not use ceftriaxone in neonates
102
Cephalosporins active against Pseudomonas
Ceftazidime (3rd gen) and Cefepime (4th), ceftolozane/tazobactam, ceftazidime/avibactam
103
Cephalosporin active against MRSA
ceftaroline (5th gen)
104
What bugs do Carbapenems not cover
MRSA, VRE, atypical, C. diff, stenothrophomonas
| Ertapenem lacks coverage against pseudomonas, acinetobacter, and enterococcus
105
Quinolone SE
tendon inflammation and/or rupture, peripheral neuropathy, seizures, QT prolongation, hypo/hyperglycemia, hepatotoxicity, photosensitivity
106
Quinolone DDI
Multi-valent cations can chelate and inhibit absorption (antacids, didanosine, sucralfate, Mg, Al, Ca, Fe, Zinc, MVI, eg)
107
Macrolide SE
QT prolongation, hepatotoxicity, GI upset
108
Macrolide DDI
lovastatin/simvastatin (clarithromycin, erythromycin)
- Erythromycin, Clarithromycin: major 3A4 substrates and inhibitors (more DDIs)
- Azithromycin: minor 3A4 substrate, weak 1A2 and Pop inhibitor
109
Macrolides use
CAP and beta-lactam alternatives for strep throat; good atypical coverage
110
Azithromycin use
COPD exacerbations, mono therapy for chlamydia, combo therapy for gonorrhea, prophylaxis for MAC; DOC for dysentery
111
Doxycycline use
RTIs, tick-borne/rickettsial diseases, spirochetes and chlamydia infections; less common: CA-MRSA in mild skin infections and VRE in UTIs
112
Tetracycline warnings
children < 8 YOA, pregnancy and breastfeeding, photosensitivity, drug-induced lupus (DILE)
113
Abx with absorption impacted by multivalent ion-containing drugs (antacids, sucralfate, Mg, Al, Ca,
quinolone, tetracyclines
114
Bugs NOT covered by Sulfonamides
Pseudomonas, Enterococci, atypicals, or anaerobes
115
Sulfonamides SE
N/V/D, anorexia, skin reactions, crystalluria (take with 8oz of water), photosensitivity, increased potassium, hypoglycemia, decreased folate, positive Combs test; significant increase in INR
116
Sulfonamides common uses
CA-MRSA skin infections, UTI, pneumocystis pneumonia (PCP)
117
Daptomycin SE
myopathy and rhabomyolysis; monitor CPK levels weekly; DO NOT use to treat pneumonia due to lung surfactant inactivating the drug
118
Daptomycin coverage/usage
(Cubicin); most gram-positives including MRSA and enterococci; also VRE (E. faecium and E. faecalis); complicated SSTIs and MRSA blood-stream infections, including right-sided endocarditis
119
Linezolid warnings/SE
(Zyvox); CI within 2 weeks of MAOIs, duration-related myelosuppression; decrease platelets, HA, nausea, diarrhea
120
Synercid use
Quinopristin/Dalfopristin; VRE E. faecium infections
121
Synercid SE
arthralgia/myalgia, infusion reactions, edema and pain at infusion site, phlebitis, hyperbilirubinemia, CPK elevations
122
Tigecycline coverage
very broad spectrum; does not cover Pseudomonas, Proteus, or Providencia; boxed warning for increased risk of death
123
Clindamycin coverage
most aerobic and anaerobic Gram-Positive bacteria, including some CA-MRSA;
124
Clindamycin boxed warning
C. difficile colitis
125
Metronidazole coverage/uses
anaerobes and protozoal infections; bacterial vaginosis, trichomoniasis, giardasis, amebiasis, C. difficile (although falling out of favor) and in combination for intra-abdominal infections
126
Fidaxomicin use
Dificid; C. diff infections; shown benefit in preventing recurrence
127
Drugs for: CA-MRSA SSTI
Bactrim DS, doxycycline, minocycline (clindamycin and linezolid)
128
Drugs for: nosocomial MRSA
Vancomycin, linezolid, telavancin, daptomycin (not in PNA)
129
Drugs for: VRE (E. faecalis)
Pen G or ampicillin, linezolid (daptomycin and tigecycline)
130
Drugs for: VRE (E. faecium)
daptomycin, linezolid, synercid
131
Drugs for: Pseudomonas
Zosyn, cefepime, ceftazidime, ceftazidime/avibactam, ceftolozane/tazobactam, carbapenems (except ertapenem), cipro, levo, aztreonam, aminoglycosides, Colistin, polymyxin B
132
Drugs for: ESBL gram-negatives
Carbapenems
133
Drugs for: Bacteroides fragilis
metronidazole beta-lactam/beta-lactamase inhibitor, cefotetan, cefoxitin, carbapenems
134
Drugs for: C. Diff
metronidazole, vancomycin (oral), fidaxomicin
135
Drugs for: Atypicals
azithromycin, doxycycline, quinolones
136
Pediatric APAP dose
10-15 mg/kg Q4-6H PRN
137
Preferred allergy medications in pregnancy
zyrtec, claritin, and budesonide nasal spray
138
Natural products for Cold
echinacea, zinc, ascorbic acid
139
Cough and cold medications CI within 14 days of MAOi therapy
Decongestants (Sudafed, Sudafed-PE) and dextromethorphan
140
mOsmol/L Equation
mOsmol/L = (g/L)/MW * #particles * 1000
141
AirDuo Respiclick
fluticasone/salmeterol
142
Major side effects of inhaled beta-2 agonists
nervousness, tremor, cough, tachycardia, hyperglycemia, hypokalemia
143
Acute bacterial meningitis treatment
<1 month: ampicillin + cefotaxime
1 month- 50 years: ceftriaxone + vancomycin
>50 years or immunocompromised: ceftriaxone + vancomycin + ampicillin
144
Preferred allergy medications in pregnancy
zyrtec, claritin, and budesonide nasal spray
145
Treatment: Outpatient CAP
Healthy and no Abx in last 3 months: macrolide or doxycycline
Abx in last 3 months, chronic disease, immunocompromised: beta-lactam (Augmentin, cefdinir, and cefpodoxime) + macrolide; or respiratory FQ monotherapy
146
Cough and cold medications CI within 14 days of MAOi therapy
Decongestants (Sudafed, Sudafed-PE) and dextromethorphan
147
AirDuo Respiclick
fluticasone/salmeterol
148
Major side effects of inhaled beta-2 agonists
nervousness, tremor, cough, tachycardia, hyperglycemia, hypokalemia
149
Treatment: HAP/VAP with high risk of mortality or high risk for MDR pathogens + MRSA risk
2 anti-pseudomonals + one anti-MRSA agent
150
Treatment: Latent TB
isoniazid 300mg PO daily x 9 months (preferred in HIV+, pregnant women, and children);
rifampin 600mg daily x 4 months if isoniazid resistant or not tolerated
151
Treatment: Outpatient CAP
Healthy and no Abx in last 3 months: macrolide or doxycycline
Abx in last 3 months, chronic disease, immunocompromised: beta-lactam (Augmentin, cefdinir, and cefpodoxime) + macrolide; or respiratory FQ monotherapy
152
Treatment: Inpatient CAP
beta-lactam (ceftriaxone or cefotaxime) + macrolide or doxycycline; respiratory FQ monotherapy; 5 days of treatment
153
IE dental prophylaxis
(for patients with artificial heart valves/conditions)
Amoxicillin 2g PO 30-60 minutes before dental procedure
--if pen allergy: Clinda 600mg or Azithro 500mg
154
Treatment: HAP/VAP without risk of mortality with MRSA risk
One anti-pseudomonal + one anti-MRSA agent
155
Treatment: HAP/VAP with high risk of mortality or high risk for MDR pathogens + MRSA risk
2 anti-pseudomonals + one anti-MRSA agent
156
Treatment: Latent TB
isoniazid 300mg PO daily for 9 months (preferred in HIV+, pregnant women, and children); rifampin 600mg daily for 4 months if isoniazid resistant or not tolerated
157
Treatment: Active TB; intensive phase
RIPE therapy (rifampin, isoniazid, pyrazinamide, and ethambutol) for 2 months
158
Treatment: Cellulitis/Abscess, mild-moderate, purulent
CA-MRSA; Bactrim or Doxycycline; if cultures demonstrate MSSA, may switch to cephalexin
159
IE dental prophylaxis
(for patients with artificial heart valves/conditions)
Amoxicillin 2g PO 30-60 minutes before dental procedure
--if pen allergy: Clinda 600mg or Azithro 500mg
160
Treatment: SBP (primary peritonitis)
ceftriaxone 5-7 days; Bactrim or Cipro as primary or secondary prophylaxis
161
Treatment: Impetigo
honey-colored crusts resulting from blisters; topical antibiotic such as mupirocin; or if numerous lesions, cephalexin
162
Treatment: Folliculitis/Furuncle/Carbuncle
systemic signs: cephalexin; if non-responsive: Bactrim or doxycycline (CA-MRSA coverage)
163
Treatment: Cellulitis non-purulent
Cephalexin or Clindamycin (if beta-lactam allergy) for 5 days
164
Treatment: Cellulitis/Abscess, purulent
CA-MRSA; Bactrim or Doxycycline; if cultures demonstrate MSSA, may switch to cephalexin
165
Treatment: Severe purulent SSTI
MRSA coverage; vancomycin 7-14 days
166
Treatment: Syphilis, late latent (> 1 year duration) or tertiary
Pen G benzathine 2.4 million units IM weekly x 3 weeks
167
Treatment: Diabetic Foot Infections, mod-severe, life-threatening
vancomycin + anti-pseudomonal 7-14 days; more severe, deeper: 2-4 weeks; severe, limb-threatening or bone/joint: 4-6 weeks
168
Treatment: Acute uncomplicated cystitis
MacroBID x 5 days; Bactrim x 3 days or Fosfomycin as alternatives
169
Treatment: Acute uncomplicated pyelonephritis
Quinolone resistance <10%: Cipro x 7 days; >10%: 1 dose of ceftriaxone then quinolone or Bactrim for 14 days
170
Treatment: bacteruria in pregnant women
Augmentin or oral cephalosporins x 3-7 days; avoid quinolone and tetracyclines
171
Treatment: Syphilis, primary, secondary or early latent
Pen G benzathine 2.4 million units IM x 1
172
Treatment: Syphilis, late latent (> 1 year duration) or tertiary
Pen G benzathine 2.4 million units IM weekly x 3 weeks
173
Treatment: Gonorrhea
ceftriaxone 250mg IM x 1 + Azithromycin 1g PO x 1 (preferred) or doxycycline 100mg BID x 7 days
174
Treatment: Chlamydia
Azithromycin 1g x 1 or doxycycline 100mg BID x 7 days
175
Treatment: Bacterial Vaginosis
fishy odor, pH>4.5
| metronidazole 500mg BID x 7 days or metronidazole 0.75% gel (5g in that stinky vagina) x 5 days
176
Treatment: Trichomoniasis
yellow-green vaginal discharge
| Metronidazole 2g PO x 1
177
Antibiotics that interfere with coagulation laboratory assays
Daptomycin, Oritavancin, Telavancin
178
Synercid common toxicities
(Quinupristin-dalfopristin; treats VRE faecium)
| arthralgias/myalgias, hyperbilirubinemia, infusion reactions
179
Drug of choice for Acinetobacter
Meropenem
180
Antibiotic that treats VRE E. faecalis
Daptomycin (Cubicin)
181
Which cephalosporin should be avoided with extensive alcohol abuse
cefotetan; causes disulfiram reaction
182
Which cephalosporins exhibit anaerobic activity?
cefotetan and cefoxitin
183
Which antibiotic classes increase risk for seizures?
FQ and beta-lactams
184
What test is used to confirm Clindamycin susceptibility in MRSA?
D-test
185
What test detects carbapenemase production?
Hodge test
186
Concentration-dependent Abx
aminoglycosides, FQs, daptomycins, others
187
Third generation cephalosporins
cefpodoxime, cefdinir, cefotaxime, ceftriaxone
188
Abx classes with atypical coverage
tetracyclines, macrolides, and anal beads, also FQs
189
Which beta-lactams require refrigeration
all except cefdinir (omnicef)
190
Which 2 PPIs should be avoided with clopidogrel?
omeprazole and esomeprazole
191
What are the contents of Prevpac for H. Pylori
amoxicillin, clarithromycin, and lansoprazole
192
Most susceptible Candida species
C. albicans
193
Most difficult to treat Candida species
C. glabrata and C. krusei
194
Which azole anti fungal requires renal dosage adjustment?
fluconazole
195
Which azoles have pH-dependent absorption?
itraconazole and ketoconazole; space 2 hours from antacids; if PPI or H2RAs required, given with 8oz of that real coke
196
Treatment: Candida albicans
- Thrush
- Esophageal infection
- Bloodstream
Thrush: mild-disease- clotrimazole, nystatin; HIV+ or mod-severe- fluconazole PO preferred
Esophageal: fluconazole or echinocandin
Bloodstream: echinocandin preferred; or fluconazole
197
Treatment: Candida glabrata or krusei
echinocandinds or amphotericin B
198
Treatment: Aspergillus
voriconazole (preferred), amphotericin B, isavuconazonium
199
Treatment: dermatophytes
nail bed infections: intraconazole, terbinafine, or fluconazole
200
Treatment: histoplasma capsulatum
liposomal amphotericin B followed by itraconazole
201
Oseltamivir dosing
Treatment (age >12): 75mg BID x 5 days
| Prophylaxis (age>12): 75mg daily x 10 days
202
Treatment of choice for CMV
Ganciclovir and Valganciclovir
203
Prophylactic OI treatment: PCP
CD4+ count <200 or oropharyngeal candidiasis or other AIDS-defining illness; Bactrim DS or SS PO daily; D/C if CD4+ count >200 for >3 months on ART
204
Prophylactic OI treatment: Toxoplasma gondii encephalitis
Toxoplasma IgG positive w/ CD4+ count <100; Bactrim DS tab PO daily; continue until >200 for >3 months on ART
205
Prophylactic OI treatment: MAC
CD4+ <50; azithromycin 1200mg PO weekly; continue until CD4+ >100 for >3 months on ART
206
Initial drug treatment of choice for GERD
8 week trial of PPI; then stop therapy and assess if symptoms return, which would require maintenance therapy
207
MOA of H2RAs in GERD
REVERSIBLY inhibit H2 receptor, decreasing gastric acid secretion
208
PPI warnings
C. diff infections, osteoporosis-related fractures, hypomagnesemia
209
3 most common causes of PUD
H.pylori-positive ulcers, NSAID-induced ulcers, and stres ulcers
210
First-line treatment of H.pylori ulcers
PPI BID + Bismuth subsalicylate 300mg QID + metronidazole 250-500mg QID + tetracycline 500mg QID for 10-14 days
211
Alternative treatment options for H. pylori ulcers
- PPI BID + Amoxicillin 1g BID + Clarithromycin 500mg BID + Metronidazole 250-500mg QID; 10-14 days
- PPID BID + Amoxicillin 1g BID + Clarithromycin 500mg BID ( if never taken a macrolide) 14 days
212
DOC for lyme disease
Doxycycline 10-21 days
213
Antidote for heparin
Protamine
214
Boxed warning for LMWHs
Spinal or epidural hematoma formation
215
Anticoagulant that cannot be used in patients with CrCl > 95 d/t reduced efficacy
Edoxaban (Savaysa)
216
A lower warfarin starting dose is recommended in which patient populations?
1. elderly or debilitated
2. liver disease
3. HF
4. high bleeding risk
217
Duration of anticoagulation recommended after cardioversion for atrial fibrillation
minimum of 4 weeks
218
How much heparin/enoxaparin will 1 mg of protamine reverse?
~100 units of heparin
| 1 mg of enoxaparin
219
What type of valve requires INR goal of 2.5-3.5?
mechanical mitral valve
220
Which natural products can increase INR?
"5 G's"
1. garlic
2. ginger
3. ginkgo
4. ginseng
5. glucosamine
221
How to calculate relative risk (RR)
probability of event occurring in studied group divided by probability of event occurring in placebo group
222
How to calculate absolute risk reduction (ARR)
probability of event occurring in studied group (%) minus probability of event occurring in placebo group (%)
223
How to calculate relative risk reduction (RRR)
1 - relative risk (RR)
224
How to calculate NNT
1/ARR
225
Type I error
False positive (rejection of true null hypothesis); related to alpha value
226
Type II error
False negative (retaining a false null positive); related to beta value (power = 1 - beta)
227
Specificity
Percentage of time it's a true negative
228
Sensitivity
Percentage of time it's a true positive
229
torsemide
Demadex (more potent than furosemide; less than bumetanide)
230
ethacrynic acid
Edecrin (least potent loop diuretic)
231
bisoprolol
Zebeta
232
Drugs that can raise BG
1. beta-blockers
2. diuretics (thiazides/loops)
3. immunosuppressants
4. niacin
5. protease inhibitors
6. quinolones
7. 2nd gen antipsychotics
8. statins
9. systemic steroids
233
Antidote for iron overdose
deferoxamine (Desferal)
234
INFeD
Iron dextran (IV); test dose
235
Ferrlecit
Sodium ferric gluconate (IV)
236
Venofer
Iron sucrose (IV)
237
Feraheme
ferumoxytol (IV); risk of fatal anaphylactic reaction
238
FeroSul
ferrous sulfate (PO) 325mg (65mg elemental) daily-TID
