Must Know treatments Flashcards
Immediate Treatments hypercalcaemia crisis
Rehydration (normal saline)
Increase renal excretion of calcium (loop diuretic/ frusemide) (dialysis is cormorbidities limit other options)
Blunting if calcium release from skeletal stores (bisphosphanates and calcitonin)
Treat underlying cause of hypercalcaemia
Paediatric fluid resuscitation volume
Crystalliod: 20ml/kg
Blood: 10ml/kg
Paediatric maintenance fluid
4:2:1 rule
4ml/kg for first 10kg
2ml/kg for next 10kg
1ml/kg thereafter
Key points of using phenol for nail wedge resection
80% phenol
Protect skin with Vaseline
3x 30 second applications with cotton swab
Wash out for iso-alcohol
Mechanism of action: tacrolimus
Calcineurin inhibitor
- binds FK506 binding protein
- prevents IL2 formation by T cells
- T-lymphocyte activation is inhibited
Mechanism of action: mycophenolate
Inhibits synthesis of purines
In turn this reduced lymphocyte proliferation, antibody formation and cell mediated immune response
Mesalamine/ 5-ASA
Used for UC
Enema preferred, also oral formulation
Exact mechanisms unknown
Thought to modulated inflammatory response by decreasing prostoglandin and leukotiene production
Various slow release forms
Sulfasalazine - prodrug that is released distal colon to rectum
Mercaptopurine and azathioprine - mechanism of action
Both prodrugs of purine analog hypoxanthine; antagonist to endogenous purines; this leads to inhibition of DNA replication, RNA and protein synthesis
Second pathway via TMPT inhibits purine synthesis
Inhibition of signaling pathway (VAc-Rac1) in t-lymphocytes induces apoptosis
Mechanism CTLA-4 inhibitors
Monoclonal antibody to CTLA-4, cytotoxic t-lymphocyte antigen-4
Unregulated CTLA-4 is blocked by antibodies, preventing down-regulation of cytotoxic T cells
Increased T-cell binding to tumour associated antigens and tumour cell death
What is in FOLFOX?
Leucivorin (folinic acid)
Fluorouracil
Oxaliplatin
