p.46
Dyslipidemia Management and Statin Therapy
How does Nicotinic Acid affect triglyceride (TG) levels?
It decreases triglyceride levels.
p.46
Dyslipidemia Management and Statin Therapy
What is the effect of Nicotinic Acid on lipoprotein lipase activity?
It increases the activity of lipoprotein lipase, leading to increased clearance of triglycerides.
p.28
Antitubercular Therapy for Pulmonary Tuberculosis
What is the mechanism of action of Rifampicin?
It inhibits DNA-dependent RNA polymerase, interrupting RNA synthesis.
p.14
Guidelines for Asthma and COPD Treatment
What effect do inhaled corticosteroids have on inflammatory cytokine production?
They decrease inflammatory cytokine production.
p.35
Antitubercular Therapy for Pulmonary Tuberculosis
What are the risks of untreated TB during pregnancy?
Intrauterine growth restriction (IUGR), preterm labor, and increased perinatal mortality.
p.33
Antitubercular Therapy for Pulmonary Tuberculosis
What type of bacteria does Streptomycin kill?
Only extracellular bacilli.
p.10
Guidelines for Asthma and COPD Treatment
What effect do β2 agonists have on microvascular leakage?
They decrease microvascular leakage.
p.6
Empiric Antibiotic Regimens for Pneumonia and Meningitis
What was the culture and sensitivity result for the patient's infection?
Positive for extended-spectrum beta-lactamases producing Klebsiella.
p.32
Antitubercular Therapy for Pulmonary Tuberculosis
What should be considered when prescribing Ethambutol?
Caution in renal disease due to excretion via the kidney.
p.40
Dyslipidemia Management and Statin Therapy
What class of drugs do atorvastatin, pitavastatin, simvastatin, and rosuvastatin belong to?
HMG-CoA reductase inhibitors.
p.37
Case Study of a 50-Year-Old Man with Pneumonia and Meningitis
What symptoms did the 40-year-old man present with?
Fever, weight loss, and a productive cough.
p.33
Antitubercular Therapy for Pulmonary Tuberculosis
Is Streptomycin contraindicated in pregnancy?
Yes, it is contraindicated in pregnancy.
p.14
Guidelines for Asthma and COPD Treatment
What are some examples of inhaled corticosteroids (ICS)?
Budesonide, Fluticasone, Beclomethasone, Ciclesonide.
p.35
Antitubercular Therapy for Pulmonary Tuberculosis
What is the intensive treatment regimen for TB in pregnancy?
HRZE + Pyridoxine for 2 months.
p.10
Guidelines for Asthma and COPD Treatment
Can β2 agonists be used alone for asthma prophylaxis?
No, they are not used alone for prophylaxis.
p.44
Drug Interactions and Theophylline Toxicity
What effect do CYP inducers have on levels of statins?
They decrease levels of statins.
p.17
Guidelines for Asthma and COPD Treatment
What therapy is suggested for Steps 3-5 in asthma management?
Daily maintenance ICS-formoterol (maintenance and reliever therapy, 'MART').
p.31
Antitubercular Therapy for Pulmonary Tuberculosis
What condition does Pyrazinamide cause related to uric acid?
Hyperuricemia – it decreases urate excretion.
p.15
Guidelines for Asthma and COPD Treatment
How do ICS affect airway hyperresponsiveness?
They decrease airway hyperresponsiveness.
p.40
Dyslipidemia Management and Statin Therapy
What is the function of ezetimibe?
Inhibitor of intestinal cholesterol absorption.
p.37
Case Study of a 50-Year-Old Man with Pneumonia and Meningitis
What did the chest x-ray show for the patient suspected of having TB?
Right apical infiltrates.
p.10
Guidelines for Asthma and COPD Treatment
What is the primary action of β2 agonists?
Increase cAMP leading to smooth muscle relaxation.
p.17
Guidelines for Asthma and COPD Treatment
What do the GINA guidelines provide for asthma management?
An annually updated evidence-based strategy for management and prevention.
p.14
Guidelines for Asthma and COPD Treatment
How do inhaled corticosteroids affect eosinophilic and lymphocytic infiltration?
They decrease eosinophilic and lymphocytic infiltration.
p.6
Empiric Antibiotic Regimens for Pneumonia and Meningitis
Why is Imipenem a suitable choice for this patient?
It is effective against extended-spectrum beta-lactamases producing organisms.
p.1
Case Study of a 50-Year-Old Man with Pneumonia and Meningitis
What symptoms did the 50-year-old man present with?
Fever, productive cough, headache, and confusion.
p.5
Empiric Antibiotic Regimens for Pneumonia and Meningitis
What type of rashes are aminopenicillins frequently associated with?
Rashes that are not caused by type I hypersensitivity.
p.18
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
What type of bronchodilators are used in COPD treatment?
β2 agonists and muscarinic antagonists.
p.20
Drug Interactions and Theophylline Toxicity
What alternative antibiotics could have been selected to avoid theophylline metabolism inhibition?
Beta-lactams like amoxicillin, cefuroxime, or azithromycin.
p.37
Antitubercular Therapy for Pulmonary Tuberculosis
Which medications were started for the patient suspected of having TB?
INH, rifampicin, ethambutol, and pyrazinamide.
p.33
Antitubercular Therapy for Pulmonary Tuberculosis
What are the major adverse effects of Streptomycin?
Ototoxicity, nephrotoxicity, neuromuscular blockade, hypersensitivity, and pain at the injection site.
p.6
Empiric Antibiotic Regimens for Pneumonia and Meningitis
What antibiotics is the patient currently receiving?
Ceftriaxone and amikacin.
p.5
Empiric Antibiotic Regimens for Pneumonia and Meningitis
What is the preferred antibiotic for community-acquired pneumonia and meningitis?
3rd generation cephalosporin (ceftriaxone or cefotaxime).
p.31
Antitubercular Therapy for Pulmonary Tuberculosis
What is a major adverse effect of Pyrazinamide?
Hepatotoxicity; contraindicated in liver disease.
p.40
Dyslipidemia Management and Statin Therapy
What are gemfibrozil and fenofibrate classified as?
Lipoprotein lipase activators, also known as fibrates.
p.52
Dyslipidemia Management and Statin Therapy
What is the family medical history of the woman?
Strong family history of cardiovascular disease.
p.18
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
What is the most effective treatment for COPD?
Triple therapy (LAMA - LABA - ICS).
p.30
Antitubercular Therapy for Pulmonary Tuberculosis
What does Pyrazinamide help to do in tuberculosis treatment?
It helps shorten the duration of treatment.
p.4
Pediatric Antimicrobial Therapy Guidelines
What pathogens are commonly found in children aged 1 to 3 months?
Chlamydia, RSV, Pneumococcus, Staph. Aureus.
p.10
Guidelines for Asthma and COPD Treatment
How do β2 agonists affect mast cells?
They decrease mast cell mediator release.
p.6
Empiric Antibiotic Regimens for Pneumonia and Meningitis
What is the diagnosis of the 55-year-old patient?
Ventilator-associated pneumonia.
p.17
Guidelines for Asthma and COPD Treatment
What is the risk associated with SABA-only treatment?
Overuse and associated risks.
p.7
Case Study of a 50-Year-Old Man with Pneumonia and Meningitis
What did the chest X-ray reveal?
Bilateral interstitial infiltrates.
p.35
Antitubercular Therapy for Pulmonary Tuberculosis
What is the significance of treating TB in pregnancy?
Treated TB poses no problem for the mother or baby.
p.17
Guidelines for Asthma and COPD Treatment
What is recommended for Steps 1-2 in asthma management?
Low-dose ICS with formoterol as needed.
p.44
Drug Interactions and Theophylline Toxicity
Which drugs can interact with statins to increase the risk of myopathy?
Fibrates, niacin, cyclosporine, azoles, clarithromycin, cimetidine, and rifampicin.
p.5
Empiric Antibiotic Regimens for Pneumonia and Meningitis
What should be avoided in this patient's treatment?
Amino cephalosporins (1st generation).
p.31
Antitubercular Therapy for Pulmonary Tuberculosis
How can Pyrazinamide affect blood sugar levels?
It can cause hyperglycemia, leading to loss of diabetes control.
p.15
Guidelines for Asthma and COPD Treatment
What is one of the benefits of ICS in terms of symptomatic relief?
They provide more complete and sustained symptomatic relief.
p.4
Pediatric Antimicrobial Therapy Guidelines
What are the usual pathogens for infants up to 1 month?
Group B Streptococcus, H. Influenzae, RSV.
p.37
Antitubercular Therapy for Pulmonary Tuberculosis
What is the primary reason for using combination therapy in tuberculosis treatment?
A. Delay or prevent the emergence of resistance.
p.33
Antitubercular Therapy for Pulmonary Tuberculosis
In what cases is Streptomycin used?
In 'previously treated' cases.
p.22
Pediatric Antimicrobial Therapy Guidelines
Which inhaler is most likely associated with Candida infection?
Beclomethasone metered dose inhaler.
p.28
Antitubercular Therapy for Pulmonary Tuberculosis
What causes resistance to Rifampicin?
Mutation in the rpoB gene.
p.38
Antitubercular Therapy for Pulmonary Tuberculosis
What is the diagnosis of the 50-year-old patient?
Multidrug-resistant tuberculosis.
p.44
Dyslipidemia Management and Statin Therapy
What are common adverse drug reactions (ADRs) associated with statins?
Headache, dyspepsia, elevated liver enzymes, muscle pain, and myopathy.
p.5
Empiric Antibiotic Regimens for Pneumonia and Meningitis
Why is vancomycin administered in this case?
To cover for potential resistant pneumococcus until culture results are available.
p.32
Antitubercular Therapy for Pulmonary Tuberculosis
Why should Ethambutol be avoided in young children?
Due to the risk of optic neuritis and its effects on vision.
p.1
Case Study of a 50-Year-Old Man with Pneumonia and Meningitis
What were the vital signs of the patient upon examination?
Febrile at 38.7 °C, hypotensive at 90/54 mm Hg, tachypneic at 36/min, and tachycardic at 110/min.
p.1
Case Study of a 50-Year-Old Man with Pneumonia and Meningitis
What did the chest X-ray reveal?
Left lower lung consolidation consistent with pneumonia.
p.1
Case Study of a 50-Year-Old Man with Pneumonia and Meningitis
What is the plan for the patient's treatment?
Start empiric antibiotics and perform a lumbar puncture to rule out bacterial meningitis.
p.1
Empiric Antibiotic Regimens for Pneumonia and Meningitis
How does the history of amoxicillin rash affect antibiotic choice?
It may necessitate avoiding amoxicillin, but does not necessarily limit other antibiotic options.
p.13
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
What is one mechanism of action of methylxanthines?
Phosphodiesterase (PDE) inhibition, which increases cAMP.
p.18
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
What often precipitates exacerbations in COPD patients?
Bacterial respiratory infections.
p.22
Pediatric Antimicrobial Therapy Guidelines
What are the other inhalers mentioned that are less likely to cause Candida infection?
Salbutamol rotahaler and Ipratropium inhaler.
p.38
Antitubercular Therapy for Pulmonary Tuberculosis
What symptom did the 50-year-old patient develop after a few months on antitubercular drugs?
Inability to distinguish between red and green color.
p.7
Case Study of a 50-Year-Old Man with Pneumonia and Meningitis
What symptoms did the 27-year-old man present with?
Low-grade fever, non-productive cough, and diffuse muscle aches.
p.5
Empiric Antibiotic Regimens for Pneumonia and Meningitis
What bacteria are targeted by the preferred antibiotics for pneumonia and meningitis?
Pneumococcus, meningococcus, and Haemophilus.
p.44
Drug Interactions and Theophylline Toxicity
What effect do CYP inhibitors have on blood levels of statins?
They increase blood levels of statins.
p.41
Dyslipidemia Management and Statin Therapy
What effect do statins have on endogenous cholesterol production?
They decrease endogenous cholesterol production.
p.41
Dyslipidemia Management and Statin Therapy
How do statins affect LDL receptors?
They increase the expression of LDL receptors on the liver and peripheral tissues.
p.15
Guidelines for Asthma and COPD Treatment
What is a rapid effect of inhaled corticosteroids (ICS)?
They have a rapid anti-inflammatory effect within a few hours.
p.41
Dyslipidemia Management and Statin Therapy
Which statins are considered prodrugs?
Lovastatin and simvastatin.
p.18
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
What is the preferred prophylactic treatment for COPD?
Combination of long-acting β2 agonist (LABA) with Tiotropium/Umeclidinium (LAMA) given by inhalation.
p.51
Dyslipidemia Management and Statin Therapy
What are the risk factors for coronary artery disease in the subject?
Male above 45 years, BMI > 25, raised total and LDL-cholesterol, low HDL-C (< 40 mg/dl).
p.43
Dyslipidemia Management and Statin Therapy
How do statins affect atherosclerotic plaques?
They stabilize atherosclerotic plaques.
p.48
Dyslipidemia Management and Statin Therapy
What are fibrates used for?
To activate lipoprotein lipase and regulate lipid levels.
p.49
Dyslipidemia Management and Statin Therapy
What effect do fibrates have on LDL and HDL levels?
They lower LDL and increase HDL.
p.22
Pediatric Antimicrobial Therapy Guidelines
What condition did the 22-year-old college student present with?
Soreness of mouth and throat irritation, typical signs of thrush.
p.28
Antitubercular Therapy for Pulmonary Tuberculosis
What type of bacteria does Rifampicin target?
It targets slow growers, spurters, and persisters.
p.14
Guidelines for Asthma and COPD Treatment
What is the mechanism of action of inhaled corticosteroids?
Inhibition of phospholipase A2.
p.17
Guidelines for Asthma and COPD Treatment
What should adults and adolescents not be treated solely with for asthma?
Short-acting β2-agonist (SABA).
p.5
Empiric Antibiotic Regimens for Pneumonia and Meningitis
What is the concern regarding the patient's history with amoxicillin?
The patient has a history of rash, but it was inconsistent with an anaphylactic reaction.
p.1
Case Study of a 50-Year-Old Man with Pneumonia and Meningitis
What is the patient's medical history?
He is a known hypertensive and allergic to amoxicillin.
p.32
Antitubercular Therapy for Pulmonary Tuberculosis
Is Ethambutol safe to use during pregnancy?
Yes, it is considered safe in pregnancy.
p.32
Antitubercular Therapy for Pulmonary Tuberculosis
What are some common adverse effects of Ethambutol?
Hyperuricemia, rashes, fever, nausea, and gastrointestinal discomfort.
p.41
Dyslipidemia Management and Statin Therapy
Name two examples of statins.
Atorvastatin and Rosuvastatin.
p.13
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
What are the oral methylxanthines used in COPD and asthma?
Theophylline, Doxophylline, Acebrophylline.
p.15
Guidelines for Asthma and COPD Treatment
How do ICS impact asthma exacerbations?
They decrease asthma exacerbations.
p.4
Pediatric Antimicrobial Therapy Guidelines
What is the empirical therapy for infants up to 1 month?
Ampicillin-sulbactam, Cephalosporin (3rd gen), Ribavirin.
p.20
Drug Interactions and Theophylline Toxicity
What happens to theophylline metabolism when erythromycin is taken?
It is inhibited, causing a rise in plasma concentration.
p.25
Antitubercular Therapy for Pulmonary Tuberculosis
What does the continuation phase of tuberculosis treatment involve?
2-3 drugs for 4-5 months to eliminate remaining bacilli and prevent relapse.
p.46
Dyslipidemia Management and Statin Therapy
What is the mechanism of action (MOA) of Nicotinic Acid?
Inhibits intracellular lipolysis in adipose tissue, leading to decreased free fatty acids in blood and decreased triglyceride synthesis in the liver.
p.28
Antitubercular Therapy for Pulmonary Tuberculosis
What is the primary action of Rifampicin?
It is tuberculocidal, killing both extracellular and intracellular bacilli.
p.16
Management of COVID-19 in Non-Hospitalized Patients
Which institution is mentioned in the context?
Faculty of Medicine, Jazan University.
p.10
Guidelines for Asthma and COPD Treatment
What is one benefit of β2 agonists regarding mucociliary function?
They increase mucociliary clearance.
p.53
Dyslipidemia Management and Statin Therapy
What is the age and health condition of the patient in the problem?
A 45-year-old obese man with a family history of coronary artery disease.
p.38
Antitubercular Therapy for Pulmonary Tuberculosis
Which antitubercular drug options were presented in the problem?
Pyrazinamide, Ethambutol, Cycloserine, Isoniazid.
p.41
Dyslipidemia Management and Statin Therapy
What is the primary action of statins?
Inhibit HMGCoA reductase enzyme.
p.32
Antitubercular Therapy for Pulmonary Tuberculosis
What is a significant adverse effect of Ethambutol?
Optic neuritis, which can lead to color blindness and decreased visual acuity.
p.30
Antitubercular Therapy for Pulmonary Tuberculosis
What is the primary action of Pyrazinamide (Z)?
It is tuberculocidal and kills intracellular organisms.
p.30
Antitubercular Therapy for Pulmonary Tuberculosis
What type of drug is Pyrazinamide considered?
A pro drug, activated by acidic medium.
p.51
Dyslipidemia Management and Statin Therapy
What medication should be used to lower LDL-C?
A statin drug, such as atorvastatin 20 mg/day or rosuvastatin 10 mg/day.
p.12
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
What is the effect of M3 receptor blockade by anticholinergics?
It decreases cholinergic tone.
p.45
Dyslipidemia Management and Statin Therapy
What is the role of NPC1L1 in relation to Ezetimibe?
NPC1L1 is involved in cholesterol absorption, which Ezetimibe inhibits.
p.25
Antitubercular Therapy for Pulmonary Tuberculosis
What is Directly Observed Therapy (DOT)?
A treatment method where a healthcare worker observes the patient to ensure treatment completion.
p.48
Dyslipidemia Management and Statin Therapy
What is one effect of fibrates on fatty acids?
They increase fatty acid oxidation.
p.30
Antitubercular Therapy for Pulmonary Tuberculosis
What does Pyrazinamide inhibit in bacteria?
Mycolic acid synthesis in the cell wall.
p.12
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
How do anticholinergics interact with β2 agonists?
They are synergistic with β2 agonists.
p.43
Dyslipidemia Management and Statin Therapy
What immune effect do statins have?
They cause immune suppression.
p.9
Guidelines for Asthma and COPD Treatment
What are anticholinergics used for in asthma management?
They are parasympathetic blockers.
p.49
Dyslipidemia Management and Statin Therapy
What are some common adverse drug reactions (ADRs) associated with fibrates?
GI side effects, elevated liver enzymes, cholesterol gallstones, myopathy with statins, and rashes.
p.8
Empiric Antibiotic Regimens for Pneumonia and Meningitis
What antibiotic was prescribed to the patient?
Erythromycin 250 mg four times a day for 5 days.
p.34
Antitubercular Therapy for Pulmonary Tuberculosis
What does XDR-TB stand for?
Extensively drug-resistant tuberculosis.
p.53
Dyslipidemia Management and Statin Therapy
Which serum concentrations should be regularly checked while on atorvastatin?
Alanine and aspartate aminotransferase.
p.41
Dyslipidemia Management and Statin Therapy
What is the result of increased LDL receptor expression?
Increased uptake of LDL from blood, leading to decreased LDL levels in blood.
p.18
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
How does the responsiveness of COPD to corticosteroids compare to asthma?
COPD is less responsive to corticosteroids than asthma.
p.31
Antitubercular Therapy for Pulmonary Tuberculosis
What are some common side effects of Pyrazinamide?
Arthralgia, abdominal pain, fever, rashes, flushing.
p.30
Antitubercular Therapy for Pulmonary Tuberculosis
When is Pyrazinamide most effective?
When inflammation is present, used only in the intensive phase.
p.2
Empiric Antibiotic Regimens for Pneumonia and Meningitis
What is the recommended treatment for high-risk adult inpatient CAP in the ICU?
Combination of IV β-lactam and clarithromycin/azithromycin or a respiratory fluoroquinolone.
p.43
Dyslipidemia Management and Statin Therapy
What effect do statins have on endothelial function?
They improve endothelial function.
p.3
Management of COVID-19 in Non-Hospitalized Patients
What is the first oral antiviral for the treatment of COVID-19?
Oral Ritonavir-Boosted Nirmatrelvir (Paxlovid).
p.21
Guidelines for Asthma and COPD Treatment
What is the peak expiratory flow percentage of the patient?
Less than 50% of the predicted value.
p.43
Dyslipidemia Management and Statin Therapy
What role do statins play in fibrinolysis?
They enhance fibrinolysis.
p.4
Pediatric Antimicrobial Therapy Guidelines
What pathogens are associated with children aged 3 months to 6 years?
Pneumococcus, H. influenzae, RSV.
p.19
Management of Chronic Obstructive Pulmonary Disease (COPD)
What antibiotic was prescribed to the patient?
Erythromycin 250 mg four times a day.
p.48
Dyslipidemia Management and Statin Therapy
What is the effect of fibrates on LDL receptors?
They increase LDL receptor expression.
p.36
Antitubercular Therapy for Pulmonary Tuberculosis
What is the risk associated with isoniazid and pyrazinamide for this patient?
Increased risk of developing hepatotoxicity due to history of alcohol use.
p.42
Dyslipidemia Management and Statin Therapy
What is the distribution characteristic of statins?
High protein plasma binding (PPB).
p.12
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
What is the role of Tiotropium, Glycopyrronium, and Umeclidinium in COPD management?
They are used for long-term prophylaxis, improving functional capacity and reducing exacerbations.
p.3
Management of COVID-19 in Non-Hospitalized Patients
What should be the condition of non-hospitalized patients for them to be treated with these antiviral options?
They should have mild-moderate COVID-19 without evidence of viral pneumonia or hypoxia.
p.50
Dyslipidemia Management and Statin Therapy
What is the primary use of Bempedoic acid?
For familial hypercholesterolemia and as an add-on with statins.
p.39
Case Study of a 50-Year-Old Man with Pneumonia and Meningitis
What should be the goal of drug therapy for this patient?
To lower LDL-C levels and reduce cardiovascular risk.
p.50
Dyslipidemia Management and Statin Therapy
What is the primary use of Mipomersen?
For homozygous familial hypercholesterolemia.
p.40
Dyslipidemia Management and Statin Therapy
What is the mechanism of action of nicotinic acid?
Inhibits lipolysis and triglyceride synthesis.
p.40
Dyslipidemia Management and Statin Therapy
What type of drugs are cholestyramine, colestipol, and colesevelam?
Bile acid-binding resins.
p.43
Dyslipidemia Management and Statin Therapy
What are the pleiotropic effects of statins?
They include stabilization of atherosclerotic plaques, improved endothelial function, inhibition of inflammatory processes in atherogenesis, decreased platelet aggregability, enhanced fibrinolysis, increased neovascularization of ischemic tissue, immune suppression, and osteoclast apoptosis with increased synthetic activity in osteoblasts.
p.45
Dyslipidemia Management and Statin Therapy
What is the mechanism of action of Ezetimibe?
It is a cholesterol absorption inhibitor.
p.49
Dyslipidemia Management and Statin Therapy
What is the primary effect of fibrates on triglycerides (TG)?
They reduce triglycerides by 20-50%.
p.31
Antitubercular Therapy for Pulmonary Tuberculosis
What should be done if adverse effects occur with Pyrazinamide?
Stop the medication and do not restart.
p.2
Empiric Antibiotic Regimens for Pneumonia and Meningitis
What are some examples of β-lactam antibiotics used for treating CAP?
Ceftriaxone, Cefotaxime, Ampicillin-sulbactam.
p.4
Pediatric Antimicrobial Therapy Guidelines
What is the empirical therapy for children aged 1 to 3 months?
Macrolide, Ribavirin, Cephalosporin (2nd gen).
p.13
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
What are the cardiovascular effects of methylxanthines?
Vasodilatation and contraction of cardiac muscle.
p.15
Guidelines for Asthma and COPD Treatment
What adverse effects are associated with ICS?
Oropharyngeal candidiasis, dysphonia, cough, and throat irritation.
p.48
Dyslipidemia Management and Statin Therapy
How do fibrates affect triglyceride clearance?
They increase the clearance of triglycerides.
p.19
Drug Interactions and Theophylline Toxicity
What symptoms did the patient present after 3 days of treatment?
Epigastric pain, restlessness, irritability, inability to sleep, palpitation, tremor, and vomiting.
p.51
Dyslipidemia Management and Statin Therapy
What should be monitored after starting lipid-lowering therapy?
Repeat the lipid profile after 4-6 weeks.
p.4
Pediatric Antimicrobial Therapy Guidelines
What is the empirical therapy for children older than 6 years?
Cephalosporin, Amox-clavulanate, Macrolide.
p.36
Antitubercular Therapy for Pulmonary Tuberculosis
How should dolutegravir be administered if chosen for the patient?
Twice daily due to interaction with rifampicin.
p.8
Case Study of a 50-Year-Old Man with Pneumonia and Meningitis
What symptoms did the patient present after 3 days of treatment?
Epigastric pain, restlessness, irritability, inability to sleep, palpitation, tremor, and vomiting.
p.42
Dyslipidemia Management and Statin Therapy
What are the primary uses of statins?
Primary and secondary dyslipidemia.
p.50
Dyslipidemia Management and Statin Therapy
What is the primary use of PCSK9 inhibitors?
For familial hypercholesterolemia and hypercholesterolemia not responsive to oral therapy.
p.26
Classification and Mechanism of Antitubercular Drugs
What is the role of Ethionamide in tuberculosis treatment?
It is a second-line antitubercular drug.
p.29
Antitubercular Therapy for Pulmonary Tuberculosis
What abdominal symptoms may occur with Rifampicin?
Nausea, vomiting, and abdominal cramps.
p.20
Drug Interactions and Theophylline Toxicity
What symptoms indicate early-stage theophylline toxicity?
Recently developed symptoms after taking erythromycin.
p.25
Antitubercular Therapy for Pulmonary Tuberculosis
What is the initial phase of tuberculosis treatment?
An intensive phase with 4-5 drugs for 2-3 months.
p.18
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
What is Roflumilast used for in COPD treatment?
It is an add-on therapy for severe COPD with frequent exacerbations.
p.12
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
What are examples of short-acting and long-acting anticholinergics?
Ipratropium (short-acting), Tiotropium, Glycopyrronium, Umeclidinium (long-acting).
p.24
Case Study of a 50-Year-Old Man with Pneumonia and Meningitis
What is the age and background of the patient in the case study?
A 55-year-old man who is a chronic alcoholic.
p.15
Guidelines for Asthma and COPD Treatment
What beneficial interaction do ICS have with beta 2 agonists?
They increase smooth muscle responsiveness to beta 2 agonists.
p.9
Guidelines for Asthma and COPD Treatment
What are the two main classifications of asthma medications?
Relievers and Controllers.
p.25
Antitubercular Therapy for Pulmonary Tuberculosis
What is the treatment for latent tuberculosis infection?
Monotherapy with Isoniazid in the absence of signs or symptoms.
p.21
Guidelines for Asthma and COPD Treatment
What is the role of Salmeterol in asthma management?
It is a long-acting bronchodilator, not typically used for acute exacerbations.
p.47
Dyslipidemia Management and Statin Therapy
What are common adverse drug reactions (ADRs) associated with niacin?
Flushing, itching, hot feeling, dyspepsia, diarrhea, hepatotoxicity, hyperglycemia, and hyperuricemia.
p.3
Management of COVID-19 in Non-Hospitalized Patients
List some high-risk conditions for disease progression in COVID-19.
Diabetes, cardiovascular disease, hypertension, chronic lung diseases, immunocompromised status, chronic kidney disease, sickle cell disease, neurodevelopmental disorders, pregnancy, and infants aged < 1 year.
p.48
Dyslipidemia Management and Statin Therapy
What is the role of lipoprotein lipase activated by fibrates?
To help clear triglycerides from the bloodstream.
p.12
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
What are common side effects of anticholinergics?
Bitter taste, dry mouth, urinary retention, and potential to precipitate glaucoma in the elderly.
p.29
Antitubercular Therapy for Pulmonary Tuberculosis
What is the effect of food on the oral bioavailability of Rifampicin?
It decreases; therefore, it should be taken on an empty stomach.
p.36
Antitubercular Therapy for Pulmonary Tuberculosis
When should rifabutin replace rifampicin?
If a protease inhibitor-based antiretroviral regimen is used.
p.27
Antitubercular Therapy for Pulmonary Tuberculosis
Is Isoniazid safe to use during pregnancy?
Yes, it is safe in pregnancy.
p.26
Classification and Mechanism of Antitubercular Drugs
What is Kanamycin used for?
It is an antibiotic used in the treatment of tuberculosis.
p.31
Antitubercular Therapy for Pulmonary Tuberculosis
What is the recommendation regarding Pyrazinamide use during pregnancy?
Safety data is inadequate; use only if benefit outweighs risk.
p.51
Dyslipidemia Management and Statin Therapy
What lifestyle changes are recommended for the subject?
Lifestyle changes are recommended alongside lipid-lowering medication.
p.15
Guidelines for Asthma and COPD Treatment
What potential effect do ICS have on disease progression?
They may retard disease progression.
p.48
Dyslipidemia Management and Statin Therapy
Which two fibrates are mentioned?
Fenofibrate and Gemfibrozil.
p.43
Dyslipidemia Management and Statin Therapy
How do statins influence platelet aggregability?
They decrease platelet aggregability.
p.48
Dyslipidemia Management and Statin Therapy
What do fibrates bind to for their action?
PPAR α (Peroxisome Proliferator-Activated Receptor Alpha).
p.12
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
How do inhaled anticholinergics affect systemic absorption?
They decrease systemic absorption, leading to fewer adverse drug reactions (ADRs).
p.24
Case Study of a 50-Year-Old Man with Pneumonia and Meningitis
What symptoms did the patient present with?
Fatigue, weight loss (10 kg), fever, night sweats, productive cough, and recurrent diarrhea.
p.13
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
What are the respiratory effects of methylxanthines?
Bronchodilatation and smooth muscle relaxation.
p.21
Guidelines for Asthma and COPD Treatment
What is the mechanism of action of Theophylline?
It is a bronchodilator that works by relaxing the muscles of the airways.
p.34
Antitubercular Therapy for Pulmonary Tuberculosis
What characterizes MDR-TB?
Resistance to isoniazid (H) and rifampicin (R) or R plus any number of first-line drugs.
p.3
Management of COVID-19 in Non-Hospitalized Patients
What is the role of IV Remdesivir in treating non-hospitalized COVID-19 patients?
It is one of the treatment options for patients at high risk for disease progression.
p.8
Drug Interactions and Theophylline Toxicity
What could be the reason for the patient's recent illness?
Possible Theophylline toxicity due to drug interactions.
p.42
Dyslipidemia Management and Statin Therapy
What are some adjuvant uses of statins?
Atherosclerosis, ischemic heart disease, cerebrovascular disease.
p.50
Dyslipidemia Management and Statin Therapy
What is the mechanism of action of Lomitapide?
It is a microsomal triglyceride transfer protein inhibitor.
p.26
Classification and Mechanism of Antitubercular Drugs
What is Levofloxacin used for?
It is an antibiotic used in the treatment of tuberculosis.
p.52
Dyslipidemia Management and Statin Therapy
Which hypolipidemic drugs should be avoided in this patient due to the risk of aggravating myositis?
Fenofibrate, Nicotinic acid, Atorvastatin.
p.25
Antitubercular Therapy for Pulmonary Tuberculosis
What is the purpose of the initial intensive phase in tuberculosis treatment?
To rapidly kill the bacilli, bring sputum conversion, and afford fast symptomatic relief.
p.45
Dyslipidemia Management and Statin Therapy
Does Ezetimibe have any effect on HDL levels?
No, it has no effect on HDL.
p.49
Dyslipidemia Management and Statin Therapy
In which patients are statins combined with fibrates (fenofibrate)?
In patients with severe hypertriglyceridemia, diabetes, and metabolic syndrome.
p.42
Dyslipidemia Management and Statin Therapy
Why should statins be taken at night?
HMGCoA activity is maximum at night.
p.45
Dyslipidemia Management and Statin Therapy
How is Ezetimibe activated in the body?
It is a prodrug converted to its active form in the intestine.
p.15
Guidelines for Asthma and COPD Treatment
What is a potential vocal effect of ICS?
Atrophy of vocal cords leading to dysphonia.
p.34
Antitubercular Therapy for Pulmonary Tuberculosis
What does MDR-TB stand for?
Multidrug-resistant tuberculosis.
p.19
Drug Interactions and Theophylline Toxicity
What could be the reason for the patient's recent illness?
Possible Theophylline toxicity due to drug interactions.
p.48
Dyslipidemia Management and Statin Therapy
Where do fibrates primarily exert their effects?
In the liver and brown adipose tissue.
p.4
Pediatric Antimicrobial Therapy Guidelines
What should be avoided in pediatric antimicrobial therapy?
Fluoroquinolones and tetracyclines.
p.24
Antitubercular Therapy for Pulmonary Tuberculosis
What drugs should be started for the treatment of presumptive pulmonary tuberculosis?
First-line antitubercular drugs such as isoniazid, rifampicin, pyrazinamide, and ethambutol.
p.8
Drug Interactions and Theophylline Toxicity
Could the patient's illness be prevented?
Yes, by monitoring Theophylline levels and avoiding drug interactions.
p.50
Dyslipidemia Management and Statin Therapy
What are some toxicities associated with PCSK9 inhibitors?
Injection site reactions and nasopharyngitis.
p.26
Classification and Mechanism of Antitubercular Drugs
Which drug is represented by the name Amikacin?
A second-line antitubercular drug.
p.29
Antitubercular Therapy for Pulmonary Tuberculosis
What are some cutaneous adverse effects of Rifampicin?
Flushing, pruritus, and rash.
p.50
Dyslipidemia Management and Statin Therapy
What are the toxicities associated with Mipomersen?
Hepatotoxicity and injection site reactions.
p.19
Management of Chronic Obstructive Pulmonary Disease (COPD)
What medications is the patient taking for COPD?
Tiotropium 20 μg/puff and Theophylline 400 mg SR.
p.13
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
How do methylxanthines help in reversing steroid resistance in COPD?
By enhancing histone deacetylation.
p.3
Management of COVID-19 in Non-Hospitalized Patients
What are the treatment options for non-hospitalized patients with mild-moderate COVID-19?
Oral Ritonavir-Boosted Nirmatrelvir (Paxlovid), IV Remdesivir, or Oral Molnupiravir.
p.8
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
What medications is the patient taking for COPD?
Tiotropium 20 μg/puff MDI and Theophylline 400 mg SR.
p.25
Antitubercular Therapy for Pulmonary Tuberculosis
What is the significance of a positive skin test in latent TB infection?
It indicates the need for treatment with Isoniazid.
p.4
Pediatric Antimicrobial Therapy Guidelines
What pathogens are common in children older than 6 years?
Pneumococcus, Mycoplasma pneumoniae.
p.43
Dyslipidemia Management and Statin Therapy
How do statins affect osteoclasts and osteoblasts?
They induce osteoclast apoptosis and increase synthetic activity in osteoblasts.
p.51
Dyslipidemia Management and Statin Therapy
What is the expected change in HDL-C levels with treatment?
HDL-C level is expected to rise above 40 mg/dl.
p.19
Drug Interactions and Theophylline Toxicity
Could the patient's illness be prevented?
Yes, by monitoring Theophylline levels and avoiding drug interactions.
p.9
Guidelines for Asthma and COPD Treatment
What types of corticosteroids are used in asthma treatment?
Inhaled and systemic corticosteroids.
p.50
Dyslipidemia Management and Statin Therapy
What is the mechanism of action of PCSK9 inhibitors like Evolocumab and Alirocumab?
They complex with PCSK9 and inhibit the catabolism of LDL receptors.
p.27
Antitubercular Therapy for Pulmonary Tuberculosis
What is a rare but serious adverse effect of Isoniazid?
Vasculitis or drug-induced lupus erythematosus.
p.50
Dyslipidemia Management and Statin Therapy
What is the mechanism of action of Bempedoic acid?
It inhibits ATP citrate lyase.
p.39
Case Study of a 50-Year-Old Man with Pneumonia and Meningitis
What medication might be appropriate for this patient if needed?
Statins (e.g., Atorvastatin).
p.2
Empiric Antibiotic Regimens for Pneumonia and Meningitis
What should be used if there is a suspected risk of pseudomonas infection?
Antipseudomonal β-lactam plus ciprofloxacin/levofloxacin or aminoglycoside.
p.3
Management of COVID-19 in Non-Hospitalized Patients
When should Paxlovid be initiated for COVID-19 treatment?
Within 5 days of symptom onset.
p.36
Antitubercular Therapy for Pulmonary Tuberculosis
What four-drug therapy should the patient be started on?
Isoniazid, rifampin, pyrazinamide, and ethambutol.
p.34
Antitubercular Therapy for Pulmonary Tuberculosis
What is the PCR-based method used for diagnosing TB?
Rifampicin resistance testing.
p.30
Antitubercular Therapy for Pulmonary Tuberculosis
What are the mechanisms of resistance to Pyrazinamide?
Mutation and decreased uptake.
p.27
Antitubercular Therapy for Pulmonary Tuberculosis
What are the two types of acetylators in relation to Isoniazid?
Slow acetylators and fast acetylators.
p.2
Empiric Antibiotic Regimens for Pneumonia and Meningitis
What is the purpose of serial monitoring of procalcitonin?
To guide the duration of antibiotic therapy.
p.47
Dyslipidemia Management and Statin Therapy
What causes the flushing and itching associated with niacin use?
Vasodilation due to PGD2.
p.34
Antitubercular Therapy for Pulmonary Tuberculosis
What characterizes XDR-TB?
MDR plus resistance to one second-line injectable and one fluoroquinolone (FQ).
p.27
Antitubercular Therapy for Pulmonary Tuberculosis
What are the mild and severe hepatotoxic effects of Isoniazid?
Mild - increased liver enzymes; Severe - hepatitis and liver damage.
p.24
Drug Interactions and Theophylline Toxicity
Which drug(s) would likely cause toxicity in this patient?
Isoniazid and rifampicin.
p.50
Dyslipidemia Management and Statin Therapy
What are the common toxicities associated with Bempedoic acid?
Hyperuricemia and muscle spasm.
p.29
Antitubercular Therapy for Pulmonary Tuberculosis
What flu-like symptoms can occur with Rifampicin use?
Chills, fever, and headache.
p.8
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
What condition does the patient have?
Moderately severe chronic obstructive pulmonary disease (COPD).
p.2
Empiric Antibiotic Regimens for Pneumonia and Meningitis
What are some antipseudomonal β-lactams mentioned?
Cefepime, ceftazidime, piperacillin-tazobactam, imipenem, or meropenem.
p.4
Pediatric Antimicrobial Therapy Guidelines
What is the empirical therapy for children aged 3 months to 6 years?
Amoxicillin, Cephalosporin (2nd gen), Amox-clavulanate, Ribavirin.
p.24
Case Study of a 50-Year-Old Man with Pneumonia and Meningitis
What significant findings were noted in the patient's chest X-ray?
Right apical infiltrates with hilar lymphadenopathy.
p.13
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
What are potential risks associated with methylxanthine use?
Seizures and arrhythmias.
p.13
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
What is the effect of methylxanthines on mediator release?
They decrease mediator release.
p.9
Guidelines for Asthma and COPD Treatment
What are PDE inhibitors and methylxanthines classified as?
Others in bronchodilators.
p.47
Dyslipidemia Management and Statin Therapy
What caution should be taken when using niacin in diabetic patients?
Caution due to the risk of hyperglycemia.
p.36
Antitubercular Therapy for Pulmonary Tuberculosis
What is a serious concern when using rifampicin with protease inhibitors?
Serious drug-drug interactions.
p.29
Antitubercular Therapy for Pulmonary Tuberculosis
What is a common adverse effect of Rifampicin related to urine?
Orange-red discoloration of urine and body secretions.
p.26
Classification and Mechanism of Antitubercular Drugs
What is the function of P-aminosalicylic acid in tuberculosis treatment?
It is used as a second-line treatment for tuberculosis.
p.34
Antitubercular Therapy for Pulmonary Tuberculosis
What is the lab-based diagnosis method for TB?
CBNAAT - Cartridge-based nucleic acid amplification test (GeneXpert).
p.43
Dyslipidemia Management and Statin Therapy
What is the effect of statins on ischemic tissue?
They increase neovascularization of ischemic tissue.
p.45
Dyslipidemia Management and Statin Therapy
What is the relationship between Ezetimibe and chylomicrons?
Ezetimibe affects the absorption of fats and cholesterol from chylomicrons.
p.12
Therapeutic Management of Chronic Obstructive Pulmonary Disease (COPD)
What is the reason for the greater effectiveness of anticholinergics in COPD?
Due to vagal tone and reversible components.
p.9
Guidelines for Asthma and COPD Treatment
What do leukotriene receptor antagonists inhibit?
Mediators of inflammation.
p.34
Antitubercular Therapy for Pulmonary Tuberculosis
What is the resistance profile of XDR-TB?
Resistant to H, R, second-line injectables, and fluoroquinolones.
p.26
Classification and Mechanism of Antitubercular Drugs
What does Capreomycin treat?
It is used for multidrug-resistant tuberculosis.
p.50
Dyslipidemia Management and Statin Therapy
What is the mechanism of action of Mipomersen?
It targets apoB-100 mainly in the liver.
p.24
Drug Interactions and Theophylline Toxicity
Does the patient have a heightened risk of developing drug toxicity?
Yes, due to chronic alcoholism and HIV.
p.9
Guidelines for Asthma and COPD Treatment
What is the role of mast cell stabilizers in asthma treatment?
To decrease inflammation.
p.39
Case Study of a 50-Year-Old Man with Pneumonia and Meningitis
What lifestyle modifications should be recommended to the patient?
Counseling on lifestyle modification.
p.50
Dyslipidemia Management and Statin Therapy
What is the primary use of Lomitapide?
For homozygous familial hypercholesterolemia.
