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SAPE October 2015 > Pharm > Flashcards

Pharm Flashcards

1
Q

What drug class should be used for Stage 1 uncomplicated HTN?

A

diuretic

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2
Q

What drug class should be used for Stage 2 uncomplicated HTN?

A

diuretic + ACE/ARB/CCB

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3
Q

What drug class should be used for a diabetic with HTN?

A

ACEI or ARB

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4
Q

What drug class should be used for a chronic kidney dz pt with HTN?

A

ACEI or ARB

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5
Q

What drug class should be used for a heart failure pt with HTN?

A

diuretic + ACE +/- BB

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6
Q

What drug class should be used for an MI pt with HTN?

A

BB +/- ACEI

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7
Q

What drug class should be used for a pt with recurrent stroke and HTN?

A

diuretic + ACE or ARB

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8
Q

What drug class should be used for a coronary dz pt with HTN?

A

BB +/- ACE or ARB

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9
Q

What drug class decreases LDL cholesterol best?

A

statnis

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10
Q

What drug class decreases TG best?

A

fibric acids

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11
Q

What drug class increases HDL best?

A

nicotinic acid

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12
Q

How is acute MI treated? (list)

A
  • oxygen 2-4 L/min
  • IV NTG
  • aspirin or clopidogrel
  • heparin for anticoagulation
  • BB within 24 hours
  • antiarrhythmics as needed
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13
Q

In CHF patients, what can be used to reduce preload?

A
  • decrease sodium intake

- diuretics

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14
Q

In CHF patients, what can be used to increase contractility?

A

-digitalis

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15
Q

In CHF patients, what can be used to reduce afterload?

A
  • ACEI

- nitrates

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16
Q

How is acute pulmonary edema in a CHF pt treated?

A
  • sit patient up
  • oxygen
  • nitro
  • diuretics
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17
Q

How is cellulitis treated?

A
  • PO or parenteral abx
  • PenG 1-2 million units IV q6h
  • also oral dicloxacillin, cephalexin, clindamycin or IV cefazolin, nafcillin
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18
Q

How is tinea cruris/corporis treated?

A

topical antifungals (ketoconazole) for 7 days or until lesion resolves

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19
Q

How is tinea pedis treated?

A

antifungal cream BID up to 4 weeks

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20
Q

How is tinea versicolor treated?

A
  • remove scales with soap and water

- selenium sulfide or ketoconazole shampoo

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21
Q

Treatment for Erythema Infectiosum (5ths Disease/Slapped Cheek)

A

symptomatic

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22
Q

Treatment for Measles

A

supportive: antipyretics, antitussives, fluids

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23
Q

Treatment for HSV 1 and 2

A
  • symptomatic

- oral antiviral

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24
Q

Treatment for Herpes Zoster

A
  • rest
  • oral antivirals
  • analgesics
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25
Treatment for Impetigo (honey colored crusts stuck on)
-systemic or topical abx: erythromycin, cephalexin, dicloxacillin
26
Treatment for Oral Candida
- antifungal rinses or cream | - dental hygiene
27
Treatment for Candida Vulvovaginitis
-topical miconazole (monistat) or fluconazole (150 mg PO x1)
28
Treatment for Lice/Pediculosis
-Nix (permethrin) or RID
29
Treatment for Scabies
- permethrin/Nix | - anti-pruritic
30
Treatment of Eczema
- hydration - oatmeal baths - limited steroid use
31
Treatment for Atopic Dermatitis
- children outgrow - oatmeal baths - Eucerin - limited topical steroids - antihistamines for pruritis
32
Treatment for Psoriasis
- emollients BID - UVB therapy - topical steroids - systemic methotrexate
33
Treatment for Actinic Keratosis
- sun protection - 5 fluorouracil - excision
34
Treatment for Folliculitis
-topical antifungal or abx cream
35
Treatment for Mild Acne
-topical retinoid +/- topical antimicrobials, salicylic acid, azelaic acid
36
Treatment for Moderate Acne
-topical retinoid + oral abx +/- benzoyl peroxide
37
Treatment for Severe Acne
isotretinoin (Accutane)
38
Treatment for Rosacea
- topical metronidazole - low dose oral TCN - NO steroids
39
Treatment for Condylomata Acuminata
- imiquimod cream | - cryotherapy or laser surgery
40
Treatment for Syphilis (all stages)
-parenteral Pen G is DOC
41
What are some rapid acting insulins?
aspart and lispro (3 hours)
42
What is a short acting insulin?
Regular (Novolog/Humalog) 6 hours
43
What is an intermediate insulin?
NPH (12 hours)
44
What are long acting insulins?
Detemir and Glargine (up to 24 hours)
45
What type of DM med should lean patients with high blood sugar take?
sulfonylureas (glyburide)
46
What type of DM med should lean pts and pts with variable meal schedules take?
meglitinides (repaglinide)
47
What type of DM med should obese pts and pts with dyslipidemia take?
-biguanide (metformin/glucophage)
48
Treatment Options for Hyperthyroidism
- radioactive iodine (CI BF or pregnant) - methimazole or propylthiouracil (PTU) - surgery
49
Treatment for Thyroid Storm
-BB
50
Treatment for Hypothyroidism
Levothyroxine/Synthroid (T4)
51
Treatment for Hashimoto's Thyroiditis
-lifelong replacement iwth thyroid hormones
52
Treatment for Cushing's
- adrenal or pituitary adenoma resection | - adrenal inhibitors
53
Treatment of AOM
- APAP or ibuprofen for pain - watchful waiting in some cases - amoxicillin 7-10 days 80-90 mg/kg divided bid/tid - severe AOM or tx failure: amox-clav 90 mg/kg/day and 6.4 mg/kg/day
54
Treatment for Otitis Externa
- bacterial: topical abx and corticosteroids | - fungal: topical antiyeast
55
Treatment for Strep Pharyngitis (bacterial)
- supportive: analgesic, rest, fluids - adults: penicillin 500 mg BID x10 days - kids: penicillin 250 mg BID x10 days
56
Treatment for Sinusitis
- nasal saline - decongestants - analgesics - nasal steroids - don't treat until 7 days of sxs or severe: amoxicillin 500 mg BID adults
57
Treatment for URI
-symptomatic: water, rest, decongestants, expectorant, antitussives
58
Treatment for Mono
- APAP, NSAIDs, lozenges | - steroids if enclosing throat
59
Treatment for Allergic Rhinitis
- antihistamine (loratidine/Claritin, diphenhydramine/Benadryl) - decongestant - intranasal corticosteroid (fluticasone/Flonase)
60
Treatment for Cataracts
-surgical
61
Treatment for Hordeolum/Sty
- warm pack, gentle massage 5-10 min QID | - antibiotic ointment
62
Treatment for Chalazion
- warm pack, massage 5-10 min QID - steroid injection - excision if large
63
Treatment for Conjunctivitis
- proper hygiene - viral (non HSV): vasoconstrictor/antihistamine - bacterial: self-limiting
64
Treatment for Acute Angle Closure Glaucoma
- emergent consult to lower IOP | - BB, diuretics
65
Treatment for Primary Open Angle Glaucoma
- facilitate aqueous outflow: prostaglandin analog, parasympathomimetics - reduce vitreous volume: BB, alpha 2 adrenergic agonists, carbonic anhydrase inhibitor
66
Treatment Uncomplicated Gallstones
-analgesices
67
Treatment Complicated Gallstones
- analgesics - IV fluids - anti-emetics - surgery
68
Treatment for Cholecystitis
- admit - IV fluids - IV abx: pip-tazo or amp-sulbactam - surgical consult
69
Treatment for Gastritis
- antacids - H2RA - sucralfate - prostaglandins - PPI - avoid NSAIDs
70
Initial Treatment for GERD
- antacids PRN | - OTC PPI or H2RA x2 weeks
71
Treatment for Phase I GERD
- lifestyle and diet changes | - H2RA or PPI in Rx doses
72
Treatment for PUD
- H2RA x8 weeks - PPI x4 weeks (PPIs are best) - duodenal = 4 weeks, gastric = 8 weeks
73
Treatment for H. Pylori PUD
-triple therapy x14 days -amox 1 g BID x5 days then clarithromycin 500 mg + tinidazole 500 mg BID x5 days then PPI
74
Tx Diverticulitis
- bowel rest - increase fiber and water - broad spectrum abx: metronidazole and cipro
75
Treatment for IBD
- abx: cipro, metronidazole - 5-ASA agents - corticosteroids: azathioprine (imuran) and 6-MP
76
Treatment for IBS
- constipation: change diet, osmotic or other laxatives, tegaserod for women - diarrhea: change diet, loperamide, alosetron for women - pain: change diet, anticholinergics, TCAs, analgesics
77
Treatment for Appendicitis
- prophylactic abx - pain control - surgery
78
Treatment for Diarrhea
- stool culture | - non-infectious can use antimotility (imodium) and antisecretory (pepto bismol)
79
Treatment for Constipation
- fiber, veggies, fruits - water - acute: stimulant (dulcolax) - chronic: emollient laxative (colace)
80
Tx for Iron Deficiency Anemia
- oral or parenteral iron | - ferrous sulfate 325 mg PO TID
81
Tx for Vit B12 Deficiency
vit B12 1-2 mg PO qd may need cyanocobalamin IM if severe deficiency
82
Tx for Folate Deficiency
-oral folic acid 1-5 mg PO qd
83
Treatment for von Willebrand Dz
- desmopressin DDAVP - FFP and cryoprecipitate - vWF and factor VIII concentrates
84
Tx for Factor V Leiden
- asymptomatic pts do NOT need anticoagulation - LMWH - warfarin
85
Tx for Lyme Dz Early
PO abx x14 days (doxy 100 mg PO BID or amox if
86
Tx for Lyme Dz Late
IV abx 14-28 days
87
Tx for Influenza
- rest, fluids, saline nasal drops, hand washing - analgesics, cold/cough meds, antipyretics - antivirals in 1st 48 hours: rimantadine, oseltamivir
88
Tx for Pertussis
- supportive care | - DOC: erythromycin or other macrolide
89
Tx for Varicella Chicken Pox
-symptomatic: antipyretics, local antipruritics
90
Tx for C. Diff
-metronidazole 500 mg PO TID
91
Tx for MRSA
-vanco 1 g IV q12h
92
Tx for Uncomplicated UTI
- TMPSMX 1 DS po BID x3 days | - cipro 250 mg po BID x3 days
93
Tx for Osteoarthritis
- weight reduction and exercise | - APAP, salicylates, intra-articular steroids
94
Treatment for RA
- PT - NSAIDs, aspirin - DMARDs: methotrexate, sulfasalazine, hydroxychloroquine
95
Tx for Gout
- elevation, rest, ice, NSAIDs - allopurinol to prevent further attacks - colchicine to reduce inflammatory response
96
Tx for Carpal Tunnel
- wrist splint to prevent flexion - NSAIDs - steroid injections - surgery
97
Tx for Lateral Epicondylitis
- RICE, NSAIDs - PT - steroid injection
98
Tx for Stroke
- IV tPA within 3 hours of sx onset - ASA, warfarin, O2 - control hyperglycemia, monitor cardiac rhythm
99
Absolute CI for tPA Therapy
- hemorrhage - previous hemorrhagic CVA - prolonged CPR - intracranial neoplasm or aneurysm - pregnancy
100
Relative CI for tPA Therapy
- recent trauma or surgery - poorly controlled HTN - active PUD - previous CVI - known hemorrhagic dz - hepatic insufficiency
101
Tx for TIA
-ASA or clopidogrel
102
Abortive Tx for Migraines
- simple analgesics + caffeine - NSAIDs - sumatriptan - cafergot
103
Prophylactic Tx for Migraines
- BB - TCA - VPA
104
Tx for Cluster Headaches
- 100% O2 at 7-10 L for 10-15 mins - sumatriptan SQ or nasal spray - cafergot
105
Tx for Tension HA
-mild analgesics: NSAIDs, ASA, APAP
106
Bacterial Meningitis Empiric Tx for
-ampicillin and cefotaxime
107
Bacterial Meningitis Empiric Tx for 1 month to 50 years
-ceftriaxone and vancomycin
108
Bacterial Meningitis Empiric Tx for >50 years old
-ceftriaxone, vanco, ampicillin
109
Meningitis Group B Strep or N. meningitidis Tx
-pen G 14-21 days
110
Meningitis H flu Tx
ceftriaxone 7-10 days
111
Meningitis S. pneumo MIC
pen G 10-14 days
112
Meningitis S. pneumo MIC 0.1-1 Tx
ceftriaxone 10-14 days
113
Meningitis S. pneumo MIC >2 Tx
vanco + ceftriaxone 10-14 days
114
Bacterial Meningitis Prophylaxis Tx for Close Contacts
-rifampin 600 mg PO q12hr x4
115
Tx of Chronic Seizures
-AEDs: phenytoin (Dilantin), carbamazpeine (Tegretol), valproic acid (Depakote), gabapentin (Neurontin)
116
Tx of Acute Bronchitis
- NO abx | - symptomatic/OTC cold meds
117
Tx of CAP
-abx: macrolide (Azithro zpak 500 mg PO x1 then 250 mg qd x4 days), doxycycline, respiratory quinolone (levofloxacin)
118
Step-Wise Asthma Treatment (class used for each of the 6 steps)
1. SABA prn 2. low dose ICS 3. low dose ICS + LABA 4. medium dose ICS + LABA 5. high dose ICS + LABA 6. high dose ICS + LABA + oral corticosteroids
119
What SABA might be prescribed for asthma?
-albuterol (Proventil)
120
What ICS might be prescribed for asthma?
-fluticasone (Flovent)
121
What LABA might be prescribed for asthma?
-salmeterol (Seravent)
122
Stage I COPD Tx
- reduce risk factors - flu vaccine - SABA PRN
123
Stage II COPD Tx
- SABA PRN and LABA PRN | - rehabilitation
124
Stage III COPD Tx
- SABA, LABA | - inhaled glucocorticosteroids
125
Stage IV COPD Tx
- SABA, LABA, inhaled glucocorticosteroids - long term O2 - consider surgery
126
Tx of Pulmonary Embolism
- emergent hospitalization | - heparin, warfarin
127
Tx of Pulmonary Edema
- admit - O2 - NTG - diuretics
128
Tx of TB
- isoniazid, rifampin, pyrazinamide, ethambutol | - DOT: direct observed therapy
129
Tx for Menopausal Hot Flashes
-gabapentin
130
Tx for Osteoporosis
- calcium, vitamin D - aerobics, weight bearing, resistance exercise - smoking cessation
131
Tx for Endometriosis
- NSAIDs for pain | - OCPs, progestins, GnRH agonists
132
Tx for Bacterial Vaginosis
- metronidazole 500 mg PO BID x7 days | - topical metronidazole or clindamycin
133
Tx for Trichomonas
-metronidazole 500 mg PO BID x7 days or 2 g x1
134
Tx for Candida
- fluconazole 150 mg PO x1 | - topical miconazole qHS 1-7 days
135
Tx of Gonorrhea
-ceftriaxone (Rocephin) 125 mg IM x1
136
Tx for Chlamydia
-doxy 100 mg PO qd x7 days or azithro 1 g PO x1
137
Tx of Syphilis
benzathine PenG 2.4 million units IM x1
138
Tx of PID Inpatient
-cefoxitin 2 g IV q6h OR cefotetan 2 g IV q 12hr + doxy 100 mg IV/PO q12hr
139
Tx of PID Outpatient
-ceftriaxone 250 mg IM + doxy 100 mg PO BID +/- metronidazole 500 mg PO BID x14 days
140
A pt on OCPs presents with increased spotting, early cycle BTB, and hypomenorrhea. How should her OCP dose be adjusted?
there is an estrogen deficiency so increase estrogen dose
141
A pt on OCPs presents with late BTB and amenorrhea. How should her OCP dose be adjusted?
progestin deficiency --> increase progestin dose
142
A pt on OCPs presents with melasma, HTN, migraine headache, and breast fullness/tenderness. How should her OCP dose be adjusted?
-excess estrogen --> decrease estrogen dose
143
A pt on OCPs presents with tiredness, weight gain, hair loss, acne, depression and breast regression. How should her OCP dose be adjusted?
excess progestin --> decrease progestin dose
144
What effect do OCPs have on anticoagulants?
can increase or decrease anticoag effects
145
What effect to OCPs have on TCAs, BBs, corticosteroids?
increase the effects of these
146
How are OCPs affected by CYP450 inducers (CBZ PHT, protease inhibitors, barbiturates)?
CYP450 inducers decrease the effect of OCPs
147
CI for OCPs
- hx of DVT/PE/CVA/MI/PVD - DM with target organ damage - breast CA - pg/lactation - migraine HA with focal aura - major surgery with prolonged immobilization
148
Non-Pharm Tx for Major Depressive Disorder
- psychotherapy - well-balanced diet - exercise - relaxation
149
1st Line Pharm Tx for Major Depressive Disorder
-SSRIs: sertraline, paroxetine, citalopram
150
Pharm Options for Major Depressive Disorder
- TCAs: amitriptyline - 5HT/NE reuptake inhibitors: venlafaxine - bupropion, mirtazapine, trazodone, MAOI
151
Pharm Tx for Bipolar Disorder
- 1st line: mood stabilizer (VPA, lithium) | - CBZ, lamotrigine, AEDs, antipsychotics
152
Pharm Tx for Generalized Anxiety Disorder
- 1st line: SSRIs, SNRIs - benzos: alprazolam, lorazopam, diazapam - TCAs - BBs
153
Pharm Tx for Panic Disorder
- SSRI - TCA - benzos
154
Tx for Alcohol Abuse/Dependence
-treat acute sxs if in withdrawal: naltrexone, topiramate

SAPE October 2015 (12 decks)

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