Naplex important questions/exam questions and answers correct/verified 100% latest

Naplex important questions/exam questions and answers correct/verified 100% latestNaplex important questions/exam questions and answers correct/verified 100% latest onsets for laxatives - correct answers-Fast : 1-osmotics oral: 30minutes to 96 hrs : 2-Osmotics rectal :15-30 minutes (Glycerin) 3-Emollient rectal : 2-15 minutes like docesate 4-Lubricant rectal : 2-15 minutes Rest of the orals are above 6 hrs... H.pylori treatment - correct answers-All therapy are for up to 14 days. First line QUAD: Pepto + flagyl + tetracycline + PPI (Tetrtra Flag PPPP) then : clarith + flagyl + PPI Triple: clarith + amox + PPI only use is clarith resitance 15% and no Macrolide before. levo + amox + PPI PI-BI-MET-TET CAMP CAP If you get an Amiodarone Case in the exam, please watch for the following: - correct answers-Look if patients in the case receive or suffer any of : 1-Digoxin and statin or warfarin (should reduce doses / Digo by 50% and statins limits) 2-Iodine sensitivity 3-No Heparin in same line. 4-pulmonary / liver ^LFTs / Thyroid 5-Sever sinus node disfunction unless patient has an artificial one) 6-Look for any drug that cause QT^ or reduce HR. Look on the process of infusion: 1-Non PVC , Need filter / slow infusion to avoid bradycardia 2-drug of choice in HF as antiarrythmic ( plus Dofelitide) 3-Always in hospital for loading Last issue : BLUE SKIN Lab test for liver - correct answers-AST / ALT elevated / Albumin low / Tbili and Amonia What is CK lab test? - correct answers-Creatinine Kinase to assess muscle damage or inflamation. Drugs could increase CK like Statin and fibrates, tenovir (Hep B and HIV)and raltegravir and dolutegravir , daptomycin Drugs that effect Thyroxine? - correct answers-Amiodarone and interferon (Up and dawn) / Lithium and (Oxy) carbamazepine decrease to mean hypothyrism Thyroxine lab reult test trap - correct answers-When TSH is elevated , it means HYPO and NOT hyper. Drugs that raise Uric acid blood level - correct answers-Diuretics , Niacin, pyrazinamide (TB treatment) and high dose Aspirin, Thyroxine lab result test trap - correct answers-When TSH is elevated , it means HYPO and NOT hyper. Drugs that can cause SJS or Ten - correct answers-Penicillin Phenytoin piroxicam (3P for SJS & Ten) Allopurinol, Sulfamethoxazole, Lamotrigine. carbamazepine Drugs that can induce Lupus - correct answers--Procainamide -anti arythmic -Hydralazine - anti histamine -INH - TB treatment -Chlorpromazine -Anti pschotic -Methyldopa - Anti TNF agent -quinidine (Malaria and arrhythmia) - Terbinafine (Anti fungal) -Minocycline (antibiotic) Mneumonic SHIPP (Salazopirin, Hydralazin,INZ,Phytoin,Procainamide) Hydra and Procain are highest. Drugs that can cause lactic acidosis - correct answers-NRTIs and Metformine NRTIs are : Abacavir (brand name: Ziagen®) Emtricitabine (FTC; brand name: Emtriva®) Lamivudine (3TC; brand name: Epivir®) Tenofovir alafenamide (TAF) Tenofovir DF (TDF; brand name: Viread®) What is RPR and what is it used to test? - correct answers-Rapid Plasma Regain; Syphillis to remenber it R for remember and P for pencillin PPD skin test - correct answers-tuberculin purified protein derivative Pneimonic : Pneimonia is not TB Test Lab BNP-High NT-ProBNP-High ? - correct answers-Heart issue , most propably HF Low Hgb & Hct - correct answers-anemia / if reticulocyte is high then it is loss of blood. High AST/ALT - correct answers-Acute liver damage / if also GGT is high then it could be Alcoholic hepatitis High ALK-T billi - GGT - correct answers-Cholestatis - billary High INR and low Albumin and platlets - correct answers-Liver chronic Damage PO4 increase in blood - correct answers-"Chronic" kidney disease also look for BUN/Scr and PTH with low HGb and HCT What lab test we request for autoimmune diseases? - correct answers-ANA / ESR / CRP What lab test we order to monitor statins? - correct answers-CPK and SrCr. as it indicate Rhabdomyolysis Also LFTs Durgs causing low calcium? - correct answers-Loops, (Oxy) Carbamazepine , SSRIs Drugs that are contraindicated in HF? - correct answers-1-NSAIDs 2-Non pyridine CCBs specially verapamil 3- C.steroids 4-some anti arrythmia drug like Flecainide and dronedarone 5-TCA , Thiazolidinediones(e.g. rosiglitazone, pioglitazone), 6-Anti cancer :Anthracyclines (doxorubicin,daunorubicin), cyclophosphamide, trastuzumab (Herceptin), tyrosine kinase inhibitors (e.g. sunitinib) may cause heart failure4 7-Closapine. 8-Decongestants for coughs and colds such as pseudoephedrine may increase workload on the heart . Drugs cannot be infused using PVC-DEHP container - correct answers-LATIN L:Lorazepam A:Amiodarone T:Tacrolimus I: Insulin N: Nitoglycerin Drugs infused only using Saline IV bags - correct answers-DEAP CIA D: Daptomycin (cubicin) E: Ertapenem ( Invanz) A: Ampicillin/sulbactam ( Unasyn) P: Phenytoin (Dilantin) C: Caspofungin(cansidas) I: INfliximab (Remicade) A: Ampicillin remember Deap is the sea which is salty... Drugs only infused in Dextrose - correct answers-AB of Suguar A: Amphotericin B B: Bactrim S: Synercid The selfish Drugs (wants their IV alone!) - correct answers-Amphotericin B , Heparin, Zosyn, Caspofungin... Three anti biotics and one heparin. Drugs that hurt the kidney ? - correct answers-Vancomycin , Aminoglycosides, cyclosporine, Tacrolimus, NSAIDs, Cisplatin, Amphotericin B, contast dye, colistimethate. remember contast dye is MAO inhibitors Antibiotics for CRE pathogen? - correct answers-Polymyxin Avycaz (cefazidime/avibactam) Antibiotic for ESDLs pathogen? - correct answers-Carbapenem Avycaz Pencillins and Cephalosporins and carbapenem MOA - correct answers-Cell wall inhibitors Vancomycin MOA - correct answers-inhibits cell wall synthesis Monobactams MOA - correct answers-inhibit cell wall synthesis Dalbavancin MOA - correct answers-inhibit cell wall telavancin and oritavancin MOA - correct answers-inhibit cell wall and cell menbrane Quinolones mechanism of action - correct answers-Bactericidal Alter DNA of bacteria, causing death Do not affect human DNA Aminoglycisides moa - correct answers-inhibit bacterial protein synthesis Tetracycline MOA - correct answers-Inhibit bacterial protein synthesis by reversibly binding to the 30S ribosomal subunit Metrodinazole moa - correct answers-Alter DNA of bacteria, causing death Do not affect human DNA Rifampin MOA - correct answers-Alter DNA of bacteria, causing death Do not affect human DNA Macrolides MOA - correct answers-Inhibit protein synthesis by blocking translocation ("macroslides"); bind to the 23S rRNA of the 50S ribosomal subunit. Bacteriostatic. Linezolid MOA - correct answers-inhibits protein synthesis Daptomycin MOA - correct answers-*Cell Membrane Damaging Agent* Polymixin mode of action - correct answers-Cell menbrane inhibitors Bactrim and aczone MOA - correct answers-Folic acid synthesis inhibitors Class the below Hydrophyllic or Lipophilic: 1-Aminoglycosides 2-Quinolone 3-Vancomycine (Glycipeptides) 4-Macrolides 5-Rifampin 6-Colistimethate - correct answers-Aminoglycosides: Hydro Quinolone: Lipo Vancomycine: Hydro Macrolides: Lipo Rifampin: Lipo Colistimethate: Hydro with Quinolone watch for: - correct answers-Tendon inflamation QT CNS/Psychatric conditions Children Pregnancy Cipro in tube Hepatotoxic Sun Glucose seizure respiratory or urine Cation chelating agent renal adj. needed except for Moxi warfarin with Quinolone watch for: - correct answers-Tendon inflamation (Risk factor Age,Corticostd, Transplant) QT CNS/Psychatric conditions Children Pregnancy Cipro in tube Hepatotoxic Sun Glucose seizure respiratory or urine Cation chelating agent renal adj. needed except for Moxi warfarin With Aminoglucosides watch for? - correct answers-Kidney Blood drug levels Dose per weight Ideal and adjusted body weight Ototoxicity Neuromuscler blockage With Macrolides watch for? - correct answers-3A4 inhibition G PAK(M)AN (except Azi-) SImvastatin and Levostatin Only Clari- need renal adjustmenty Azi- and Eri- don't. Watch for resistance. QT Hepatotoxicity GI upset (M) IN PackMan specially Simavastatin and lovastatin (A) Adjustment only for clarith (C) QT What is quinolones coverage? - correct answers-To remember : Resp Quinolone and urinary Quinolones Gemi, Levo, Mox : G+ and Atypical Cipro and Levo: G- and Pseudo Mox: Anaerobic and G+ Tetracycline covarge - correct answers-to remember a speciality is unique pathogens like spirochetes, Rickettsiae(Lyme disease), Treponema (syphlis) Dox- got MRSA coverage Dox -got VRE coverage Then also got negative and positive coverage. What to watch for with Tetracycline? - correct answers-Cation chelating agents pencilline Sun children8 pregnancy No pseudo coverage renal adjustment only with Mino and tetra (Not with Doxy) Bactrim coverage - correct answers-Gram negatives HPEK & SSS + G+ including MRSA Bactrim do not cover : VRE, PSEUDO, Atypical, Anaerobic 9 to watch for with Bactrim? - correct answers-1-Dosing :Double dose or singlr dose/Weight dosing is based on TMP componant ratio always 5:1 SD 400/80 DD 800/160 / injection (5ml is SD tablet) 2-Sulfa allergy 3-pregnancy at terma and 4-breastfeeding 5-coombs test / TEN&SJS 6-Folate 7-Warfarin/ INR^ 8-For injection: Do not freeze 9-dextrose only 9 to watch for with Bactrim? - correct answers-1-Dosing :Double dose or singlr dose/Weight dosing is based on TMP componant ratio always 5:1 SD 400/80 DD 800/160 2-Sulfa allergy 3-pregnancy at terma and 4-breastfeeding 5-coombs test / TEN&SJS 6-Folate 7-Warfarin/ INR^ 8-For injection: Do not freeze 9-dextrose only What to watch for with Linezolid? - correct answers-1- MOA sprerate by 14 days 2-Seretonergic or adrenargic drugs 3-HYPOglycimea 4-Myelosuppression / thrombocitopenea (remember chemically it is like Xalerto) 5-Do not shake (suspension) 6- PO and IV 7- Lactic acidosis 8- Hypertension when with adrenergic drugs WHat to watch for with Metrodinazol treatment? - correct answers-1- Dark urine 2-Pregnancy 1 term (systematic ) 3-Alcohol use within 3 days 4-Disulfiram 5-Seizure 6- Rash and SJS/TEN 7-Warfarin (^ INR) What to watch for with Nitrofurantoin? - correct answers-1-CrCl 60 2-Brawn Urine (Harmless) 3-G6PD 4-Hepatotoxicity 5-Macrobid (BID) Furadantin (QID) - look below! 6-Optic neuritis 7-three type as below Macrocrystals (Macrodantin, Furadantin, and equivalents): 50-100 mg PO q6hr for 7 days or for 3 days after obtaining sterile urine Monohydrate/macrocrystals (Macrobid and equivalents): 100 mg PO q12hr for 7 days or for 3 days after obtaining sterile urine Long-term prophylaxis/suppression: 50-100 mg macrocrystals PO HS for up to 12 months What to watch for with B-lactam? - correct answers-1-Allergy (except Syphilis-Pregnant & Otisis) 2-Seisures (specially with renal failures) 3- renal adjustment except (Oxi - Decloxi - Naf) When are Quinolones first line? - correct answers-Always last line when no alternative When are Quinolones first line? - correct answers-Always last line when no alternative except complicated UTIs What to watch for with cubiccin? - correct answers-1- No use in pneumonia neither HAP nor VAP 2-muscle damage specially with Statins or renal failure 3-CPK ^ 4- it cover VRE 5- False PTT and INR 6- NS only (D) eap CIA THE D is for Daptamycin What to watch with Tygacil? - correct answers-1- Do not cover 3Ps 2- should be yellow orange otherwise disregards 3-DO not use for blood stream infection (do not stay in blood) what to watch for with Ripe treatment for TB? - correct answers-1- LFTs Hepatotoxic 2-Discoloration of body fluids from Rifampin 3-Drug interaction with rifampin (Can replace with Rifabutin) 4-CBC because of INH 5-Lupus , SJS, TEN due to INH 6-Neuropathy due to ING (USe Pyridoxine to reduce ) 7-GOUT due to Pyrazinamide 8- Eye problem due to Ethambutol 9- Mental status 10- Warfarin , PI (HIV treat) , Contraceptive, Oral Anticoagulant. (Rifampin is stroing inducer) what to watch for with Ripe treatment for TB? - correct answers-1- LFTs Hepatotoxic 2-Discoloration of body fluids from Rifampin 3-Drug interaction with rifampin (Can replace with Rifabutin) 4-CBC because of INH 5-Lupus like , SJS, TEN due to INH 6-Neuropathy due to INH (USe Pyridoxine "B6" to reduce ) 7-GOUT due to Pyrazinamide 8- Eye problem due to Ethambutol 9- Mental status 10- Warfarin , PI (HIV treat) , Contraceptive, Oral Anticoagulant. (Rifampin is stroing inducer) Antibiotics for meningitis - correct answers---Below 1 month: Ampicillin + (cefotaxime or Gentamycin) --1month to 50 years: Ceftriaxone + Vancomycin --Over 50 years: Ampicillin+Vancomycin+Ceftriaxon Acute Otitis Media Treatment - correct answers-first line : Amoxicilin high dose 90mg/kg/day or Augmentin high dose 90mg/kg/day use lowest Clavunate Second line : ceftriaxon IM or IV . We can use beta lactam in this case even with non sever PNC alleragy bronchitis treatment Antibiotics (non COPD) - correct answers-Macrolids or Bactrim Bronchitis treatment Antibiotics(COPD) - correct answers-Antibiotics only if on ventilator or purulent sputum : Azithromycin or Doxycyclin Bronchitis treatment Antibiotics(COPD) - correct answers-Antibiotics only if on a ventilator or purulent sputum : Amoxicillin/clavulanate Azithromycin or Doxycyclin HAP/VAP Antibiotics treatment - correct answers-1 drug anti Pseudo 1 drug anti Pseudo and 1 Anti MRSA 2 drug anti Pseudo and 1 Anti MRSA RIPE treatment - Active - correct answers-4 Drug for 2 months and 2 drugs for 4 months (can be extended to 7) INH 2-3 weekly or daily no food Rifampin no food (Give B6) Pyrazinamide Ethambutol TB Latent treatment - correct answers-Monotherapy: INH 9 months daily Rifampin 4 months daily (give B6 ) Priftin ( INH and Rif) weekly 4 months MRSA (respiratory) - correct answers-Vancomycin, linezolid,quinupristin/dalfopristin (Synercid).... be careful Daptomycin(Cubiccin) is not active in lung infective endocarditis - correct answers-Beta-Lactam + Gentamycin (synergy) infective endocarditis prophylaxis - correct answers-Amoxicillin If allergic to PNC: Clindamycin or Azithro or Clarith Mneumonic (ACAC) Primary peritonitis Antibiotics? - correct answers-Ceftriaxone 5-7 dys Alternative: Genta , Cipro Prophyloaxis : Cipro or Sulfa. Usualy caused by (C)irhossis so we pick C antibiotics : Cetriaxon , Cipro. Impetigo antibiotics - correct answers-Topical Bactroban (Mupirocin) Cephalexin 250 QI