rxfiles notes part 2 Flashcards
uncomplicated cystitis treatment duration for nitrofurantoin and septra
nitroFurantoin=Five, sulfamethoxazole Trimethoprim=Three
realisitic decrease (%) in chronic pain
30-50%
analgesics of choice in renal or hepatic failure
renal- hydromorph, oxy, fent, methadone. hepatic- morphine, hydromorph, oxy, fent, methadone
when should NSAIDs be avoided in renal dysfx
crcl less than 40 (unless dialysis)
best for GAD (SSRIs)
EPS- escit, parox, sert
lowest effective antiinflammatory dose for ibu and naprox
ibu- 400mg, naprox 375
what is the saturation point of uric acid
over 405umol/L. Target we want is less than 300-360. If asxatic, can be higher and no big deal may not treat (usually don’t)
do not start, stop or adjust allopurinol during acute gout attack- TF
T- first time, wait 1-2 weeks after inflammation/attack settles before starting as it may destabilize crystals
when can allopurinol be used not in gout attack
to proph while waiting for allopurinol to kick in- 0.6mg OD-BID for 3-6 months when starting allo
allopurinol should be taken AC- TF
F- preferred after food
MOA of ASA, how long does effect last?
irreversible platelet inhibition- lasts 7-10 days
which NSAID has the most CNS effects
indomethacin (CNS confusion esp in elderly). Dosed 25-50mg TID (max 200)
what is the equivalency between oral morphine and fentanyl
90MEq in about 25mg/day patch
what is the watchful dose for morphine and how long should you taper opioids over
200mg, taper over 2-16 weeks
how long does it take to lose tolerance to an opioid dose
as little as 1-2 weeks; careful when tapering off to caution patients not to abruptly go back to previous dose
dose of dimenhydrinate
50-100mg q6h prn
what automatically volumes you up a level on the CAROC scale for OP
pre if greater than or equal to 7.5 mg/day for over 3 months or frag fracture after age 40
bisphosponates should not be used below a crcl of
30
what is etidronate good for
weak antiresorptive; only for vertevral fracture in those at high risk (NOT hip or non vertebral) and must be 2 hours before food… sucks!
what is raloxifine? who is it CI in?
SERM- SE hot flushes/flushing, leg cramps, VTE is rare but serious. CI in women of childbearing potential and active or past thromboembolic events. Only decreases risk of vertebral
how does teriperatide work?
anabolic- only one that works on osteoblasts- it increases activity. SE- N, Dizzy, aching. For vertebral and non vertebral (ie not hip) in postmenopausal if severe OR glucocorticoid induced OR men. Given SC daily
list foods that contain about 300mg calcium
1 cup milk or orange juice, 3/4 cup yogurt, 1/2 pack of cards sized serving of cheese
what does Ca decrease the absorption of? what should it be taken with to increase absorption?
Decreases cipro, iron, PI, tetracyclines, thyroid meds. PPIs can decrease Ca absorption (citrate best in this situation). Usually give carbonate; if with meal it will increase its F (menopausal- 1200mg per day, age 19-50 1000mg daily)
how much vitamin D in OP per day
800-2000IU per day
