Medications Flashcards
GTN
Glyceryl trinitrate
Spray 400microg
Tablet 300microg-600microg
Champix
Varenicline
0.5mg once daily for 3 days, then 0.5mg twice daily for 4 days, then mg twice daily for total 12 weeks
SE: mood changes
Antibiotics for CAP in children
1. Amoxicillin 25mg/kg 8hrly for 3 days If non severe penicillin allergy cefuroxime Immediate or severe penicillin allergy Azithromycin Clarithromycin Or if >8yo doxycyline
Otitis media dosing in atsi guideline
- Amoxycillin 50mg/kg/day 2-3x per day for at least 7 days
If not improving in 4-7days
Increase amoxil dose to 90mg/kg/day
Or single dose azithro 30mg/kg
- repeat if not improving
If still persistent then either continue high dose amoxil or start augmentin 90mg/kg/day
Easy OM doses
Amoxicllin 15mg/kg q8h for 5 days
Or 30mg/kg bd
Augmentin 22.5/3.2mg/kg
Croup
Prednisolone 1mg/kg
Dexamethasone 0.15mg/kg
If severe 0.6mg/kg (Max 12mg)
+ nebulised adrenaline 0.5ml/kg of 1:1000 to Max 5ml undiluted
Scarlet fever
Phenoxymethylpenicillin 500mg q12h for 10 days
Kids 15mg/kg
Pinworm
Mebendazole 100mg (if <10kg 50mg)
Pyrantel 10mg/kg up to 1g
Albendazole 400mg or if <10kg 200mg
As single dose
Anaphylaxis
Adrenaline 1:1000 IM 0.5ml stat
Or 0.01ml/kg in kids (10mcg/kg)
Constipation kids
Parrafin oil (parachoc) Macrogol 3350 1-4 sachets per day Osmolax Lactulose 10-40ml per day Coloxyl/poloxamar 0.8ml tds
Pertussis
Azithromycin 500mg day 1 then 250mg for 4 further days
Or. Clarithromycin 500mg q12h for 7 days
2. Bactrim 160/800 q12h for 7 days
Cystitis kid
Trimetoprim + sulfamethoxazole 4+20mg/kg up to 160/800mg orally 12hrly for 3 days
Or just trimethoprim 4mg/kg bd up to 150mg if available
2. Cephalexin 12.5mg/kg up to 500mg q6h for 3 days
Cystitis non pregnant adults
- Trimethoprim 300mg daily for 3 days
2 . Nitrofurantoin 100mg q6h for 5 days
If neither above can be used
Cefalexin 500mg bd for 5 days
Cystitis pregnancy
- Nitrofurantoin 100mg q6h for 5 days
- Cefalexin 500mg q12h for 5 days
If 2nd or 3rd trimester trimethoprim 300mg daily for 3 days
Cystitis in men
- Trimethoprim for 7 days
- Nitrofurantoin for 7 days
- If prostrations unlikely cefalexin 500mg q12h for 7 days
Vaginal hrt
Estriol 1mg/g cream one applicator (0.5mg) nocte for 2-3 weeks then once or twice weekly
Trigeminal neuralgia
Carbamazepine 100mg er bd increased as needed every 7 days up to 400mg bd
OM with allergy to penicillin
- Cefuroxime 15mg/kg to 500mg bd for 5 days
2. trimethoprim/sulfamethoxazole 4+20mg/kg to 160/800mb 12hrly for 5 days
Chronic suppurative otitis media
Ciprofloxacin 0.3% ear drops 5 drops into affected ear q12h until the middle ear free of dc for at least 3 days
Restless legs syndrome
- Levodopa + benserazide (or carbidopa) 100+25mg orally before bed
If severe
Gabapentin 100mg orally up to 1200mg nocte
Pregabalin 75mg nocte up to 450mg nocte
Or
Pramipexole 0.125mg nocte 2hrs pre bed
Parkinsons disease
- Levodopa + carbidopa or benserazide 50+12.5mg tds increasing up to 100+25 over 1-2 weeks
- Pramipexole mr 0.375mg orally daily up to 4.5mg daily (there is a ir available which is tds)
- Rotigotine 2mg transdermally once daily, increasing by 2mg every week to Max 8mg daily
Se - nausea, take with food, tolerance to nausea develops quickly
Treatment for Paget’s disease
Zolendronic acid 5mg IV over 5 mins
ensure Vit D, Ca normal, pt well hydrated and eGFR >35
alkternatively risedronate 30mg orally on empty stomach daily for 2/12
Seizure
midazolam 0.2mg/kg (up to 10mg) bucally, intranasally, IM - repeat in 10mins if seizure continues
Pericarditis
Colchcine 500mg oral BD for 3 months (if <70kg once daily)
AND
aspirin 750-1000mg Q8H fir 1-2 weeks, then decreased by 250-500mg every 1-2 weeks then stop
Iburpofen 600mg Q8H for 1-2 weeks, then decreased dose by 100-200mg every 1-2 weeks then stop
Psoriasis on trunk and lims
- Coal tar prepared 1% emulsion or gel TOP once or twice daily for 1 month
- LpC 6% + salicylic acid 3% cream or ointment TOP twice daily for 1 month
If tar alone is not sufficient or for acute flares
1. Methylprednisone aceponate 0.1% ointment once daily until skin is clear (usually 2 to 6 weeks)
Or
Mometasone 0.1% ointment once daily until skin clear as above
If inadequate after 3 weeks change steroid to betamethasone dipropionate 0.05% ointment once daily until skin is clear
If few scattered plaques, not responding to tar, or needing longer term steroids consider
Calcipotriol + betamethasone dipropionate 50+500 microg/g ointment once daily - don’t use >100g per week due to risk hypercalcaemia
Acute angle closure glaucoma
if opthalmologist >1 hr away and significant vision loss OR IOP >40mmHg
give Timolol 0.5% one drop to affected eye then wait 1 minute
(CI if CI to beta blockers)
Strep throat IM dose
benzathine benzylpenicillin IM single dose >20kg 1.2million units 12-16kg 0.6million units 6-12 kg 0.45million units <6kg 0.3 million units
2nd line treatment OCD
Clomipramine 25-75mg PO increase up tolerated to dose of 150mg; max 300mg; need ECG first and at 6 weeks
migraine triptan
sumitriptan 20mg intranasally - max 40mg in 24hours
sumitriptan orally 50-100mg; max 300mg in 24 hrs
wait 2 hours before repeating dose; repeat dose if needed, if some response but inadequate; if not response from triptan do not give 2nd dose this attack (can retry during another attack)
bell’s palsy
prednisone 1mg/kg up to 75mg od for 5 days; + if within 72 hrs valaciclovir 1g q8h for 5 days (low quality evidence)
Implanon
Etonogestrel 68mg implant subdermally
Mirena
Levomorgestrel releasing IUD 52mg inserted into the uterus
Depot
Medroxyprogesterone 150mg by deep IM every 12 weeks
Norethisterone
5-10mg once daily
Cocp
Ethinyestradiol 30mcg +levonorgestrel 100mcg
Acute gout
- Local corticosteroid injection (triamcinolone acetonide 40mg/ml, 0.1-0.25ml administer by intra articular injection
- Nsaid 3-5 days
- . Prednisone 15-30mg po until symptoms abate, 3-5 days
- Colchicine 1mg then 1 hr later 500microg
Solar keratoses
- Fluorouracil 5% cream TOP once or twice daily for 2-4 weeks on the face or 3-6 weeks on arms and legs
- Imiquimod cream 5% topically nocte 3x per week for 3-4 weeks, washing area with mild soap and water in tbe morning; review at 4 weeks and if ongoing spots repeat once only
Ingenol mebutate 0.015% gel TOP on face or scalp, OD for 3 consecutive days
Tinea treatment
terbinafine 1% gel TOP once to twice daily for 7-14 days
onychomycosis
terbinafine 250mg orally once daily; 12 weeks toenails, 6 weeks fingernails
guttate psoriasis
coal tar topical 1% gel/emulsion
LPC6% + salicyclic acid 3% cream BD for a month
potent corticosteroid
calcipotriol (vit D anaolgs) top daily cream; no moe than 100g/week
preseptal cellulitis
for 7 days
1. flucloxacillin 500mg (12.5mg/kg) PO Q6H for 7 days
cefalex same dose if delayed non severe HS to penicillin
clindamycin 450mg (10mg/kg) Q8H if severe HS to pencillin
if concurrent sinuisitis, RFs for HIB (<5yo not vaccinated) - augmentin 22.5/3.2mg/kg up to 875/125mg for 7 days
OR 2nd line cefuroxime 500mg (15mg/kg) Q12H for 7 days
Oral candidiasis
- miconazole 2% gel 2.5mL TOP then swallowed, 4x dailym after foor, 7-14 days; continue treatment at least 7 days after symptoms resolve
- amphotericin B 10mg lozenge sucked, then swallowed, 4x daily, after food for 7-14 days continue 2-3 days after symptoms resolve
- nystatin 100 000 Units/mL 1mL TOP, then swallowed, 4x daily, for 7-14 days, continue treatment 2-3 days after symptoms reslve
HIV PREP
tenofovir 300mg/emtricitabine 200mg 1 daily (continuous)
or on demand 2-1-1 method
2 pills at least 2h before sex (can be up to 24hr), 1 pill 24hr later and then 1 pill 48hr after first dose
diabetic neuropathy
- amitriptyline
2. duloxetine/gabapentin/pregabalin
Iron
elemental iron 100-210mg (kids 3-6mg/kg); i.e. ferrous sulfate 325mg
when do you use fenofibrate in diabetes
add on to statin or in place of if not tolerated when TG >2.3 or HDL is low
bloods to confirm type 1 diabetes
glutamaic acid decarboxylase (GAD) and insulinoma antigen 2 (IA-2) anitbodies + in 90% type 1; c-peptide (<0.2) considering
paracetamol dose in kids
15mg/kg
ibuprofen dose in kids
10mg/kg TDS
doses of cardioselective B-blockers
bisoprolol 1.25mg daily - up to 10mg daily
carvedilol 3.125mg BD - up to max 25mg BD (can go to 50mg if >80kg)
metoprolol succinate MR 23.75mg daily - to max 190mg daily
treatment of hyperthyroidism
- carbimazole 10-20mg if mild, 30 to 45 mg orally if severe (thyroid hormones 2.5x higher), daily in 2 or 3 divided doses. Adjust the dose at 4- to 6-weekly intervals as required
- propylthiouracil 100-200mg if mild, 300 to 450 mg orally if severe, daily in 2 or 3 divided doses. Adjust the dose at 4- to 6-weekly intervals as required
Emergency contraception
levonorgestrel 1.5mg STAT
or levonorgestrel 750microg stat and repeat in 12 hours
ulipristal 30mg orally STAT
Chlamydia
when pregnant: azitrhomycin 1g STAT
doxycycline 100mg BD for 7 days
in symptomatic anorectal infection doxy for 21 days
Gonorrhea
ceftriaxone 500mg IM in 2mL lignocaine 1%
+ Azithromycin 1g STAT
if pharyngeal azitrho dose 2g
if conjuncivitis ceftriaxone increases to 1g
PID
Ceftriaxone 500mg in 2mL lignoacine 1% IM or IV STAT 500mg
+ metronidazole 400mg BD for 14 days
+ doxycycline 100mg BD for 14 days
If pregnant change doxy to azithro 1g now and in one week
menopause, non HRT
desvenlafaxine 25-150mg daily
pregabalin 75-150mg BD
clonidine 25-75microg BD
Abs for COPD exacerbation
Amoxil 500mg 8h, or 1g 12hr
doxy 100mg daily
LABA
onbrez breezhaler = indacterol 150microg INH via DPI daily, increasing to 100microg daily if needed
LAMA
Tiotropium 5 microg by HN via mist inhaler, daily
Spiriva respimat
SABA
salbutamol 100-200microg by inhalation via pMDI with spacer
LAMA/LABA dual therapy
olodaterol+tiotropium 5+5 microg by INH by mist inhaler daily
Spiolto respimat
LABA/LAM/ICS
trelegy ellipta
fluticasone 100/umeclidinium62.5/vilanterol 25 microg via INH via DPI daily
SAMA
not recommended as reliever alone in COPD
tiotropium (atrovent)
asthma exacerbation severities
mild/mod - sats >94%, whole sentence
severe - access muscles, can’t complete sentence, sats 90-94%
life threatening - sats <90%, poor resp effort, reduced LOC
nebulised asthma med doses
ipratropium bromide 500mcg
salbutamol 5mg
montelukast doses
adults 10mg daily
6-14yo 5mg
1-5yo 4mg
note it is less effective than ICS
Gout prophylaxis
allopurinol 50mg orally for 4 weeks, then increase by 50mg every 2-4 weeks –> to max 900mg daily
first line medications for painful peripheral acute neruopathy
gabapnetin 100-300mg PO nocte - increasing to eventually max TDS total 3600mg, max 900mg if frail/>70
pregabalin 25-75mg orall nocte - to max 600mg/day, 300mf if >70/frail
treatment giant cell arteritis
prednisone 40-60mg orally dailly (can be divied into 2 doses), for minimum 4 weeks; once symptoms resolve and inflam markers normal reduce dailly doses by 10mg every 2 weeks to 20mg daily, then 2.5mg every 2-4 weeks to 10mg, then 1mg every 4-8 weeks then stop
aspirin 100mg
if any visual loss - IV methylprednisolone 0.5-1g IV over 1 hour daily for 3 days then switch to oral prednisone
treatment of UTI in pregnancy
- nitrofurantoin
- cefalexin
in 2nd and 3rd trimester could use trimethoprim
if resistance on sample and needs change - amoxicillin (500 Q8H)
- augmentin (500/125 BD)
empirical therapy for acute infectious diarrhea
- ciprofloxacin 500mg POR Q12H for 3 days
- norfloxacin 400mg PO Q12H for 3 days
If infection likely to be aquired where there is quinolone resitance or child needing oral susepcion:
Azithromycin 500mg PO daily for 3 days
treatment for persistent pruritis ani
methylprednisolone aceponate 0.1% fatty ointment TOP, once daily until skin is clear and itch gone - for up to 4 weeks
Giardia
- tinidazole 2g STAT - discontinued in Aust
- metronidazole 2g PO daily for 3 days (children 30mg/kg)
- metronidazole 400mg Q8H (childrenm 10mg/kg) for 5 days
naloxone dose
V/IM/SC, 400–800 micrograms repeated as necessary; larger initial doses may be required; be guided by pupil size and clinical response. If the diagnosis of opioid poisoning is correct, the patient should improve in 1 minute.
eTG says if hypoventilation 400micrgo to 2mg
oral canididiasis in children <2yo
- nystatin 100 000 U/mL 1mL TOP QID after feeding for 7-14 days, continue for 3 days after symptoms
- Miconbazole gel 2% 1.25mL TOP QID after feeding for 7-14 days, continue for 7 days after symptoms resolve
allergic conjunctivitis
azelastine 0.05% eye drops 1 drop both eyes 2-4x/day
ketotifen 0.025% eye drops, 1 drop both eyes, twice daily
HSV keratitis
aciclovir 3% eye ointment 5x daily, for 10-14 dars OR at least 3 days after healing (whichever is shorter); if topical NA
valaciclovir 500mg PO Q12H for 7-10days
cyclopegic
dilates pupil
one drop cyclopentolate 1% opthalmic solution
topical eye pain relief
one drop 0.5% tetracaine opathalmic solution, may repeat in 5-10mins if needed
herpes zoster opthalmicus
valaciclovir 1g PO Q8H for 7 days
oral therapy for preseptal cellulitis
- flucloxacillin 500mg (kids 12.5mg/kg) POR Q6H for 7 days
if delayed non severe HS to pencillincs
cefalexin 500mg (kids 12.5mh/kg) PO Q6H for 7 days
severe or immedaite HS penicllin
Clindamycin 450mg (10mg/kg) PO Q8H for 7 days
if Hib RFs/concurrent sinusitis
augmentin duo forte
cirrhosis examination findings
spider naevi
palmar erythema
gynaecomastia
splenomegaly
cirrhosis examination findings
spider naevi
palmar erythema
gynaecomastia
splenomegaly
hep C antivirals (treatment niave)
epclusa: sofosbuvir+velpatasvir (400/100mg) 1 tablet daily for 12 weeks
H Pylori treatment
Esomeprazole 20mg BD for 7 days
amoxicillin 1g BD for 7 days
Clarithromycin 500mg BD for 7 days
H Pylori eradication if penicillin allergy
PPI BD
metronidazole 400mg PO BD for 7 days
clarithromycin 500mg PO BD for 7 days
risks PPI use
short term - interstitial nephritis
long term - hypoMg, increased risk pneumonia, C.Fidd, impair nutrient absorption, increased # risk
dermatitis herpetiformis
dapson
Seborrhoeic dermatitis in infants
scalp: 1% sulphur + 1% salicyclic acid - apply overnight and wash off in morning; 3x/week
older kids: ketoconazole 2% shampoo
treatment erysipelas
phenoxymethylpenicillin 500mg Q6H for 5 days
OR procaine benzylpenicillin 1.5g IM daily for 3 days
if HS penicillins cefalexin 500mg Q6H for 5 days
severe HS penicillin
Clindamycin 450mg Q8H for 5 days
treatment for purulent cellulitis (associated ulcer, abscess, penetrating trauma)
- dicloxacillin
- cefalexin
increased risk MRSA: - bactrim
- clindamycin
alpha blocker for BPH
tamsulosin or prazosin
5 alpha reductase inhibitor
finasteride/dutasteride
naltrexone
50mg once dailly
acamprosate
666mg TDS, start 1 week after drinking cessation
treatment for bipolar depression in adults
lamotrigdine lihtium lurasidone olanzapine quetiapine
croup
prednisonhe 1mg/kg;
or dex 0.15mg/kf
severe - adrenal 0.1% 5mL INH via neb
+ pred 2mg/kr or dex 0.6mg/kg
high risk cervical cancer - refer without 12 month repeat
2 or more years overdue for CST
identify as ATSI
ages 50-69
treatment vulvovaginal candidiasis
clotrimazole 1% cream intaveginally nocte for 6 nights; or 10% for one night or fluconazole 150mg PO stat
non pharm management of thrush
non soap cleanser
avoid tight clothing
avoid irritants/steroid cream
Nortriptyline
start 10-28days before quitting, continue for 12 weeks after stopping
25mg once daily –> increased to 75mg gradually
SE - arryhtmia in CV, dry mouth
Bupropion
start whie smoking, set quit date for 2 weeks later
150mg daily for 3 days, then BD for total 9/52 course
SE - seizure, CI if on MAO-I, caution with antipsychotics/depot
Apixaban
VTE - 10mg BD for 7 days, then 5mg BD ongoing - if Crcl >25
AF - 5mg BD
if 2 of <60kg, >80yo, CrCl >133 = 2.5mg BD
Rivaroxaban
VTE - 15mg BD for 3 weeks, then 20mg daily ongoing (needs Cr Cl>30)
prophylaxis of VTE - 10-20mg once daily
AF 20mg once daily
CAD - 2.5mg BD with aspirin
Dabigatran
needs clexane bridging on commencement for 5 days
VTE- 150mg BD
>75yo/high bleeding risk/eGFR <50 - 110mg BD
heart failure specific beta blockers with doses
carvedilol 3.125mg BD –> titrate to 50mg BD
Metoprolol succinate 25mg once daily –> titrated up to 200mg once daily
NEbivololv
Bisoprolol 125mg once daily –>10mg once daily
prostatis first line treatment
trimpethoprim 300mg PO daily for 14 days
Otitis externa prevention
Acetic acid + isopropyl ear drops 4-6 drops after water
Otitis externa fungal and not fungal
Flumetasone + clioquinol 0.02%+1% ear drops 3 drops bd for 7 days
