General Question Flashcards
What are the three most common orthopedic presentations of the shoulder and the major test used to evaluate them?
Glenohumeral joint instability
—Glenohumeral apprehension test
Rotator cuff injury
—Apley’s scratch test
—Codman’s (drop-arm) test
—Hawkins-Kennedy (Neer’s) test
Bicipital instability
—Lippman’s test
—Speed’s test
—Yergason’s test
What homeopathic remedy has repressed feelings and is unable to cry?
Nat-mur
What drugs are contraindicated in lactation?
Lithium
Metronidazole
Sulphonamides
Nitrofurantoin
Cyclosporin
Bromocriptine and Benzodiazepines
Radioactive isotopes and Rizatriptan
Ergotamines and Ethosuximide
Amiodarone and Amphetamines
Stimulant laxatives and Sex hormones
Tetracyclines and Tretinoin
“Like Me Some Nice C-Cup BREASTs”
What homeopathic remedy has every cold go to the chest?
Phosphorus
What homeopathic remedy has no two stools alike?
Pulsatilla
What homeopathic remedy is cheerful after large stools?
Nat-Sulph
What nutrient supplements are indicated in hypothyroidism?
Tyrosine is a precursor for thyroid hormone synthesis, and can be useful in hypothyroidism.
What homeopathic remedy wants to be rocked without being touched?
Cina
What are the ten classes of respiratory herbs and major examples of each?
Adaptogens
Echinacea spp.
Eleutherococcus
Panax spp.
Withania somnifera
Antimicrobials
Bryonia alba
Eucalyptus globulus
Sambucus nigra
Thymus vulgaris
Antispasmodics
Atropa belladonna
Cordyceps sinensis
Datura stramonium
Bronchodilators
Coleus forskohlii
Ephedra sinica
Relaxing expectorants
Grindelia robusta
Prunus serotina
Symphytum officinale
Tussilago farfara
Verbascum thapsus
Stimulating expectorants
Asclepias expectorants
Aspidosperma quebracho
Lobelia inflata
Sanguinaria Canadensis
Mixed expectorants
Inula helenium
Anticartarrhals
Solidago odora
Anti-inflammatories
Boswellia serrata
Ginkgo biloba
Glycyrrhiza Glabra
Demulcents
Althea officinalis
Plantago major
Symphytum officinale
Ulmus rubra
What homeopathic remedy hates being looked at?
Antimonium
Why do drugs that weakly bind to albumin have a risk for overdose?
Drugs that are weakly bound to albumin are easily displaced and therefore are likely to interact with other substances. If they are given with drugs that bind more tightly to albumin, the weakly bound drug will be displaced, leading to increased serum concentration and greater likelihood of overdose.
What nutrient supplements are contraindicated in pregnancy?
Iodine
Niacin
Quercetin
Tryptophan
What homeopathic remedies are aggravated by music?
Graphites (cold but not > heat)
Nat-sulph (ailments after head injury, > changing position)
What homeopathic remedy has childhood asthma that is aggravated by dampness?
Nat-sulph
What homeopathic remedy is filled with desires but doesn’t know for what?
Ipecac
What are the four main classes of vasodilating drugs and major examples of each?
Alpha adrenergics
Mixed Alpha I/ Beta I and II antagonists
Alpha II agonists (Clonidine)
Angiotensin acting
ACE inhibitors (Lisinopril)
ARBs (Valsartan)
Ion channel acting
Calcium channel blockers (Amlodipine)
Nitrates
Nitroglycerin
From a pharmacognosy perspective, Reserpine and Rawolfia are peripherally acting catecholamine antagonists, decreasing sympathetic tone at the tissue level, similar to Alpha II agonists. Tilia europaea, Veratrum alba and Viscum album are hypotensive, vasodilatory herbs analogous to CCBs in that they decrease peripheral resistance.
Nutritionally, L-arginine, Magnesium glycinate and Zinc are useful vasodilatory supplements.
What are the three classes of male-specific drugs and major examples of each?
Antispasmodics
Adrenergics (Tamsulosin)
Anti-androgens
5-alpha reductase inhibitors (Finasteride)
Vasodilators
Phosphodiesterase inhibitors (Sildenafil)
What homeopathic remedy has nausea with a clean tongue?
Ipecac
Differentiate between Norgestimate, Medroxyprogesterone, Norelgestromin and Levonorgenstrel.
All four are progestins.
Norgestimate and Medroxyprogesterone are usually used in combination with estradiol for menopausal symptoms (atrophic vaginitis, vulvar atrophy, osteoporosis prevention). Medroxyprogesterone is also injected for use as long term contraception.
Norelgestromin is used in the contraceptive patch.
Levonorgestrel is used in combined and progestin only contraceptive pills as well as IUDs and PlanB.
In homeopathic prescribing, what types of conditions should homeopathy not be used for?
Genetic conditions
Organ failure
Diseases of suggestion
Diseases of lifestyle excess or deficiency
What homeopathic remedy has rattling, difficult to expectorate mucus and a white-coated tongue?
Antimonium
What test is used for the screening of tuberculosis?
Mantoux skin test (intracutaneous purified protein derivative (PPD) tuberculin skin test)
A chest radiography is required if test is positive
What is drug hypersensitivity syndrome and which drugs are the most common causes?
Drug hypersensitivity syndrome classically occurs
-10 days after drug exposure and is characterized by fever followed by symmetrical red exanthemata eruptions and internal organ involvement (hepatitis, arthralgia, nephritis, pneumonitis, lymphadenopathy, hematologic abnormalities).
The most commonly causes of drug hypersensitivity syndrome are:
Sulfonamides
Anticonvulsants (Phenytoin, Carbamazepine)
What are the five classes of gastrointestinal herbs and major examples of each?
Bitters
Achillea millefolium
Angelica archangelica
Arctium lappa
Berberis aquifolium/ vulgare
Capsicum frutescens
Chionanthus virginicus
Cynara scolymus
Gentiana lutea
Hydrastis canadensis
Juniperus communis
Leonurus cardiaca
Leptandra virginica
Olea europaea
Momordica charantia
Rumex crispus
Taraxacum officinale
Verbena officinalis
Carminatives
Cinnamomum zeylanicum
Foeniculum vulgare
Matricaria recutita
Melissa offcinalis
Mentha piperita
Piper nigrum
Zingiber officinale
Cathartics
Cassia senna
Rhamnus frangula
Rhamnus purshiana
Rheum officinale
Ricinus communis
Astringents
Geranium maculatum
Hamamelis virginiana
Quercus alba
Rubus pendulum
Choloretics
Chelidonium majus
Iris versicolor
What nutrient supplements are contraindicated in concomitant anticoagulant use?
Anticoagulants
Glucosamine and Chondroitin
Policosanol
Warfarin
Vitamin K
Zinc
What homeopathic remedy is aggravated by sex and masturbation?
Staphysagria
What are the common indications and contraindications of bitters?
Bitter are used in conditions where stimulation of the digestive tract is indicated, such as:
Dyspepsia, hypochlorhydria, anorexia
Biliary insufficiency, biliary dyskinesia
Atonic constipation
They should be avoided in conditions where stimulation of the digestive tract is contraindicated, such as:
Gastritis, hypochlorhydria, peptic ulcer disease, GERD
Acute cholelithiasis
Biliary obstruction
Acute diarrhea
What homeopathic remedy has bashful stools?
Sililca
What nutrient supplements are indicated in serotonin deficiency?
Tryptophan is a precursor for serotonin.
What homeopathic remedy has a feeling of sand under the eye?
Ferrum-phos
With respect to frequency and amplitude settings of electrical physical therapy machines, what are the proper settings for acute and chronic pain?
Transcutaneous electrical nerve stimulation (TENS)
Acute pain [80-140 Hz]
Chronic pain [1-15 Hz]
High voltage galvanism
Acute pain [ + galvanic, 70-150 bps]
Chronic pain [ + galvanic, 1-15 bps]
Low voltage galvanism
Acute pain [ + galvanic]
Chronic pain [ + galvanic, 1-15 bps]
Low voltage galvanism
Acute pain [ + galvanic ]
Chronic pain [ – galvanic ]
Sine wave
Pain [ 70-130 hz ]
Which physical therapy modality is indicated in large and deep joint problems?
Interferential current
What is the most common cause of drug-induced hemolytic anemia?
Cephalosporins
True or False – Sulphonamides are known to cause thrombocytopenia?
True
What are the indications for interferon-alpha and interferon-beta?
Interferon-alpha: Chronic hepatitis B, chronic hepatitis C, condyloma acuminatum, leukemia, AIDS-related Kaposi’s sarcoma, malignant melanoma
Interferon-beta: Multiple sclerosis
What homeopathic remedy craves cold drinks, but vomits after drinking?
Phosphorus
What nutrient supplements are indicated in diabetes?
Ascorbic acid (vitamin C)
Biotin
Chromium
Flavonoids
Glutathione
Inositol hexaphosphate (phytic acid)
Magnesium
Manganese
Niacin (vitamin B3)
Oleic acid (omega 9)
Potassium
Taurine
Pyridoxine (vitamin B6)
Ubiquinone (coenzyme Q10)
Vanadium
What are the four main classes of peripherally acting pain medications and major examples of each?
Peripherally acting pain medications tend to decrease inflammation, where as centrally acting pain medications decrease sensitivity to nociception.
Non-steroidal anti-inflammatories
Nonselective COX 1 and 2 inhibitors (Aspirin, Ibuprofen, Naproxen)
Selective COX 2 inhibitors (Celecoxib)
Steroidal anti-inflammatories
Corticosteroids (Dexamethasone, Mometasone)
Glucocorticoids (Prednisone, Hydrocortisone)
Disease-modifying anti-rheumatic drugs
TNF alpha inhibitors (Adalimumab, Hydroxychloroquine, Sulfasalazine)
T cell inhibitor (Cyclosporine)
Folic acid analogue (Methotrexate)
Uricosuric Agents
Neutrophil inhibitor (Colchicine)
From a pharmacognosy perspective, Boswellia serrata is an anti-inflammatory herb useful in inflammatory conditions. Aconitum napellus, Atropa belladonna, Bryonia alba, Gelsemium sempervirens, Piscidia erythrina and Pulsatilla vulgaris are useful in general pain management. Actaea racemosa, Dioscorea villosa, Mentha piperita, and Viburnum opulus are spasmolytic herbs that can be beneficial for muscle pain and cramping, while Piscidia erythrina and Tanacetum parthenium tend to be specific for migraines
What homeopathic remedies are aggravated by cold, but crave cold drinks?
Aconite (< wind)
Calc-carb (< cold, especially feet)
Veratrum (< motion)
What homeopathic remedies are adverse to bathing?
Baryta-carb (> open air)
Sulphur (< heat)
What are the two main classes of cancer medications and major examples of each?
Cell replications inhibitors
Mitotic inhibitors (Pacilitaxel, Vinblastine)
DNA synthesis inhibitors (5-Fluorouracil, Methotrexate)
Cytokines (Interferon alpha)
Anthracyclines (Doxorubicin)
Hormone modulators
Aromatase inhibitors (Anastrozole)
What nutrient supplements contraindicated in gout?
Molybdenum
What is the emergency management protocol for seizures?
Intravenous benzodiazepines (Diazepam, Lorazepam)
What homeopathic remedy predicts the time of their death?
Aconite
What homeopathic remedy thinks they are well when they are not?
Arnica
What homeopathic remedy has difficulty urinating in public?
Nat-mur
What nutrient supplements are indicated in gout?
Ascorbic acid (vitamin C)
Folic acid
What homeopathic remedy has an inability to fulfill urges (cough, urinate, defecate)?
Nux vomica
What homeopathic remedies have sensitivity of the soles of the feet?
Kali-carb (sensitivity, < cold)
Ledum (painful soles, > cold)
Medorrhinum (burning soles, > night)
Sulphur (burning feet that can’t be covered, < heat)
How does cocaine work as an anesthetic?
Cocaine is an amino ester that acts as local anesthetic by blocking the generation & conduction of nerve impulses via the reduction of sodium permeability and increased action potential threshold.
Adverse effects from cocaine include anxiety, palpitations, tachycardia, hypertension, and seizures.
What are the safest antibiotics to use in pregnancy?
Penicillins including Amoxicillin
Cephalosporins including Cephalexin
Clindamycin
What homeopathic remedy bends their head back, extending the neck when they cough?
Hepar-sulph
What are the four most common orthopedic presentations of the hip and the major tests used to evaluate them?
Sacroiliac joint dysfunction:
Gaesnslen’s joint dysfunction
Gaenslen’s test
Hibb’s (prone gapping) test
Patrick’s (FABER) test
Pelvic rock test
Yeoman’s test
Muscular dysfunction:
Ely’s test (rectus femoris)
Ober’s test ( iliotibial band tensor fascia lata)
Thomas’ test (iliopsoas and tensor fascia lata)
Trendelenberg’s sign (gluteus medius and hip abductors)
Nerve root compression: Nachlas’s test
Trauma and congenital abnormalities:
Ortolani click
Telescoping test
What homeopathic remedy is better on hands and knees?
Eupatorium
What are the six main classes of immunological medications and major examples of each?
Antibiotics:
Beta-lactam inhibitors (Penicillin VK, Penicillin G, Cephalexin)
Protein synthesis inhibitors (Clindamycin, Doxycycline)
Nucleic acid inhibitors (Ciprofloxacin, Azithromycin, Sulfamethoxazole, Trimethoprim)
Antivirals:
Influenza vaccine Amantadine)
Nucleoside analogues (Zidovudine)
Antifungals:
Topicals (Nystatin)
Triazole (Fluconazole, Terbinafine)
Antiparasitics:
Pediculicides (Permethrin)
Antiprotozoals (Metronidazole)
Anthelmintics (Mebendazole)
Anticancer:
Aromatase inhibitor (Anastrozole)
Anthracycline (Doxorubicin)
Cytokines (Interferon)
DNA synthesis inhibitors (5-Fluorouracil, Methotrexate)
Mitotic inhibitor (Pacitaxel, Vinblastine)
Immunosuppressants:
Steroids (Prednisone, Hydrocortisone, Dexamethasone, Mometasone)
TNF alpha blockers (Sulfasalazine, Hydroxychloroquine, Adalimumab)
T-cell inhibitors (Cyclosporine)
What nutrient supplement is contraindicated in systemic lupus erythematous?
Tryptophan
What are the three main classes of antibacterial medications and major examples of each?
Beta-lactam inhibitors:
Penicillins (Penicillin VK, Penicillin G, Amoxicillin)
Cephalosporins (Cephalexin)
Protein synthesis inhibitors:
Aminoglycosides
Lincosamides
Tetracyclines (Doxycycline)
Nucleic acid inhibitors:
Fluoroquinolones (Ciprofloxacin)
Macrolides (Azithromycin)
Sulphonamides (Sulfamethoxazole)
Folic acid analogues (Trimethoprim)
From a pharmacognosy perspective, Commiphora molmol, Echinacea spp., and Thymus vulgaris are broad spectrum antimicrobial herbs useful in treating various different infections. Rosmarinus officinalis, Salvia officinalis, Sambucus nigra, Sanguinaria canadensis, and Thymus vulgaris have an affinity for the respiratory tract and are beneficial in treating URTIs. Baptisia tinctoria, Eucalyptus globulus, Salvia officinalis, and Thuja occidentalis are also effective in treating pharyngitis and tonsillitis.
What are the three main classes of urinary medications and major examples of each?
Incontinence control:
Anticholinergics (Dicyclomine, Tolterodine)
ADH analogues
Antimicrobials:
Protein synthesis inhibitors (Clindamycin, Doxycycline)
Nucleic acid inhibitors (Ciprofloxacin, Azithromycin, Nitrofurantoin, Sulfamethoxazole, Trimethoprim)
Analgesics:
Phenazopyridine
What homeopathic remedy is better cold but aggravated by cold drinks?
Cantharis
What nutrient supplement is indicated in patients using oral contraceptive pills?
Pyridoxine (vitamin B6)
What nutrient supplements are contraindicated in renal disease?
Arginine
Dimethylaminoethanol (DMAE)
Dialysis:
Ascorbic acid (vitamin C)
Potassium
What nutrient supplements are indicated in cervical dysplasia?
Beta carotene
Cobalamin (vitamin B12)
Folic acid
Indole-3 Carbinol
Retinol (vitamin A)
What nutrient supplements are indicated in benign prostatic hyperplasia?
Alanine
Zinc
What are the three most common orthopedic presentations of the knee and the major tests used to evaluate them?
Ligament injury:
Anterior drawer test (ALC)
Lachman’s test (ACL)
Posterior drawer test (PCL)
Apley’s distraction test
Varus (lateral) stress test (LCL)
Valgus (medial) stress test (MCL)
Meniscus injury:
Apley’s compression test
Bounce home test
McMurray’s test
Reduction click
Patellar pathology:
Clark’s sigh (patellar grind test)
Patellar grind test
What are the three main classes of antiarrhythmic drugs and major examples of each?
Adrenergics affect heart rate, decreasing cardiac demand and increasing diastolic filling time:
Beta blockers (Atenolol, Propranolol)
Electrolyte channel antagonists affect heart rhythm, increasing cardiac reperfusion time:
Calcium channel blockers (Amlodipine)
Sodium channel blockers (Amiodarone)
Intropics increase efficiency of the myocardium:
Cardiac glycosides (Digoxin)
From a pharmacognosy perspective, Reserpine and Rawvolfia are peripherally acting catecholamine antagonists, decreasing sympathetic tone at the tissue level, similar to Alpha II agonists. Inotropic herbs include Crataegus oxycantha, Selenicereus grandiflorious, and Leonurus cardiaca, while Convallaria majalis and Digitalis purpurea contain cardiac glycosides (they are also diuretics, making them useful in CHF).
What homeopathic remedy is better covering the head and mouth?
Rumex
What are the three main classes of respiratory medications and major examples of each?
Centrally acting:
Sympathomimetics (Albuterol, Salbutamol, Epinephrine)
Parasympatholytics (Atropine, Tiotropium bromide)
Anti-histamines (Diphenhydramine)
Cough suppressants (Dextromethorphan)
Locally acting:
Mucolytics (Guaifenesin)
Anti-inflammatories:
Leukotriene inhibitors (Montelukast)
Steroids (Fluticasone, Prednisone, Hydrocortisone, Dexamethasone, Mometasone)
From a pharmacognosy perspective, Atropa belladonna, Boswellia serrata, Datura stramonium, Ephedra sinica, Inula helenium, and Verbascum thapsus are useful in relaxing the bronchioles and decreasing inflammation associate with asthma.
What homeopathic remedy feels they must stay in motion or their heart will stop?
Gelsemium
What are the four most common orthopedic presentations of the spinal column and the major tests used to evaluate them?
Cervical pain:
Cervical compression test
Cervical distraction test
Shoulder depression test
Spurling’s (foraminal compression) test
Soto-Hall test
Brudzinski-Kernig’s test
Thoracic outlet syndrome:
Adson’s maneuver
East’s (Roos’) test
Wright’s (hyperabduction) test
Low back pain and sciatica:
Lidner’s test
Milgram’s test
Minor’s sign
Kemp’s test
Braggards test
Straight leg raise
Postural abnormalities:
Adam’s sign
What homeopathic remedy is thirsty with no desire to drink?
Cantharis
What homeopathic remedy has a disparity between pulse rate and temperature?
Pyrogenium
What are the four main classes of anxiolytic medications and major examples of each?
GABA acting:
Benzodiazepines (Alprazolam, Diazepam)
Serotonin acting:
Serotonin agonists (Buspirone)
Serotonin antagonist and reuptake inhibitors (Trazodone)
Dopamine acting:
Dopamine agonists (Prochlorperazine)
Histamine acting:
Histamine antagonist (Hydroxyzine)
From a pharmacognosy perspective, Passiflora incarnata, Scutellaria baicalensis and lateriflora, Melissa officinalis, and Valeriana officinalis are all nervine anxiolytics with sedating properties, acting similarly to GABA affecting anxiolytics. Avena sativa and Piper methysticum are non-sedating anxiolytics, acting similarly to non-GABA affecting anxiolytics.
Nutritionally, magnesium acts on acetylcholine receptors block acetylcholine receptors block acetylcholine release, both centrally and peripherally, which is why it has calming effects.
What drug is used in the management of acute opioid overdose?
Naloxone (Narcan)
Which physical therapy modalities are indicated in chronic inflammation?
Constitutional hydrotherapy (hot applications)
Diathermy
Ultrasound
What homeopathic remedy has perspiration that smells like urine?
Colosynthis
In homeopathic prescribing, what is the difference between an aggravation and a suppression?
Aggravations (or “healing crises”) are a transient intensification of pre-existing symptoms, typically followed by amelioration and resolution of symptoms. They are representative of suppressed symptoms being released, and are never entirely new symptoms.
A suppression is any treatment that produces a change in Hering’s Law. *Suppression can occur from homeopathic remedies, botanical medicines or pharmaceutical prescriptions.
*Hering’s Law: cure progresses from more important to lesser important organs or systems, from inside to outside, from top to bottom, and from most recent symptoms to older symptoms.
What nutrient supplements are indicated in osteoporosis?
Boron
Calcium
Cholecalciferol (vitamin D)
Cobalamin (vitamin B12)
Fluoride
Magnesium
Vitamin K
What are the three most common orthopedic presentations of the wrist and the major tests used to evaluate them?
Carpal tunnel syndrome:
Phalen’s test
Tinel’s sign
De Quervain’s tenosynovitis:
Finkelstein’s test
Ligamentous or capsular contracture:
Retinacular test
In homeopathic follow ups, what is the appropriate response if a patient does not react to a homeopathic prescription?
If the patient did not take the medicine or if an acute illness or stress interfered with the reaction to the medicine, re-prescribe the same medicine and potency.
If the patient has already taken multiple doses of this remedy at this potency and is no longer sensitive, prescribe a higher potency.
If the patient took the medicine, had no intervening factors, and had no reaction, retake the case and prescribe a better medicine.
What nutrient supplements are indicated in dyslipidemia?
Chromium
Gamma linolenic acid and linoleic acid
Inositol hexaphosphate (phytic acid)
Niacin (vitamin B6)
Oleic acid (omega 9)
Pantothenic acid (vitamin B5)
Policosanol
Tocopherols (vitamin E)
What are the two most common orthopedic presentations of the elbow and the major tests used to evaluate them?
Epicondylitis:
Cozen’s test
Mill’s test
Ligament injury:
Varus (radial) stress test
Valgus (ulnar) stress test
True or False – NSAIDs are renal toxic?
True
What homeopathic remedy desires to be covered?
Aconite
What is the most anaphylactic drug allergy?
Penicillin
What nutrient supplements are contraindicated in diabetes?
Arginine
What homeopathic remedy has burning pains that are better with heat?
Aarsenicum
What nutrient supplements are indicated in male infertility?
Arginine
Carnitine
Zinc
What are the four main heavy metal toxicities and their respective chelating agents?
Mercury—-DMPS (chelates arsenic, gold and lead to lesser extents)
Lead—-DMSA
Copper—-Penicillamine
Iron—-Deferoxamine
What five drugs compete for renal transport and why is this important?
Penicillin
Salicylates
Sulfonamides
Thiazides
Uric acid
If given together, drugs that compete for renal transport will decrease mutual excretion, leading to increased plasma drug levels and increased likelihood of overdose.
What are the two main causes of centrally acting pain medications and major examples of each?
Centrally acting pain medications decrease sensitivity to nociception, whereas peripherally acting pain medications tend to decrease inflammation.
Muscle relaxants:
Anticholinergics (Cyclobenzaprine)
Ion transport calming (Carisoprodol)
CNS depressants
Benzodiazepines (Diazepam, Alprazolam)
Analgesics:
NMDA receptor antagonist (Ketamine)
Prostaglandin formation inhibition (Acetaminophen)
Opioids agonist (Codeine, Oxycodone, Hydrocodone, Morphine, Methadone)
From a pharmacognosy perspective, Aconitum napellus, Atropa belladonna, Bryonia alba, Gelsemium sempervirens, Piscidia erythrina, and Pulsatilla vulgaris are useful in general pain management. Actaea racemosa, Dioscorea villosa, Mentha piperita, and Viburnum opulus are spasmolytic herbs that can be beneficial for muscle pain and cramping, while Piscidia erythrina and Tanacetum parthenium tend to be specific for migraines.
What homeopathic remedy has a feeling of sand in the teeth, bowels and bones?
Silica
What nutrient supplements are indicated in ophthalmic conditions?
Cataracts:
Cysteine
Flavonoids
Folic
Glutathione
Riboflavin (vitamin B2)
Selenium
Macular degeneration:
Beta-carotene
Copper oxide, zinc oxide
Flavonoids
Retinol (vitamin A)
Riboflavin (vitamin B2)
Selenium
What herbs are contraindicated in pregnancy?
Anticholinergics:
Atropa belladonna
Datura stramonium
Hyoscyamus niger
Cardiac glycosides:
Convallaria majalis
Digitalis purpurea
Selenicereus grandiflorus
Pyrrolizidine alkaloids:
Eupatorium perfoliatum
Eupatorium purpureum
Symphytum officinale
Tussilago farfara
Adrenergics and stimulants:
Ephedra sinica
Pausinystalia yohimbe
Rauvolfia serpentina
Schisandra chinensis
Alteratives:
Phytolacca americana
Anodynes:
Aconitum napellus
Bryonia alba
Cannabis sativa
Corydalis ambigua
Gelsemium sempervirens
Piscidia erythrina
Pulsatilla vulgaris
Scutellaria baicalensis
Tanacetum parthenium
Antimicrobials:
Arctostaphylos uva-ursi
Baptisia tinctoria
Berberis aquifolium
Eucalyptus globulus
Glycyrrhiza glabra
Hydrastis canadensis
Larrea tridentata
Podophyllum peltatum
Salvia officinalis
Sanguinaria canadensis
Thuja occidentalis
Antiparasitics:
Artemisia annua
Juglans nigra
Momordica charantia
Tanacetum vulgare
Choleretics:
Chelidonium majus
Iris versicolor
Circulatory stimulants:
Rosmarinus americanus
Vinca major/ minor
Hormone modulators:
Lycopus virginicus
Fucus vesiculosus
Panax spp
Verbena officinalis
Vitex angus-castus
Immune modulators:
Veratrum alba
Viscum album
Withania somnifera
Simulating expectorants:
Asclepias tuberosa
Aspidosperma quebracho
Lobelia inflata
Sanguinaria canadensis
Stimulating laxatives:
Aloe vera (latex)
Cassia spp.
Rhamnus purshiana
Rheum officinale
Ricinus communis
Uterine tonics:
Actaea (Cimicifuga) racemosa
Chamaelirium luteum
Caulophyllum thalictroides
Mitchella repens
*Contraindicated only in early pregnancy
Caffeine – What are the indications and contraindications?
Caffeine is a CNS stimulant and respiratory stimulant. It has bronchodilating and diuretic properties and facilitates the performance of muscular work.
MOA:
Methylxanthine that acts as a phosphodiesterase inhibitor. It has an antagonistic effect at central adenosine receptors.
Indications:
Migraines
Contraindications:
Hypersensitivity
Caution in pregnancy
Adverse Effects:
Insomnia, restlessness, nervousness, mild delirium
Nausea, vomiting, GI upset
Interactions:
Reduces sedative effects of Benzodiazepines
Increased levels with Ciprofloxacin
Aspirin
Caution with beta-adrenergic agonists
What homeopathic remedy has a cough that is triggered by pressure in the substernal fossa?
Rumex
What are the six classes of Gynecologic herbs and major examples of each?
Antimicrobials
Baptisia tinctoria
Echinacea spp
Commiphora myrrh
Melaleuca alternifolia
Styptics
Achillea millefolium
Capsella bursa-pastoris
Cinnamomum zeylanicum
Geranium maculatum
What are the different types of agnosia?
Agnosia is a disorder of the recognition of sensory stimuli in the presence of intact sensations and naming.
Apperceptive visual agnosia:
Inability to recognize visually presented objects due to distorted visual perception (recognition by touch remains intact)
Associative visual agnosia:
Inability to recognize visually presented objects due to a disconnect between the visual cortex and the language areas (visual perception remains intact)
Prosopagnosia:
Inability to recognize familiar faces despite intact visual perception and auditory recognition
What medications can cause ocular toxicity?
Chloroquine, hydroxychloroquine
Amiodarone, aminoglycosides
NSAIDS
Bisphosphonates
Atropine
Digitalis
Sulphonamides
Interferon
Haloperidol
Tetracycline
“CAN cause BAD SIgHT”
What are the major endocrine glands and their respective hormones?
Hypothalamus:
Corticotropin releasing hormone (stimulates ACTH release)
Gonadotropin releasing hormone (stimulates Gn release)
Thyrotropin releasing hormone (stimulates THS release)
Growth hormone releasing hormone (stimulates GH release)
Antidiuretic hormone releasing hormone (stimulates ADH release)
Oxytocin releasing hormone (Stimulates oxytocin release)
Anterior pituitary gland:
Growth hormone (growth and development
Luteinizing hormone
Follicle-stimulating hormone
Thyroid-stimulating hormone (stimulates release of T3 and T4)
Adrenocorticotropic hormone (stimulates release of glucocorticoids, androgens, mineralocorticoids
Prolactin (lactation)
“Go Look For The Adenoma Please”
Posterior pituitary gland:
Antidiuretic hormone (water retention)
Oxytocin
Thyroid gland:
Triiodothyronine (metabolism)
Thyroxine (metabolism)
Calcitonin (decreases serum calcium)
Parathyroid gland:
Parathyroid hormone (Increases serum calcium and magnesium)
Adrenal glands:
Aldosterone (water retention, electrolyte balance)
Cortisol (sympathetic stimulation: gluconeogenesis, insulin resistance, protein catabolism, PTH release)
Androgens (secondary sexual characteristics)
Catecholamines (sympathetic stimulation: gluconeogenesis, insulin resistance, protein catabolism, PTH release)
Pancreas:
Insulin (fed state: anabolic)
Glucagon (starved state: catabolic)
Testes:
Testosterone
Ovaries:
Estrogen
Progesterone
What homeopathic remedies are the coldest?
Hepar-sulph (vulnerability on all levels)
Psorinum (weak constitution)
Veratrum (cold to the point of being blue)
What homeopathic remedy is better with their abdomen uncovered?
Tabacum
What homeopathic remedy has religious mania?
Veratrum
What homeopathic remedy wants to be fanned?
Carbo-veg
What are the most common drugs associated with drug-induced lupus?
Isoniazid
TNF alpha inhibitors (ex: Adalimumab)
Not on NPLEX: Hydralazine, Minocycline, Quinidine
What nutrient supplement is indicated in catecholamine deficiency?
Tyrosine (which can be synthesized endogenously from phenylalanine) is a precursor for dopamine, norepinephrine, and epinephrine.
What nutrient supplements are indicated in hyperemesis gravidarum?
Pyridoxine (vitamin B6)
What nutrient supplements are contraindicated in seizure disorder?
Dimethylaminoethanol (DMAE)
Methionine and S-Adenosylmethionine (SAMe)
Which physical therapy modality is indicated in benign prostatic hyperplasia?
Diathermy
What are the hormones involved in the menstrual cycle?
Follicular (proliferative) phase
Estrogen is the dominant hormone, causing endometrial proliferation
HPO axis cause elevated GnRH, FSH and LH
FSH acts on the ovaries to stimulate follicular growth
Ovulation
LH surge is the initiating event, which is caused by peaking of estrogen
Luteal (secretory) phase
Progesterone, secreted from the corpus luteum, is the dominant hormone, stopping endometrial proliferation
HPO axis feedback causes decreased LH
Menstruation
Progesterone drop is the initiating event, which is caused by degeneration of the corpus luteum in absence of fertilization
What homeopathic remedy is chilly but better with cold baths and applications?
Ledum
What homeopathic remedy has urinary urges when the bladder is almost empty?
Equisetum
What homeopathic remedy fantasizes about heroic deeds?
Cinchona
What homeopathic remedy has a chill that starts in the lumbar area and ascends?
Eupatorium
What vaccine is given in countries where tuberculosis is common?
Bacillus Calmette-Guerin (BCG) vaccine
What are the three main classes of neurological medications and major examples of each?
Stimulants
Amphetamines (Dextroamphetamine, Phentermine)
Non-amphetamine stimulants (Methylphenidate, Modafinil)
Anticholinergics (Amantadine)
Dopaminergics (Bromocriptine, Pramipexole, Levodopa-Carbidopa)
Depressants
GABA acting (Gabapentin, Alprazolam, Diazepam, Zolpidem)
Sodium channel blockers (Carbamazepine, Phenytoin)
Cholinesterase inhibitors (Donepezil, Rivastigmine)
Antihistamines (Hydroxyzine)
Vasoconstrictors
Histamine acting
Serotonin agonist (Sumatriptan)
What is the function of the hypothalamic-pituitary axis?
The hypothalamic-pituitary axis integrates information about cortical inputs, automatic function, environmental cues (light, temperature) and peripheral hormone feedback.
The hypothalamus acts as the coordinating centre of the endocrine system and sends signals to the pituitary to release hormones to affect the thyroid, adrenals, gonads, growth, milk production and water balance.
What are the four classes of cardiovascular herbs and major examples of each?
Adrenergics:
Rauvolfia serpentina
Vasodilators:
Coleus forskohlii
Ganoderma lucidum
Tilia europaea
Veratrum alba
Vinca minor/ major
Viscum album
Circulatory stimulants:
Allium cepa/ sativum
Camellia sinensis
Theobroma cacao
Inotropes:
Crataegus oxycantha
Leonurus cardiaca
Selenicereus grandiflorus
Convallaria majalis
Digitalis purpurea
From a pharmacology perspective, Alpha II agonists deplete catecholamines, decreasing sympathetic tone at the tissue level, similar to Rauvolfia serpentina. Other adrenergically active drugs include Alpha I and Beta blockers. ACE inhibitors, ARBs, Alpha II agonists and calcium channel blockers are hypotensive, vasodilatory agents that decrease peripheral resistance, analogous to Tilia europaea, Veratrum alba, and Viscum album. Aldosterone antagonists are electrolyte sparing diuretics similar to Taraxacum officinale leaf and Urtica dioica leaf, while Thiazides and Loop diuretics are electrolyte wasting diuretics, similar to Convallaria majalis and Digitalis purpurea. Cardiac glycosides, CCBs, and sodium channel blockers are inotropic, antiarrhythmic drugs that increase the force of heart muscle contraction, analogous to Crataegus oxycantha, Leonurus cardiaca, Selenicereus grandiflorius, Convallaria majalis and Digitalis purpurea.
Nutritionally, L-arginine, Magnesium glycinate and Zinc are useful vasodilatory supplements.
Triamcinolone – What are the indications and contraindications?
Triamcinolone is a corticosteroid used for the treatment of inflammatory conditions such as rheumatoid arthritis, allergic rhinitis, multiple sclerosis, alopecia areata, dermatoses etc.
Contraindications:
Systemic fungal infections
Idiopathic thrombocytopenic purpura (ITP)- Live or live attenuated vaccines
What is the indication for the use of potassium chloride?
Hypokalemia
What type of addiction is Varenicline indicated for?
Smoking
What are the two main classes of anti-seizure medications and major examples of each?
Seizure medications aim to reduce brain activity either by enhancing GABA or calming ion transport.
GABA enhancing:
GABA agonists (GABApentin)
Barbiturates
Benzodiazepines (Diazepam and Alprazolam)
Ion calming:
Sodium channel blockers (Carbamazepine, Phenytoin)
From a pharmacognosy perspective, Scutellaria baicalensis is a GABA acting nervine useful in seizure treatment.
Nutritionally, essential fatty acids, phosphatidylcholine, folic acid and calcium are useful in treatment of seizures as they act to calm the neurological membranes.
What are the seven main classes of gastrointestinal medications, and major examples of each?
Acid neutralizing:
Proton pump inhibitors (Esomeprazole)
H2 blockers (Ranitidine)
Mucus membrane protective:
Demulcents (Sucralfate, Bismuth subsalicylate)
Anodynes:
Sulfonamides (Sulfasalazine)
Antimicrobials:
Antibiotics (Ciprofloxacin, Trimethoprim-Sulfamethoxazole)
Antiparasitics (Metronidazole, Mebendazole)
Antifungals (Nystatin)
Antivirals (Interferon)
Immunosuppressants:
TNF-alpha blockers (Adalimumab)
T-cell inhibitors (Cyclosporine)
Centrally acting:
Antidopaminergics (Prochlorperazine, Metoclopramide)
Anticholinergics (Dicyclomine, Loperamide, Atropine)
Adrenergics (Phentermine)
Locally acting:
Stimulating laxatives (Bisacodyl)
Osmotic laxatives (Sodium phosphate enema)
Stool softeners (Docusate)
From a pharmacognosy perspective, Berberis aquifolium, Glycyrrhiza glabra, Hydrastis canadensis and Thymus vulgaris are antimicrobial herbs beneficial in treating H. pylori infections (common cause of PUD), while demulcents such as Aloe spp., Althea officinalis, Glycyrrhiza glabra, Matricaria recutita, Plantago major and Ulmus spp. are useful in soothing the stomach lining and providing symptom relief in PUD.
What are the three main classes of hypertensive medications and major examples of each?
Adrenergics affect heart rate, decreasing cardiac demand and increasing diastolic filling time.
Mixed Alpha I/ Beta I and II antagonists
Alpha II agonists (Clonidine)
Beta blockers (Atenolol, Propranolol)
Diuretics affect blood volume, decreasing blood pressure and after-load:
Thiazides (Hydrochlorothiazide)
Loop diuretics (Furosemide)
Aldosterone antagonists (Spironolactone)
Vasodilators affect peripheral resistance, decreasing preload:
ACE inhibitors (Lisinopril) and ARBs (Valsartan)
Calcium channel blockers (Amlodipine)
Nitrates (Nitroglycerine)
From a pharmacognosy perspective, Reserpine and Rauvolfia are peripherally acting catecholamine antagonists, decreasing sympathetic tone at the tissue level, similar to Alpha II agonists. Tilia europa, Veratrum alba and Viscum album are hypotensive, vasodilatory herbs analogous to CCBs in that they decrease peripheral resistance. Taraxcum officinalis leaf and Urtica dioica leaf are aquaretics (electrolyte sparing diuretics) similar to aldosterone antagonists, while Convallaria majalis and Digitalis purpurea are electrolyte wasting diuretics similar tol Thiazides and Loop diuretics (they also have cardiac glycosides, making them useful in CHF, angina arrhythmia).
What homeopathic remedy has extreme sensitivity to noise?
Nitricum
In homeopathic follow ups, what are the five signs of a positive reaction to a homeopathic prescription?
- Exonerative discharge
- Return of old symptoms
- Initial aggravation followed by improvement of chief complaint
- Significant improvement of chief complaint without aggravation
- Improvement of patient as a whole person
When doing a follow up assessment, look for changes in energy level, mental and emotional state, and chief complaint or strong physical symptoms. The follow up for constitutional homeopathy is generally 4-8 weeks. If a patient is reacting positively to a previous dose of a remedy, there is no need to re-dose or change the prescription.
Remember: Don’t change a remedy if the patient is approving, if symptoms are following Hering’s Law or if there was an aggravation after administration.
What are the three primary hormone precursors that can be exogenously administered, and what are their indications and contraindications
Hormone production:
Cholesterol-> Pregnenolone-> DHEA->
Androstenedione-> Androgens and Estrogens
Pregnenolone is the precursor to all steroid hormones
Indications:
Memory enhancement
Stress reduction
DHEA is the precursor to Androstenedione
Indications:
Inflammation (cardiovascular disease, asthma, rheumatoid arthritis)
Memory and cognition (Alzheimer’s)
Contraindications:
Breast cancer
Prostatic hypertrophy
G6PD deficiency
Androstenedione is the precursor to Estrogen and Testosterone
Indications:
Mainly used by weightlifters as an anabolic steroid
What nutrient supplements are indicated in atherosclerosis?
Alpha linolenic acid, eicosapentaenoic acid and docosahexaenoic acid (ALA, EPA, DHA)
Ascorbic acid (vitamin C)
Beta carotene
Carnitine
Chromium
Folic acid
Gamma linolenic acid and linoleic acid
Inositol hexaphosphate (phytic acid)
Magnesium
Oleic acid (omega 9)
Pantothenic acid (vitamin B5)
Pyridoxine (vitamin B6)
Selenium
Taurine
Tocopherols (vitamin E)
Ubiquinone (coenzyme Q10)
What homeopathic remedy is cold but not better warm?
Graphites
What homeopathic remedy has ailments from perceived lack of maternal love?
Mag-phos
Which physical therapy modalities are most indicated in soft tissue injury?
Microcurrents
Laser therapy
What are the three most common orthopedic presentations of the ankle and foot and the major tests used to evaluate them?
Ankle injury
Anterior and posterior drawer test (talofibular ligament)
Talar tilt test (calcaneofibular ligament)
Thompson’s test (Achilles tendon)
Foot injury
Morton’s test
Functional disturbances
Tibial torsion test
Forefoot adduction test
What is the effect of drugs that reduce p450 enzyme activity?
Drugs that decrease p450 activity will decrease phase I drug metabolism, leading to increased plasma drug levels and increased likelihood of overdose.
What is the result of drugs that increase p450 activity?
Drugs that increase p450 activity will increase phase I drug metabolism, leading to decreased plasma drug levels and decreased effects
What nutrient supplements are contraindicated in bipolar disease?
Dimethylaminoethanol (DMAE)
Gamma-aminobutyric acid (GABA)
What homeopathic remedies have constant clearing of the throat?
Causticum (> damp)
Tabacum (> abdomen uncovered)
What are the three main classes of hematological medications and major examples of each?
Anticoagulants:
COX inhibitors (Aspirin, Clopidogrel)
Coumadin (Warfarin)
Anti-thrombin activator (Heparin)
Circulatory stimulants:
Xanthene derivative
Hypolipidemics:
HMG CoA reductase inhibitors (Atorvastatin)
Fibrates (Gemfibrozil)
From a pharmacognosy perspective, Allium cepa, Allium sativum and Capsicum frutescens are anti-inflammatory, anti-platelet aggregation herbs that can be beneficial in conditions where blood viscosity is an issue.
In homeopathic prescribing, what is antidoting?
Antidoting is anything that cancels or nullifies the beneficial action of a remedy.
What homeopathic remedy has pain that is better with their feet on a chair?
Conium
In homeopathic follows ups, what is the appropriate response if a patient reacts to a homeopathic prescription?
If the patient does not react positively, retake the case (including the new symptoms) and prescribe a new remedy.
If the patient reacts positively, and is still reacting, do not re-prescribe.
If the patient reacts positively, and is not still reacting, retake the case to determine if the case is still covered by the original remedy. If it is, re-prescribe the original remedy and potency. If the case is no longer covered by a different remedy, prescribe the new remedy. If the case is no longer covered by a different remedy, consider prescribing the same remedy at the different potency.
Cannabis – What are the indications and contraindications?
Cannabidiol (CBD) is the main medicinal ingredient in the marijuana plant while tetrahydrocannabinol (THC) is the main psychoactive ingredient in the marijuana plant.
MOA:
THC acts both centrally and peripherally on endogenous cannabinoid receptors. Activating cannabinoid receptors affects serotonin release, increases catecholamines, inhibits parasympathetic activity, and inhibits prostaglandin biosynthesis.
Indications:
Analgesia
Antiemetic
Appetite stimulant
Glaucoma
Contraindications:
Hypersensitivity
Adverse Effects:
Altered senses, dizziness, somnolence, fatigue, impaired balance, euphoria, paranoia, hallucinations, anxiety, hypertension, nausea
Interactions:
CNS depressants have an increased effect with cannabis
What drugs are contraindicated in pregnancy?
Immune:
Aminoglycosides (Azithromycin)
Tetracyclines (Doxycycline)
Sulphonamides (Sulfamethoxazole)
Fluoroquinolones (Ciprofloxacin)
Antiparasitics (Metronidazole, Mebendazole)
Trimethoprim
Immunosuppressants (Interferon alpha, Adalimumab)
Inflammation:
Colchicine
NSAIDs
Salicylates (ASA, Aspirin)
CNS:
Amitriptyline
Naltrexone
Depressants (Benzodiazepines, Melatonin, Lithium, Diazepam)
Stimulants (Dextroamphetamine, Phentermine)
Anticonvulsants (Phenytoin, Carbamazepine, Carisoprodol)
Cardiovascular:
ACE inhibitors (Lisinopril)
Cardiac glycosides (Digoxin)
Amiodarone
Clopidogrel
HMG-CoA reductase inhibitors (Atorvastatin)
Warfarin
Respiratory:
Dexamethasone, Mometasone
Gastrointestinal:
Bismuth subsalicylate
Sulfasalazine
Bisacodyl
Genitourinary:
Finasteride
Nitrofurantoin
Endocrine:
Estrogens
Testosterone
Prostaglandin analogues (Misoprostol)
Cancer:
Methotrexate
Other:
Retinoids (Accutane)
In homeopathic prescribing, what is the difference between potency and frequency?
Potency is the strength of the remedy, whereas frequency is how often the dose is administered.
Lower potencies (6C-12C, LM) are used in patients that are hypersensitive or have a low vital force, whereas higher potencies (> 30C) are usually prescribed to patients with a normal vital force or when the level of certainty regarding the remedy is very high.
Lower potencies often need to be repeated at regular intervals, whereas higher potencies are usually prescribed as a single dose, and are only repeated in the case of relapse or antidote.
During acute illness, a lower potency is often given at a higher frequency (tid, qud, prn) until symptoms improve, at which point the remedy is ceased. Constitutional prescriptions for chronic conditions are typically given as a single dose of period of > 2 months before re-prescribing.
What homeopathic remedy must get up in the middle of the night to eat?
Psorinum
What drugs are considered to be bactericidal and when are they indicated?
Bactericidal antibiotics are typically indicated in immunocompromised patients.
Beta-lactam inhibitors:
Penicillins (Penicillin VK, Amoxicillin)
Cephalosporins ( Cephalexin)
Protein synthesis inhibitors:
Aminoglycosides
Lincosamides (Clindamycin)
Nucleic acid inhibitors:
Fluoroquinolones (Ciprofloxacin)
From a pharmacognosy perspective, Commiphora molmol, Echinacea spp., and Thymus vulgaris are broad spectrum antimicrobial herbs useful in treating various different infections. Rosmarinus officinalis, Salvia officinalis, Sambucus nigra, Sanguinaria canadensis, and Thymus vulgaris have an affinity for the respiratory tract and are beneficial in treating URTIs. Baptisia tinctoria, Eucalyptus globulus, Salvia officinalis, and Thuja occidentalis are also effective in treating pharyngitis and tonsillitis.
What nutrient supplements are contraindicated in psoriasis?
Ascorbic acid (vitamin C)
Biotin
Calcium
What are the four main classes of hematologic herbs and major examples of each?
Venotonics:
Centella asiatica
Hamamelis virginiana
Aesculus hippocastanum
Geranium maculatum
Collinsonia canadensis
Vaccinium myrtillus
Circulatory stimulants:
Ginkgo biloba
Capsicum frutescens
Rosmarinus officinalis
Vinca minor/ major
Hypolipidemics:
Allium cepa/ sativum
Camellia sinensis
Commiphora mukul
Cynara scolymus
Theobroma cacao
Olea europaea
Gymnema sylvestre
Linum usitatissimum
Styptics:
Capsella bursa-pastoris
Cinnamomum zeylanicum
What are the three main classes of antidepressants and major examples of each?
Catecholamine acting drugs (Phenelzine, Bupropion, Amitriptyline) affect dopamine and norepinephrine, and will have sympathetic side effects. Serotonin acting drugs (Fluoxetine, Trazodone) have less sympathetic side effects.
Catecholamine acting:
Monoamine oxidase inhibitors (Phenelzine)
Atypical antidepressants (Bupropion)
Serotonin acting:
Selective serotonin reuptake inhibitors (Fluoxetine)
Serotonin antagonist and reuptake inhibitors (Trazodone)
Mixed:
Tricyclic antidepressants (Amitriptyline)
From a pharmacognosy perspective, Corydalis ambigua, Hypericum perforatum, Pausinystalia yohimbe and Schisandra chinensis are effective antidepressant herbs.
What nutrient supplements are contraindicated in sarcoidosis?
Calcium
Cholecalciferol (vitamin D)
What are the four classes of neurologic herbs and major examples of each?
CNS depressants
Bacopa monnieri
Passiflora incarnata
Ganoderma lucidum
Gelsemium sempervirens
Valerianaa officinalis
Humulus lupulus
Matricaria recutita
Melissa officinalis
Piscidia erythrina
Scutellaria baicalensis and lateriflora
Eschscholzia californica
Pulsatilla vulgaris
CNS stimulants:
Pausinystalia yohimbe
Camellia sinensis
Cerebrovascular tonics:
Centella asiatica
Ginkgo biloba
Rosmarinus officinalis
Vinca major/ minor
Anodynes:
Aconitum napellus
Atropa belladonna
Corydalis ambigua
Tanacetum parthenium
Hyoscyamus niger
What nutrient supplements are contraindicated in hepatic disease?
Arginine
Dimethylaminoethanol (DMAE)
Niacin
Retinol (vitamin A)
Selenium
What are the major drug classes indicated in asthma and when are they used?
Short acting beta-2 agonist bronchodilators (SABA): “rescue” inhaler taken prn, fasting acting, first-line therapy for acute bronchospasm
Salbutamol (Albuterol in US)
Short acting muscarinic antagonist bronchodilators: anticholinergic, maintenance therapy for asthma & COPD and rescue therapy for severe asthma, slower onset of action compared to beta-2 agonists but longer duration of action
Ipratropium bromide (often combined with Salbutamol (Albuterol))
Long acting beta-2 agonist bronchodilators (LABA): slow onset, should not be used in asthma unless patient is also taking an inhaled corticosteroid as monotherapy increases risk of death
Salmeterol
Long acting muscarinic antagonist bronchodilators (LAMA): anticholinergic, add-on maintenance therapy
Tiotropium bromide (first-line long-term therapy for COPD bronchospasm)
Describe the pharmacology of Heroin.
Heroin is a highly addictive narcotic derived from the morphine alkaloid found in the opium poppy plant. Heroin is metabolized to morphine and other opioid agonist metabolites, which bind to opioid receptors.
Heroin causes a surge of euphoria followed by an alternately wakeful and drowsy state. It can cause respiratory depression, pupil constriction, and nausea. Heroin overdose can cause hypotension, shallow breathing, blue lips & nails, muscle spasms, convulsions, coma, and potential death
What are the common indications and contraindications of carminatives?
Carminatives are used in conditions where smooth muscle relaxation and gas relief is indicated, such as:
Dyspepsia
Gas, flatulence
Irritable bowel syndrome
Infant colic
They reduce the tone of lower esophageal sphincter, and therefore should be avoided in conditions of excess stomach acid, such as:
Gastric, hyperchlorhydria, peptic ulcer disease, GERD
What are the two main classes of anti-Parkinson’s medications and major examples of each?
Dopamine amplifiers
Dopamine precursors (Levodopa) and breakdown inhibitors (Carbidopa)
Anticholinergics (Amantadine)
Dopamine agonists
Ergots (Bromocriptine)
Nonergots (Pramipexole)
