Final pharm exam (1).docx

Duration no shorter than 2 weeks medrol dose packs

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duration no shorter than 2 weeks Medrol dose packs too short and may result in rebound flare Facts re: Lice (pediculosis): Very contagious Can be resistant to medications Spread via person to person or person to object that is infested (i.e. hats, hairbrush, pillows, etc.) Medications work by paralyzing the lice—same in scabies Suffocation is another mechanism of action Spinosad (Natroba): both ovicidal and insecticidal Permethrin: also both ovicidal and insecticidal MOA—causes neuronal excitation of lice which then paralyzes them and they die. Benzyl Alcohol (Ulesfia) Only prescription medication that is non neurotoxic Penetrates respiratory system of lice and causes asphyxiation Non pharmacological measures- causes asphyxiation Remove eggs with a nit comb, hair conditioner mayonnaise, olive oil, Petroleum Jelly Facts re: Scabies (pediculosis): Sarcoptes scabiei — infectious agent Highly contagious infestation Takes 3 to 4 days for eggs to hatch Incubation period: up to 1-2 months after exposure (laying eggs can extend from 4 to 6 weeks) Spread: Direct exposure to an infested person or unwashed clothing, bedding used by infested person First line treatment Elimite (permethrin 5%)—both insecticidal and ovicidal Safe in pregnancy and children down to 2 months Ivermectin 200 mcg/kg- day 1 and again 14 days later FUNGAL Nystatin(Mycostatin);trocheandtopicalcream • Triazoleorimidazolepreparations • Topicalantifungalpreparations – Azole antifungals • Clotrimazole (Lotrimin) 1% cream (OTC) • Ketoconazole (Nizoral) 1% cream • Miconazole (Monistat) 1% cream • Oxiconazole (Oxistat) and others – Allylamine antifungals • Butenafine (Mentex) • Naftifine (Naftin) • Terbinafine (Lamisil) Oral antifungal preparations – Should be reserved for severe or extensive cases • Griseofulvin (Grifulvin) 500–1,000 mg daily • Itraconazole (Sporanox) 200 mg qd • Terbinafine (Lamisil) 250 mg qd • Fluconazole (Diflucan) 100–200 mg/d • Important considerations: – Treatment up to 3 months – Monitor LFTs – Drug interactions: • Oral azoles: statins • Oral allylamine: cimetidine, rifampin GRISEOFULVIN Preferred agent for tinea capitis and tinea corporis if oral treatment needed • Fungistatic: prevents further fungal invasion into keratin • Microsize vs. ultramicrosize: be careful! – Microsize10–20mg/kg/day – Ultramicrosize5–10mg/kg/day • Liquid form easiest for patients to find • Absorption is increased by simultaneous ingestion of fatty foods • CAN cause hepatotoxicity so CLOSE follow-up is mandated – SomewilldrawLFTsatbaseline,mostrecommendafter1–2 months of therapy • Drug interactions: – Increases levels of warfarin(Coumadin) – Decreasesoralcontraceptiveeffectiveness,levelsofbarbiturates and cyclosporine Tinea Pedis is typically caused by: Causative organisms E.floccosum T. rubrum T.mentagrophytes C. albicans Treatment—typically needs 4 weeks of treatment Azole antifungals—causes leakage of the fungal cell wall membrane Sertaconazole—indicated for interdigital tinea pedis Allymine antifungals—affects fungal cell membrane
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  • Summer '17
  • Selective serotonin reuptake inhibitor, Serotonin Syndrome, cimetidine, griseofulvin

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