DOCs/Indications Flashcards
1st line for allergic rhinitis
Nasal steroids
1st line for HTN in a patient with CKD (regardless of race or diabetes)
ACE-I or ARB
DOCs for black patients with HTN
HCTZ, CCB
DOCs for non-black patients with HTN
ACE-I, beta blocker
1st line for HTN only if concomitant BPH
Alpha 1 adrenergic antagonists
1st line for Stage A COPD
Short-acting bronchodilator (SABA prn, SAMA, or combo)
1st line for Stage B COPD
Long-acting bronchodilator (LABA or LAMA)
1st line for Stage C COPD
Long-acting anticholinergic (LAMA)
1st line for Stage D COPD
Combination LABA + LAMA
Pain control for end stage renal disease
Fentanyl (patch or parenteral)
Methadone
DOC for DM, CKD, HFrEF (Cardiac lecture, for HTN or STEMI)
ACE Inhibitors
Step 1 asthma control
SABA PRN
Step 2 asthma DOC
low dose inhaled glucocorticoids
DOC for UNcomplicated acute exacerbation of COPD
Macrolide: azithromycin or clarithromycin
DOC for complicated acute exacerbation of COPD
Fluoroquinolone: moxifloxacin
gemifloxacin
levofloxacin
Exercise induced bronchospasm
Montelukast
Off label use for uticaria
Montelukast
Only approved to treat depression
Citalopram (celexa)
Desvenlafaxine (Pristiq)
Mirtazapine (Remeron)
Only approved for GAD
Escitalopram (lexapro)
Opioid induced constipation
Methylnaltrexone
weaker diuretics, more often used for HTN or as adjunct to strengthen loop
Thiazide diuretics
DOC for moving large volumes of fluid (edema, HTN)
Loop diuretics
Overall weak diuretic effect, used in combination with other diuretics, may eliminate need for K+ supplementation
Aldosterone Antagonists
K+ sparing diuretics
The only inotrope used to treat HF
Digoxin
SAD
Buproprion (wellbutrin)
Smoking cessation
Zyban (buproprion)
Elderly patients to help with depression, sleep, and/or appetite/ weight
Mirtazapine (Remeron)
Useful adjunct to H1 blockers for urticaria
H2 blockers
Antihistamines you can give to a transportation driver
Loratadine (Claritin)
Fexofenadine (Allegra)
allergies + BPH
2nd generation antihistamine (no anticholinergic effects=no urinary retention)
Scabies
Permethrin cream (Elimite) 5%
Chronic autoimmune urticaria
Responds well to a non-sedating antihistamine
Poison Ivy
Triamcinolone (Kenalog) steroid cream
+
2nd gen antihistamine
Anaphylaxis
Benadryl + Epi + IM/IV glucocorticoid (Decadron (dexamethasone)
+epi pen long term
Appendicitis
Morphine .05/.1 mg/kg q2-4 hours
+
Antiemetics
T1DM + 2nd degree burns on hands
Give opioids and transfer to burn center
Compression fracture
<5 days of short acting opioid medications
Acute exacerbation of HF
Loop diuretics
Decrease preload AND afterload
ACE inhibitors
ARBs
Mild to moderate HFrEF with symptoms of low energy
Digoxin
if on BB, could also choose to reduce that dose 1st
Prinzmetal (vasospastic) angina
CCB
Pregnancy + refractory HTN
Methyldopa
Prophylaxis to prevent an anginal attack
Nitroglycerin spray/sublingual
Bronchospasm or acute asthma exacerbation
small volume nebulizer (SVN) with short-acting beta agonist
+/- oral glucocorticoid
Bronchodilator + Anti-inflammatory, Purpose = Control COPD
Long Acting B2 Agonist + Inhaled corticosteroid
Managing AKI
fluid resuscitation (NS)
monitor I+Os
monitor potassium
Complicated (renal issues) pneumonia
respiratory fluoroquinolone
OR
beta lactam plus macrolide
pain associated with diabetic neuropathy
Or
fibromyalgia
Duloxetine (Cymbalta)
GERD
H2 blocker
Reflux esophagitis
PPI
Quadruple therapy for an ulcer
PPI
Bismuth
Metronidazole
Tetracycline
Preventing NSAID induced ulcers
Misoprostol
Antispasmodic medication helpful in the treatment of IBS
Dicyclomine
IBS psychosocial component and relief of abdominal pain
Amitriptyline
IBS-D
Eluxadoline
C difficile
Vancomycin or Metronidazole
Diverticulitis
Flagyl + Cipro
Follow up colonoscopy 6-8 weeks
Acute flair of IBD
short burst of Corticosteroids in tapering doses to induce remission
IBD maintanence therapy
Mesalamine (Lialda)
Abx for perianal crohn’s disease
Cipro + Flagyl
Outpatient CAP
oral macrolide (azithromycin, clarithromycin erythromycin) or doxycycline
Inpatient CAP
oral macrolide (azithromycin, clarithromycin erythromycin) or doxycycline
PLUS
Add a β‐lactam (cefotaxime, ceftriaxone, high‐dose ampicillin)
+/- quinolone for antistreptococcal: Moxifloxacin, levofloxacin
CAP with known pathogen: Strep pneumo
High dose PCN
Uncomplicated UTI
Bactrim (TMP-SMX) if no E coli resistance or Nitrofurantoin
Complicated UTI: DM
Ciprofloxacin (effective against P. aeruginosa and Enterobacteriaceae)
PID, unknown pathogen
Ceftriaxone/Cefotaxime IM x1 + Oral Doxycycline
Uncomplicated chlamydia PID
Doxycycline or azithromycin
Gonorrhea PID
Ceftriaxone + Azithromycin
Gonorrhea PID + pregnancy
Ceftriaxone + Azithromycin
same as before
Chlamydia PID + pregnancy
Azithromycin (alternatives if cannot tolerate azithro→ erythromycin or amoxicillin)
NO tetracyclines
Preferred abx in pregnancy
PCNs and cephalosporins
Bacterial Meningitis
3rd generation Cephalosporin (ceftriaxone, cefotaxime)
+/- Vancomycin for PCN resistant strep pneumo
Inpatient cellulitis
Choose one:
Vancomycin
daptomycin
oxazolidinone (linezolid, tedizolid)
Poison Ivy that doesn’t improve
Oral steroid taper
PCN allergy rash
Zyrtec, +/- IM steroids or antihistamin +/- taper oral steroids
If refractory→ adjunct tx H2 blockers→ Ranitidine, Famotidine
Bilateral lower paralumbar muscles, spasm, decreased flexion
No opioids or muscle relaxants
Give all the adjunct therapies
Diabetic neuropathy
Gabapentin (Neurontin)
Pregabalin (Lyrica)
Cymbalta
TENS Unit
Fibromyalgia
Gabapentin (Neurontin)
Pregabalin (Lyrica)
Cymbalta
Most effective for decreasing nocturnal acid formation
H2 blockers
Outpatient cellulitis
Bactrim + tetracycline + clindamycin