Bugs & Drugs
This antibiotic is commonly used to treat serious MRSA infections and requires careful monitoring for nephrotoxicity.
What is Vancomycin?
This medication is a selective serotonin reuptake inhibitor commonly used to treat depression and anxiety in pediatric patients. It also inhibits CYP2D6.
What is fluoxetine?
A child presents with polyuria, polydipsia, weight loss, hyperglycemia, metabolic acidosis, and elevated serum ketones.
What is diabetic ketoacidosis (DKA)?
A neonate receiving ampicillin and gentamicin for suspected sepsis has cultures that remain negative and clinical status improves. What pharmacist intervention should be considered?
What is antibiotic de-escalation/discontinuation?
A patient develops respiratory depression and pinpoint pupils after an opioid overdose. Which medication rapidly reverses opioid-induced respiratory depression?
What is naloxone?
This organism is associated with antibiotic-associated diarrhea and can cause pseudomembranous colitis?
What is Clostridioides difficile?
This antipsychotic is associated with agranulocytosis and requires regular ANC monitoring through a dedicated monitoring program.
What is clozapine?
A child presents with fever, neck stiffness, photophobia, and altered mental status. CSF shows neutrophilic pleocytosis, elevated protein, and decreased glucose.
What is bacterial meningitis?
A patient is prescribed methotrexate 15 mg PO daily for rheumatoid arthritis. What critical prescription error should the pharmacist identify?
What is an incorrect frequency, once weekly?
A child accidentally ingests a large amount of acetaminophen. Which antidote replenishes hepatic glutathione and prevents formation of the toxic metabolite?
Answer: What is N-acetylcysteine (NAC)?
This antibiotic is active against MRSA but is not used to treat pneumonia because pulmonary surfactant inactivates it.
What is daptomycin?
This medication inhibits platelet aggregation by irreversibly inhibiting the P2Y12 receptor. Also is a prodrug that is activated by CYP2C19.
What is clopidogrel?
A child presents with fever, mucosal changes, bilateral conjunctival injection, rash, and swelling of the hands and feet, creating concern for coronary artery complications.
What is Kawasaki disease?
A child with a documented severe immediate hypersensitivity reaction to penicillin has an order for ampicillin IV. What should the pharmacist do?
What is clarify that patient has true allergy and recommend an appropriate alternative if needed?
A patient receiving heparin develops significant bleeding. Which medication binds directly to and neutralizes heparin?
Answer: What is protamine sulfate?
This antibiotic inhibits bacterial protein synthesis at the 50S ribosomal subunit and is commonly used for serious Gram-positive infections, including MRSA. It can be administered orally or by IV
What are Linezolid?
This medication is an NMDA receptor antagonist used for procedural sedation and can cause emergence reactions.
What is ketamine?
A child develops fever, hypotension, altered mental status, prolonged capillary refill, and elevated lactate following a serious bacterial infection despite adequate fluid resuscitation.
What is septic shock?
A patient has an order for potassium chloride 40 mEq IV push for hypokalemia. What should the pharmacist identify?
What is an unsafe route of administration? Administered by controlled IV infusion not a push.
A patient develops life-threatening toxicity after receiving a large dose of methotrexate with delayed clearance despite leucovorin rescue. Which enzyme rapidly converts methotrexate into inactive metabolites?
What is glucarpidase?
This antibiotic is commonly used for serious infections caused by ESBL-producing Enterobacterales but does not provide coverage against Pseudomonas aeruginosa.
What is Ertapenem?
This medication is used to treat tumor lysis syndrome by converting uric acid into the more soluble compound allantoin.
What is rasburicase?
A child presents with fever, encephalopathy, seizures, and acute liver dysfunction after receiving aspirin during a viral illness. Laboratory testing demonstrates markedly elevated ammonia and transaminases with hypoglycemia.
What is Reye syndrome?
A pediatric patient has an order for phenytoin 100 mg IV push over 1 minute. What should the pharmacist identify?
What is an excessively rapid IV administration rate? (not to exceed 50mg/min)
A patient develops severe bleeding after receiving dabigatran. Which monoclonal antibody fragment specifically binds dabigatran and reverses its anticoagulant effect?
What is idarucizumab?