PEARLS 2 Flashcards
“new hypertensive patient or one with a BP that is hard to control, consider”
“chlorthalidone 12.5 to 25 mg alone or combined with ACEI or ARBs (or another antihypertensive drug class). Baseline electrolytes, such as sodium, potassium, and calcium, are needed.”
“prescribing ACEIs/ARBs to sexually active, reproductive-aged females who are not consistently using birth control”
“categories C and D during the second and third trimester. Warn patients taking salt substitutes that some contain potassium.”
“In the United States, most heart attacks occur during the”
“morning hours (6 a.m. to 12 p.m.)”
“The day of the week when most MIs occur is”
Monday
“the season when most MIs occur is”
in winter.
“Advise patients to use only one pharmacy so that all the drugs they take are on one database.”
“This makes it easier for the pharmacy to check for drug interactions.”
“if warfarin is mixed with erythromycin or clarithromycin.”
“May prolong INR and increase risk of bleeding”
“HIV patients are at high risk (25%–50%) for”
“sulfa-related Stevens–Johnson syndrome.”
“In the United States, the typical G6PD deficiency anemia patient is a person of”
“African American (10%) descent. Usually asymptomatic, but may present with hemolysis/jaundice secondary to being treated with a sulfa drug or after eating fava beans. Look for a low hemoglobin and hematocrit (H&H) and jaundice. G6PD anemia is also seen with Mediterranean ancestry.”
“the second most frequent cause of allergic drug reactions”
Sulfonamide antibiotics
“the first most frequent cause of allergic drug reactions”
penicillins and cephalosporins
“Prophylaxis/ treatment of PCP (Pneumocystis carinii pneumonia) (HIV-patients)
MRSA cellulitis
Urinary tract infections, pyelonephritis”
“TMP-SMX, Bactrim DS BID”
Bacterial conjunctivitis
Burns
“Topical and ophthalmic sulfas
Sulfacetamide ophthalmic
Silver sulfadiazine (Silvadene)”
“Decongestants are contraindicated with”
“hypertension, CAD (angina, MI).”
“Advise patients that mixing decongestants with other stimulants (caffeine, Ritalin, albuterol inhaler) will cause”
“heart palpitations, tremors, and anxiety.”
“A severe case of poison ivy or poison oak rash may require”
“14 to 21 days of an oral steroid to clear”
“The most common cause of acute liver failure in the United States is”
“acetaminophen overdose (Poison Control Center: (800) 222-1222)”
“Alternative medicine practitioners are more likely to prescribe Armour thyroid tablets (desiccated thyroid glands from pigs), which contain”
“natural T3 and T4 for hypothyroidism.”
“All hyperthyroid patients should be referred to an”
“endocrinologist as soon as possible.”
“People with subclinical and overt hyperthyroidism are at higher risk of”
“bone (osteopenia/osteoporosis) and cardiac (atrial fibrillation) complications.”
“New-onset atrial fibrillation, check”
TSH
“Keep TSH between 1.0 and 4.0 mU/L as goal for thyroid hormone supplementation.”
“Diabetics are at higher risk for”
cataracts and glaucoma
“In morbidly obese patients, bariatric surgery can result in”
“remission of type 2 diabetes”
“Any patient with at least a decade or more history of chronic heartburn should be referred to”
“gastroenterologist for an endoscopy to rule out Barrett’s esophagus.”
“Patients with Barrett’s esophagus have up to 30 times higher risk of”
“the esophagus (adenocarcinoma type).”
“PPIs cure ulcers faster than”
H2-blockers
“High rates of clarithromycin resistance (42%) in the United States. Avoid using clarithromycin therapy if”
“there is high resistance in your area. Eradication rates in the United States using traditional triple therapy are now less than 80%.”
“Imaging test with the highest sensitivity/specificity for kidney stones is”
“noncontrast CT scan (initial imaging is renal ultrasonography).”
“Patients with preexisting kidney disease and/or diabetes are at higher risk of kidney damage from”
Contrast Media
“CT, MRI, and angiogram contrast media may damage kidneys (2%) or cause nephrogenic systemic fibrosis.”
“Serum potassium should be monitored upon initiation of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker therapy if”
“the patient has kidney disease. Potassium levels may initially rise and then taper off in 2 to 3 months. Continued monitoring of serum potassium is recommended.”
