Psych-Neuro-Msk Flashcards
1
Q
Acute Agitation
in Delirium DOC
A
Antipsychotic Risperidone or Haloperidol
2
Q
Acute Agitation
in Dementia DOC
A
Very low dose of Risperidone
3
Q
Acute Agitation
in Brain Injury DOC
A
Propranolol
4
Q
Acute Agitation
in DLB DOC
A
Memantine or Anticholinestrase
5
Q
Acute Agitation
in Psychosis DOC
A
Antipsychotic +|- Lorazepam
6
Q
Acute Agitation
in Mania DOC
A
Antipsychotic +|- Lorazepam +|- Mood stabilizer
7
Q
IM Olanzapine Caution
A
Do not use it with parenteral BZPs
8
Q
Acute Agitation
if Situational Or if caused by drug abuse DOC
A
Both:
Haloperidol 5 mg Oral or IM
+ Lorazepam 2 mg Oral or IM
9
Q
ADHD Treatment
in below 6 yo
A
Only nonpharma,
no Medications +Behavioral therapy
10
Q
ADHD
1st line tx: Stimulants Or……..
A
Atomoxetine (NE Reuptake inhibitor)
(If no response or intolerance to stimulants)
11
Q
ADHD
Two medications with no potential for abuse
A
Atomoxetine
Guanfacin (Alpha 2 Agonist)
12
Q
ADHD
How to prescribe Methylphenidate SR?
A
Trial for 3-4 w
Then continue for 6-12 months
Then 1-2 months holiday and reassess
13
Q
ADHD
Wen do you prescribe Alpha 2 agonists?
Guanfacin, Clonidin
A
Both: More effective on hyperactivity and impulsivity
G: less SEs
C: if Tic disorder coexists
14
Q
Panic disorder DOC
A
SSRI or SNRI
+|- Clonazepam (maximum 6-8 w)
15
Q
Agoraphobia DOC
A
SSRI or SNRI
+|- CBT
16
Q
Social Anxiety Disorder
1st line: SSRI or SNRI
2nd line: ………..
A
Moclobemide (MAOI-A, reversible)
Caution: Avoid with SSRI or TCA or Meperidine
17
Q
Specific Phobia DOC
A
No medication:
Only CBT
18
Q
GAD 1st line: SSRI or SNRI
If no response or intolerant, then ……….
A
Pregabalin
19
Q
Anxiety or Mood Disorders
Best SSRIs if Breastfeeding (2)
A
Paroxetine
Sertraline
20
Q
Smoking Cessation 5”A”s
A
Ask
Advise
Assess
Assist
Arrange
21
Q
Smoking Cessation: Nonpharma
- Pick a Date
- Asking for Help
- Social support
4,5,6 ?
A
Medications
Counselling
+|- CBT 8-24 W
22
Q
Smoking Cessation: In Pregnancy
A
Preferably no medications
If not, either Gums or Bupropion
23
Q
BMD
Acute Episode of Mania DOC
A
Risperidone +|- Li
24
Q
BMD Episodes of Depression:
1st line
…………. or ……………. or …………..
A
Li or Lamotrigine or Li + Bupropion
(avoid monotherapy with antidepressants)
25
BMD
Li Monitoring:
1. Thyroid
2. Renal function
3,4 ?
Electrolytes
24h urine and Clearance of Cr
26
BMD
Li Overdose signs/symptoms (5)
1,2 Ataxia Tremor
3,4 Diarrhea Vomiting
5,6 ?
Sedation/Agitation
Seizures
27
BMD
Valproate SEs (5)
1. Teratogenic
2. Wt gain
3. Hepatotoxic
4,5 ?
Thrombocytopenia
PCOS
28
BMD
Li SEs (6)
1,2 DI, Hypothyroidism
3,4 Tremor, GI
5,6 ?
Wt gain
Impotence
29
BMD Maintenance treatment
In Pregnancy
Avoid mood stabilizers
+Prepare advance directive
30
BMD
Li drug interactions
Caution with:
Thiazides (Important), NSAIDs, ACEIs, ARBs,
31
BMD
If cognitive impairment with Li
Decrease dosage
Or use SR form of Li
32
OCD
1st line tx
1st. SSRI + CBT
2nd. SNRI + CBT
33
Anorexia Nervosa
1st line tx
Prokinetics:
Domperidone (best)
Metoclopramide
Erythromycin
Prucalopride (new)
34
Anorexia Nervosa
Adjunctive treatments
1. Zinc Gluconate
2. Olanzapine
3,4 ?
Thiamine
Cyproheptadine
35
Bulimia Nervosa: DOC
SSRI + CBT (Usually: Fluoxetine)
36
PTSD Tx
within first month after trauma
Avoid BZPs
Avoid Antidepressants
+ Trauma-focused psychotherapy
37
PTSD
1st line tx
SSRI or Venlafaxine
+|- augmentation with Risperidone
38
PTSD
Why should we avoid monotherapy with BZPs?
Abuse, Disinhibition
39
PTSD
If associated with insomnia DOC
Trazodone Or Perazosin
40
Insomnia 1st line
Temazepam 15 mg QHS
or Oxazepam 10-15 mg QHS
41
Insomnia
Best Agonist of BZPs
Zopiclone 3.75 mg QHS
42
Insomnia
In Pregnancy
BZP ~ ok
Zopiclone ~ ok
Zolpidem: No
43
Dementia Alzheimer's: 1st line
Anti cholinestrase Inhibitors
Donepezil Or Rivastigmine Or Galantamine
44
Dementia Alzheimer's: 2nd line
NMDA Antagonists Memantine (Ebixa)
45
Dementia Alzheimer's:
Anticholonestrase inhibitors SEs
1,2 GI intolerance, PUD or GI Bleeding
3,4 ?
Seizures
Worsening of Asthma or COPD
46
Dementia Alzheimer's:
Most commonly prescribed drug is.......
Donepezil (In all stages of Alzheimer's)
47
Dementia
DOC in Lewy Body Dementia
Rivastigmine
48
Dementia Caution in DLB
Never prescribe antipsychotics because of
AP Sensitivity Sd:
Irreversible Parkinsonism or Autonomic Disorders or Confusion
49
RBD in Dementia (Responsive Behaviors in Dementia)
If antidepressant: SSRI
If antipsychotic: very low dose
If movement disorders: .......
Quetiapine (Does not cause EPS or movement Disorders)
50
RBD in Dementia (Responsive Behaviors in Dementia)
If Agitated Or Sundowning Or Insomniac
Best: Trazodone
51
Depression Three antidepressants with lowest Sx SEs
1. Bupropion 2........ 3........
Mirtazapine
Moclobemide
52
Depression
Antidepressants discontinuation Sd is more common with Short half lives like .........
Venlafaxine
Paroxetine
53
Depression
To avoid Antidepressants discontinuation Sd :
Decrease 25% dosage per week
54
Depression
Moclobemide is a 1st line tx
Serotonin Sd?
HTN Crisis?
S: yes, with SSRIs or TCAs or Meperidine
H: No
55
Depression
Three indications for referral
1. Suicidal 2. ........ 3.........
Psychotic Features
3 times failure
56
Depression
Antidepressants in Pregnancy
SSRI is ok
But preferably not in 3rd trimester
57
Depression
Examples of Augmentation tx
Li, T3, Atypical AP, Modafinil, Ritaline, ..........
SSRI + Bupropion
58
Depression
Switching from MAOI to another antidepressant
2 weeks wash out
59
Depression
Switching from an antidepressant (other than Fluoxetine) to MAOI
5 half lives wash out
60
Depression
Switching from Fluoxetine to MAOI
5 weeks wash out (=5 half lives)
61
Depression
Switching from Moclobemide to another antidepressant
5 days wash out (=5 half lives)
62
Stimulants
Withdrawal Tx?
SR forms of Amphetamines or Ritaline
63
Opioids Withdrawal Tx
Three medications: Methadon ........... ...........
Buprenorphine
Buprenorphine + Naloxone
64
BZPs
Withdrawal Tx?
Long Acting BZP like Diazepam And taper slowly
If insomnia: Trazodon
65
NAS Neonatal Abstinence Sd (Opioids)
Tx:
1. Nonpharma (7) ?
2. Diluted tincture of Opium
Swaddling, Gentle Rocking
Holding, Pacifier
Low volume high calorie meals, Repetitive diaper change,
Silence + white noise
and +/-
Methadon to the Breastfeeding mother
66
Psychoses
Three APs that should be taken in the mornings? Aripiprazole, ........, .........
Paliperidone
Ziprasidone
67
Psychoses
Two APs that should be taken with food
Lurasidone
Ziprasidone
68
Psychoses
Caution with Asenapine (2)
Oral hyposthesia
Probable hypersensitivity or Angioedema
69
Psychotic Agitation
Haloperidol 5 mg
+/- Lorazepam 2 mg Or ........
Oral rapid dissolving form of Olanzapine or Risperidone
(If the patient cooperates)
70
Psychoses
Two APs in which the dosage should be increased rapidly to avoid activation Sd
Ziprasidone
XR form of Quetiapine
71
Psychoses
DOC for smoking Cessation?
NRT is preferred
72
Psychoses
NMS (medical emergency) DOC?
Dantrolene IV + hydration and cooling
+|- Bromocriptine Oral
73
Psychoses
Three SGA APs with highest sedation
Quetiapine, ......., .......
Olanzapine
Clozapine
74
Psychoses
Two SGAs with highest risk of EPS
Risperidone
Paliperidone
75
Psychoses
Tx of Akathisia:
1. Decrease dosage
2. .......
Propranolol or BZP
76
Psychoses
AP with highest CVS SEs
Clozapine
77
Psychoses
In Pregnancy:
1. Minimum effective dose is recommended
2 ?
No AP is preferred to others
78
Psychoses
DOC Acute Dystonia
IM Benztropine
Or IM Diphenhydramine
79
Acute Pain
Meperidine (Pethidine)
CIs: Hepatic disease, Renal disease, Elderly, ......., .......
MAOIs within last 2 weeks
Pain longer than 3 hours
80
Acute Pain
Three examples of local anesthetics
1. Lidocaine (+/- Epinephrine)
2,3 ?
TAC (Tetracaine, Adrenaline, Cocaine)
EMLA (Mixture)
81
Acute Pain
Opioids in Pregnancy?
Are safe (if low dose and caution close to term)
82
Acute Pain
Opioids in Breastfeeding
Generally Safe
(except for Meperidine, Codein)
83
Bell's Palsy DOC?
(Tx should be started within first 72 hours)
Prednisone Oral 5 days (1 mg/kg)
+|- Acyclovir (Then taper in 5 days)
But If paralysis is complete: CS for 10 days (Then taper in 5 days)
84
Chronic Fatigue Sd Nonpharma:
............, good nutrition, good sleep, multivitamins, enough salt, CBT
GET Graded Exercise Therapy: Divide daily tasks to small parts and start with minimal activity, Avoid push/crush cycles
85
Chronic Fatigue Sd
4 medications that "might be" helpful
1,2 Mg, NADH
3,4 ?
Vit D
L carnitine
86
Chronic Spasticity
1st line Tx
Baclofen
87
Chronic Spasticity
Baclofen SEs
1. Highly sedative
2. .........
If suddenly discontinued:
Confusion, Seizures, Hallucinations
88
Chronic Spasticity
2nd line Tx
Tizanidine (Alpha2 Agonist)
(SEs: Dry mouth, drowsiness)
89
Chronic Spasticity
Alternative Tx: For nighttime symptoms?
Diazepam or Clonazepam
90
Chronic Spasticity Alternative Tx:
1. If associated with neuropathy: Gabapentine
2. If associated with MS and pain?
Sativex (THC buccal Spray)
91
Chronic Spasticity
If Focal?
Injection of Phenol every 6 months
Or Injection of Botox every 3 months
92
Fibromyalgia
Only two drugs are approved in Canada: 1.......... 2.........
Duloxetine
Pregabaline (Preferably low dose)
93
Fibromyalgia
Tx in Pregnancy
Preferably nonpharma
Duloxetine is ok But Pregabaline is NOT safe
94
Fibromyalgia
Nonpharma:
..........., CBT, Massage, TENS, Education, Meditation, Acupuncture
GAE Graded Aerobic Exercises
95
Muscle Cramps
If severe and not iatrogenic, Tx?
Quinine Sulfate for 4-6 weeks
(Never longer than 3 months)
96
Muscle Cramps
Quinine Sulfate:
Monitoring ?
Other SEs ? (3)
Bleeding because of thrombocytopenia
Other SEs: Arrhythmia, SJS, Vasculitis
97
Muscle Cramps
Tx in Pregnancy
Mg 2-4 weeks
98
Persistent Hiccups (2-30 days)
1st line Tx
Chlorpromazine IV
25-50 mg IV slowly within 30 min in ER (Sometimes Oral trial)
99
Persistent Hiccups
2nd line Tx
3rd line Tx
2: Haloperidol IM or Oral
3: Metoclopramide IV or Oral
100
Intractable Hiccups (over 1 month) Tx
Baclofen (Then taper slowly)
101
Restless Leg Sd
1st Line if Intermittent type
Levodopa/Carbidopa
Or BZP
Or Codeine (low potency opioid)
102
Restless Leg Sd
1st Line if chronic persistent type
Pramipexol or Ropinirol (Dopamine agonists)
Or Pregabaline
103
Restless Leg Sd
Chronic Persistent type: a transdermal patch?
Ritogotin (Dopamine Agonist)
104
Restless Leg Sd
Tx in Pregnancy or Breastfeeding
No dopaminergic No GABA
But BZP or Opioids are not contraindicated
105
Neuropathic Pain
Acute pain in Herpes Zooster (Shingles)
Acyclovir Oral
+|- Gabapentin or Amitryptyline
106
Neuropathic Pain
Chronic Radiculopathies
Acetaminophen/ Codeine/ NSAIDs
107
Neuropathic Pain
Chronic Peripheral Neuropathies
1st line Tx
TCA or GABA
108
Neuropathic Pain
Chronic Peripheral Neuropathies
2nd line Tx
3rd line Tx
2. SNRI or Lidocaine
3. Opioids (Preferably transdermal or SR)
109
Neuropathic Pain In Pregnancy
No GABA, No Carbamazepine
Caution with Opioids
Others are +|- ok
110
Neuropathic Pain
In Breastfeeding
No GABA, No BZP
Caution with Opioids, Others are ok
111
Neuropathic Pain
Relative CIs for Opioids (5)
- Hx of addiction
- Frequent Migraine
- Fibromyalgia
............, ...........,
Tensions Headache
Psychosomatic pains
112
Gout Nonpharma
Avoid: liver, kidney, ......, alcohol, high fructose foods, beef, lamb, pork, ......., gravies, desserts, sweetened beverages, high fat diaries
Sweet breads, Sardine, Shellfish
113
Gout
Allopurinol Hypersensitivity Sd (AHS) may result in SJS or TEN. Three Risk factors ?
Thiazides
Renal Dysfunction
Starting with high doses
114
Gout
Chronic Phase: If renal function is impaired, Tx?
Febuxostat (But it may increase liver enzymes)
115
Gout
Three rules for Uricosurics like Probenecid or Losartan
1. Not 1st line
2. No monotherapy
3. Not recommended if ClCr \< 50 or if hx of renal stones
116
Gout Alluporinol interactions:
- Increases risk pf rash with Amoxicillin
- ............
Inhibits hepatic metabolism of Warfarin (Bleeding)
117
Gout
Colchicine interaction
May increase myopathy with Statins
118
Headache
Triptans CIs (3)
-Cardiac diseases
........., .........
HTN
Basilar or hemiplegic Migraine
119
Headache, Acute Phase
1st line Acetaminophen, ASA, NSAIDs
2nd .........
DHE Spray
or Oral Triptans
120
Headache Prophylaxis
CCBs: Verapamil or ..........
Flunarizine
(CI: hx of depression)
121
Headache In Pregnancy
Ergot derivatives: CI
Triptans: CI
Other: +|- ok
122
Headache in Children:
watch for ....... when prescribing 1st line meds
ASA and Reye Sd
123
Headache in Children
Prophylaxis: In younger children? In others?
Y: Cyproheptadine
O: Flunarizine (CCB), (watch for depression)
124
Headache in Children
The Only approved treatment for acute headache in 12-18 yo (in Canada)
Almotriptan
125
Headache Prophylaxis
for Migraine around menses
Triptans Start 2 days before menses, Continue for 1 week
126
MS
1st Line Tx (2)
Glatiramer, Interferon beta
127
MS Serious SEs:
Glatiramer: is usually well tolerated,
Interferon beta?
Rare: Severe Hepatotoxicity
128
MS
Serious SEs: Alemtuzumab?
Autoimmunity often in thyroid
129
MS
Serious SEs: Dimethyl Fumarate (2)
Pr Uria
Increased Liver Enzymes
130
MS
Serious SEs: Fingolimod Monitoring
Regular LFT
131
MS
Serious SEs: Mitoxantrone (2)
Cardiotoxicity
Leukemia
132
MS
Serious SEs: Natalizumab
PML
(Progressive Multifocal Leukoencephalopathy)
133
MS
Serious SEs: Teriflunomide Caution
CI in Pregnancy And washout is needed
134
MS
In Canada, ......... is approved for gait disturbances in MS (Adjunctive Tx)
Fampridine
135
MS
Vit D?
Recommended 1000 IU daily To all patients
136
Seizures
DOC in Focal (Partial) Seizures, Including Simple and Complex
Carbamazepine
137
Seizures
DOC in Generalized Seizures:
1. Petit mal: Ethosuximide
2. Grand mal?
3. Atonic?
4. Myoclonic?
All: Valproate
138
Seizures
Monitoring for Valproate (2)
CBC for Plts
LFT
(and Not recommended for women in fertility ages)
139
Seizures
Most of antiepileptic medications are enzyme inducers, except for ........
Valproate Which is Inhibitor
140
Antiepileptics SEs
- Vigabatrin ?
- Levetiracetam?
- V: Visual field defects
- L: Psychiatric SEs
141
Carbamazepine
Serious SEs (2)
Cardiac Conduction disturbances
Neutroenia
142
Phenytoin
Serious SEs (3)
1. Gyngival Hypertrophy
2. Coarse facies
3. ..........
Folate deficiency
143
Headache
Migraine Prophylaxis
1. Beta blocker
2 to 6 ?
Valproate, Topiramate, Verapamil, Lithium, Flunarizine
144
Headache
Cluster headache Prophylaxis
1. Verapamil
2,3 ?
Lithium
Flunarizine
145
Headache
Cluster: Acute Attack
................. or ............. or High flow Oxygen or Intranasal lidocaine
Sumatriptan Or Dihydroergotamine
146
Headache
Migraine Acute Attack
1st line Acetaminophen or ASA +|- Caffeine
2nd line NSAIDs
3rd line ..........
5HT Agonists (Sumatriptan) +|- Antiemetic
147
Parkinson's disease
Recommended medications based on age:
Above 60 yo: Start with Levodopa/ Carbidopa
Below 60 yo: Start with Ropinirol/ Pramipexol
148
Parkinson's disease
Four SEs of Levodopa/ Carbidopa
1. On/Off 2. ......... 3........... 4...........
2. Peak-dose dyskinesia
3. Off period dystonia
4. Diphasic dyskinesia
149
Parkinson's disease
Why is Bromocriptine less commonly used?
Pulmonary Fibrosis
150
Parkinson's disease
SEs of Ropinirol/ Pramipexol/ Bromocriptine
1. Sleepiness during the day
2. Impulse control problems
3. ............
Psychiatric: Hallucinations, Confusion
(and GI, Ortho-Hypo)
151
Parkinson's disease
Transdermal patch
Rotigotine
152
Parkinson's disease
MAO-B Inhibitors:
Example............ Indication...........
Selegiline Only initial Tx in mild Parkinson's
153
Parkinson's disease:
NMDA Antagonist: .............
SEs: 1. Edema 2. Erythema 3............
Amantadine
3. Livedo reticularis
154
Parkinson's disease:
Amantadine
Indication: Movement Disorders with Levodopa
Two CIs ?
1. Cognitive disorder
2. Confusion
155
Parkinson's disease:
Anticholinergics: THF, Benztropine
Indication..........
Only effective on tremor at rest
156
Parkinson's disease
COMT Inhibitors, example......... Indication..........
Entacapone
Only with Levodopa for wearing off
157
Parkinson's disease
COMT Inhibitors: Entacapone
SE (1)
Urine color change (benign)
158
Parkinson's disease
If we abruptly discontinue dopamine agonists, .......... might happen.
Parkinsonism Hyperpyrexia Sd. (Similar to NMS)
159
Low back pain If acute:
watch for Red Flags
Example: Epidural Abcess? IV drug abuser, Fever, ........, ........,
Pain which is not related to position, Sensory, motor problems
160
Low back pain
If a pregnant woman needs imaging?
MRI (without Contrast)
161
Neck pain and Whiplash
WAD Classification:
WAD 1. Only pain,
WAD 2. .........., WAD 3. ..........,
WAD 4. Fx or Dx or Instability
2. ROM is decreased
3. Sensory or Motor or Reflex deficit
162
Neck pain and Whiplash
Bone and Joint Classification:
BJ 1. NL activity is ok
BJ 2. .......... BJ 3. ..........
BJ 4. Structural lesion
2. NL activity is impaired
3. Neurological findings
163
Neck pain and Whiplash
Nonpharma:
WAD 1,2: ...........
WAD 3: .........
WAD 4: Urgent refer
1,2: symptomatic Tx, no collar, no immobilization
3: rest + semi-hard collar for 3-6 weeks
164
Sport Injuries
Nonpharma Tx
RICE Protocol
Rest/ Ice: 20 min QID/ Compress/ Elevation
165
Sports Injuries
Local injection of Triamcinolone is a good choice in most of sports injuries, except for: 1......... 2........
Patella, Achilles
166
Sports Injuries
Nitroglycerin patch may be used in .........
Chronic pains
1/4 of a patch per day, Regularly change the site
167
Sports Injuries
Platelet Rich Plasma (PRP) May be used in: 1. ........ 2 ......
Elbow, Achilles
168
Sports Injuries:
Ankle Sprain Tx:
Grade 1,2: Rice, Symptomatic Tx
Grade 3: ?
G3: Removable cast brace If no response after 6-8 weeks, then refer
169
Giant Cell Arthritis (Temporal Arthritis) 1st line?
Prednisone Oral ASAP 40-60 mg daily
170
Polymyalgia Rheumatica 1st line Tx
Prednisone Oral 10-20 mg daily
171
In PMR and in GCA, our long term management includes: 1. Bisphosphonates
2. Ca, Vit D
3. ..........
Try to decrease dosage of Prednisone to less than 7.5 mg daily
172
Osteoporosis
Nonpharma Tx
1. Ca, Vit D, decrease alcohol
2. Smoking Cessation
3. ........ 4. ........
3. Regular impact type exercise
4. Decrease falls risk in elderly
173
Osteoporosis
DOC if Osteoporosis is secondary to CS
Bisphosphonates
174
Osteoporosis
Two best Bisphosphonates
1. Alendronate
2. ........
Residronate (Both are Oral)
175
Osteoporosis
Bisphosphonates: ............... IV is only used once in a year
Zoledronate
176
Osteoporosis
Bisphosphonates SEs
1. Esophagitis or Ulcer
2. AFib
3. ......... 4..........
3. ONJ Osteonecrosis of the Jaw
4. AFSF Atypical Femoral Shaft Fx
177
Osteoporosis
a drug that works through RANK receptor
Denozumab
178
Osteoporosis
SERMs: Raloxifen SE? (1)
VTE
179
Osteoporosis
A possibly good candidate for HRT?
Recently menopause with severe hot flushes
180
Osteoporosis
Anabolics (PTH Analogues)
Example......... (Max: for 2 years) Possible SE..........
Teriparatide
Possible Osteosarcoma (Daily SC injection)
181
Rheumatoid Arthritis
MTX, SEs:
1. Stomatitis 2. Abortogenic 3. Teratogenic 4............. 5.............
4. Hepatotoxic 5. Pneumonitis
182
Rheumatoid Arthritis
MTX should be prescribed with.......
Folic Acid or Folinic Acid (8-12h later)
183
Rheumatoid Arthritis
Hydroxychloroquine, SEs:
1. .............. 2. Severe Hypoglycemia
Retinal Deposition
Monitoring: eye exam once a year
184
Rheumatoid Arthritis
Sulfasalazine,
SEs: Hepatotoxicity - ......... , ..............
- Hemolytic anemia -
- Reversible Oligospermia
185
Rheumatoid Arthritis
Leflunomide SE ?
Hepatotoxic (avoid alcohol, avoid MTX)
186
Rheumatoid Arthritis
Biological Treatments:
1- monitor for latent TB
2- Discontinue in time of infection or surgery
3- with live vaccinations?
No live vaccines
187
Rheumatoid Arthritis
DOC in Pregnancy
CS is the safest (No MTX, Leflunomide, biological)
188
SLE
Tx for Malar rash or discoid rash?
Topical CS
or Topical Tacrolimus
189
SLE
ASA and NSAIDs are used to treat serositis. Why shouldn't we use high doses?
They increase the risk of aseptic meningitis if prescribed high dose
190
SLE
Intervals needed to Pregnancy -
MTX: 3-6 months -
Micophenolate: ............
Leflunomide ............
- Mic: 6 weeks
- Lef: 11 days washout
191
SLE
DOC in Pregnancy
Chloroquine or CS
192
SLE
Why should we avoid SMX/TMP?
Increases rashes Or causes flares
193
SLE
Azathioprine Monitoring
CBC weekly for 1 month
(Leukopenia or thrombocytopenia)
+ LFT and Cr monthly
194
SLE
Micophenolate Monitoring
CBC weekly for 1 month (Anemia, Leukopenia or thrombocytopenia) + LFT and Cr monthly
