Treatments (Rapid Review) Flashcards
P450 inducers
“CRAP GPS”
Carbamazepine
Rifampin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas
P450 inhibitors
Valproate
Ketoconazole
Isoniazid
Sulfonamides
Chloramphenicol
Amiodarone
Erythromycin
Quinidine
Grapefruit juice
ethylene glycol/methanol intoxication
fomepizole (alcohol dehydrogenase competitive inhibitor)
chronic hepatitis B or C
IFN-alpha (HBV and HCV); ribavirin, simeprevir, sofosbuvir (HCV)
Streptococcus bovis
penicillin prophylaxis; evaluation for colon cancer if linked to infective endocarditis
Clostridium botulinum
human botulinum immunoglobulin
Clostridium tetani
antitoxin and wound debridement
Clostridioides difficile
oral vancomycin or fidoxamicin
refractory cases: repeat regimen or fecal microbiota transplant
Neisseria gonorrhoeae
ceftriaxone (add azithromycin or doxycycline to cover likely concurrent C. trachomatis)
Neisseria meningitidis
penicillin/ceftriaxone, rifampin/ciprofloxacin/ceftriaxone (prophylaxis)
Haemophilis influenzae (B)
amoxicillin (+clavulanate) for mucosal infections; ceftriaxone for meningitis, rifampin for prophylaxis
Legionella pneumophila
macrolides (azithromycin) or fluoroquinolones
Pseudomonas aeruginosa
piperacillin-tazobactam, cephalosporins (3rd/4th gen), monobactams, fluoroquinolones, carbapenems
Treponema pallidum
penicillin G
Chlamydia trachomatis
azithromycin or doxycycline (+ceftriaxone for gonorrhea coinfection), or erythromycin to treat chlamydial conjunctivitis in infants
Candida albicans
topical azoles (vaginitis)
nystatin, fluconazole, capsofungin (oral)
fluconazole, capsofungin, amphotericin B (esophageal or systemic)
Cryptococcus neoformans
induction with amphotericin B and flucytosine, maintenance with fluconazole (in AIDS patients)
Sporothrix schenckii
itraconazole, oral potassium iodide (only for cutaneous/lymphocutaneous)
Pneumocystis jirovecii
TMP-SMX (prophylaxis and treatment), pentamidine, dapsone, atovaquone
Toxoplasma gondii
sulfadiazine + pyrimethamine
malaria
chloroquine, mefloquine (chloroquine resistant cases), atovaquone/proguanil, primaquine (for liver hypnozoite)
Trichomonas vaginalis
metronidazole (patient and partner[s])
Streptococcus pyogenes
penicillin
streptococcus pneumoniae
penicillin/cephalosporin (systemic infection, pneumonia), vancomycin (meningitis)
Staphylococcus aureus
MSSA: nafcillin, oxacillin, dicloxacillin
MRSA: vancomycin, daptomycin, linezolid, ceftaroline
Enterococci
vancomycin, aminopenicillins/cephalosporins
VRE: daptomycin, linezolid, tigecycline, streptogramins
Rickettsia rickettsii
doxycycline, chloramphenicol
Mycobacterium tuberculosis
RIPE (rifampin, isoniazid, pyrazinamide, ethambutol)
recurrent UTI prophylaxis
TMP-SMX
influenza
oseltamivir, zanamivir
HIV pre-exposure prophylaxis
tenofovir, emtricitabine
patent ductus arteriosus
close with NSAIDs (indomethacin, ibuprofen) or acetaminophen; keep open with PGE analogs
stable angina
sublingual nitroglycerin
hypercholesterolemia
statin (first-line)
hypertriglyceridemia
fibrate
arrythmia in damaged cardiac tissue
class IB antiarrhythmic (lidocaine, mexiletine)
prolactinoma
bromocriptine (dopamine agonist)
diabetes insipidus
central: desmopressin
nephrogenic: hydrochlorothiazide, indomethacin, amiloride
SIADH
fluid restriction, IV hypertonic saline, tolvaptan, demeclocycline
diabetic ketoacidosis/hyperosmolar hyperglycemic state
fluids, insulin, K+
pheochromocytoma
alpha-antagonists (phenoxybenzamine) then B-blockers
carcinoid symptom control
octreotide (somatostatin analog), telotristat (inhibits tryptophan hydroxylase)
diabetes mellitus type 1
dietary intervention (low carbohydrate) + insulin replacement
diabetes mellitus type 2
dietary intervention, hypoglycemic agents, and insulin (if refractory)
gestational diabetes
dietary intervention and exercise, add insulin if refractory
Crohn disease
glucocorticoids, infliximab, azathioprine
ulcerative colitis
5-ASA preparations (mesalamine), 6-mercaptopurine, infliximab, colectomy
sickle cell disease
hydroxyurea (increases fetal hemoglobin)
chronic myelogenous leukemia
BCR-ABL tyrosine kinase inhibitors (imatinib)
acute promyelocytic leukemia (M3)
all-trans retinoic acid, arsenic trioxide
drug of choice for anticoagulation in pregnancy
low-molecular-weight heparin (unless there’s renal insufficiency, then you have to use unfractionated heparin)
immediate anticoagulation
heparin
long-term anticoagulation
warfarin, dabigatran, direct factor Xa inhibitors
heparin reversal
protamine sulfate
warfarin reversal
vitamin K (slow) +/- fresh frozen plasma or prothrombin complex concentrate (rapid)
dabigatran reversal
idarucizumab
direct factor Xa inhibitor reversal
andexanet alfa
HER2 + breast cancer
trastuzumab
hemorrhagic cystitis from cyclophosphamide/ifosfamide
mesna
nephrotoxicity from platinum compounds
amifostine
cardiotoxicity from anthracyclines
dexrazoxane
myelosuppression from methotrexate
leucovorin
osteoporosis
calcium/vitamin D supplementation (prophylaxis); bisphosphonates, PTH analogs, SERMs, calcitonin, denosumab (treatment)
osteomalacia/rickets
vitamin D supplementation
chronic gout
xanthine oxidase inhibitors (allopurinol, febuxostat)
acute gout attack
NSAIDs, colchicine, glucocorticoids
Buerger disease
smoking cessation
Buerger disease = thromboangiitis obliterans (medium vessel vasculitis)
Kawasaki disease
IVIG, aspirin
Kawasaki = medium vessel vasculitis
giant cell arteritis
high-dose glucocorticoids (before biopsy)
granulomatosis with polyangiitis
cyclophosphamide, glucocorticoids
granulomatosis with polyangiitis = Wegener granulomatosis (small vessel vasculitis)
neural tube defect prevention
prenatal folic acid
migraine
abortive therapies (sumatriptan, NSAIDs); prophylaxis (propranolol, topiramate, anti-CGRP antibodies, amitriptyline)
trigeminal neurolgia
carbamazepine
multiple sclerosis
disease modifying therapies (beta-interferon, glatiramer, natalizumab, alemtuzumab, rituximab); for acute flares, IV steroids
tonic-clonic seizures
levetiracetam, phenytoin, valproate, carbamazepine
absence seizures
ethosuzimide
malignant hyperthermia
dantrolene
ADHD
methylphenidate, amphetamines; behavioral therapy; atomoxetine (NE reuptake inhibitor); guanfacine, clonidine (alpha-2 agonists)
schizophrenia
atypical antipsychotics (quetiapine, ziprasidone, aripiprazole, clozapine, risperidone, olanzapine)
anorexia nervosa
nutrition, psychotherapy, SSRIs (citalopram, dapoxetine, escitalopram, fluoxetine, paroxetine, sertraline)
bulimia nervosa
nutrition rehabilitation, psychotherapy, SSRIs (citalopram, dapoxetine, escitalopram, fluoxetine, paroxetine, sertraline)
alcohol use disorder
disulfiram, acamprosate, naltrexone, supportive care
bipolar disorder
mood stabilizers (lithium, valproate, carbamazepine), atypical antipsychotics (quetiapine, ziprasidone, aripiprazole, clozapine, risperidone, olanzapine)
depression
SSRIs (citalopram, dapoxetine, escitalopram, fluoxetine, paroxetine, sertraline)
generalized anxiety disorder
SSRIs (citalopram, dapoxetine, escitalopram, fluoxetine, paroxetine, sertraline), SNRIs (venlafaxine, desvenlafaxine, duloxetine); buspirone (5-HT1A partial agonist; second line)
hyperaldosteronism
spironolactone
benign prostatic hyperplasia
alpha-1 antagonists, 5-alpha-reductase inhibitors, PDE-5 inhibitors, TURP
infertility
leuprolide, GnRH (pulsatile), clomiphene
breast cancer in postmenopausal women
aromatase inhibitor (anastrozole)
ER/PR positive breast cancer
tamoxifen
uterine fibrinoids
leuprolide, GnRH (continuous)
prostatic adenocarcinoma
flutamide, GnRH (continuous), degarelix, ketoconazole
medical abortion
mifepristone
erectile dysfunction
sildenafil
pulmonary arterial hypertension (idiopathic)
sildenafil, bosentan, epoprostenol, iloprost
schistosomiasis
praziquantel
acromegaly
pituitary adenoma resection; octreotide (somatostatin analog), pegvisomant (GH receptor antagonist), or cabergoline (dopamine agonist)
thyroid storm
B-blockers (propranolol), propylthiouracil, glucocorticoids (prednisone), potassium iodide
iodide load => decreased T4 synthesis (Wolff-Chaikoff effect)
serotonin syndrome
cyproheptadine (antihistamine with antiserotonergic properties)
distal esophageal spasm
nitrates and calcium channel blockers
primary biliary cholangitis
ursodiol
granulomatosis with polyangiitis
glucocorticoids + rituximab or cyclophosphamide
Enterovius vermicularis (pinworm)
albendazole
endometritis
gentamicin + clindamycin +/- ampicillin