USMLE Step 2 Review 18 02 Drugs of Choice Intro to Drugs of Choice

USMLE Step 2 Review 18 02 Drugs of Choice Intro to Drugs of Choice

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Let’s start our USMLE Review with Drugs of Choice from the Gold Standard USMLE Step 2 Audio Review program.

Play USMLE Audio MP3 18 02 Drugs of Choice Intro to Drugs of Choice Below

Begin 18 02 Drugs of Choice Intro to Drugs of Choice Transcription

Welcome to Drugs of Choice, Number 1. These CDs have 2 purposes for you: to help you get ready for the boards, and to help prepare you for clinical rotations. The order is random, because that’s the way you will hit things in the boards and in rotations, and getting hit with topics in a random order is a much better way to memorize.

Many of these questions are for the boards. Some have additional parts that prepare you for rotations. Generic names are always asked for first. PO means by mouth, IM is intramuscular. With some classes of drugs, board questions are more on side effects and mechanisms than on indications, so when you hit a long section on side effects, don’t worry—you’ll be glad you learned it…later.

Which is more likely to give rise to a nasty infection? A cat bite? Or a dog bite?

  • A cat bite. Eighty percent of cat bites become infected.

What is the organism usually involved?

  • Pasturella multocida.

There is another organism sometimes involved, also nasty. What is it?

  • Staph aureus.

Again, what are the 2 organisms usually involved in cat bite infections?

  • Pasteurella multocida and Staph aureus.

What is the combination drug of choice?

  • Amoxicillin and Clavulanate.

Trade name?

  • Augmentin.

Please give both generic and trade name for the combination drug of choice for cat bite infections:

  • Amoxicilin and Clavulanate; Augmentin.

Now, which of the 2 cat bite bugs is taken care of by the amoxicillin?

  • Pasturella multocida.

And which bug requires the addition of Clavulanate?

  • Staph aureus.

What does Staph aureus produce that requires Clavulanate?

  • Beta-lactamase.

What then is Clavulanate?

  • A beta-lactamase inhibitor.

What is another general term for the enzyme represented by the word “beta lactamase”?

  • Penicillinase.

Teenagers are prone to acquiring an acute bronchitis which may become chronic. Once chronic, it is often erroneously referred to as “walking pneumonia.” What is the likely organism?

  • Mycoplasma pneumoniae.

And what are two families of drugs, which are drugs of choice for Mycoplasma pneumoniae?

  • Tetracyclines and Macrolides.

Which drug in the tetracycline family is the drug of choice for Mycoplasma pneumoniae?

  • Doxycycline.

Two trade names for Doxycycline:

  • Vibramycin or VibraTabs.

Now, what 3 generics in the macrolide family are also drugs of choice for Mycoplasma pneumonia?

  • Erythromycin, Azithromycin, Clarithromycin.

There are too many trade names for Erythromycin to list them all here, however, for Clarithromycin and Azithromycin, are newer Macrolides, with fewer side effects, and probably preferable if cost is not an obstacle.

Trade name for Clarithromycin?

  • Biaxin.

Trade name for Azithromycin?

  • Zithromax.

What is the drug of choice for the initial treatment of panic attacks and phobias?

  • Imipramine.

Trade name for Imipramine?

  • Tofranil.

What type of drug is Imipramine/Tofranil?

  • It’s a tricyclic antidepressant.

Because Imipramine/Tofranil has anticholinergic side effects, what 2 conditions are contraindications to its use?

  • Narrow-angle glaucoma, and prostatic hypertrophy.

Now, what newer class of drugs is a good alternative for panic attacks and phobia?

  • 5-HT reuptake inhibitors, which are also known as Serotonin Reuptake Inhibitors.

What initial side effect can cause problems with treatment with the 5-HT reuptake inhibitors?

  • Initially, drug induced anxiety.

Which of the 5-HT reuptake inhibitors is most likely to cause initial anxiety?

  • Fluoxetine.

Trade name for fluoxetine?

  • Prozac.

What are 3 other 5-HT reuptake inhibitors (SRI’s or SSRI’s) that may be useful?

  • Sertraline, Fluvoxamine, Paroxetine.

What’s the trade name for Sertraline?

  • Zoloft.

And the trade name for Fluvoxamine?

  • Luvox.

And the trade name for Paroxetine?

  • Paxil.

Finally, what drug will rapidly relieve panic symptoms, but withdrawal symptoms such as anxiety, depression, and insomnia have raised doubts about its use?

  • Alprazolam.

And what’s the trade name for Alprazolam?

  • Xanax.

What class of drug is Alprazolam/Xanax?

  • It’s a benzodiazepine.

What is the drug of choice for iron poisoning?

  • Deferoxamine.

Now, what’s the trade name for deferoxamine?

  • Desferal.

****END OF TRANSCRIPTION****

 

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