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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 19 03 Drugs of Choice Ocular Herpes Below
What is the topical drug of choice for herpes simplex infection in the eye (Primary herpes keratoconjunctivitis and recurrent herpes epithelial keratitis)?
And the trade name for Trifluridine?
What is the drug of choice for the cutaneous filariasis onchocera volvulus, which is also called onchoceriasis?
And the trade name for Ivermectin?
What is the currently recommended drug of choice for all the rest of filariasis (the lymphatic filariasis, including Wuchereria bancrofti or Brugia malayi or Brugia temori and the cutaneous filariasis Loa Loa, or Eyeworm Disease)?
And the trade name for Diethylcarbamazine?
What drug due to much shorter duration of treatment may ultimately replace Diethylcarbamazine for the treatment of filariasis (Hint: It’s the drug of choice for onchoceriasis)?
And the trade name for Ivermectin?
What is the Vinca Alkaloid used for ABVD therapy, VAMP therapy, and for testicular cancer?
In this case, Vinblastine is represented by the V in the acronyms.
What cancer is the ABVD therapy used for?
- Advanced Hodgkin’s disease.
And what cancer is the VAMP therapy used for?
- Acute Lymphocytic Leukemia.
What chemical should patients on Cephalosporins avoid?
- Alcohol, including medicinal syrups containing alcohol.
Why is mixing Cephalosporins and alcohol contraindicated?
- Disulfiram reaction.
What is the trade name for Disulfiram?
What toxin builds up in a Disulfiram reaction?
What enzyme is inhibited that would otherwise oxidize acetaldehyde to acetate in the liver?
- Aldehyde dehydrogenase.
The Cephalosporins can cause what reaction in the blood?
- A direct Coomb’s reaction.
And what is a Coomb’s reaction?
- A positive result in a test for antibodies which damage red blood cells.
Is a direct Coomb’s reaction as a result of cephalosporin use of any known clinical significance?
- No, it isn’t, actually.
What 2 treatable or transient blood disorders are occasionally associated with Cephalosporins?
- Transient serum sickness and treatable prolongation of pro-thrombin time.
What is the treatment and probable preventive agent for prolonged pro-thrombin time due to Cephalosporins?
- Vitamin K.
What effect do all of the 3rd generation Cephalosporins have on mucous membranes?
- Profound alteration of normal flora.
What particular GI problem has been associated with all of the Cephalosporins, especially the 3rd generation Cephalosporins?
- Pseudomembranous colitis.
And what organism is usually involved in pseudomembranous colitis?
- Clostridum difficile.
What is the drug of choice for treating pseudomembranous colitis due to overgrowth of Clostridum difficile?
And the trade name for Metronidazole?
What is the second-line drug of choice for pseudomembranous colitis but which may cause emergence of resistant Enterococci in the gut?
Trade name for Vancomycin?
Which of the 3rd generation Cephalosporins can cause reversible sludging of the gallbladder and displacement of bilirubin from albumin binding sites?
Trade name for Ceftriaxone?
What is the central nervous system adverse effect that can occur with high dosage or IV administration of some of the Cephalosporins?
What are the 2 serious toxicities of the Aminoglycosides?
- Ototoxicity and nephrotoxicity.
Now, which older Aminoglycoside used via IM or IV presents the most risk of ototoxicity and nephrotoxicity?
Which newer Aminoglycoside used IM or IV presents less risk but still obligates the physician to monitor for nephrotoxicity and ototoxicity?
And the trade name for Gentamycin?
What toxicity of Aminoglycosides can be potentiated by certain diuretics?
What type of diuretics can potentiate the ototoxicity of Aminoglycosides?
- Loop diuretics.
Which class of antibiotic poses a higher overall risk of nephrotoxicity- the Penicillins or the Aminoglycosides?
- The Aminoglycosides.
Which antibiotic closely related to Aminoglycosides may be used IM for gonorrhea, and carries much less risk of nephrotoxicity and ototoxicity?
And the trade name for Spectinomycin?
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