Medications Flashcards
Venixxa
For chronic venous disease - like haemorrhoids and varicose veins.
Made from orange peel extracts, to use when there is a flare up, take 2x times a day.
If using a cream - can try Anucort
SGLT2
GLP-1
SGLT2 - Not in DKA! Will not help type 1 DMs , can be useful in heart failure
GLP-1 - not as helpful in non-obese diabetics
Lithium
Use for Bipolar - quite effective for some reason
Need to monitor for chronic kidney damage leads to diabetes inspidus
Huge amounts can be sedating
Naproxen
Good for medium pain - better than Advil, less hardcore than Tordol
Can use Aleve 220mg if no drug coverage for Naproxen
Biogaia
Baby probiotics (for use with abx) or if colicky
Haloperidol dosing?
For older psychotic patient - start at 1mg x 1 hour no more than 3mg
For healthy younger patients - start around 1-2mg if easy to give to them. If having to restrain them/ IM injection up to 3mg at once.
VERY sedating!
Statins?
Moderate potency - 10-20mg usually atorvastatin or rosuvastatin
High potency - 20-40mg usually atorvastatin or rosuvastatin
Starting insulin?
Start off with long-acting - Tresura - 10 units bedtime
Efudex (Flurouracil)
For the chemical removal of AKs, not generally used over liquid nitrogen, and don’t give it to the cognitively less than sharp - can burn their skin off.
Suboxone
Not great for analgesia - but safe has a ceiling effect on respiratory depression
On long term PPI’s? What considerations must be made?
May have decreased Mg, Fe absorption (Vit C and Fe supplementation), consider stopping and decreasing them once a year (bad rebound)
BID/QID vs q_hours?
BID/QID etc - is an instruction of how many times a day should be given
q_hours - is an instruction of the time intervals the med should be given
Vimovo?
NSAID with stomach protector
Amiodarone
Type 3 antiarrhythmic - not a nodal blocker so is good for wide complex tachycardia. Can be used for a.fib and left ventricular systolic dysfunction
Cholestyramine
Cream for diaper rash, any area of acidic skin exposure
On methadone - do they need further analgesia for a procedure such as setting a shoulder or giving birth?
Yes! Methadone does not offer very good analgesia, and given likely tolerance and hyperalgesia will likely need more pain relief. Also methadone is given once a day, so it is low dose and slow release.
- May not accept opioids. Can contact college for advice about methadone prescription. Can try other options first - like tordol.
Uterine relaxants
It’s Not My Time -indomethecin, Nifedipine, Mg sulfate, Terbutraline
C. Diff and on a PPI?
Take them off the PPI!
Misoprostal SE
Temporary explosive diarrhea, GI upset, painful bleeding and cramping
Scopalimine can cause what eye sx?
Unilateral dilated eye - because of the patch
Avoid NSAIDs with?
Anticoagulants, renal and hepatic failure, 3rd trimester of pregnancy
LU codes?
Over age 50, look up the drug using an app - basically means that government will only cover a certain amount under certain criteria
Celecoxib and furosemide avoid in?
People with true Sulfa allergies
Zyloprim?
Lots of side effects, for the prevention of gout, try to use to titrate the urate down then stop. Use colchicine after that.
Prednisone taper?
Less than 15mg usually less significant side effects, taper slowly down to 15 and then from 1mg from there until you get the sx again.
Anbesol?
For teething pain, pinky finger to rub on gums. Try cold things and gummy things to chew on first. Can use Advil, infant dosing too
Do PPV and NPV relate to the population or a sample?
Relate to a sample population (and of you are dealing with something VERY rare the PPV will usually be crappy (because you are testing for something so exceedingly uncommon)
Metaclopramide
First line for N/V but not in bowel obstruction, geriatric. Can also be good for headaches in pregnancy
HTN management?
ACE/ARB
Beta blockers
CCB
Diuretics
Some people that it is appropriate to give benzos to for anxiety?
Panic attack disorder without anxiety underlying. Palliative patients that are not mobile
Contrave
Can’t give if heavy alcohol and opioids, half dose with plavix
Very useful in obesity and diabetes, use in AM, and late afternoon - will keep you up otherwise.
Dubrii
For psoriasis- affected skin only, 2 tubes a month
Before starting biologic
Screen for TB
Keppra
Needs a loading dose, for seizure disorder - but does not need regular monitoring. Can make drowsy + GI
Tantum rinse
For sore throats you aren’t going to give them abx
Aspirin in kids?
Not usually, because of risk of Reyes, but give in Kawasaki
Ferrous Sulfate s/e
GI upset - can cause constipation. Darkening of stools
Ferrous glucanate is more preferred - better absorbed
Trumemba
Men B vaccine - for age 10-25, quite effective
Bexsaro for babies - important especially for children with cochlear implants
Provide with Tylenol
Fomepizole?
For toxic alcohol ingestion - can also just get them really drunk
Admission orders - standard
Tylenol 1g q6h PO PRN
Zofran 4-8mg PO PRN
PEG 3350 17-34g packet PRN
Benzatropine
Aka cogentin, for treatment of EPS sx of antipsychotics - not useful for tardative dyskinesia
How does Lasix work?
Act on the thick ascending loop of Henle, and gets there by binding albumin - so if they are ESRD realize that they have terrible filtration so you can give them tons - start on 120 BID for lasix, and increase. Just stop when they start getting otoxicity
Metalozone
Thiazides diuretic, can give with lasix if the lasix does not work - need to monitor potassium.
Vennofer
Iron surcrate - 300mg for 2-3 days.
Propranolol for
Graves’ disease
Side effects of amnioderone
Hypothyroidism, pulmonary fibrosis - not a good long term drug
Eye drops
Ciprofloxacin opthamalogic drops, 2 drops q2hrs for 2 days, while awake then q4hrs for 5 days while awake
How to start antidepressants
Half therapeutic dose for a week then increase to therapeutic. If no improvement after 3-4 weeks, switch, if any improvement at all increase dose by half until at max or not tolerated, then if still needed add on an augmentation - novel antipsychotics - can treat mild thyroid. If flattening from SSRI/SNRI lower dose and try bupropion (so long as no anorexia/anxiety)
Escitalopram vs venlafaxine for anxiety first line
SSRI (good for depression/sleep/ appetite as well as anxiety) SNRI (good for autonomic sx predominant anxiety) also consider family hx - was there an agent that worked best?
Prescribing benzos?
Put a strict time limit - no unlimited refills (6-8weeks while waiting for SSRI/SNRI) warn they are addictive, alcohol use should be avoided.
Adjunct to SSRI/SNRI?
Abilify - try to wean off after a year to avoid risk of EPS
Don’t trust them with benzos but they don’t want the weight gain effects?
Buspar
