pharma osce Flashcards
Teratogenic
may cause fetal hypertension and renal hypoperfusion with subsequent ischemia and anuria
ARB & ACE Inhibitor
Best drug for pregnant mothers with hypertension
methyldopa
Teratogenic
Embryopathy that involves the CNS, face, heart and thymus.
Vitamin A)
DOC for cap (child)
Ceftriaxone
Cefuroxime
Cefotaxime
DOC for cap (adult)
OPD
macrolide
Amoxicillin
Tetracycline
IPD Macrolide + Cefotaxime Ceftriaxone ertapenem Ampicillin
CAP LOW RISK WITHOUT co-morbid illness
5-7 days
Amoxicillin 1 gm TID OR extended macrolide:Azithromycin 500 mg OD OR Clarithromycin 500 mg BID
CAP LOW RISK WITH STABLE co-morbid illness
Co-amoxiclav 1 gm BID OR Sultamicillin 750 mg BID OR Cefuroxime axetil 500 mg BID [+/-] Azithromycin 500mg OD OR Clarithromycin 500 mg BID
CAP MODERATE RISK
7 to 10 days
10 to 14 days Mycoplasma and Chlamydophila pneumonia
14 to 21 days Legionella pneumonia
28 days Gram-negative, S. aureus or P. aeruginosa pneumonia, bacteremia
Ampicillin-Sulbactam 1.5gm q6h IV OR Cefuroxime 1.5 gm q8h IV OR Ceftriaxone 2 gm OD [+] Azithromycin 500 mg OD PO OR Clarithromycin 500 mg BID PO OR Levofloxacin 500 mg OD PO OR Moxifloxacin 400 mg OD PO
CAP HIGH RISK
NO risk for P. aeruginosa
28 days Gram-negative, S. aureus or P. aeruginosa pneumonia, bacteremia
Ceftriaxone 2 gm OD OR Ertapenem 1 gm OD [+] Azithromycin dihydrate 500 mg OD IV OR Levofloxacin 500 mg OD IV OR Moxifloxacin 400 mg OD IV
CAP HIGH RISK
Risk for P. aeruginosa
Piperacillin-tazobactam 4.5 gm q6h OR Cefepime 2 gm q8-12h OR Meropenem 1 gm q8h [+] Azithromycin dihydrate 500 mg OD IV [+] Gentamicin 3 mg/kg OD OR Amikacin 15 mg/kg OD
Discontinuation
Response
Resolution of fever
48-72h
24-72h
24h
empiric trt for UTI
Ceftriaxone 75mg/kf OD (3rd gen)
Cefotaxime 150mg/kg q6-8h (3rd gen)
Ceftazidime 100-150mg/kg q8h (3rd gen)
Gentamicin and Tobramycin 7.5mg/kg q8h (Aminoglycoside)
Piperacillin 300mg/kg q6-8h (Penicillin)
PO
Amoxicillin-clavulanate
Trimethoprim-sulfamethoxazole
Cefixime
Acute uncomplicated UTI
neonates
children
adult
neonate (10-14d)
- cefotaxime (50mg/kg q12h)
- amikacin (7.5mg/kg q12h)
children (7-14d)
- Amoxicillin-clavulanate:
(20-40mg/kg/d q8h)
- Cefuroxime ( 20-30mg/kg/d PO q12h)
adults (7-14d)
- Cefuroxime (250-500mg PO q12h)
- Nitrofurantoin (only for cystitis) 5-7mg/kg/d q6h
IV
Ampicillin-Sulbactam 100-200 mg/kg/d q6h (ampicillin component) IM or IV infusion over 10-15 min
OR
Cefuroxime 75-150mg/kg/d q8h (Max dose: 6g/d)
UTI, RECURRENT CATHETER RELATED
OR WITH CO-MORBID
neonate (7-14d)
- ceftriaxone (50mg/kg q24h)
- amikacin (7.5mg/kg q12h)
Htn first line agents
thiazide
ace inhibitors
ARB
CCB
Htn second line agents
loop diuretics K+ sparing diuretics aldosterone agonist diuretics beta blocker alpha-1 blocker central alpha-2 agonist direct renin inhibitor direct vasodilator
Htn agents for DM (+ target BP)
<130/80
all first line agents
Htn agents for SHID (+ target BP)
<130/80 GDMT BB ACE inh ARB \+ dCCB thiazide aldosterone agonist diuretics
Htn agents for HFpEF (+ target BP)
<130/80 diuretics Ace inh ARBs BB
Htn agents for pregnancy (+ target BP)
methyldopa
nifedipine
labetalol
standard regimen for TB
2 months Rifampicin 150mg Isoniazid 75mg Pyrazinamide 400mg Ethambutol 275mg
4 months
Rifampicin 150mg
Isoniazid 75mg
Recommendation for clinical ASCVD
reduce LDL-C with
high-intensity statin therapy or maximally
tolerated statin therapy
Recommendation for very high-risk ASCVD
(history of multiple major ASCVD
events or 1 major ASCVD event and multiple
high-risk conditions)
use a LDL-C threshold
of 70 mg/dL (1.8 mmol/L) to consider addition of
nonstatins to statin therapy
Recommendation for severe primary
hypercholesterolemia (LDL-C level ≥190 mg/dL
[≥4.9 mmol/L]), without calculating 10-year
ASCVD risk
begin high-intensity statin therapy
