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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