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Long Case Medications Flashcards

1
Q

What do you use to treat CHF exacerbation?

A

Frusemide 40mg IV **patients already on frusemide may require higher doses

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2
Q

A “normal ef” is ____

A

LVEF 55-70%

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3
Q

What would you prescribe for an acute gout flare?

A
  1. Naproxen
    1. Load 750mg PO once
    2. 500mg PO 8hrs later
    3. 250mg TDS
  2. Prednisone 20-40mg PO OD
  3. Colchicine
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4
Q

How to start someone on Allopurinol?

A

50-100mg OD, increasing at 3-4 week intervals until reach target serum urate of <0.36mmol/L

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5
Q

Acute treatment of Meningitis?

A
  1. CALL ID
  2. Dexamethasone 10mg IV Q6h for 4/7: stops inflammation in the subarachnoid space cause by antibiotics
  3. Ceftriaxone 2g IV Q12h
  4. Vancomycin
  5. Benzypenicillin
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6
Q

What can be used to treat Myasthenia Gravis?

A
  1. AChEi: neostigmine
    1. Reduce breakdown of ACh which leaves more in the NMJ, counteracting the effect of the autoantibody
  2. Immunosuppresive drugs; methotrexate, Prednisone
    1. Decrease amount of autoantibodies made from B cells
  3. Surgical removal of thymus
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7
Q

What drugs can cause Parkinsonism?

A
  • Haloperidol (antipsychotic)
  • Metoclopramide or prochlorperazine (Dopamine antagonists (anti-emetic)
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8
Q

What drugs do you give for parkinsons disease and why?

A
  • Leva dopa (precursor of dopamine, can cross BBB unlike dopamine and improve sx. Is also converted to dopamine peripherally)
  • Carbidopa (inhibits the enzyme that breaks down LD into dopamine in PNS, as dopamine can become epinephrine and cause arrhythmias etc)

Known as ‘sinemet’

  • Dopamine Agonists: Ropinerole or pramipexole (trick brain into thinking more dopamine is there)
  • Anticholinergics: Benzhexol or orphenadrine (reduce the ACh, therefore normalising the relative amount of ACh to dopamine, helps with tremor)
  • COMT inhibitors: tolcapone (given with LD to stop it’s breakdown, allowing it to enter the brain)
  • MAO-B inhibitors
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9
Q

Side effects of Sinemet (LD + carbidopa)?

A
  • Dyskinesia
  • On-off phenomenon
  • Painful dystonia (uncontrollable contractions)
  • Visual hallucinations
  • Psychosis
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10
Q

What are the symptoms of ‘Anticholinergic syndrome’, a side effect profile of too many anti-cholinergic drugs

A
  • Dizziness
  • Confusion/delerium
  • Dry mouth
  • Urinary retention
  • Seizures
  • miosis

Ex: Atropine, digoxin, tiotropium bromide, ipratropium bromide, orphenadrine, benzhexol, amitriptyline, frusemide

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11
Q

An example, when used and side-effects of Loop-diuretics

A
  • Frusemide

Used for

  • HEart failure, Hypertension and Edema (HE, HE)

SE:

  • Hyponatremia, Hypokalamia, Hypomagnesemia, oedema (HYPO)
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12
Q

Type of potassium-sparing diuretics, SE, CI and when used

A
  • Aldosterone antagonists
    • Spironolactone
  • Direct Na+ channel inhibitors

SE: Hyperkalamia, gynaecomastia

CI: NSAIDs, ACEi, Lithium

Used for: hyperaldosterism, HTN, Some HFs

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13
Q

Side effects of dopamine agonists?

Eg; pramiprexole or ropinerole

A
  • Hallucinations, disinhibition
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14
Q

When seeing a patient with psychosis who has a background of Parkinsons, what do you need to consider before treating?

A

Whether this is a complication of the disease (likely concurrent depression present) or a medication side effect.

Should consider changing the dose of the dopamine agonist if an issue

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15
Q

Treatment of Mild vs mod/severe Psoriasis

A

Mild

  • Daivobet cream
  • Salicylic acid
  • emolliants
  • Tar cream

Mod/Severe: Immunosup +/- phototherapy

  1. Methotrexate or cyclophosphamide
  2. PUVA phototherapy
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17
Q

What are you 1st, 2nd and 3rd line options for ABx treatment of Rheumatic fever?

18
Q

Treatment for Community-acquired Pneumonia

A
  1. Amoxicillin 500mg po TDS (CURB: 0-2)
    • +/- Doxycycline
  2. Augmentin 1.2g IV q8hr + Clarithromycin 500mg IV q12hr (CURB: 3-4)
19
Q

Hospital Acquired Pneumonia

A
  • Augmentin
    • 625mg po TDS
    • 1.2g IV q8hr
20
Q

Acute exascerbation of COPD or chronic bronchitis

What if penicillin allergy?

A
  1. Amoxicillin 500mg po TDS
  2. Doxycycline 200mg BD
21
Q

ABx treatment of pharyngitis with risk factors for RF

?Alternative if allergic to penicillin?

A
  1. Penicillin VK 500mg po BD
  2. Erythromycin 400mg po BD
22
Q

Blepharitis and conjunctivitis treatment?

A

Chloramphenicol 1% eyedrops or ointment

23
Q

Antibiotic treatment of skin and soft tissue infections?

If allergic to penicillins?

A
  1. Flucloxacillin 500mg po QDS or
  2. Cefalexin 500mg po QDS
24
Q

What is digoxin used for and what medication class is it?

A

Treats AF, HF and atrial flutter

Cardia glycoside, positive inotrope

Long case drugs (2 decks)

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