Clinical Scenario//Inferred medication Flashcards
Patient is treated for a pulmonary embolism or deep vein thrombosis
Anticoagulation Heparin Warfarin Xa inhibitors -------------------
Patient is admitted for treatment of a congestive heart failure exacerbation
electrolyte changes :
Patient has a history of autoimmune disease (eg, systemic lupus erythematosus
Cushing syndrome, tertiary adrenal insufficiency, or avascular necrosis of the femoral head:
Patient has a history of rheumatoid arthritis
- Methotrexate-> pulmonary fibrosis,hepatotoxicity, oral ulcers
- hydroxychloroquine-> corneal deposits
- infliximab-> reactivated tuberculosis
Patient has a history of depression
Antidepressants
- SSRIs
- Serotonin-norepinephrine reuptake Inhibitor
- TCAs
- Monoamine oxidase inhibitors
Patient has a history of chronic headaches, joint pain, or back pain
Over-the-counter pain medications: Acetaminophen NSAIDs ---- chronic interstitial nephritis, renal papillary necrosis, decreased renal plasma flow, gastritis
Patient has a history of heart failure and atrial fibrillation
Digoxin
Patient was recently treated for a urinary tract infection y ahora tiene anemia hemolitica
G6PD deficiency
Patient was recently treated for tuberculosis
B6 deficiency (Pyridoxine) and sideroblastic anemia
Patient was treated for bacterial pneumonia or a chronic obstructive pulmonary disease exacerbation
QT prolongation and torsades de pointes
Patient was treated for herpes simplex virus encephalitis
crystalline nephropathy due to acyclovir therapy
Patient received chemotherapy for breast cancer
2
- *Tamoxifen -> increased risk of endometrial cancer
* *Trastuzumab-> dilated cardiomyopathy
Proxilaxis Neutropenic Fever
Temp > 38
Neutrofilos < 500
1) granulocyte colony-stimulating factor (GCSF) to stimulate granulocyte production
2) Antibioticos -> piperacillin-tazobactam, cefepime, vancomycin, and fluoroquinolones.
community-acquired pneumonia
Macrolidos (azithromycin and clarithromycin )
-binding to the 50S subunit of RNA
o
bind to the 30S subunit of RNA (Doxycycline)
————
Prolongan el QT
patients have been treated for pneumonia within the previous 3 months
Prolongan el QT y relacionadas a rotura del tendon de aquiles.
2)Penicillins act by interfering with the transpeptidation reaction in bacterial cell wall synthesis and inhibit peptidoglycan
treatment of Pneumocystis jiroveci pneumonia
1) Trimethoprim/sulfamethoxazole acts by inhibition of dihydrofolate reductase
or 2) dapsone
cryptococcal meningitis
1) amphotericin B and flucytosine
CMV meningitis/encephalitis
Foscarnet
Ganciclovir
cluster headaches (acute management)
100% O2 or sumatriptan
cluster headaches (prophylaxis)
Verapamil
Migraine (acute management)
NSAIDs, triptans, or dihydroergotamine
Migraine (prophylaxis)
Lifestyle changes amitriptyline topiramate valproate beta-blockers
Tension headaches (acute management)
Analgesics (eg, NSAIDs or acetaminophen)
Tension headaches (prophylaxis)
Amitriptyline, behavioral therapy
nephroprotective in patients with diabetes mellitus
1) ACE’s
2) ARB’s
heparin-induced thrombocytopenia (HIT)
- Patients receiving heparin therapy
- Acute drop in platelets (≥50% in type II)
1) Inhibidores del factor Xa-> fondaparinux
2) Direct thrombin inhibitors-> argatroban and bivalirudin.
postoperative arthroplasty patient
Se anticoagulant normalmente con heparina
Patient develops delirium (or has worsening delirium) following treatment with a neuroleptic agent (eg, haloperidol)
Underlying Diagnosis-Lewy Body dementia
Alcoholic develops encephalopathy and/or nystagmus after treatment with glucose/dextrose
Thiamine deficiency
Patient with macrocytic anemia develops neurologic symptoms following treatment with folate supplementation
Vitamin B12 deficiency
Patient develops abdominal pain, polyneuropathy, and port-wine colored urine after treatment with a cytochrome P-450 inducer
Acute intermittent porphyria
Chest pain following treatment with sumatriptan
Variant (vasospastic) angina
