Miscellaneous Flashcards
Preventing chronic constipation
Fluid and fibre intake
Physical activity
Reduce meat and processed food
Reduce stress
73 yr old Man diagnosed with osteoarthritis of knee.
Best initial therapy?
Acetaminophen
Books and their topics
Meylers side effects of drugs —> side effects
The harriet lane handbook (john hopkins hosp)
—> new guidelines parameters of pharmacology and more
Drug interaction facts by david tatro : drug interaction
Natural medicine comprehensive database : food herb supplements
Enzyme polymorphism that can alter clopidogrel efficacy
Cyp 2c19
Where does the electron transport chain reaction pathway take
Inner mitochondrial membrane
Abbreviation for by mouth
P.O
Per oral
Non essential amino acid
Cysteine
Major histocompatibility complex is unique in
Each individual
Infliximab Side effects long term
Increased risk of TB , URTIs ,
invasive fungal infection, hep B worsening of Hep C,
Girl vomiting . Dehydration. Potassium level low
Give 0.9% sodium chloride with potassium chloride
Oxybutynin
For over active bladder
Urea synthesis occurs in
Liver
Supercoiling of DNA regulated by
Topo isomerase
Other enzymes in option
Primase : ssDNA dependant RNA polymerase . Involved in polymer enlongation
Initiating chain synthesis (RNA polymerase)
Helicases: remodel nucliec acid
DNA helicases separate double strand to single allowing each strand to be copied
Reverse transcriptase: DNA polymerase enzyme transcribes single stranded RNA to DNA. Then synthesize a double stranded DNA.
RSV (respiratory syncytial ) infection in child.
Best treatment?
Fluid and supportive care
Prevention: Pavlizumab (mostly for children at high risk e.g with CHD or premature children under 1 yr
Drugs that can cause pneumonia
Amiodarone Methotrexate Cytotoxic drugs Nitrofurantoin Imidazoline Paraffin Protein tyrosine kinase Omeprazole (PPIs) Metformin
Main absorptive function of colon (large intestine)
Water
Salts (sodium , chloride)
Large intestine = 10% digestion
Small intestine = 90% digestion
Small intestine = food nutrients and minerals
Serotonin syndrome
Confusion Agitation Shaking Restless Delirium Diaphoresis (sweating) Nausea Vomiting Mydriasis Htn tachy
Citalopram
SSRI
Antidepressant
Linezolid drug drug interaction
Citalopram SSRIs MAOs Diet pills Appetite suppressants ADHD drugs Benzodiazepines
Estimated amount of plasma
Plasma volume is 25% of ECF
ECF is 20% of body weight (normally 14 L/)
So for a 70kg male plasma volume is 3.5 L
Rheumatoid arthritis therapy
NSAIds
Corticosteroids
DMARDs disease modifying antirheumatics
Cytotoxins
First line
Methotrexate
Hydroxychloroquine
Sulfasalazine
Second line Azathioprine Leflunamide Corticosteroids Cyclophosphamide Cyclosporine AP Minocycline
DAS28
Daily activity score for rheumatoid arthritis Tender joint count Swollen joint count Physician assessment SDAI (simplified disease activity index) CDAI ( Clinical disease Activity index)
Scores
< 2.6 remission or very good control
2.6 - 3.2 low disease activity
3.2 - 5.1 moderate
> 5.1 high
Ethics in consulting
Autonomy _ determine their own action
Non maleficence _ avoid harm
Beneficence _ provide benefit
Justice _ treat all patients fairly without discrimination
Prevention of constipation from morphine (start)
Docustae
Senna
Sulfa drugs ( to avoid in sulfa allergy)
Sulfamethoxzole Sulfasalazine Dapsone Sulfisoxazole Sulphonamides Furosemide other loop diuretics thiazide diuretics Sulphonyl ureas Sodium thiosulfate
Indications of sevelamer in a patient of chronic kidney disease
Hyperphosphatemia
Sevelamer is a phosphate binding medication used to treat hyperphosphatemia in chronic kidney patients
Digoxin monitoring appropriate time for plasma blood sample
6 hr post dose
7 yr old girl comes with complain of itchy scalp
It’s a lice infestation
Dimethicone lotion
Permethrin is also used but dimethicone is superior
Hyperthyroidism
Low TSH and elevated free T4
Effect of smoking on serum olanzapine levels
Decreased levels
Nicotine is an inducer so olanzapine is quickly metabolized reducing it’s levels
31 yr old methamphetamine addict was treated for HTN. Later presented with depression.
Which HTN drug was given?
Methyl dopa
Methamphetamine increases cascading release the dopamine amount and inhibit it’s re-up take ( euphoric)
Methyl Dopa: decreases cascading epinephrine dopamine and serotonin
Senna glycoside that damages liver on prolonged use
Anthraquinone
Hepatotoxic anesthesia
Halothane
Desflurane
Isoflurane
Chemical reactions to briefly see
Oxidative deamination ( removes N group and gives a byproduct of NH4)
Hydrolysis (breakdown by water)
O dealkylation (an alkyl group is removed from O and replaced with H)
a hydroxylation (hydroxyl group added at a position)
Salbutamol (albuterol)
Ventolin
Bronchodilator
B2 agonist
Benign prostate hyperplasia treatment
Tamsulosin (a blocker)
5 alpha reductase inhibitors (finastride (proscar), dutasteride)
Tadalfil (also used for for erectile dysfunction)
Medication for ripening and dilation of cervix
Misoprostol
Atosiban
Labor suppressant
Inhibits oxytocin and vasopressin
Chlorpromazine
Antipsychotic
Blocks histamine H1 dopamine D2 and muscarinic M1 receptors in vomiting center
Antiemetic
Premature ejaculation drugs
Dapoxetine
SSRIs escitalopram, sertaline, paroxetine, fluoxetine)
Sildenafil (viagra) tadalfil, verdenafil
What is best described as drug dependence?
Discontinuing the drug will cause withdrawal symptoms
Body removes 99% drugs by first order kinetic after single dose in how much time?
7 half lives
Celiac disease
Autoimmune disease
Celiac sprue or gluten sensitive enteropathy.
Immune reaction to gluten in barley rye wheat.
Malabsorption of protein cz of villi damage
