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Human Development 2 > Drugs > Flashcards

Drugs Flashcards

1
Q

How can you treat endometriosis

A

 NSAIDs for pain, Norethisterone or COCP (4 packets run together),
 Secondary Care-Danazol and GnRH agonists, Surgery.

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2
Q

How do you treat fibroids

A

 Tranexamic Acid, COCP/LARCs

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3
Q
  • Clomiphene
A

Ovulatory stimulant - causes ovulation to happen

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4
Q

how do you treat hyperprolactinaemia

A

Bromocriptine which is a dopamine agonist

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5
Q

Alpha 1 adrenergic blocker

A
  • Tamulosin
  • • This is an antagonist to the alpha 1 receptor, this causes the smooth muscle to relax and allow the outflow of the urine from the bladder, improves urine outflow
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6
Q

5 alpha reductase inhibitors

A
  • Finasteride
  • Dutasteride
  • can reduce the amount of growth in the prostate
  • these inhibit 5 alpha reductase which is responsible for the conversion of testosterone into DHT
  • DHT drives the proliferation of the epithelial cells so without this apoptosis commences as there is now a less high ratio between DHT and oestradiol allowing apoptosis to be driven
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7
Q

How does viagra work

A

It inhibits PDE5 therefore slowing the breakdown of cGMP

Phosphodiesterase type 5 inhibitor.
o Sildenafil (Viagra)
o Vardenafil (Levitra)
o Taladafil (Cialis)
  • Takes 20-60 minutes and lasts for 6 hours
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8
Q

How do you treat peryronies disease

A

o Non-surgical
 Stretching – break down sar tissue
 Para-aminobenzoate – b vitamin that you can take and rub on, increases oxygen to the penis and improves the scar tissue
 Topical verapamil

o surgical

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9
Q

how do you manage VZV

A
  • prevention
  • varicella zoster immunoglobulin (post exposure)
  • vaccination (pre exposure)
    Treatment (val) acyclovir – safe during pregnancy
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10
Q

What is the treatment of toxoplasmosis

A
  • spyramicin, pyrimethamine/sulfadiazine/folinic acid

* depends on trimester

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11
Q

How do you treat syphilis

A
  • Penicillin
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12
Q

What do you give someone who has group b streptocoosus during labour

A

• Benzylpenicillin in labour

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13
Q

How do you treat urinary tract infections

A
  • Penicillins
  • Cephalosporins
  • Nitrofurantoin
  • BE CAREFUL – trimethoprim teratogenic therefore avoided in the first weeks of pregnancy
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14
Q

What is the treatment of chylmydai and gonnorhea

A

• Azithromycin (tetracyclines are teratogenic)

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15
Q

How do you manage failure to progress in labour

A

Powers – ‘uterine inertia’
= give Syntocinon judiciously – artificial oxytoxcin, 3 to 4 in 10 lasting a minute each

Passenger – ‘malpresentation’ or ‘malposition’
= consider ECV/ rotational forceps or ventouse delivery/ Caesarean section

Passages – ‘contracted pelvis’ or ’rigid cervix’
= Caesarean section

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16
Q

list the uterotonics that can be used and what with

A
  • Syntometrine – drug that is commonly used (made up of oxytocin and ergometrine)

IVI syntocinon 40units in 500ml over 4 hours – drug that causes the uterus to contract (sometimes used in labour)

PGE1 misoprostol 800mg PR - give 4 or 5 tablets into the rectum and this can cause the uterus to go into contraction

PGF2α carboprost 250mcg IM - this causes the uterus to go into contraction, can give 8 doses every 15 minutes in order to control the bleeding

Give IV/IM ergometrine 500 mcg - this causes vasoconstriction

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17
Q

How do you control fits

A

 Loading Dose: MgSO4 (8mls + 12mls saline) over 20 minutes

 Maintenance Dose: 1-2g MgSO4/hr (20 + 30).
o Maintain for 24 hours post-delivery.

 Therapeutic Levels: 2-4mmol/litre.

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18
Q

What are the potential targets for neuroprotection

A
  • Decrease energy depletion - increase glucose, use hypothermia and barbiturates.
  • Glutamate (inhibition of release). = via calcium channel blockers, magnesia, adenosine, hypothermia, free radical scavengers
  • Inhibition of leukocyte/microglial/cytokine effects. = hypothermia, free radical synthesis inhibitors

• Blockage of downstream cellular events.
o Free radical synthesis inhibitors
o Free radic

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19
Q

what is the prevention dn treatment of GBS

A

• Main principles of prevention of vertical transmission
– Intrapartum antibiotic prophylaxis to women who show carriage during screening in pregnancy
– Other risk factors

• Treatment
– Benzylpenicillin with amikacin or gentamicin

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20
Q

how do you treat hypoglycaemia in small for gestational age babies

A

 Feeds

 Bolus of dextrose + IV infusion if very low glucose

21
Q

what antibiotics can you give for GBS, E.coli and listeria

  • for older children
  • and young infants les than 3 months old
A 
•	Older children
–	Ceftriaxone – covers all 3 
•	Young infants (<3 months old)
–	Cefotaxime or ceftriaxone 
–	Amoxicillin (penicillin derivate) also needed for Listeria cover
22
Q

How do you treat empyema caused by pneumoccoal

A
  • use a chest drain and urokinase

- use video assistant thoracoscopic surgery (VATS)

23
Q

What are the two vaccinations used for pneumococcal

A
  • Pneumococcal Polysaccharide Vaccine (PPV) = adults

* Pneumococcal Conjugate Vaccine (PCV). = children

24
Q

How do you treat candida and ring worm

A

 Treat both with topical antifungal (nystatin).

25
Q

how do you treat candidaemia

A
  • IV anti fungal treatment
26
Q

what are the treatments of malaria

A
  • Artemisinin
  • Combination treatment (eg Coartem: artemether-lumefantrine)
  • More rapid reduction in parasitaemia
27
Q

How do you treat retinoblastoma

A
  • small tumours = cryotherapy, laser therapy or thermotherapy is used
  • in more advanced tumours - chemotherapy, surgery and radiation is used
  • Systemic or intraocular chemotherapy can be used to shrink tumours before cryotherapy or laser therapy
28
Q

what is the treatment for a neuroblastoma

A
  • Surgery, chemotherapy, radiation therapy
  • High risk disease – high dose chemotherapy and stem cell transplantation
  • Targeted therapy – crizotinib against ALK mutations
  • Immunotherapy
29
Q

What is the treatment for acute lymphoblastic leukaemia

A

• Patients stratified into risk groups according to clinical, biological and genetic features
• Therapies of varying intensities applied to different risk groups
• Standard treatment phases:
-Induction (e.g.Vincristine, Corticosteroid, L-asparaginase, Anthracycline)
- Consolidation; CNS directed treatment(e.g.Cyclophosphamide, Cytarabine, Mercaptopurine, Methotrexate; Dexamethasone)
- Maintenance(e.g. Mercaptopurine, Methotrexate) - Bone marrow transplantation

30
Q

How to you treat consitpation

A 
- use high dose laxatives or enemas to clear out 
then use maintenance therapy 
Maintenance therapy 
•	Softener – Movicol (PEG 4000)
•	Stimulant – Senna or picosulphate
•	Rectal washout - Enemas/Peristeem
31
Q

what is the medical treatment of GORD

A
  • most do not need treatment
  • positioning of the infant while eating
  • thickening of food
  • reduce acids using H1 antagonists, proton pump inhibitors
  • promotility agents such as domperidone can be used
32
Q

what is the surgical treatment of GORD

A
  • Jejunostomy feeds
  • Nissen’s fundoplication. - this is when you wrap the stomach around the base of the oesophagus therefore preventing food from going back up
33
Q

what is the treatment of eosinophilic oesophagitis

A

• Dietary
o Food exclusions
o Pragmatic trials.

  • Oral budesonide
  • Monteleukast.
34
Q

what is the treatment for h.pylori

A
  • triple therapy
  • use 2 antibiotics amoxycillin and clarithromycin for 2 weeks
  • and a proton pump inhibitors or H2 antagonists such as laproprozole
  • then repeat the stool test for HP antigen 3/12 after treatment to ensure it has gone
35
Q

how do you induce remission in IBD

A

• Exclusive enteral nutrition (Chron’s)
o Reduce inflammation
o Correct undernutrition
o 6/52 of milk based formula

  • Steroids
  • 5-ASA
  • Biologicals (e.g. anti-TNF infliximab).
36
Q

what is the pharmacological treatment of ADHD

A
  • Offer methylphenidate (either short or long acting) as the first line pharmacological treatment for children aged 5years and over and young people with ADHD
  • Consider switching to lisdexamfetamine (prodrug version of methylphenidate)
37
Q

How do you manage idiopathic short stature

A

• Administration of GH

• Oxandrolone - anabolic steroid used for a long time and extradites growth but doesn’t increase adult height
o Very little change in most cases.

38
Q

who does NICE recommend be given somatostatin as treatment

A

Have growth hormone deficiency.

Have Turner syndrome.

Have Prader-Willi syndrome.

Have chronic kidney disease.

Are born small for gestational age with subsequent growth failure at 4 years of age or later.

Have short stature homeobox-containing gene (SHOX) deficiency

39
Q

How do you treat disseminated HSV

A
  • IV Aciclovir
40
Q

How do you treat CMV

A

For babies with symptomatic disease:

- IV ganciclovir (requires a central line) or oral valganciclovir (pro-drug of ganciclovir) – inhibits DNA synthesis

41
Q

How do you reduce the risk of HepB transmission at birth

A
  • give Hep B virus vaccine at birth and then at 1 month of age
  • and HBIG as well (hepatitis B immunoglobulin)
42
Q

What is the treatment for bronchiolitis

A

Palivizumab (monoclonal Ab) for RSV prophylaxis - given monthly as an injection to high risk babies which prevents them from getting RSV infection

43
Q

what vaccines can now be used for rotavirus

A

RotaTeq

RotaRix (included in UK schedule since 2013

44
Q

What is the treatment of chlamydia trachomatis

A

Azithromycin, Doxycycline

45
Q

How do you manage genital warts

A

Vaccination

Management

  • Topical podophyllotoxon, imiquimod
  • Cryotherapy - freeze them of
46
Q

What is the treatment of HSV

A

Aciclovir
Famciclovir - prodrugs
Valaciclovir - prodrugs

47
Q

What is the treatment of syphlis

A

Penicillin - injections

Doxycycline - for allergic to penicillin, slightly less efficous

48
Q

what makes up HAART treatment

A
  • protease inhibitors
  • integrase inhibitors
  • nucleoside reverse transcriptase inhibiters
  • fusion inhibitors
  • Non-Nucleoside RT inhibitor

Human Development 2 (34 decks)

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