USMLE Step 2 Review 18 11 Drugs of Choice Neonatal Pneumonia

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 Begin 18 11 Drugs of Choice Neonatal Pneumonia Transcription

If the neonate, birth to 5 days old, has a severe pneumonia, what is the most likely organism?

• E. coli.

What group of organisms are next most likely?

• Group A, B, or G Strep.

What 2 antibiotics are administered together as the drug of choice for severe pneumonia in a neonate (birth to 5 days)?

• Ampicillin and Gentamycin.

And what are the trade names for Ampicillin?

• Ampicillin is in Omnipen, Principen, or Unasyn.

And the trade name for Gentamycin?

• Garamycin.

Again, what are the 2 drugs of choice administered together for neonatal pneumonia (birth to 5 days)?

• Ampicillin and Gentamycin.

And the trade names for both?

• Ampicillin is Omnipen, Princepen or Unasyn; Gentamycin is Garamycin.

What is the drug of choice for torsades de pointes?

• Magnesium sulfate.

Is magnesium sulfate still the drug of choice for torsades de pointes if serum magensium levels are normal?

• Yes.

What is the drug of choice for compulsive hair pulling?

• It is also the drug of choice for obsessive compulsive disorders, and also used for depression. Clomipramine.

And the trade name for Clomiprimine?

• Anafranil.

And what class of drug is Clomiprimine/Anafranil?

• It’s a tricyclic.

What is the drug of choice for genital herpes simplex (primary or recurrent) in both the immunocompetent and immunocompromised patient?

• Acyclovir.

And the trade name for Acyclovir?

• Zovirax.

What is the drug of choice for both acute and chronic copper poisoning?

• D-penicillamine.

And what are 2 trade names for D-penicillimine?

• Cuprimine and Depen.

What is the drug of choice for all tapeworms in humans- mainly those that have come from eating uncooked beef, pork, or fish, or swallowing eggs of the dog or dwarf tapeworms?

• Praziquantel.

Trade name?

• Biltricide.

Again, generic and trade name for tapeworms?

• Praziquantel/Biltricide.

What is the vitamin pro-coagulant, sometimes needed in premature infants?

• Vitamin K.

And what is another name for vitamin K3?

• Menadione.

What is the first line drug of choice for acute attacks of migraine or acute cluster headache?

• Sumatriptan.

What type of drug is Sumatriptan?

• A serotonin agonist.

Specifically, what receptor is stimulated by Sumatriptan?

• 5HT1.

And the trade name for Sumatriptan?

• Imitrex.

How is Sumatriptan/Imitrex administered?

• PO or subcutaneous injection.

If Sumatriptan/Imitrex doesn’t work, what combination is the next choice (this used to be the first line treatment)?

• Ergotamine Tartrate and Caffeine.

And the mechanism of action of Ergotamine and Caffeine?

• Vasoconstriction.

How administered?

• Either PO or rectal suppository.

Now the trade name for Ergotamine Tarartrate and caffeine in a rectal suppository form?

• Cafergot.

Trade name for Ergotamine Tartrate and Caffeine in PO Tab form?

• Wigraine.

Ergotamine Tartrate is also available by itself in IM or IV injection form, when other means of administration are not available. Trade name?

• DHE-45.

What is an effective prophylactic Ergot alkaloid drug for migraine, which can only be administered for 3 months at a time, with a rest in between?

• Methysergide.

And the trade name for Methysergide?

• Sansert.

What is the side effect which limits use to only 3 months at a time for Methysergide/Sansert?

• Retroperitoneal fibrosis.

What 2 drugs offer long term prophylaxis in about 50% of patients but should not be used with patients that have bradycardia, heart block, CHF, or asthma?

• Propranolol or Timolol.

What class of drugs are Propranolol or Timolol?

• They’re both non-cardioselective beta  blockers.

And the trade name for Propranolol?

• Inderal.

And the trade name for Timolol?

• Blocadren.

For chronic headache, which is psychogenic or post-traumatic and does not migraine or cluster, physicians sometimes supplement Aspirin or Acetominophen with what 2 classes of drugs, despite their potential for abuse and side effects?

• Tricyclics or Benzodiazepines.

What is the usual organism in a rat bite?

• Streptobacillus moniliformis.

And the drug of choice?

• Amoxicillin plus Clavulanate.

And the trade name?

• Augmentin.

What is a good alternative if the patient is allergic to Penicillins?

• Doxycycline.

Trade name?

• Vibromycin.

Is rabies prophylaxis usually indicated in a rat bite?

• Surprisingly, no.

What is the NSAID of choice for menstrual cramps?

• It’s also used for arthritis, bursitis, tendonitis.

And fever?

• Ibuprofen.

And what are 3 trade names for Ibuprofen?

• Advil, Motrin, Nuprin.

What are the 2 most likely organisms in a brain abscess in an AIDS patient?

• Toxoplasma or Nocardia.

What is the combination drug of choice for ongoing infection with toxoplasmosis?

• Pyrimethamine Sulfadiazine.

And the trade name?

• Fansidar.

While treatment of Nocardia brain abscess in AIDS is complicated and difficult, which is the drug of choice for starting a multi-drug regimen?

• Trimethoprim Sulfa.

And what are 2 trade names for Trimethoprim Sulfa?

• Bactrim, Septra.

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