Pharmocology Flashcards
How do you treat gout in a patient with CKD?
Remember that NSAIDS (normally the 1st line treatment) are contra-indicated in patients with CKD.
Instead, treat a gout flare with prednisone
What is the treatment of choice for acute epididymitis in a pt greater than 35?
Epididymitis in a pt >35
=
E. coli or pseudamonas
=
levofloxacin
What is the treatment of choice for acute epididymitis in a pt under than 35?
Epididymitis + <35
=
N. gonorrhea/Chlamydia
=
ceftriaxone + doxycycline
Prophylactic treatment for PJP?
Prophylactic treatment for PJP:
TMP-SMX
Dapsone
pentamadine
atovaquone
Names of loop diuretices
Loop diuretices end in the suffix “-mide”
bumetanide
furosemide
torsemide
ethacrynic acid
*loop diuretics are the mainstay therapy for acute and chronic HF
What is the treatment regimine for Bacterial Vaginosis?
Treatment for bacterial vaginosis is metronidazole for the patient only.
Since BV is associated with sexual activity but isn’t considered an SDT you don’t need to treat the partner.
What is the mechanism of action of organophosphates?
Why are they toxic?
Organophosphates irreversibly block acetylcholinesterase which leads to an increase in ACh activity and signalling.
*signs of organophosphate posioning include increased secretions: diarrhea, myosis, drooling, bradycardia, and tremor
What is the initial treatment for organophosphate posioning?
definitive treatment?
initial treatment for organophosphate posioning is ATROPINE
*atropine treats the symptoms of organophosphate posioning by reversing the effect of the acetylcholinesterase inhibitor
definitive treatment is with pralidoxime.
*pralidoxime reactivates the acetylcholinesterase
What is the treatment for H. ducreyi?
A single PO dose of azithromycin
*Other treatments include:
- Single IM dose of ceftriaxone
- erythromycin 3x/d for 7 days
- ciprofloxacin 2x/d for 3 days
What is the treatment for neuroleptic malignancy?
treat neuroleptic malignancy with dantrolene (muscle relaxant) or bromocriptine (dopamine agonist)
look for a history of increased dose of an antipsych med, plus rigidity, fever, AMS, and autonomic instability to make the diagnosis
What is the treatment for severe hyponatremia?
Severe hyponatremia is defined as a serum sodium <120 mEq/dL.
Treat severe hyponatremia with a 100mg bolus of 3% saline
*seizures usually occur when sodium <120. also look for obtundation, coma, and respiratory arrest.
What class of medications commonly cause delerium in the elderly?
Anticholinergic medications commonly cause delerium in the elderly.
benztropine
diphenhydramine
hydroxazil
tricyclic antidepressants
What is the treatment for Heparin Induced Thrombocytopenia?
Treat HIT with bivalirudin or agatroban (direct thrombin inhibitors)
Signs of HIT:
development of DTV while on heparin therapy (4-7 days after starting therapy)
low platelets
What drugs are contra-indicated in patients with prinzmetal angina?
Non-selective beta blockers (propranolol) are contraindicated in pts with prinzmetal angina because they may cause vasospasm
Treat with CCBs and Nitrates instead
What is the MoA for bispohosphonates?
Bisphosphonates bind to hydroxyapatite crystals in bone and prevent osteoclast activity
what agent is an acceptible treatment for osteoperosis in patients with a GFR <30?
denosumab is an appropriate therapy for osteoperosis in patients with a GFR <30.
Denosumab binds to RANKL and inhibits osteoclast activity.
*Bisphosphonates are excreted by the kidney and are thus not indicated in patients with poor kidney function.
When is medical treatment indicated for the treatment of osteopenia?
Bisphosphonate therapy is initiated if the patient has osteopenia (T score of -1 to -2.5) plus a fracture risk of 3% within the next 10 years
What is the first line treatment for ovulation abnormalities leading to infertility?
Clomiphene citrate is the first line therapy for ovulation abnormalities causing infertility.
Clomiphine citrate downregulates the estrogen receptor in the hypothalamus blocking the negative feedback loop in the HPA.
Look for: women with PCOS that wish to become pregnant
What herbal treatment can you take for decreased libido?
Panax Ginsing is a commonly used herbal medication for decreased libido
(don’t panax if your sex drive is going down)
side effects include: insomina
Treatment for TB may result in what vitamin deficiency?
Isoniazid- part of RIPE treatment for TB can lead to a deficiency in B6- pyridoxime
B6 deficiency presents with sideroblasts, seizures, and neuropathy
