Drugs Flashcards
(182 cards)
1
Q
Parkinson’s (4 classes)
A
- Levodopa
- Ropinerole, Carbergoline, Bromocriptine
(D agonists) - Selegiline (MOA-B inhibitors)
- Entacapone, Tolcapone (COMTi)
2
Q
Bell’s Palsy (2)
A
- Prednisolone within 72hrs
- Artificial tears
3
Q
Trichomonas
A
- Oral Metronidazole 5-7 days
4
Q
Scarlet Fever (2)
A
- IV Penicillin
- Azythromycin if allergic
5
Q
Treatment for Syphilis (1)
A
- Benzathine Penicillin
6
Q
TIA and Stroke (3)
A
- Aspirin 300mg
2nd Prevention:
- Clopidogrel 75mg
- Control RFs - statins, DM drugs and HTN drugs
7
Q
Antiemetic suitable for Parkinson’s Disease (1)
A
- Domperidone (histamines worsen it)
8
Q
Wernicke’s Encephalopathy (1)
A
- Pabrinex - Vit B n C
9
Q
Hyperemesis Gravidarum (2)
A
- Oral Cyclizine / Promethazine (Antihistamines)
- Ondansteron or Metoclopramide (5HTs)
slight risk of cleft palate in 1st tri
IF SEVERE DEHYDRATION
3. Fluids + Electrolytes + Pabrinex - replace Vit B and C if wernickes
10
Q
Viral Induced Wheeze (2)
A
- SABA
- ICS +/- LTRA (Monteleukast)
11
Q
Post-Partum Thyroiditis (2)
A
Hyper thyroid stage managed with:
1. Propanolol
(not overactive thyroid so not carbimazole, this is purely symptomatic Tx)
Hypothyroid stage:
2. Thyroxine
12
Q
PPH
A
(After ABCDE, Fluid resus, Mechanical palpation of uterus etc..)
- IV Oxytocin
- Ergometrine (CI HTN)
- Carboprost (CI Asthma)
- Misoprostol
Basically you’re trying to get the uterus to contract heavily to occlude/tamponade bleeding
Surgery from there on
13
Q
Brain Abscess (3)
A
- Cefotaxime (IV 3rd Gen Cephalosporin)
AND - Metronidazole (covers fungal? i think….)
- Dexamethasone - Raised ICP Mx
14
Q
Thread Worm (1)
A
- Mebendazole (and hygiene measures, FOR WHOLE HOUSEHOLD)
15
Q
Whooping Cough (1)
A
- Macrolide - Clarithromycin or Azithromycin
14 day course
MUST BE WITHIN 21 DAYS OF Sx ONSET
Admit kids under 6 months, notifiable disease, 48hr school exclusion after ABx, Household PPx
16
Q
Eclampsia (Seizures)
A
- MgSO4 for 24hrs post seizure or delivery
17
Q
Pre-Eclampsia
A
- Labetalol (Nifedipine if Asthmatic)
Delivery of baby is definitive Tx
18
Q
Adenomyosis (1)
A
- GnRH agonists (leuprolide)
Plus a hysterectomy eventually
19
Q
Atrophic Vaginitis (2)
A
- Moisturisers and emollients
- Topical Oestrogen Cream
20
Q
Medical Termination of Ectopic Pregnancy (1)
A
- Methotrexate
21
Q
Endometrial Cancer in frail elderly women
A
- Progestogen therapy (basically bc surgery is CI)
22
Q
Endometrial Hyperplasia (1)
A
- High dose progestogens or IUS
23
Q
Endometriosis (3)
A
- NSAIDS +/- Paracetamol
- COCP
- GnRH analogues - induce pseudo-menopause
Drugs aint super useful tbh but could reduce symptoms
24
Q
HMB
(3 for if contraception needed, 1 for if not, 1 for rapid stopping of HMB)
A
Requires Contraception:
1. IUS
- COCP
- Long acting Progestogens
Does NOT require contraception:
4. Mefenamic Acid 500mg or Tranexamic Acid
Rapid termination of HMB
5. Norethisterone
25
Medical termination/support of a miscarriage(1)
1. Misoprostol
26
PID (4)
1. Oral Ofloxacin
AND
2. IM Ceftriaxone
AND
3. Oral Doxycycline
AND
4. Oral Metronidazole
Basically, blast it with broad specs
27
PCOS (6)
General:
1. COCP - could help induce regular bleeds
Hirsutism:
COCP benefits this
2. Eflornithine
3. Spironolactone under specialists
Infertility:
4. Clomifene - Specialists and is debated
5. Metformin
6. Gonadotrophins
28
PMS (2)
Moderate:
1. 3rd gen COCP
Severe
2. SSRIs
29
Termination of Normal Pregnancy (1)
<9 wks:
1. Mifepristone (anti-progesterone) + prostaglandins to stimulate contractions
after which its surgery
30
Which psych drug class increases risk of gi bleed if taken with NSAIDS (thus requiring PPI co-prescription)
SSRIs
31
Urge Incontinence (2)
after bladder retraining,
1. Antimuscarinics - Oxybutynin, tolterodine or darifenacin
2. Mirabegron (B3-agonist, avoid if frail)
32
Only antiemetic suitable for Parkinson's disease
1. Domperidone (doesn't cross BBB)
Other anti-histamines like cyclizine or prochlorperazine may worsen PD
33
Stress Incontinence (1)
after pelvic floor exercises:
1. Duloxetine (SnRI)
*(increase ser and nor conc in pudenal nerve = increased sphincter stimulation - better sphincter)
34
Fibroids (6)
To manage Menorrhagia:
1. IUS (LNG-IUS) - (only for small ones)
2. NSAIDS - Mefenamic acid
3. Tranexamic acid
4. COCP
5. Oral Progesterone / injectable
To Shrink Fibroids:
6. GnRH agonists - shrink by inducing pseudo-menopause since fibroids are E2 sensitive
35
Vaginal Candidiasis (Thrush) (3)
1. Oral Fluconazole
2. Clotrimazole intravaginal pessary
3. Topical imidazole for vulvar Sx
oral Tx CI in Pregnancy
FOR RECCURENT:
fluconazole on a weird regimine - dont bother basically
36
Acute Dystonia (Oculogyric crisis / Torticollis) (1)
1. Procyclidine
37
Tardive Dyskinesia (1)
1. Tetrabenazine
38
Side Effects of Typical Antipsychotics (11)
Again, just to have as notes, not necessarily to learn by wrote, but you need to know each individually well as psych questions are pretty pharm specific
1. Parkinsonism
2. Acute Dystonia
3. Tardive Dyskinesia
4. Akathisia
5. Antimuscarinic: dry mouth etc
6. Weight gain, sedation
7. Raised Prolactin
8. Impaired Glucose metabolism
9. Reduced Seizure Threshold
10. Neuroleptic Malignant Syndrome
11. Haloperidol is a QTc drug
39
Tardive Dyskinesia (1)
1. Tetrabenazine
40
Suppression of Lactation (1)
1. Cabergoline
(Dopamine Receptor Agonist and Dopamine inhibits Prolactin release)
41
Chickenpox EXPOSURE in pregnancy
If in doubt over mums immuno status, varicella ABs need checking
if 20 wks:
2. Antivirals - oral acyclovir 7 to 14 days post exposure
42
Puerperal Pyrexia/Endometritis (2)
1. Clindamycin
AND
2. Gentamicin
43
Contracted chickenpox in Pregnancy (1)
Seek specialist help
1. Oral Acyclovir if >20wks within 24hrs of rash
if less than 20 wks, use is cautionary as potential risks to baby
44
Chorioamnionitis (1)
Prompt delviery and:
1. IV broad spec ABxs
45
Epilepsy drugs in Pregnancy
Benefits of controlling epilepsy > risks to foetus
1. Folic acid 5mg (which is higher dose) as higher risk of NTDs
2. Valproate: risk of NTDs
3. Carbamazepine: least teratogenic of older antiepileptics
4. Phenytoin: cleft palate and needs vit k in last month to prevent newborn clotting disorders
5. Lamotrigine: lower risk seemingly
46
Indications for high dose Folic Acid (5mg vs 400mcg) (3)
1. Partner with NTD or previous NTD baby or strong FHx
2. Antiepileptic drug use, has DM, Coeliac or Thalassaemia
3. BMI > 30
*Still take till 12th week
47
Gestational DM (2)
If <7mmol/L at diagnosis then start trial of diet and exercise for 2 weeks, if failed then:
1. SHORT ACTING Insulin
then
2. Metformin if still not controlled
If already >7mmol/L at diagnosis
1. Start the Insulin straight away
48
Mx of pre-existing DM in pregnancy (3)
1. Stop hypoglycaemic agents except Metformin
2. Start Insulin (Short acting)
3. FOlic acid 5mg till wk 12
tight glycaemic control needed
49
Group B Streptococcus infection - Pregnancy (1 drug, 4 indications)
1. BenPen (BenzylPenecillin)
Intrapartum Antibiotic Prophylaxis (IAP) should be offered to women who:
- Detected GBS in this pregnancy
- Previous GBS pregnancy
- All Preterm labours / PROMs
- Pyrexia in labour of >38 degrees
50
Foetus born to Hep B +ve mother (2)
1. Vaccination
2. Hep B IVIG
51
Outline SSRI Withdrawal Syndrome (5)
1. GI disturbance - diarrhoea
2. Headaches/electric shock feelings
3. Paraesthesia
4. Sweating
5. Restlessness and mood changes
52
HIV in Pregnancy (2)
1. ART for mum throughout regardless of prior usage
2. Zidovudine infusion 4 hrs pre C-section
Neonate:
2. Zidovudine
1. Triple ART therapy for 4-6 wks
DONT BREASTFEED
53
Induction of Labour (IoL) (2)
surgical membrane sweep +/-
1. Vaginal Prostaglandin E2
2. Maternal oxytocin infusion
other methods are surgical and therefore not in these flashcards - check textbook chapter on passmed
54
Uterine Hyperstimulation (1)
If possible remove vaginal prostaglandins and offer tocolysis with:
1. Terbutaline
55
Intrahepatic Cholestasis of Pregnancy (2)
induce labour at 37-38 wks
1. Ursodeoxycholic acid
2. Vit K supplements
56
Anaemia in pregnancy (1 with 3 thresholds)
1. Ferrous Sulfate
treat if if:
1st trimester - hb < 110
2nd/3rd trimester - hb < 105
Post-partum - hb < 100
57
Jaundice in Pregnancy (1)
1. Ursodeoxycholic acid for Sx relief
58
Cord Prolapse (1)
Mainly surgical, this card is to remind you that you can use tocolytics to reduce contractions and reduce risk of it prolapsing acutely again
59
VTE in Pregnancy
1. 4 or more RFs means LMWH PPx
AVOID DOACS
60
Acute Stress Disorder (1)
following Trauma-focused CBT
1. Benzodiazepines
(only prescribe short term for acute agitation and sleep disturbance)
61
Alcohol Withdrawal (2)
1. Long acting Benzodiazepines - Chlordiazepoxide or Diazepam
2. Carbamazepine also effective
62
Key Side-effects of Typical Antipsychotics (10 - less to memorize, more to read through and remind yourself)
1. Parkinsonism - (such that they are CI in Parkinson's and dimentia)
2. Acute Dystonia/dystonic reaction - (torticolis, oculogyric crisis)
3. Akathisia
4. Tardive Dyskinesia (chewing jaw, choreoid movements)
5. Increase CVA and VTE risk
6. Antimuscarinic SEs: dry mouth, blurred vision, urinary retention, constipation
7. Sedation and weight gain
8. Neuroleptic Malignant Syndrome: pyrexia, muscle stiffness
9. Reduced seizure threshold
10. Impaired glucose tolerance
11. Raised Prolactin
12. QT interval lengthening -haloperidol
63
Key SE of Clozapine (1)
1. Agranulocytosis - dropped white cells and subsequent easy infection and immunosuppression
requires monitoring and is affected by smoking cessation or increase
64
The atypical antipsychotic with the best SE profile?
Aripiprazole
65
MoA of Benzodiazepines
Increase Frequency of chloride channel opening on GABA receptors (opens them more often - Frenzos - Frequency)
66
Otitis Media (1)
1. Amoxicillin
In practice nothing is given its conservative and self limiting - NNT is like 35 or something and GPs dont give this but this is the medschool answers for SBAs
67
SEs of MOA-B inhibitors (4)
1. Hypertensive Crisis
2. Nausea
3. Insomnia
4. Dyspnoea
68
Class of antibiotics safe at any stage of pregnancy (1)
1. Cephalosporins
eg: NOT
Nitrofurantoin (avoid in 3rd tri -haem anaemia and G6PD def)
Sulphonamides (3rd tri - kernicterus)
Tetracyclines (teeth staining and skeletal issues)
Trimethoprim (folate antagonist - NTDs)
69
Medication used in Sickle Cell to manage complications (2)
1. Prophylactic Penicillin
2. Hydroxycarbamide - prevent crisis
70
Med given to reverse DOAC/NOAC anticoagulation (1)
1. Beriplex
71
Med given to reverse heparin effects (1)
1. Protamine
72
Paracetamol Overdose (1)
N-acetylcysteine (NAC or acetadote) - replenishes glutathione stores
73
Common SEs of Dopamine Agonists - Ropinirole (3)
1. Disinhibition/Compulsive behaviour
2. Nausea
3. Daytime drowsiness
74
Common Levodopa SEs (4)
1. Nausea
2. Loss of Appetite
3. Discolouration of Urine
4. Drug induced parkinsonism and on/off/wearing off effect
75
MoA of Barbiturates
Increase Duration (barbiDURATes) of Chloride channels on GABA receptors - hold em open longer
76
Anti-craving medication for alcoholics (1)
1. Acamprosate
77
Alternative to Methadone for Opiate withdrawal regimes
1. Buprenorphine
78
Bipolar Disorder (3)
Stabilise with:
1. Lithium - requires monitoring
Treat mania with:
- removing antidepressant then
2. Antipsychotics - Olanzapine or Haloperidol
Treat Depression with
- Talking therapies then
3. Fluoxetine
79
Drug that makes you feel sick on drinking alcohol (to prevent relapse)
1. Disulfiram
80
Depression (1)
SSRIs
Sertraline used in history of CVS disease
passmed doesnt deal with this in great detail, on placement ive seen patients on mirtazapine too for its appetite and sleep benefits and i think SnRIs could also be used but yeah, check for yourselves
81
Generalised Anxiety Disorder and Panic Disorders (2)
1. SSRI - Sertraline
then
2. SnRI if not working - Duloxetine or Venlafaxine
alongside education, CBT etc..
My GP tutor said anxiety really needs that CBT and that its harder to treat than Depression with drugs
82
Insomnia (1)
Drugs only indicated if daytime function significantly impaired and lifestyle / sleep hydeine is being addressed too
1. Z-Drugs (Hypnotics) - Zopiclone, Zolpidem, Zaleplon
Use as little as possible for as short as possible
83
When do you monitor Lithium dosages?
12 hrs post dose then weekly until stable
once stable, every 3 months unless a change is made
TFTs and U/Es checked every 6 months
Lithium toxicity:
- N&V
- Tremor
- Nephrotoxicity - polyuria
- Hypothyroid Sxs
- Weight gain
HYEPRCALCAEMIA - 2nd to hyperparathyroidism
84
OCD (1)
1. SSRIs
85
PTSD (2)
1. SnRIs - Venlafaxine
2. SSRIs - Sertraline
CBT and EMDR are the best though
86
Schizophrenia (1)
1. Oral Atypical Antipsychotics
Realistically this is super specialist and very complex, you trial lots of different antiPs and find what works. Passmed doesnt deal with second-line stuff here
oh yeah and + CBT
87
Seasonal Affective Disorder (1)
1. SSRIs
88
SSRI of choice in paediatrics
Fluoxetine
89
What needs co-prescribing with an SSRI and NSAID combo?
Proton Pump Inhibitor
90
Which SSRI can characteristically lengthen QTc interval?
Citalopram (and escitalopram)
91
3 drugs that may increase risk of serotonin syndrome if prescribed alongside SSRIs (3)
1. Triptans
2. TCAs - amitriptyline
3. MOA-Bis
92
How long after resolution of depressive symptoms should SSRIs be continued for?
6 months
93
Acute Epiglottitis (1)
After intubation and O2
1. IV ABxs
94
Paediatric Exacerbation of Asthma / acute attack (3)
1. b-2-agonist 1 puff every 30-60 secs up to 10 (Salbutamol)
2. Steroids
Obviously ABCDE and Admission if severe
I also saw on Paeds use of MgSO4 in really really bad exacerbations so:
3. MgSO4
95
Routine Management of Asthma in 5 - 16 y/os
Stepwise algorithm
1. SABA
2. SABA + low dose ICS
3. SABA + low dose ICS + LTRA
4. SABA + low dose ICS + LABA (notice the LRTA is stopped here)
5. SABA + MART (combo of LABA and ICS i believe)
6. SABA + moderate dose ICS MART (or separate LABA and moderate ICS dose)
7. SABA + one of the following:
- Paeds High dose ICS
- Theophylline
- Specialists involvement
Basically, think of the SABA as an emergency reliever, its there to puff on when you get bad. The ICS/LRTA/LABA/MART are all then additions to prevent getting bad in the first place, almost maintenance prophylaxis meds
96
Routine Management of Asthma in <5 y/os
Stepwise algorithm
1. SABA
2. SABA + 8wk trial of MODERATE dose ICS and reassess symptoms:
- If no resolution - consider different Dx
- If recurred within 4wks of no ICS - low dose ICS
- If recurred outside 4wks of stopping ICS - Repeat trial
3. SABA + paeds low dose ICS + LTRA
4. Stop the LTRA and refer to paeds asthma specialist
97
ADHD (3)
drug therapy as last resort:
1. Methylphenidate - 6wk trial - monitor weight and height as reduces appetite
2. Lisdexamfetamine 2nd line
3. Dexamfetamine if lisdexamfetamine is not tolerated but was useful
all cardiotoxic potentially so do ECG before starting
98
Autism Spectrum Disorder
nothing disease altering, but Sx control with
1. SSRIs - depression
2. Antipsychotics - Aggression
3. Methylphenidate: ADHD
99
Cerebral Palsy (4)
For Spasticity:
1. Diazepam
2. Intrathecal Baclofen
3. Botox
4. Anticonvulsants and analgesia as required
100
Chickenpox (2)
1. Calamine lotion
2. VZIG if immunocompromised and exposed peripartum
101
Constipation in Paediatrics (3)
1. Movicol (Polyethylene glycol 3350 + Electrolytes) for impaction
2. Add Stimulant if not effective in 2wks
3. Lactulose is an osmotic one and is used as a substitute if movicol isn't tolerated
In infants:
breastfed - constipation rare so look for causative Dx
Bottle-fed - give extra water between feeds
102
Cows Milk Allergy (2)
1. eHF - Extra hydrolysed Formula is first-line replacement
2. AAF - Amino Acid Formula if no response to eHF or if severe CMA
103
Croup (3)
1. Single dose oral Dexamethasone (0.15mg/kg) regardless of severity (Prednisolone is alternative )
Emergency:
2. High-flow O2
3. Nebulised Adrenaline
104
Cyanotic Heart Disease in Newborn (thinking TGA) (1)
1. Prostaglandin E1 - alprostadil
maintains ductus arteriosus for surgery
105
Patent Ductus Arteriosus (2)
1. Indomethacin - an NSAID - closes PDA
if needed to be preserved - eg. TGA
2. Prostaglandin E1 - Alprostadil
(INDOmethacin ENDS the pda, PRostaglandins PRESERVE it)
106
Cystic Fibrosis (3)
(Physio, avoiding other CF patients, high calorie diet, MDT approach) PLUS:
1. Vit K supplements
2. Pancreatic enzyme supplements
3. Lumacaftor/Ivacaftor - potentiator or CFTR transporter
107
Eczema in Kids (3)
1. Simple emollients
2. Topical steroids (low dose, applied 30 mins after emollient)
3. In severe - maybe ciclosporin
108
Paediatric GORD (2)
Lots of prior lifestyle and education interventions, THEN:
1. Trial GAVISCON
2. PPI if unexplained feeding difficulties, distressed behaviour or faltering growth
109
Migraines in Children (3)
1. Ibuprofen > Paracetamol
2. Triptans used in >12 yrs
3. Propranolol for migraine PPx
110
ITP in children (3)
usually no treatment
if severely low platelets:
1. Corticosteroids
2. IVIGs
3. Platelet Transfusion
111
Infantile Spasms (West syndrome) (2)
poor prognosis
1. Vigabatrin
2. ACTH is also used
112
Kawasaki Disease (2)
1. High-dose Aspirin
2. IVIG
(F/U with echocardiogram for coronary artery aneurysm)
(one of the only paeds indications of aspirin I believe due to normal risk of Reye's syndrome)
113
Meningitis in children (4)
1. Antibiotics:
- <3 months - IV Amoxicillin + IV Cefotaxime
- >3 months - IV Cefotaxime (or Ceftriaxone)
2. Steroids:
- Dexamethasone
- < 3 months NICE say don't give
- >3 months and lots of WBC in LP +/- purulent CSF etc
3. Fluids:
- Treat shock
(Prophylaxis for contacts with 4. Ciprofloxacin)
114
Chlamydia (1) (plus alternative for pregnancy)
1. Doxycycline 7 days BD 100mg
In Pregnancy
2. Azithromycin
115
Bacterial Vaginosis (1)
1. Oral Metronidazole
116
Gonorrhoea (1)
1. IM Ceftriaxone
add sensitivities according to micro - often Ciprofloxacin
117
Trichomonas Vaginalis (1)
1. Oral Metronidazole
118
Neonatal Hypoglycaemia (1)
if feeding encourage more
if really low or not feeding:
1. Fluids w/ 10% dextrose
119
Neonatal Sepsis (1)
First-line
1. Benzylpenecillin + Gentamicin
(CRP is taken frequently to monitor progression)
then close monitoring and supportive therapy, avoiding hypoglycaemia, electrolyte and fluid imbalance and acidosis
120
Nocturnal Enuresis (1)
1. Desmopressin
(following failure of advice, reward systems, enuresis alarms - in that order)
121
Pneumonia in Children (3)
1. Amoxicillin
2. Macrolides added if no response
3. Co-Amoxiclav if influenza is associated
122
PARDS (2)
1. Surfactant via endotracheal tube + assist ventilation
2. Should have had corticosteroids in-utero to mature lungs
123
Rickets (rare) (1)
1. Oral Vit D
124
Seborrhoeic Dermatitis in Children (2)
mild-moderate:
1. Baby Shampoo and oils
Severe:
2. Topical 1% hydrocortisone cream
125
UTIs in children (2)
<3 months urgent refer to paeds
>3 months with upper UTI - admit then:
1. Cephalosporin (or Co-amoxiclav) 7-10 days
>3 months with lower UTI - home treatment with:
2. Oral Trimethoprim
(or nitrofurantoin, cephalosporin or amoxicillin)
126
Acute Confusional State/Delirium (COTE) (2)
1. Haloperidol or
2. olanzapine
(CI in Parkinson's)
127
Alzheimer's
1. Acetylcholinesterase Inhibitors - Donepezil, Galantamine, Rivastigmine
2. Memantine (NMDA receptor antagonist)
"DONE a PUZZLE by the RIVer containing MANatees"
(donepezil, rivastigmine, memantine)
128
List 7 classes of drug that cause postural hypotension and thus falls in the elderly? (7)
1. Nitrates
2. Diuretics
3. Anticholinergic meds
4. Antidepressants
5. BBs and AlphaBs
6. L-Dopa
7. ACEi and CCBs
(notice many are blood pressure meds, fall prevention is often focussed on DE-prescribing as often elderly are being over medicated)
129
List 7 drug classes associated with falls in the elderly (not through postural hypotension)
1. Benzos
2. Antipsychotics
3. Opiates
4. Anticonvulsants
5. Codeine
6. Digoxin
7. Sedatives
Notice most are Psych/neuro meds
130
Lewy Body Dementia
1. Ach Esterase Inhibitors - Donepezil, Rivastigmine
2. Memantine
(same as alzheimer's)
131
Chemotherapy-related nausea (1)
1. 5HT3 Antagonists - Ondansetron, Palonosetron
132
Absence Seizures (3)
Firs line:
1. Ethosuximide
2nd Line
2. Male: Sodium Valproate
3. Female: Lamotrigine or Levetiracetam
Carbamazepine may make them worse
133
Focal Seizures (3)
1st Line
1. Lamotrigine or Levetiracetam
2nd Line
2. Carbamazepine
134
Myoclonic Seizures (2)
1. Male: Sodium Valproate
2. Female: Levetiracetam
135
Tonic or Atonic Seizures (2)
1. Males: Sodium Valproate
2. Females: Lamotrigine
136
Generalised Tonic-Clonic Seizures
1. Males: Sodium Valproate
2. Females: Lamotrigine or Levetiracetam
137
Status Epilepticus (3)
ABCDE + check glucose then:
1. IV Benzodiazepines - Diazepam (pre-hospital) or lorazepam (hospital)
2. Phenytoin if ongoing
If no response within 45 minutes
3. General Anaesthesia
138
Encephalitis (1)
1. IV Acyclovir
139
Essential Tremor (2)
First-line
1. Propranolol
2nd line
2. Primidone sometimes used
140
Guillain-Barre Syndrome
NEVER GIVE STEROIDS
1. IVIGs if needed
141
Herpes Simplex Encephalitis (1)
1. IV Acyclovir
142
Idiopathic Intracranial Hypertension (2)
after weight loss advice
1. Diuretics - Acetazolamide
2. Topiramate - helps also with weight loss
143
Lambert-Eaton Syndrome (2)
Treat underlying SCC of lung
1. Immunosuppression - Prednisolone
2. IVIGs/Plasmapheresis
144
Intracranial Venous Thrombosis (1)
1. Anticoagulation - LMWH
145
Medication Overuse Headache
You can abruptly stop Simple analgesia and Triptans
Wean off Opioids gradually
146
Migraine Acute Management (Adults) (2)
1. Triptans + NSAIDs
2. Metoclopramide - D2 receptor antagonist if above doesn't work
147
Migraine Prophylaxis (Adults) (4)
(2 or more attacks/ month)
Women of childbearing age:
1. Propranolol
Everyone else:
2. Topiramate
Women with predictable menstruation migraines:
3. Frovatriptan/Zolmitriptan as mini prophylaxis
4. Mefenamic acid can also be used
148
Migraine in Pregnancy
1. Paracetamol
2. NSAIDs 2nd line in 1st/2nd trimester
AVOID aspirin and opiates
149
Migraine with COCP
Migraine with aura is an absolute UKMEC4 contraindication of COCP use
150
Motor Neurone Disease / ALS (1)
1. Riluzole
151
Multiple Sclerosis Acute Relapse (1)
1. Steroids - IV Methylprednisolone
152
Multiple Sclerosis Disease Modifying Drugs (5)
Reducing relapse risk:
1. Natalizumab - Antagonises receptor on leukocytes
2. Ocrelizumab - anti-CD20 drug
3. Fingolimod
4. Beta-Interferon
5. Glatiramer Acetate - acts as immune decoy
153
Drugs used to manage MS complications (5)
Fatigue:
1. Amantadine
Spasticity:
2. Baclofen + Gabapentin
3. Diazepam
Oscillopsia:
4. Gabapentin
Bladder Dysfunction
5. Anticholinergics
154
Myasthenia Gravis (3)
1st line:
1. Pyridostigmine - (Long-acting Ach Esterase Inhibitor)
2. Prednisolone - Immunosuppression
3. Azathioprine, cyclosporine etc - immunosuppression
(+thymectomy)
155
Myasthenic Crisis (2)
1. Plasmapheresis
2. IVIGs
156
Narcolepsy (1)
1. Modafinil - daytime stimulants
157
Neuroleptic Malignant Syndrome (2)
Stop the Antipsychotic, admit and IV Fluids then:
1. Dantrolene - sometimes used
2. Bromocriptine - (Dopamine agonist) sometimes used
158
Neuropathic Pain (5)
1. Amitriptyline 10mg (neuropathic dose),
2. Duloxetine,
3. Gabapentin,
4.Pregabalin
Generally monotherapy
5. Tramadol for exacerbations
159
Paroxysmal Hemicrania (1)
1. Indomethacin
160
Raised ICP (1)
1. Mannitol
161
Restless Legs Syndrome (4)
1. Treat Iron deficieny - Ferrous Sulphate
THEN:
first line:
2. Dopamine Agonists - Ropinirole, Pramipexole
3. Benzodiazepines
4. Gabapentin
162
Ischaemic Stroke (2)
Depends on type and position but generally
1. Thrombectomy within 6hrs + thrombolysis (Alteplase) in 4.5 hrs
2. Aspirin 300mg if Haemorrhagic ruled out
163
Prophylaxis of ischaemic stroke (2)
1. Clopidogrel
2. Aspirin +/- Dipyridamole if Clop not tolerated
164
Tension Headache (Adults) (2)
Acute:
1. Aspirin, Paracetamol or NSAIDs
Prophylaxis:
2. low-dose Amitriptyline
165
Trigeminal Neuralgia (1)
1. Carbamazepine
166
Tardive Dyskinesia (1)
1. Tetrabenazine
167
Impetigo (4)
SO, ABxs are NOT always indicated:
IF
A) Limited Localised Disease:
1. Hydrogen Peroxide 1% Cream
B) Lesions near eye or peroxide not suitable
2. TOPICAL Fusidic acid (ABx cream)
C) Extensive Disease or Immunosuppressed
3. Oral Flucloxacillin - fighting the Staph Aureus
(4. Erythromycin/clarithromycin if pen allergic)
+ School exclusion till lesions have dried out
168
Mechanism of Action of Acamprosate (1)
1. GABA2 agonist (and weak NMDA agonist) increasing GABA activity which interferes with the anticipatory phase of drinking (reduces cravings)
169
Mechanism of Action of Disulfiram (1)
1. Causes build-up of Acetaldehyde on consumption of alcohol causing unpleasant flushing, headaches and anxiety
170
Mechanism of Naltrexone (1)
1. Acts as opioid antagonist to reduce the initial pleasure of the "first sip" - anti alcoholism drug
171
Drug used to reduce pleasure of the "first-sip" of alcohol (1)
1. Naltrexone
172
Drug used in Depression for its side effects of improving sleep and appetite (1)
1. Mirtazepine
173
1st Line anti-psychotic for acute delirium (1)
1. Haloperidol 0.5mg PO
174
List 4 medications that interact with Methylphenidate (4)
1. Isocarboxazid - (MAO-Bi causes hypertensive crisis)
2. Linezolid - (ABx increases risk of high BP)
3. Risperidone - (Atypical Antipsych - causes dyskinesia risk)
4. Carbamazepine - may decrease levels of methylphenidate
175
Emergency contraception PILL suitable for up to 5 days post-UPSI (1)
1. Ulipristal Acetate- EllaOne
Remember by Ella"120" - 120 hrs = 5 days
Also requires 5 days after taking before starting hormonal contraception again as that may interfere with EllaOne efficacy
176
Emergency contraception PILL suitable for up to 3 days post-UPSI (1)
1. Levonorgestrel (Levonelle) - 72hrs after
can start contraception straight away after i believe
177
Most effective emergency contraception (1)
1. Copper coil
120hrs/5days after UPSI
178
Med used in Pre-Eclampsia if mother has asthma (1)
1. Nifedipine
use labetalol if she doesn't 1st line
178
Med used in Pre-Eclampsia if mother has asthma (1)
1. Nifedipine
use labetalol if she doesn't 1st line
179
Initial management of Corda Equina prior to surgery (1)
1. Dexamethasone 16mg
Basically "High-Dose Dex" reduces compression as it reduces oedema around the tumour site/cauda equina site - this is followed by surgical decompression but is the immediate way of reducing harm
180
Meds used 1st line in Heart Failure (2)
1. ACEi
AND
2. Beta-Blockers
These reduce actual morbidity and mortality,
you would also likely need a loop diuretic like Furosemide to manage oedema and a CCB to deal with HTN etc etc but those tow drugs are disease modifying
181
Medications used in Gout (2 chronic to lower uric acid, 1 in acute attacks)
1. Allopurinol
second line
2. Febuxostat
ACUTE
3. Colchicine
