Pharmacology Flashcards
Treatment for M. pneumoniae
azithromycin
Which ß blocker is contraindicated in pregnancy?
atenolol - associated with low birth weight
Metronidazole has good [] coverage.
Metronidazole has good obligate anaerobe coverage.
Ampicillin-sulbactam (Unasyn) and carbapenems have good [] coverage.
Ampicillin-sulbactam (Unasyn) and carbapenems have good obligate and facultative anaerobic coverage. Excellent pulmonary penetration.
Acute bacterial prostatitis treatment?
Levofloxacin or TMP-SMX (Bactrim).
Osteomyelitis treatment?
•usually S. aureus
-vancomycin or clindamycin
•if patient has SCD, could be S. aureus +/- Salmonella
- vancomycin, clindamycin, oxacillin, nafcillin
- 3rd generation cephalosporin: ceftriaxone or cefotaxime
amoxicillin + clavulonic acid =
Augmentin
ampicillin + sulbactam =
Unasyn
pipercillin + tazobactam =
Zosyn
Amoxicillin is (PO/IV) and ampicillin is (PO/IV).
Amoxicillin is PO and ampicillin is IV.
A possible complication of local epidural anesthetic?
Entering vasculatrue by accident leading to systemic toxicity.
Contraindications to fluoroquinilones?
•upregulate cell matrix metalloproteases –> increased collagen degradation
- Achilles tendon rupture
- retinal detachment
- aortic aneurysm rupture
•don’t use with
- HTN
- EDS
- Marfans
- aortic aneurysm
- atherosclerotic disease
Treatment for Candidiasis?
fluconazole
Treatment for HSV?
acyclovir
Treatment for CMV?
gancyclovir
First and second line treatments for ascites?
1) spironolactone
2) furosemide
Treatment for UC and Crohn’s?
•SASA agents
- sulfasalazine
- mesalamine
Treatment for diffuse esophageal spasm and achalasia?
- CCBs
- nitrates
Treatment for Carcinoid syndrome?
octreotide
Treatment for bleeding esophageal varices?
octreotide
Treatment for hepatic encephalopathy (hyperammonemia)?
rifaxamin
Rifaximin is a poorly absorbed antibiotic that is thought to reduce ammonia production by eliminating ammonia-producing colonic bacteria.
Rifaximin acts by inhibiting RNA synthesis in susceptible bacteria by binding to the beta-subunit of bacterial deoxyribonucleic acid (DNA)-dependent ribonucleic acid (RNA) polymerase enzyme. This binding blocks translocation, which stops transcription.
Treatment for Small Intestine Bacterial Overgrowth (SIBO)?
rifaxamin
Rifaximin acts by inhibiting RNA synthesis in susceptible bacteria by binding to the beta-subunit of bacterial deoxyribonucleic acid (DNA)-dependent ribonucleic acid (RNA) polymerase enzyme. This binding blocks translocation, which stops transcription.
Treatment for IBS?
TCAs (amytriptyline)
Treatment for GERD and mild PUD?
•PPIs - short term
-omeprazole
•H2 receptor antagonists - long term
- rantidine
- cimetidine
Treatment for prophylactic gastritis?
PPIs
Treatment for ZE syndrome?
PPIs
Treatment for the pruritus associated with Primary Sclerosing Cholangitis and Primary Biliary Cholangitis?
ursodeoxycholic acid
Treatment for acute appendicitis?
cefazolin + metronidazole
Antibiotics for ascites?
3rd generation cephalosporins
Treament for H. pylori?
amoxicillin (or metronidazole) + clarithromycin + PPI
Treatment for MALT Lymphoma?
amoxiciilin (or metronidazole) + clarithromycin + PPI
Treatment for mesenteric ischemia?
broad spectrum antibiotics
- metronidazole + fluroquinolone
- metronidazole + 2nd, 3rd generation cephalosporin
Treatment for ischemic colitis?
broad spectrum antibiotics
- metronidazole + fluroquinolone
- metronidazole + 2nd, 3rd generation cephalosporin
Treatment for cholecystitis?
broad spectrum antibiotics
- metronidazole + fluroquinolone
- metronidazole + 2nd, 3rd generation cephalosporin
Mechanism by which antipsychotic meds can lead to hyperprolactimemia.
•dopamine blockade
-dopamine is a prolactin inhibitor
•prolactin seldom >200
-in prolactinomas, prolactin >200 and there are visual disturbances and headaches
Treatment for essential HTN?
- thiazide diuretics
- ACEi
- ARB
- dihydopyridine CCB
Treatment of HTN with HF?
- diuretics
- ACEi/ARB
- ß blockers (not for decompensated or cardiogenic shock)
- aldosterone antagonists
Treatment fo HTN with DM?
- ACEi/ARB
- CCB
- thiazide diuretics
- ß blocker
Treatment of HTN with asthma?
- ARB
- CCB
- thiazide diuretic
- cardioselective ß blocker
Treatment of HTN in pregnancy?
- hydralazine
- labetolol (not atenolol!)
- methyldopa
- nifedipine
Treament of bradycardia?
- atropine
- pacemaker
Treatment of atrial fibrillation?
- anticoagulant
- rate control
- CCB
- ß blocker
- digoxin
•rhythm control
- cardiovert
- Class I, Class III
Treatment for MAT?
- anticoagulant
- rate control
- CCB
- ß blocker
- digoxin
•rhythm control
- cardiovert
- Class I, Class III
Treatment for AVRT/AVRNT?
- vagal maneuvers
- adenosine
Treatment for WPW?
•procainamide or amiodarone
Treatment for PVC?
•ß blocker
Treatment for VT?
- amiodarone
- lidocaine
- procainamide
Treatment for TdP?
•IV Mg2+
Treatment for stable angina?
- ASA
- ß blocker
- ACEi/ARB
- statin
- nitro
*ASA and ß blockers improve mortality!
Treatment for Prinzmetal angina?
- CCB
- no ASA
- no ß blocker
Treatment for unstable angina/NSTEMI in the hospital?
- morphine
- nitrates
- ASA + 2nd antiplatelet (continue for 12 months)
- ß blocker (if HTN, tachycardic, LV <40%)
- LMWH
-enoxaparin, no apixaban
Treatment for unstable angina/NSTEMI long term?
- ASA (2nd antiplatelet only for 12 months after hospitalization)
- ß blocker
- ACEi/ARB
- statin
- nitro
Treatment for STEMI in hospital?
- morphine
- nitrates (not in RHF!)
- ASA + 2nd antiplatelet (continue for 12 months)
- ß blocker
- LMWH
Treatment for STEM
- ASA (2nd antiplatelet only for 12 months after hospitalization)
- ß blocker
- ACEi/ARB
- statin
- nitro
Treatment for HCM?
- CCB
- ß blocker
- NO DIGOXIN OR SPIRONOLACTONE
Treatment for acute HFREF?
- loop diuretics
- ACEi/ARB
- dobutamine
- morpine
- nitrates
Treatment for chronic HFREF?
- ß blocker
- ACEi/ARB
- spironol;actone or eplerenone
- loop diuretics
- digoxin
- statins and ASA (if MI)
- sacubitril/valsartan (if continued dyspnea)
- ivabradine (if ß blocker contraindicated)
*ß blockers, ACEi/ARB, spironolactone or eplerenone, sabubitril/valsartan imporve mortality!
Treatment for HFpEF?
- diuretics
- ß blocker
- ACEi/ARB
- CCB
- NO DIGOXIN OR SPIRONOLACTONE!
*ACEi/ARB, ß blocker, CCB maintain HR, BP control
Treatment for HTN emergency?
- nitroprusside
- nicardipine
- labetolol
Treatment for HTN urgency?
- ACEi
- ß blocker
- clonidine
Treatment for native valve endocarditis?
• vancomycin or daptomycin 4-6 weeks
*acute
-S. aureus or S. pneumoniae
*subacute
-S. viridians
Treatment for prosthetic valve endocarditis?
•<60 days
-vancomycin + cefepine
•in between
-vancomycin + gentamycin
•>365 days
-vancomycin + gentamycin + ceftriaxone
Treatment for DVT?
•SQ LMWH
or
•IV unfractionated heparin
f/b warfarin or NOAC for 3-6 months
Treatment for PAD?
•acute
-heparin + revascularization
•aspirin + statin
Treatment for gonorrhea?
ceftriaxone
OR
fluoroquinolone (but not for pregnant women! Or pediatric population.)
Treatment for chlamydia?
doxycycline for one week
OR
azithromycin once
Which antidepressant is contraindicated in patients with bulimia?
bupropion
•increased risk of seizures
Treatment for vulvovaginal candidiasis?
•single dose of oral fluconazole
or
•several days of miconazole or clotrimazole vaginal creams
What is edrophonium and what is it good for?
- acetylcholinesterase inhibitor
- used to confirm the diagnosis of mysathenia gravis
- fast and short acting, give patient some and if symptoms improve right away then diagnosis is confirmed
Most common antibiotics for COPD exacerbation
amoxicillin, TMP-SMX, doxycycline
But you also need to give corticosteroids!
Treatment for mild vWF deficiency?
Desmopressin - icreases the productionand release of vWF from endothelium
•more severe bleeding may require cryoprecipitate
Treatment for acute gout flare?
NSAIDs, colchicine, steroids
tacrolimus
- calcineurin inhibitor
- inhibits IL 2 to reduce T lymphocyte activity
- solid organ transplant
- SE: nephrotoxicity, HTN, glucose intolerance
Drugs that can cause sensorineural hearig loss:
- aminoglycosides
- cisplatin (chemo)
- high dose salicylates
- loop diuretics
