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Naplex important questions
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Naplex important questions
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Naplex important questionsonsets for laxatives - ANS-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 - ANS-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: -
ANS->>>>>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 - ANS-AST / ALT elevated / Albumin low / Tbili and Amonia
What is CK lab test? - ANS-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? - ANS-Amiodarone and interferon (Up and dawn) / Lithium
and (Oxy) carbamazepine decrease to mean hypothyrism
Thyroxine lab reult test trap - ANS-When TSH is elevated , it means HYPO and NOT
hyper.
Drugs that raise Uric acid blood level - ANS-Diuretics , Niacin, pyrazinamide (TB
treatment) and high dose Aspirin,
Thyroxine lab result test trap - ANS-When TSH is elevated , it means HYPO and NOT
hyper.
Drugs that can cause SJS or Ten - ANS-Penicillin Phenytoin piroxicam (3P for SJS &
Ten) Allopurinol, Sulfamethoxazole, Lamotrigine. carbamazepine
Drugs that can induce Lupus - ANS--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 - ANS-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? - ANS-Rapid Plasma Regain; Syphillis
to remenber it R for remember and P for pencillin
PPD skin test - ANS-tuberculin purified protein derivative
Pneimonic : Pneimonia is not TB
Test Lab BNP-High NT-ProBNP-High ? - ANS-Heart issue , most propably HF
Low Hgb & Hct - ANS-anemia / if reticulocyte is high then it is loss of blood.
High AST/ALT - ANS-Acute liver damage / if also GGT is high then it could be Alcoholic
hepatitis
High ALK-T billi - GGT - ANS-Cholestatis - billary
High INR and low Albumin and platlets - ANS-Liver chronic Damage
PO4 increase in blood - ANS-"Chronic" kidney disease also look for BUN/Scr and PTH
with low HGb and HCT
What lab test we request for autoimmune diseases? - ANS-ANA / ESR / CRP
What lab test we order to monitor statins? - ANS-CPK and SrCr. as it indicate
Rhabdomyolysis
Also LFTs
Durgs causing low calcium? - ANS-Loops, (Oxy) Carbamazepine , SSRIs
Drugs that are contraindicated in HF? - ANS-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 - ANS-LATIN
L:Lorazepam
A:Amiodarone
T:Tacrolimus
I: Insulin
N: Nitoglycerin
Drugs infused only using Saline IV bags - ANS-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 - ANS-AB of Suguar
A: Amphotericin B
B: Bactrim
S: Synercid
The selfish Drugs (wants their IV alone!) - ANS-Amphotericin B , Heparin, Zosyn,
Caspofungin...
Three anti biotics and one heparin.
Drugs that hurt the kidney ? - ANS-Vancomycin , Aminoglycosides, cyclosporine,
Tacrolimus, NSAIDs, Cisplatin, Amphotericin B, contast dye, colistimethate.
remember contast dye is MAO inhibitors
Antibiotics for CRE pathogen? - ANS-Polymyxin
Avycaz (cefazidime/avibactam)
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