Treatments Flashcards
Management of NSTEMI/unstable angina low risk (GRACE score)
Aspirin
Fondaparinux
Ticagrelor if low bleeding risk, clopidegrol if high bleeding risk
Angina treatment
All should receive:
aspirin +statin
GTN
1st line:
- bblocker (atenolol, bisoprolol)
- CCB (amlodopine, diltiazem)
2nd line: Long acting nitrates (Isosorbide mononitrate) K ATP channel activatir (nicorandil) ACEI (dec bp) Ivabradine (HCN channel blocker)
Stemi treatment
Aspirin
- PCI within 120 mins (assuming they’ve come in no longer since 12hrs since MI)
- prasugrel
- unfractioned heparin + glycoprotein
PCI not available:
- Fibrinolysis + antithrombin
- ticagrelor following procedure
- consider PCI for ongoing myo ischaemia/ cardiogenic shock
COPD acute treatment
I SOAP Ipratropium (sama) Salbutamol (nebulised) Oxygen (24-28%, keep saO2 between 88%-92%) Amoxicillin (/doxy/clarithomycin) Prednisolone oral (/hydro IV)
Aminophyline IV (if no response) Non invasive ventillation + docapram IV Consider intubated assisted ventilation if pH< 7.6
How to induce remission in crohns
1st. Monotherapy glucorticoids (prednisolone etc)
En considered in kids
2nd. + azathioprine/mercatopurine to induce remission (check tmpt activity before)
Severe: infliximab/ infliximab + ICS
How to treat acute MI
Morphine (IV) + anti emetic Oxygen (if hypoxic) Nitrates (if ongoing discomfort) Aspirin LMWH (dalteparin) (anticoag) Clopidogrel/ ticagrelor (antiplatelet) Bblocker
H. Pylori treatment
Omeprazole, amoixicillin, clarithomycin/metronidazole
Penicillin allregic:
Omeprazole + clarithomycin+ metronidazole
Gallstones treatment
None if asymptomatic (80%)
If symptomatic:
Laparoscopic cholecystectomy or bile salt acids eg. ursodeoxycholic acid (for smaller stones)
Cholangitis treatment
Emergency ERCP
IV fluids, analgesia, broad spectrum antibiotics
Surgery if ercp fails
Cholecystitis treatment
Acute: nil by mouth,
NSAIDs/opiates,
IV antibiotics (cephlasporin/tazobactam + metronidazole in v ill)
Laparoscopic cholecystectomy
Treatment of hypertension
Examples of Ace: lisinopril Arb: losartan Calcium channel blocker: amlodipine Thiazide like diuretic (d): bendroflumethiazide
Tb treatment
RIPE for 2 months
RI for a further 4 months
Rifampicin
Isonazid
Pyrazinamide
Ethmabutol
(Also negative pressure rooms and N-95 masks)
Tb treatment side effects
Isoniazide- numbness in fingertips/feet
(Im-so-numb-azid)
Ethambutamol- difficulty recognising colours (eye- thambutol)
Rifampicin- orange/red tears/urine
Pyrazinamide- liver toxicity
High risk unstable angina/NSTEMI
aspirin
PCI
Parasugrel/ticagrelor
Unfractioned heparin
COPD treatment for someone w no asthmatic features
1) saba/sama (salbut. / ipatropium)
2) + lABA + LAMA
3) + ICS
COPD treatment for someone w asthmatic features
1) SABA/SAMA
2) + LABA + ICS
3) + LAMA
Pulmonary embolism treatment. Drug name examples
Prevention treatment and who gets preventative treatment
Haemolytically stable:
LMWH (eg. Fragmin) & warfarin (stop when INR 2-3)
Or (1st line) doac - dabigatran
or factor x (rivoraxaban)
Massive PE- thrombolyse (tenectplase)
Prevention: heparin to all immobile patients
Croup treatment
Dexamethasone and supportive treatment
Pneumothorax vs tension pneumothorax
Pneumothorax: >2cm/ sob= aspirate Secondary: 1-2cm aspirate >2cm/sob chest drain
Tension pneumothorax:
- Cannula Needle decompression 2nd ics mid clavicular line
- then insert chest drain and Do Cxr
Symptoms of a tumour invading the oesophagus
Dysphagia
Symptoms of a tumour invading the SVC
Puffy eyelids. Headache, distended EJV, visible anastomosis to IVC
Symptoms of a tumour invading the the pleura and chest wall
Pleuritic chest pain and pleural effusion
Tumour invasion of the sympathetic chain symptoms
Horners syndrome, wonky eye etc.
Tumour invasion of the pericardium symptoms
Breathlessness, AF, pericardial effusion
