Medications Flashcards
Management of bacterial meningitis in pregnancy
Cefotaxime 2g iv 4-hourly
Amoxicillin 2g iv 4-hourly
Aciclovir 10mg/kg iv tds if HSV encephalitis suspected
Treatment of bacterial meningitis in >18yo
Cefotaxime 2g iv 4-hourly
Aciclovir 10mg/kg iv tds if HSV encephalitis suspected
Treatment of abdominal sepsis
Cefuroxime 1.5g iv tds
Metronidazole 400mg po tds
Treatment of cholangitis / cholecystitis
Ciprofloxacin 750mg po bd
Or
(If severe) Piperacillin/tazobactam 4.5g iv tds
+ Gentamicin 5mg/kg iv stat
Triple therapy for H. Pylori eradication.
Omeprazole 20mg po bd
+ Amoxicillin 1g po bd
+ clarithromycin 500mg po bd
Management of bacterial peritonitis
Cefuroxime 1.5g iv tds
+ Metronidazole 500mg iv tds
Treatment of mild / moderate CAP
Amoxicillin 500mg PO TDS
Doxycycline 200mg PO BD for 48hrs
then 200mg PO OD
Treatment of severe CAP
Benzylpenicillin 1.2-2.4g iv qds
+ Doxycycline 200mg po bd for 48hrs then 200mg od
OR
Clarithromycin 500mg iv bd
Treatment of infective exacerbation of COPD
Doxycycline 200mg po bd for 48hrs then 200mg od
5-7d
Treatment of aspiration pneumonia
Doxycycline 200mg po bd for 48hrs then 200mg od
+ Metronidazole 400mg po tds
7d
Treatment of mild / moderate HAP
Doxycycline 200mg po bd for 48hrs then 200mg od
Treatment of mild cellulitis
Flucloxacillin 500mg -1g po qds
or if MRSA-positive
Doxycycline 200mg po bd for 48hrs, then 200mg po od
Treatment of infected diabetic ulceration
Doxycycline 200mg po bd for 48hrs then 200mg po od
Ciprofloxacin 750mg po bd
Metronidazole 400mg po tds
Treatment of animal / human bite
Co-amoxiclav 1.2g iv tds
7-10d
Antibiotic prophylaxis of open fracture
Co-amoxiclav 1.2g iv tds
3d
Treatment of necrotising fasciitis
Piperacillin/tazobactam 4.5g iv qds
+ Clindamycin 1.2g iv qds
+ Metronidazole 500mg iv tds
+ Gentamicin 5mg/kg iv stat (renal function permitting)
Treatment of septic arthritis
Benzylpenicillin 1.2g iv qds
+ Flucloxacillin 2g iv qds
+ Sodium fusidate 500mg po tds
TReatment of UTI
Trimethoprim 200mg po bd 3 days,
or Nitrofurantoin1 50-100mg po qds 7 days
Treatment of pyelonephritis
Ciprofloxacin 750mg po bd (400mg iv bd if nil-by-mouth or not absorbing) for 7 days
[+ Gentamicin 5mg/kg iv protocol for up to 48hours if severe sepsis]
Signs of digoxin toxicity
Confusion, nausea, arrhythmia, visual disturbance.
Add on therapy for loop diuretic resistant Oedema in HF
Thiazide
E.g metolazone
What drugs improve mortality in heart failure?
Spironolactone
Beta-blockers (bisoprolol, carvedilol)
ACE Inhibitors / ARB
(Isosorbide dinitrate with hydralazide for Afro-carribeans)
Digoxin DOES NOT
Dobutamine is for SHORT term use only in acute decompensation.
Management of acute severe pulmonary oedema
15L O2 NRB
IV morphine 5mg - slowly
IV furosemide 20-40mg - slowly
Sublingual GTN 2 sprays
What does amiodarone do?
Prolongs the Q-T interval
Increase the refractory period.
Used to treat VT.
Long term consequences amiodarone?
Brachycardia Pulmonary fibrosis, hepatic fibrosis Corneal micro-deposits Photosensitive rash Thyroid dysfunction
Side effects of beta-blockers
Lightheadedness, syncope, dizziness Bradycardia Cool hands and feet Tiredness Impotence Vivid dreams
Side effects of ACE inhibitors
Persistent Dry cough
Dizziness
Angio-oedema
Decreased kidney function
Side effects of the digoxin
Dizziness Blurred or yellow vision Nausea Diarrhoea Skin rash Gynaecomastia
Side effects of spironolactone
Gynaecomastia
Fatigue
Dizziness
Side effects of verapamil
Constipation
Nausea
Headache
Side-effects of nifedipine
Palpitations, dizziness, feeling faint Flushing Nausea, indigestion, constipation, diarrhoea Headache, ankle oedema
Side effects of thiazide diuretics
Gout
What is minoxidil
Vasodilator
+ scalp solution for hair loss
Side effects of hydralazide
Drug induced SLE
Signs of aminophylline toxicity
Nausea, vomiting, cardiac arrhythmia.
First line treatment of mild CAP
Amoxicillin 500mg PO TDS
Antibiotics to treat cellulitis
Benzylpenicillin
Flucloxicillin
First line antibiotic for meningitis in hospital
Cefotaxime
Important side effect of carbimazole
Agranulocytosis
–> dramatic fall in neutrophils, basophils, eosinophils.
Predisposes patient to overwhelming sepsis.
Usual trimethoprim dose
200mg BD
3-5d for UTI
Usual dose of metoclopramide
10mg TDS
Uses of metoclopramide
Antiemetic
Prokinetic
Common dose of prednisolone
40mg OD
Common dose of hydrocortisone
100mg IV BD
Anaphylaxis dose of adrenaline
1mg of 1 in 1000 IM = 1ml
Cardiac arrest dose of adrenaline
1mg of 1 in 10,000 IV = 10 ml
What is Reye’s syndrome + it’s cause
Fatty infiltration of the liver
Severe encephalopathy
Coma
40% fatality
Caused by giving aspirin to children
Why are patients warned not to drink alcohol with metronidazole
Metronidazole inhibits aldehyde dehydrogenase
Causes facial flushing, tachycardia, vomiting,
What are amphetamines used to treat
Narcolepsy
What is donepezil used for
Alzheimer’s disease
Anticholinesterase inhibitors - others = rivastigmine, galantamine
Treatment of TB meningitis
6 months - rifampicin, isoniazid, pyrazinamide, ethambutol
Further 6 months - rifampicin, isoniadpzid (total 12 months)
What is chlordiazepoxide used for
Alcohol withdrawal
What drug acts by inhibiting the gama-carboxylation of vitamin k dependent clotting factors
Warfarin
Factors II, VII, IX, X
What is hyoscine used for
And how does it work
Used for irritable bowel syndrome, abdominal cramping and motion sickness.
Can reduce gastric and respiratory secretions.
It is an antimuscarinic (anticholinergic)
It has many side effects
How does omeprazole work
It is a proton pump inhibitor.
Inhibits parietal h+/k+ ATPase proton pumps
How do NSAIDs work
Cox inhibitors (cyclo-oxygenase) Which is responsible for synthesis of pro-inflammatory prostaglandins.
Why do NSAIDs increase the risk of gastritis / Peptic ulcer disease
Cox inhibition decreases prostaglandin synthesis.
Prostaglandins help regulate gastric acid production.
So a reduction leads to gastric mucosa damage by gastric acid.
What patients should not be prescribed NSAIDs
Asthmatics
Pts prone to gastritis or peptic ulcer disease
Pts with renal impairment
Management of erysipelas
2 days IV - flucloxacillin 500 mg QDS
2 weeks oral - flucloxacillin 500mg QDS
Erythromycin 500 mg QDS if penicillin allergic
How does adrenaline help in a cardiac arrest
Peripheral and splanchnic vasoconstriction diverts blood away from GI tract and skin to the heart and brain.
Increases coronary and cerebral perfusion pressures
How does amiodarone work
Membrane stabilising drug
Increases the refractory period of the cardiac cycle
Used in VF and VT
How does atropine work
Antimuscarinic drug
Blocks the vagus nerve
Increases the rate of the SA node and AV node
SE of sulfasalazine
Oligospermia
Bone marrow suppression
Hepatitis
SE of gold treatment
Bone marrow suppression
Nephrotic syndrome
SE of penicillamine
Taste alteration
Nephrotic syndrome
Myasthenia
SE of chloroquine
Retinopathy
Tinnitus
SE of steroids
Weight gain Thin skin Easy bruising Muscle weakness Stretch marks Osteoporosis Diabetes onset / worsening of existing DM Hypertension Glaucoma Cataracts Slow wound healing Increased risk of infection
What nutritional supplements may aid wound healing
**vitamin C** vitamin A Zinc Arginine Glutamine Glucosamine
