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| amlodipine with atorvastatin |
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| ketek - use 7-10 days for CAP |
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| razadyne (reminyl previously) |
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| only 2 penicillins hepatically eliminiated |
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| Sr is 12 hours, XR is 24 hours |
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| a magnesium salt formulation, unlike the RX form, so not substitutable! |
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| preferred agent for non-resistant S. pneumoniae |
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| penicillin G, amoxicillin |
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| metoclopramide (can cause parkinson-like syndrome) |
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| meloxicam (slightly cox 2) |
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| sulindac (this is the generic) |
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| omega-3-acid ethyl esters |
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| WelChol (625mg tab 6 at once or 3 bid) |
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| 23-valent polysaccharide vaccine (pneumonia) |
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| pneumovax-23 (for old people, q 5 yrs, SC or IM) |
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| 7-valent cojugated polysaccharide vaccine (pneumonia) |
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| prevnar (for 2yrs and under, IM) |
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| preferred for non B-lactamase producing H. influenzae |
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| ceph generations, lower the generation, the more gram + |
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| CSF penetration in most 3rd gen cephs. |
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| only hepatically excreted ceph |
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| fortaz/tazicef (3rd gen), antipseudomonal activity |
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| flouroquinolones were based on this. tx gram-. non-fluorinated quinolone |
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| drugs causing memory loss |
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| benzodiazepines, sedative hypnotics, antocholinergics, opiod analgesics, antipsychotics, anticonvulsants, alcohol |
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Definition
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| weirneke korsakov syndrome |
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Definition
| ataxia, vision changes, confusion, nystagmus, memory impairment. korsakov portion is halucinations produced by psychosis. happens when there is too little thyamine. give a banana bag...but if amnesia and psychosis have happened, full mental recovery is unlikely. |
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| tetracyn/sumycin/achromycin |
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| oxacillin (pcn resistant pcn) |
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| hospitalize your patient for CAP if CURB65 |
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Definition
| confusion, uremia (high), respiratory rate (high), blood pressure (low), 65 or older. hospitalize if 2 or more are present. |
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| methicillin (pcn resistant pcn) |
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| piperacillin and tazobactam |
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| switch from iv to oral tx when: |
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| pts are hemodynamically stable, improving clinically, able to ingest meds, have normal GI |
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| Rolaid soft chews, mylanta, tums |
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Definition
| calcium carbonate (ok for kids in small amounts, other antacids NOT For kids) |
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| cefadroxil, efazolin, cephalexin, cephapirin, cephardrin |
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| ticarcillin and clavulanic acid |
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| calcium carbonate and mg hydroxide |
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Definition
| mylanta gel caps, rolaids, rolaids ES |
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| aluminum hydroxide and mg trisilicate |
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Definition
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| aluminum hydroxide and magnesium carbonate |
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| cefepime (4th gen, antipseudomonal activity) |
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| omeprazole and sodium bicarbonate |
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| rosuvastatin and fenofibric acid |
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| S. pneumoniae that is PCN resistant (mic less than or equal to 2microg/ml) |
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Definition
| choose based on susceptibility. cefotaxime, ceftriazone, fluoroquinolone |
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Term
| non-B-lactamase producing H. influenzae |
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Definition
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| B-lactamase producing H. influenzae |
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Definition
| 2nd or 3rd gen ceph; amox-clavulanate |
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| m. pneumoniae/ c. pneumoniae |
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Definition
| macrolide, a tetrocycline |
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| 1. streptomycin, 2. gentamicin |
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| bacilius anthracics (inhalation) |
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Definition
| ciprofloxacin, levofloxacin, doxycycline (usually with a second agent) |
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Definition
| 3rd gen ceph. (carbapenem is drug of choice if extended specturm beta lactamase producer) |
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Definition
| antipseudomonal B-lactam plus cipro or levaquin or aminoglycoside |
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Term
| Burkholderia pseudomallei |
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Definition
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Definition
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| s. aureus that is methicillin susceptible |
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Definition
| antistaphylococcal penicillin |
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| methicillin resistant S. aureus |
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Definition
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Definition
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| anaerobe (aspiration pneumonia) |
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Definition
Blactam/Blactamase inhibitor
clindamycin |
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Definition
| oseltamivir or zanamivir (tamiflu or relenza) |
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Term
| mycobacterium tuberculosis |
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Definition
| isoniazid plus rifampin plus ethambutol plus pyrazinamide |
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Definition
| for uncomplicated infection in a normal host, no therapy generally recommended, for therapy, itraconazole, fluconazole |
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Definition
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Definition
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| strep pneumoniae that is not resistant to penicllin (MIC over 2 micrograms/ml) |
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Definition
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| piperacillin, mezlocillin, azlocillin |
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Definition
| cause choleostatic jaundice |
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Definition
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| oxa, napha, and carbenicillin (carboxypenicillins) |
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Definition
| cause increased transaminases |
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| hypocalemia and hyponaturemia are caused by |
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Definition
| carbenacillin (more than ticar) and ticarcillin |
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Term
| penicillins cause seizures in renally impaired |
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Definition
| because they are renally excreted |
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Definition
| tooth spots, black furry tongue, phototoxicity, teratogen |
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| max effect of PPIs is seen after 3 to 4 days except for |
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Definition
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Definition
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Definition
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Definition
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| chief cells (xymogenic cells) secrete |
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Definition
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| enterochromaffin cells secrete |
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Definition
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Definition
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| parietal cells have receptors for |
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Definition
| histamine, acetylcholine, and gastrin |
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Definition
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Definition
| plays role in gastric phase (the second phase of gastric secretion), when you get low pH around 2.5, gastrin secretion slows and stops at 1.0. This effect is mediated through negative feedback loop by somatostatin that is secreted by D cells. |
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Definition
| you cannot open the capsule and sprinkle it!!! take only with water. |
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Term
| tetracyclines, quinolones, and macrolides |
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Definition
| DO not take these antibiotics with antacids |
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Term
| these cause photosensitivity |
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Definition
| zithromax, tetracyclines, quinolones |
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Term
| thiazides are the only diuretics that increse: |
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Definition
| calcium...and they are the worst one for diabetics and cause photosensitivity |
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Term
| Which lung are you more likely to get aspiratory pneumonia in? |
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Definition
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Term
| how many lobes are there in your lungs, total? |
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Definition
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Definition
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Definition
| H2RA antagonist, not with antacids, inhibits 3A4, 2C19, don't take phenytoin,warfarin, theophylline, metronidazole, give 2 hrs before any drug needing a low pH for metabolism, off-label use for warts, DNE 2400mg/day in general. GERD max 1600/day. maint and healing doses different. available tabs, injections, solutions. CNS effects in elderly.use lowest dose for renal and increase interval. DO NOT GIVE to children under 12. injections have benzyl alcohol as preservative and can cause gasping syndrome in preemies.has LOTS of interactions.Gynecomastia!Can breastfeed with this. |
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Definition
| 20mgbidx6wks, swallow before meal (15-60min)with full glass of water, can give to 2mos and older, adjust in renal,CAN take with antacids.tabs, gelcaps, ODT, injections, suspensions, |
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Definition
| tablets, capsules, oral solution, renally dosed. Do not take with antacids.causes most nausea and headaches of other H2RAs, false positive on urobilirubin tests. NOT FOR under 12yo. |
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Definition
| with or without food! can be used 1 mo. and up in age. injection, tablet, syrup. Some hepatic effects. |
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Definition
| arrhythmias and AV block, all preg cat B, all are renal dose adjusted, you can only take antacids with famotidine and can only breastfeed with cimetidine. Famotidine is 2mos and older, ranitidine is 1mo and older.Cimetidine is the one with the bad side effects.cimetidine and ranitidine cannot be rapidly infused, will cause bradycardia. |
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Term
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Definition
| caps, tabs, and suspensions. take 1hr before meals, mix pellets in applesauce, can give suspension by NGtube, heptically dosed, but not renally dosed. has short t1/2 but has dose-dependent additive effect. plateau after 4 days, if you stop, secretory action returns 3-5 days. |
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Term
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Definition
| metbolized through 2C19 and 3A4, all prolong elimination of benzos, warfarin, and phenytoin, DO NOT take them with voriconazole (doubles PPI concentration), are hepatically dosed. absorbed in duodenum, not stomach. Interfere with pH dependent drugs: ketoconazoles, digoxin, penicillin and ampicillin esters, and iron salts. contraindicated with antiretroviral therapy especially atazanavir. All preg cat B except omeprazole which is cat C. All show up in breast milk. |
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Term
| zegerid (omeprazole and sodium bicarb) |
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Definition
| capsule. DO NOT OPEN. also powder that can be used in NG tube, but be careful about dosage form and strength because both strengths of powder form have same amounts of sodium bicarb. watch out for metabolic alkalosis due to bicarb. |
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Term
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Definition
| promotility agent. black box for cardiac arrhythmias, DO NOT TAKE with macrolides, antifungals, protease inhibitors, phenothiazines, antiarrhytmics, antidepressants, antipsychotics, grapefruit juice, get it special from the manufacturer, works on LES tone and gastric emptying, accelerates gastric emptying, CYP3A4 metabolized, hasn't been proven safe/effective in pts under 16, causes lost of headache. |
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Term
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Definition
| stimulates upper GI tract, increases LES pressure, decreases pyloric sphincter pressure and relaxes duodenal bulb, antiemetic, available in tab and injection, renal dosing, don't give to kids, don't use for more than 12 weeks, can cause depression, tardive dyskinesia, preg cat B, can cause parkinson-like symptoms, use caution with MAOIs, extrapyramidal effects |
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Term
|
Definition
| cholinergic agonist, do not use in PUD, promotility agent, take on empty stomach, preg cat C, taking with othe rAChE inhibitors enhances AERs, not for kids, comes in tabs |
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Term
| aluminum and calcium cause |
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Definition
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Term
|
Definition
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Term
| gaviscon tablet vs liquid: |
|
Definition
| tab has mg trisilicate and liqid has mg carbonate. both contain alginic acid. |
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Term
|
Definition
| prevpac (prevpac is 10-14 days), helidac (14 days quad, H2RA not included), pylera (10 days bismuth subcitrate quadtx PPI not included) |
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Term
| if you use an H2RA you must tx for 14 days, if you use a PPI you can tx 7-14 days. 1st choice is clarithromycin, amoxicillin, and PPI. If allergic to amox, sub in metronidazole (teratogen, no etoh) |
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Definition
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|
Term
| when using quad tx for h pylori, primary tx option is: |
|
Definition
| metronidazole, tetracycline, bismuth subsalycilate, PPI H2RA. Take QID 30 to 60 minutes before meal for 10-14 days then continue PPI or H2RA for 4 to 6 weeks total. |
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|
Term
| sequential therapy in h pylori |
|
Definition
| PPI and amox for 5 days then use metro and clarith for 5 days. this reduces the bacterial load. |
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Term
|
Definition
| esophageal protectant, alters absorption of many drugs including warfarin, quinolones, phenytoin. don't use with H pylori tx because it doesn't give any added benefit.take 1 hr before meals and at bedtime, 1g tabs and suspension, SHAKE WELL! |
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|
Term
| amlodipine is a CCB in whis class |
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Definition
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Term
|
Definition
|
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Term
|
Definition
| Rats ate some long peppery fries (rosuv, atorv, simva, lovastatin, prava, fluvasta) |
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Term
| lipophilicty of statins (high to low) |
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Definition
| little, small ant fight raging piranhas (lovast, simva, atorv, fluva, rosuva, prava) |
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Term
| Statins: R and A any time of day, the rest take at night. Lovastatin needs a snack |
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Definition
| Rosuvastatin and Atorvastatin take whenever |
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Term
| statins that don't interact with warfarin (they're too good. they are AP students) |
|
Definition
| atorvastatin and pravastatin |
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Term
|
Definition
| simva, atorva, and lova all work with 3A4 |
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Term
| statins that are prodrugs |
|
Definition
| "lazy statins" Lovastatin and simvastatin (L and S) |
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Term
| for rosuvastatin, how do you dose asian patients? |
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Definition
|
|
Term
| statins have the greates _____ lowering capacity |
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Definition
|
|
Term
| fibrates and nicotinic acid have the greatest ____lowering capacity |
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Definition
|
|
Term
| nicotinic acid has the greatest increase in _________ capacity |
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Definition
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|
Term
| Fibrates can possibly increase ______ in patient with high _______. |
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Definition
|
|
Term
| bile acid resins may increase _____ but they do lower _____ modestly (15-30%) and increase _______ slightly (3-5%) |
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Definition
|
|
Term
| WelChol shows a potential 10% increase in ________. |
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Definition
|
|
Term
| you cannot use niacin in a patient with _______ |
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Definition
|
|
Term
| when TGs are over 400, initiate: |
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Definition
|
|
Term
| lopid has the highest incident of rhabdo when combined with________ but it is NOT contraindicated, just a monitoring issue. |
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Definition
|
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Term
|
Definition
| muscle pain (of which rhabdo is a type) |
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|
Term
| rhabdo happens when CPK values are ____ the upper limits of normal |
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Definition
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Term
|
Definition
|
|
Term
| T/F myositis is inflammation of the skeletal muscles and occurs when 3x the normal CK level is reached. |
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Definition
|
|
Term
| if someone has too much homocysteine give them _______ |
|
Definition
| folic acid so that it can be converted to methionine. the more atherosclerotic plaques you have, the more homocysteine. |
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|
Term
| fenofibrate has less risk of myopathy and rhabdo than ________ |
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Definition
|
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Term
|
Definition
| it is in active form and doesn't go through the liver so there are fewer interactions, so safer with statins..FDA approved to be used with 3 statins: RAS |
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|
Term
| Rosuvastatin, atorvastatin, and simvastatin are approved for use with this new fibrate: |
|
Definition
|
|
Term
| gemfibrozil must be given _______ meals |
|
Definition
|
|
Term
| the most prominent pathogen causing community-acquired pneumonia in helathy adults is |
|
Definition
| S. pneumoniae (75% of acute cases). other bugs causing it are M. pneumoniae, legionella, c. pneumoniae, and h. influenzae |
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|
Term
| the most prominent pathogen causing hospital-acquired pneumonia is |
|
Definition
| S. aureus and gram-negative aerobic bacilli either enteric (klebsiella or E. coli, or nonenteric: psuedomonas) |
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|
Term
| the most common bacteria for pneumonia due to aspiration of gastric or oropharyngeal contents are: |
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Definition
|
|
Term
| respiratory system defense is comprised of: |
|
Definition
| humoral immunity, cellular immunity, anatomic mcechanisms |
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|
Term
| the most common infectious cause of death in the US is: |
|
Definition
|
|
Term
| most common cause of pneumonia in neonates |
|
Definition
|
|
Term
| T/F use of H2RAs can exacerbate the occurrence of noscomial pneumonia |
|
Definition
| true because lowered gastric pH may encourage upper GI bacteria to grow |
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|
Term
| The ability of a drug to get into pulmonary secretions depends on: |
|
Definition
| molecule size, lipid solubility, degree of ionization at serum and biologic fluid pH and extent f protein binding |
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|
Term
| The pH of infected bronchi is often more _____ than that of normal tissue and blood |
|
Definition
|
|
Term
| concentration indepentdent antimicrobials used to tx bacterial pneumonia: |
|
Definition
| B-lactams and carbapenems |
|
|
Term
| concentration dependent antimicrobials used to tx bacterial pneumonia |
|
Definition
| aminoglycosides and fluoroquinolones |
|
|
Term
| empirical tx for CAP in helathy adult not recently on antibiotics |
|
Definition
|
|
Term
| tx for CAP in otherwise healthy adult who has taken an antibiotic recently |
|
Definition
| respiratory fluoroquinolone; macrlode + high-dose amoxicillin; advanced macrolide plus high-dose amox-clav |
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|
Term
| tx for CAP in adult with comorbidities and no recent AB tx |
|
Definition
| advanced macrolide or respiratory fluoroquinolone |
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|
Term
| tx for CAP in pt with comorbidities and recent AB use |
|
Definition
| resp. Fluoroquinolone; advanced macrolide plus B-lactam |
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|
Term
| CAP with suspected aspiration with infection |
|
Definition
|
|
Term
| CAP from influenza with bacterial superinfection |
|
Definition
| B-lactam or respiratory fluoroquinolone |
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|
Term
|
Definition
| give fluoroquinolone alone or macrolide plus B-lactam...if used AB recently, pick the one of these they haven't used lately |
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|
Term
| in ICU, CAP not from pseudomonas is tx with |
|
Definition
| B-lactam plus advanced macrolide OR B-lactam plus fresp. fluoroquinolone...if they have aB-lactam allergy, use resp. quionolone with or without clindamycin |
|
|
Term
| if CAP in ICU is from pseudomonas, |
|
Definition
| use antipseudomonal plus cipro OR antipseudomonal plus amamminoglycoside plus a resp fluoroquinolone/macrolide |
|
|
Term
| if an ICU pt has pneumonia from psudomonas and has a B-lactam allergy, use |
|
Definition
| aztreonam and levofloxacin OR aztreonam and moxifloxacin/gatifloxacin (with or without added aminoglycoside) |
|
|
Term
| for peniccilin-resistant pneumococcla pneumonia use |
|
Definition
| cefotaxime or ceftriaxone |
|
|
Term
| for oral tx of pneumococcal pneumonia with no penicillin resistance use |
|
Definition
|
|
Term
| For ICU patients without pseudomonas infection, tx pneumonia with |
|
Definition
| B-lactam plus macrolide/resp.fluoroquinolone |
|
|
Term
| for ICU pts with a penicillin-resistant bacterial pneumonia, use |
|
Definition
| ceftriaxone, cefotaxime, resp fluoroquinolone |
|
|
Term
| treat non-hospitalized pts with legionnaires' |
|
Definition
| erythromycin, doxycycline, azithromycin, clarithromycin, or a fluoroquinolone |
|
|
Term
| treat hospitalized pts with legionnaires' with |
|
Definition
| azithromycin or a fluoroquinolone |
|
|
Term
|
Definition
| drug interaction with ginkgo and st. john's wort, CYP 2D6 and 3A4, ODT and tab form, just works on ACHE, longest t1/2, highest rotein binding, for mild to severe AD, with or w/o food. Has a piperidine. |
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|
Term
|
Definition
| patch, cap, solution, works on butyl and acetyl CHE, NOT CYP, only one approved for PDD. take with food. Significant N/V. has a carbamate in its structure. |
|
|
Term
|
Definition
| take with food. ACHE and enhances action of ACH on nicotinic recpetors. 2D6 and 3A4. Comes in ER and regular tabs. Hepatically and renally dosed in moderate impairment D/C in severe impairment. |
|
|
Term
|
Definition
| NMDA antagonist. limited helpfulness in vascular dementia, renally dosed, don't give with dextromethorphan. drugs increasing urine pH can decrease elim. For moderate to severe AD. |
|
|
Term
|
Definition
| has a acridine or pyridine (part of the acridine); hepatotoxicity is BAD so we don't use it anymore. qid dosing is crappy. |
|
|
Term
| PSI - pneumonia severity index |
|
Definition
| 5 levels. 1-3 outpatient, 4 and 5 inpatient. demographics (sex/age), comorbities, physical exam, laboratory findings. get points per category. below 70, you are risk class 1, above 130, risk class 5. high number is bad. |
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|
Term
|
Definition
| Confusion, uremia (BUN over 19), respiration rate over 30, anything less than 90/60 BP; age 65 or over. |
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|
Term
|
Definition
|
|
Term
|
Definition
| suspected coronary occulusion or heart disease or hepatocellular disease |
|
|
Term
|
Definition
| deritis ratio over 1 is viral hepatitis, under 1 is not |
|
|
Term
| red yeast rice active ingredient |
|
Definition
| monakolin K, same as lovastatin. form monascus purpurea |
|
|
Term
|
Definition
| anemia, loss of weight, anorexia, regurgitation, mass/melena, swallowing difficulty |
|
|
Term
| statins to monitor at 12 weeks |
|
Definition
|
|
Term
| SAL loves ______ for statins |
|
Definition
|
|
Term
| respiratory fluoroquinolones: |
|
Definition
| GLM: gemflox, levoflox, moxiflox |
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