This osmotic laxative is first-line for the treatment and prevention of hepatic encephalopathy by reducing ammonia absorption in the gut.
What is lactulose?
This short-acting insulin should be administered approximately 30 minutes before a meal, while rapid-acting insulins can be given immediately prior.
What is regular insulin?
This inhaled or IV medication promotes intracellular potassium uptake via β₂ receptor stimulation and is useful as adjunct therapy in severe hyperkalemia.
What is albuterol (or nebulized β₂ agonist)?
This glycopeptide antibiotic, dosed by weight and adjusted for renal function, inhibits cell wall synthesis and requires trough monitoring to prevent nephrotoxicity.
What is vancomycin?
When this lipid-lowering class is combined with daptomycin, there’s an increased risk of myopathy and rhabdomyolysis.
What are statins?
This non-absorbable antibiotic is often added to lactulose therapy for recurrent hepatic encephalopathy to further reduce ammonia-producing gut bacteria.
What is rifaximin?
If a patient's insulin to carbohydrate ratio is 1:10, how many units of regular insulin should be administered for a meal containing 60 grams of carbohydrates?
What is 6 units?
This intravenous cation does not lower potassium, but stabilizes the cardiac membrane to reduce the risk of arrhythmias in severe hyperkalemia.
What is calcium gluconate (or calcium chloride)? Calcium gluconate is preferred in non-emergent or peripheral access situations due to reduced tissue irritation.
This broad-spectrum penicillin with a β-lactamase inhibitor is a workhorse in the hospital for intra-abdominal infections, diabetic foot infections, and sepsis.
What is piperacillin-tazobactam (Zosyn)?
Combining linezolid with these serotonergic medications (like SSRIs, SNRIs, or TCAs) can lead to this potentially life-threatening condition.
What is serotonin syndrome?
This is recommended diuretic combo regimen for managing ascites and edema in patients with cirrhosis. Provide drug names and dose ratio.
What is spironolactone and furosemide maintaining a 100:40 ratio?
This medication class improves insulin sensitivity but is contraindicated in NYHA Class III–IV heart failure due to risk of fluid retention.
What is thiazolidinedione (TZD)? pioglitazone (or rosiglitazone)?
This rapid-acting agent shifts potassium into cells by stimulating the Na⁺/K⁺-ATPase pump and is typically given with glucose to avoid hypoglycemia. Give route of administration and dose.
What is regular insulin (with dextrose)? IV 5-10 units.
This oxazolidinone antibiotic, available IV and orally, covers resistant gram-positive organisms including MRSA and VRE — but prolonged use can cause thrombocytopenia and serotonin syndrome.
What is linezolid?
This antibiotic, commonly used for UTIs and MRSA skin infections, can cause hyperkalemia and increased serum creatinine. List the name of the antibiotic and concomitant medications that could be problematic.
What is trimethoprim-sulfamethoxazole (Bactrim, TMP-SMX)? K raising medications.
Patients with variceal bleeding due to portal hypertension may receive these non-selective beta blocker for secondary prevention by reducing portal venous pressure. Name one.
What is propranolol or nadolol?
For patients with diabetic neuropathy, these two medications are FDA-approved to manage neuropathic pain associated with diabetes.
What are duloxetine and pregabalin? (tapentadol ER and capsaicin 8% topical)
This newer inpatient potassium binder, with a fast onset (within 1–2 hours), exchanges potassium for sodium and hydrogen and can be used in both acute and chronic settings.
What is sodium zirconium cyclosilicate (Lokelma)?
Oral vancomycin is considered first-line for C. difficile infection treatment (along with fidaxomicin). When treating a patient with oral vancomycin would your recommend vancomycin level monitoring (trough, peak, random)?
What is no? Oral vancomycin has poor systemic absorption and acts directly in the intestines.
Warfarin and metronidazole can dangerously increase bleeding risk due to inhibition of this metabolic enzyme.
What is CYP2C9?
This IV colloid solution is used after large-volume paracentesis (>5 L removed) to prevent paracentesis-induced circulatory dysfunction.
What is albumin?
A patient is going to convert from his U-100 regular insulin to U-500 insulin. He currently uses 100 units of U-100 regular insulin with his evening meal. How many mL of U-500 insulin will he need with his evening meal to get the same dose?
what is 0.2 ml?
This cation exchange resin, once a mainstay for hyperkalemia, exchanges sodium for potassium in the gut but is less preferred due to delayed onset and GI side effects.
What is sodium polystyrene sulfonate (Kayexalate)?
During rounds your patient is diagnosed with PNA. The patient has risk factors for MRSA. The MD wants to order daptomycin to provide empiric coverage for MRSA. What would be your recommendation in this scenario?
Daptomycin is explicitly not recommended for treating pneumonia because it is inactivated by pulmonary surfactant.
Coadministration of MAO inhibitors with tyramine-rich foods can precipitate this dangerous adverse event due to excessive catecholamine release.
What is hypertensive crisis?