Classic/Relevant Treatments (First Line per First Aid) Flashcards by Kenneth Felsenstein

Absence seizures

Ethosuximide

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Acute gout attack

NSAIDs, colchicine, glucocorticoids

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Acute promyelocytic leukemia (M3)

All-trans retinoic acid

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ADHD

Methylphenidate, amphetamines, CBT, atomoxetine

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Alcoholism

Disulfiram, acamprosate, naltrexone, supportive care (AA)

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Alcohol withdrawal

Long Acting Benzodiazepines

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Anorexia

Nutrition, psychotherapy, mirtazapine, SSRIs

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Anticoagulation during pregnancy

Heparin

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Arrhythmia in damaged cardiac tissue

Class IB antiarrhythmic (lidocaine, mexiletine, tocainide)

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B12 deficiency

Vitamin B12 supplementation (work up cause with Schilling test)

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Benign prostatic hyperplasia

a1 antagonists (Tamsulosin), 5a-reductase inhibitors (Finasteride), PDE-5 inhibitors

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Bipolar disorder

Lithium, valproate, carbamazepine, lamotrigine (mood

stabilizers), atypical antipsychotics

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Breast cancer in postmenopausal woman

Aromatase inhibitor (anastrozole)

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Buerger’s disease

Smoking cessation

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Bullimia nervosa

SSRIs

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Candida albicans

Topical azoles (vaginitis); nystatin, fluconazole, caspofungin (oral/esophageal); fluconazole, caspofungin, amphotericin B (systemic)

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Carcinoid syndrome

Octreotide

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Chlamydia trachomatis

Doxycycline (+ ceftriaxone for gonorrhea coinfection), erythromycin eye drops (prophylaxis in infants)

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Chronic gout

Xanthine Oxidase Inhibitors (e.g. allopurinol, febuxostat), Probenecid (underexcretor)

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Chronic hepatitis B or C

IFN-a (HBV & HCV); ribavarin, simeprevir, sofosbuvir (HCV)

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Chronic myelogenous leukemia

Imatinib

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Clostridium botulinum

Antitoxin

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Clostridium difficile

Oral metronidazole; if refractory, oral vancomycin

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Clostridium tetani

Antitoxin + vaccine booster + diazepam

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Crohn's disease

Corticosteroids, infliximab, azathioprine

Cryptococcus neoformans

Fluconazole (prophylaxis in AIDS patients)

Cyclophosphamide-induced hemorrhagic cystitis

Mesna

Cystic fibrosis

N-acetylcysteine + antipseudomonal prophylaxis (tobramycin/ azithromycin)

CMV

Ganciclovir, foscarnet, cidofovir

Depression

SSRIs (first-line)

Diabetes insipidus

Desmopressin (central); hydrochlorothiazide, indomethacin, amiloride (nephrogenic)

Diabetes mellitus type 1

Dietary intervention (low-sugar) + insulin replacement

Diabetes mellitus type 2

Dietary intervention, oral hypoglycemics, and insulin (if refractory)

Diabetic ketoacidosis

Fluids, insulin, K+

Enterococci

Vancomycin, aminopenicillins/cephalosporins

Erectile dysfunction

Sildenafil, tadalafil, vardenafil

ER-positive breast cancer

Tamoxifen

Ethylene glycol/methanol intoxication

Fomepizole (alcohol dehydrogenase inhibitor)

Haemophilus influenzae (B)

Rifampin (prophylaxis)

Generalized anxiety disorder

SSRIs, SNRIs (first line); buspirone (second line)

Granulomatosis with polyangiitis (Wegener)

Cyclophosphamide, corticosteroids

Heparin reversal

Protamine sulfate

HER2/neu-positive breast cancer

Trastuzumab

Hyperaldosteronism

Spironolactone

Hypercholesterolemia

Statin (first-line)

Hypertriglyceridemia

Fibrate

Immediate anticoagulation

Heparin

Infertility

Leuprolide, GnRH (pulsatile), clomiphene

Influenza

Oseltamivir, zanamivir

Kawasaki Disease

IVIG, high-dose aspirin

Legionella pneumophila

Macrolides (e.g. azithromycin)

Long-term anticoagulation

Warfarin, dabigatran, rivaroxaban, and apixaban

Malaria

Chloroquine, mefloquine, atovaquone/proguanil (for blood schizont), primaquine (for liver hypnozoite)

Malignant hyperthermia

Dantrolene

Medical abortion

Mifepristone

Migraine

Abortive therapies (e.g. sumatriptan, NSAIDs); prophylaxis (e.g. propanolol, topiramate, CCBs, amitriptyline)

Multiple sclerosis

Disease modifying therapies (i.e. B-interferon, natalizumab); for acute flares, use IV steroids

Mycobacterium tuberculosis

RIPE (rifampin, Isoniazid, pyrazinamide, ethambutol)

Neisseria gonorrhoeae

Ceftriaxone (add doxycycline to cover likely concurrent Chlamydia)

Neisseria meningitidis

Penicillin/ceftriaxone, rifampin (prophylaxis)

Neural tube defect prevention

Prenatal folic acid

Osteomalacia/rickets

Vitamin D supplementation

Osteoporosis

Calcium/ vitamin D supplementation (prophylaxis); bisphosphonates, PTH analogs, SERMs, calcitonin, denosumab (treatment)

Patent ductus arteriosus

Close with indomethacin; open or maintain with PGE analogs

Pheochromocytoma

a-antagonists (e.g., phenoxybenzamine)

Pneumocystis jirovecii

TMP-SMX (prophylaxis in AIDS patient)

Prolactinoma

Cabergoline/ Bromocriptine (dopamine agonists)

Prostate adenocarcinoma/uterine fibroids?

Leuprolide, GnRH (continuous)

Prostate adenocarcinoma?

Flutamide

Pseudomonas aeruginosa

Antipseudomonal penicillins + aminoglycosides, carbapanems

Pulmonary arterial hypertension (idiopathic)

Sildenafil, bosentan, epoprostenol

Rickettsia rickettsii

Doxycycline, chloramphenicol (especially in context of aplastic anemia)

Ringworm infections

Terbinafine, griseofulvin, imidazole

Schizophrenia (negative symptoms)

5-HTZA antagonists (e.g., second-generation antipsychotics)

Schizophrenia (positive symptoms)

D2 receptor antagonists (e.g., first- and second-generation antipsychotics)

SIADH

Fluid restriction, IV hypertonic saline, conivaptan/tolvaptan, demeclocycline

Sickle cell anemia

Hydroxyurea (increases fetal hemoglobin)

Sporothrix schenckii

Itraconazole, oral potassium iodide

Stable angina

Sublingual nitroglycerin

Staphylococcus aureus

MSSA: nafcillin, oxacillin, dicloxacillin (antistaphylococcal penicillins); MRSA: vancomycin, daptomycin, linezolid, ceftaroline

Streptococcus bovis

Penicillin prophylaxis; evaluation for colon cancer if linked to endocarditis

Streptococcus pneumoniae

Penicillin/cephalosporin (systemic infection, pneumonia), vancomycin (meningitis)

Streptococcus pyogenes

Penicillin prophylaxis

Temporal arteritis

High-dose steroids

Tonic-clonic seizures

Leviteracetam, phenytoin, valproate, carbamazepine

Toxoplasma gondii

Sulfadiazine + pyrimethamine

Treponema pallidum

Penicillin

Trichomonas vaginalis

Metronidazole (patient and partner)

Trigeminal neuralgia (tic douloureux)

Carbamazepine

Ulcerative colitis

5-ASA preparations (e.g. mesalamine), 6-mercaptopurine, infliximab, colectomy

UTI prophylaxis

TMP-SMX

Warfarin toxicity

Fresh frozen plasma (acute), vitamin K (chronic)