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Flashcards in Family Medicine Techniques, Tips and Treatment Options Deck (159):
1

Drug addiction and withdrawal

Suboxone (Buprenorphine)

2

How to treat anxiety

Initiate an SSRI as baseline and use a benzodiazepines for break through.

Zoloft (Sertraline) or
Xanax (Alprazolam)

3

Withdrawal symptoms

Vistaril (hydroxyzine)

4

How to treat depression

Celexa (Citalopram)

5

What is the benefit of Welchol

Lowers LDL-C and improves glycemic control. Good for dyslipidemia and diabetes

6

Dannitol

Phenobarbital +Atropine + scopolamine

6

Blepharitis

Inflammation of the eye follicles

7

High blood pressure

The list is far too long.

According the ATP-3; consider starting with HCT and then adding an ACE or beta blocker for Heart failure

8

Treatment options for hyperthyroidism

Methimazole,
PropylThioUracil,
Tapazole

9

Treatment for pre-diabetes

1. Diet and exercise
2. Metformin
3. Janumet
4. Glyburide

10

Treatment for neuropathic pain

Neurontin (Gabipentin)
Lyrica (Pregabalin)

11

Neuropathic Pain management

Neurontin (gabapentin)
Lyrica (Pregabalin)

12

Treatment of Migraines

Imitrex (Sumatriptin)
Amerge (Naratriptin)

13

What is used as an anti convulsant and for neuropathic pain and is more potent than gabapentin

pregabalin

14

prevention of migraines

Topamax (Topiramate)

15

What are some options for pain control

NSAIDS Percocet Exalgo Opana Norco Lortabs Nucyntra (tapentadol) Ultram (tramadol)

16

Diagnostic protocol for gall bladder issues

1. Ultrasound
2. Hidascan
3. Endoscopy

17

What are the first generation anti depressants

Tricyclics

18

Scoring system of AFIB

CHAD S2 Score: Congestive Heart Failure, Hypertension, Age > 75, Diabetes Mellitus, Stroke (Prior)

19

What are the 2nd generation heterocyclic Anti depressants

Trazodone (Desyrel)
Buproprion (Wellbutrin)

20

What is the determination of a liver transplant

MELD Score:
MELD = 3.78[Ln serum bilirubin (mg/dL)] + 11.2[Ln INR] + 9.57[Ln serum creatinine (mg/dL)] + 6.43

21

What are the 3rd generation heterocyclic Anti depressants

Venlafaxine (Effexor)
Nefazodone (Serzone)
Mirtazopine (Remeron)
Vilazodone (Viibryd)

22

What is the Common bacteria associated with hospital acquired pneumonia

Pseudomonas

23

What is the mechanism of action of the 3rd generation heterocyclic anti depressants

Block serotonin and Nor epinephrine

24

What is the treatment for HAP

1. Flouroquine
2. Zosyn
3. Vancomycin

25

name the SSRI's

Fluoxetine (prozac)
Sertraline (zoloft)
Paroxetine (paxil)
Fluvoxamine (luvox)
Citalopram (Celexa)
Escitalopram (Lexapro)

26

What are the bugs associated with community acquired pneumonia

1. Strep Pneumo 2. Mycoplasma

27

Name the short acting benzodiazepines

Triazolam (Halcion)
Oxazepam (serax)
Midazolam (Versed)
Alprozolam (xanax)

28

What is the treatment for CAP

Option A.
1. Rocefin
2. zithromax

Option B.
Levoquin

29

What is the duration of short acting benzo's

2-8 hours

30

Can Amiodarone lead to a complete loss of thyroid function

Oh yea

31

Name the intermediate acting benzodiazepines

Temazepam (Reston)
Lorazepam (Ativan)

32

What labs are needed when admitting a new patient

CMP,
CBC,
Chest Xray,
EKG,
Sed Rate

33

What is the duration action of intermediate acting benzo's

10-20 hours

34

What is the cutoff value for determination of COPD vs CHF?

BNP of 100

35

Name the long acting benzodiazepines

Chlordiazepoxide (librium)
Diazepam (Valium)
Fluorazepam (Dalmane)
clonazepam (Klonipin)

36

What is the lab short hand for electrolytes

NA/K,
Cl/CO2,
BUN/Cr,
Ca/Glucose

37

What is the first line treatment for depression

SSRI's

38

What is the lab shorthand for blood

WBC>HG/HCT

39

What class of drugs will lower LDL the most

Statins (18-55% reduction)

40

What are the 2nd generation heterolytic antidepressants

Trazodone (desyrel)
Buproprion (wellbutrin)

41

Name the statins

Lovastatin
Pravastatin
Simvastatin
Fluvostatin
Atorvastatin
Cerivastatin

42

Name the 3rd generation heterolytic anti depressants

Venlafaxine (Effexor)
Nefazodone (Serzone)
Mirtazopine (Remeron)

43

What is the effect of the statins

LDL (reduced 18-55%)
HDL (reduced 5-15%)
TG (Reduced 7-30%)

44

What is the mechanism of the 3rd generation heterolytic anti depressants

Block serotonin and nor epinephrine

45

Name the bile acid sequestrants

Cholestyramine
Colestipol
Colesevalam

46

Name the SSRI's

Fluoxetine (prozac)
Sertraline (Zoloft)
Paroxetine (paxil)
Fluvoxamine (luvox)
Citalopram (celexa)
Excitalopram (lexapro)

47

What are the effects of the bile acid sequestrants

LDL (reduced 15-30%)
HDL (reduced 3-5%)
TG (no change or increased)

48

Name the short acting benzo's (2-8 hours)

Triazolam (halcion) oxcizepam (serax) midazolam (Versed) Clonazepam (klonipin)

49

What are the effects of nicotinic acid

LDL (reduced 5-25%)
HDL (reduced 15-35%)
TG (reduced 20-50%)

50

Name the intermediate acting benzo's (10-20 hours)

Temazepam (Restron)
Lorazepam (Ativan)

51

Name the fibric acids

Gemofibrozil
Fenofibrate
Clofibrate

52

Name the long acting benzo's (1-3 days)

Chlordiazepoxide (librium) Diazepam (Valium) Fluorazepam (Dalmane)

53

What are the effects of fibric acids

LDL (reduced 5-20%)
HDL (reduce 10-20%)
TG (Reduced 20-50%)

54

What is natural penicillin used to treat

Streptococci
Meningococci
Clostridium
Listeria
Enterococci
Diptheria
Anthrax
Syphilis
Spirochetes
Actinomycosis
Bacteroides

55

What can be used for nausea

Zofran (Ondansetron)
Reglam (metoclopromide)

56

Name the antipseudomonal penicillins

piperacillin (zosyn)

57

What can be used to improve memory

Nomanda (memantine)
Exelon (Rivastigmine)

58

Name the extended spectrum penicillins

Amoxicillin
Ampicillin

59

What can be used to prevent coagulation

Pradaxa (Dabigatran)
Plavax (Clopidogrel)
Warfrin (Coumadin)
Heparin Enoxaparin

60

Name three examples of B-lactamase inhibitors

clavulonic acid Sulbactam Tazobactam

61

What is an FDA approved prescription weight loss drug

Bellviq (locaserine hydrocholoride)
Qsymia (Phentermine + topiramate)

62

1st gen cephalosporins treat what organisms

GRAM + and PECK:
Gram positive (Pneumococci, streptococcus and staphylococcus),

Gram Negative bacilli (PEcK)
Proteus,
E. Coli,
Klebsiella

63

What drug is used to tx narcolepsy

provigil (modafinil)

64

What organisms can be treated by 2nd Generation cephalosporins

HEN PECK:
H. Influenzae,
Enterobacter,
Neisseria
PECK from the first generation

65

What is used to clean ears

Debrox (carbamide peroxide)

66

What organisms can be treated by 3rd generation cephalosporins

HEN PECK + Pseudomonas, Enterobacter, citerobacter and providencia

67

What can be used to increase WBC counts

neurogen (Filgastim)

68

Name the first generation cephalosporins

cefadroxil (duricef)- Oral,
cephalexin (keflex) - Oral,
Cephradine (Velosef) - Oral,
Cefazolin (Ancef) - IV

69

What can be used to relax muscles associated with tension head aches

Dolgic (Acetamenaphen + butabital)

70

Name the second generation cephalosporin

Cefaclor (ceclor) - PO, Cefuroxime (Ceftin) - PO, Loracarbef (Lorabid) - PO, Cefprozil, Cefotetan (Cefotan) - IV, Cefoxitin (Mefoxin) - IV, Cefuroxime (Zinacef) - IV

71

What can be used to treat against C-diff in addition to parasites and other bacteria.

Flagyl (Metronidazole)

72

Name the 3rd generation cephalosporin

Cefoperazone (cefobid) - IV,
Cefotaxime (Claforan) - IV,
Ceftazidime (Fortaz) - IV,
Ceftizoximine (Cefizox) - IV,
Ceftriaxone (Rocephin) - IV,
Cefpodoxime (Vantin) - PO,
Cefdinir (Omnicef) - PO,
Ceftibuten (Cedax) - PO

73

What can be used for BPH

Proscar (finasteride)

74

Name the 4th generation cephalosporin

Cefepine (maxipine) - IV Only

75

What can be used for cough suppression

Tessalon (benzonate)

76

What are the clinical indications of aztreonam (azactam)

Aerobic gram negative rods (pseudomonas, klebsiella, serratia)

77

What can be used to treat ADHD

Vyvanse (lisdexamphetamine)

78

name a central acting muscle relaxant

Zanaflex (tizanidine)

79

Name the carbapenems

Imipenem (Primaxin)
Meropenem (merrem)
ertapenem

80

How are all carbapenems administered

IV only

81

Name the aminoglycoside

Amikacin
Netilmicin
Neomycin
Tobramycin
Gentamycin

82

What organisms with Carbapenems treat agains

All gram positive, gram negative, anaerobic organism.
Exceptions include MRSA, VRE, C. Difficile

83

Name the tetracyclines

Tetracycline
Doxycycline
Demeclocycline
Minocycline

84

When should you use Vancomycin

MRSA and Severe infections. IV Only

85

Name the macrolides

Erythromycin
Clarithromycin
Azithromycin

86

When should you use bacitracin

topical against gram +

87

What's the difference between CMP and BMP

A CMP is a BMP (kidney, electrolytes) PLUS liver function

88

Cycloserine is used against what

Mycobacterium Tuberculosis that are resistant to first line drugs.

89

Problems with welchol and diabetes

1. Not to be taken with glyburide
2. Can improve glycemic control in NIDDM

90

Name the aminoglycosides

Amikacin (amikin) Netilmicin (netromycin) Neomycin (mycifradin) Tobramycin (Nebcin) Gentamycin (Garamycin)

91

What needs to be considered when treating a patient long term with lasics

Electrolyte level.
Consider using 10 mg of oral potassium for every 20 mg of lasics

92

What is the therapeutic use for aminoglycosides

(KEEP)
Klebsiella
E. Coli,
Enterobacter,
pseudomonas;
DO NOT COVER ANAEROBES

93

What are some causes of pitting edema

Venous insufficiency/ stasis.
Poor Kidney function.
Right Heart Failure Pulmonary HTN

94

What are the toxicity associated with aminoglycosides

Nephrotoxicity, Ototoxicity, NMB

95

What are anticoagulation treatment options

Coumadin
Pradaxa (dabigatran)
Rivaroxaban
Apixaban

96

Name the tetracyclines

Tetracycline (Symycin)
Doxycycline (Vibramycin)
Demeclocycline (declomycin)
Minocycline (minocin)

97

What is Pradaxa

Dabigatran:
A direct thrombin inhibitor used to anti-coagulate

98

What is the antibiotic spectrum of tetracycline

bacteriostatic against:
Gram positive,
Gram negative,
Anaerobes,
chlamydiae,
Mycoplasma,
Rickettsiae

99

What drug can be used to cardiovert AF of short duration

Flecanide.
Not to be used with LV insufficiency

100

What are the adverse affects of tetracyclines

GI Upset, Boney structures and teeth, LIver tox, Photo sensitivity, Vestibular resactions, Renal tox

101

What drug can be used for cardioversion with structural heart disease

Ibutilide (IV Only).
It prolongs repolarization and the QT interval

102

name the macrolides

Erythromycin (E-mycin),
Clarithromycin (Biaxin),
Azithromycin (Zithromax)

103

What is the max creatinine clearance level for metformin

1.5

104

What is azithromycin used for

Alternative for penicillin allergic patients: gram positives (less than erythromycin), H INfluenza, M. Catarrhalis, Mycobacterium avium, mycoplasma, legionella, C. trachomatis, Corynebacterium diptheria, B. Pertusis.

105

What is a severe side effect of metformin

Rhabdomyolysis which can lead to Renal failure with Creatinine clearance greater than 1.5

106

What are the averse effects of macrolides

GI Upset,
Cholestatic hepatitis,
allergic reaction,
prolonged qt

107

If a patient is on metformin and about to undergo contrast imaging, what must be done.

STOP THE METFORMIN

108

what is the clinical use of clindamycin

severe infections by anaerobic bacteria:
bacteroides fragilis,
streptococci,
staphylococci,
pneumococci,
Clostridium perfringens

109

Pediatric Hepatitis vaccinations should be given when?

1. Birth
2. 1-2 Months
3. Not before 24 Weeks and not after 16 weeks after initial dose

110

Can an atypical antipsychotic be used for anxiety

OH YEA; Seraquel (quetiapine)

111

What are the 2 month pediatric vaccines

1. RV
2. DTaP
3. Hib
4. PCV
5. IP

112

What is the mechanism for using cranberry juice for a UTI

Laboratory studies have demonstrated that cranberry juice inhibits adherence of uropathogens to uroepithelial cells. The mediators of this anti-adherence effect may be fructose, which could interfere with adhesion of type 1 fimbriated E. coli to uroepithelium, and proanthocyanidins, which can inhibit adherence of P-fimbriated E. coli.

Efficacy is yet to be determined.

113

What are the 4 month pediatric vaccines

1. RV
2. DTaP
3. Hib
4. PCV
5. IP

114

When should you begin treating a UTI

Symptomatic and when the colony count is greater than 100,000

115

What are the 6 month pediatric vaccines

1. DTaP
2. PCV

116

At what interval is the QT considered prolonged

great than 500

117

What ages are the Rotavirus vaccine given

2 months 4 months

118

How do you treat hyponatremia in the elderly

1. Hydration
2. Increase salts
3. Steroids
4. Alpha agonist (midodrine)

119

What ages the are the DTaP vaccine given

1. 2 months
2. 4 months
3. 6 months
4. 15-18 months
5. 4-6 years

120

What are treatment options for menopause

1. soy products
2. SSRI

121

What ages are the Hep B vaccine given

1. Birth
2. 1-2 months
3. 6-18 months

122

What is a good cocktail for a steroid injection?

1. 0.5 cc Lidocaine 2. 0.5 cc Marcaine 3. 2.0 cc Depot-medrol; Check up to date for a better mixture

123

What are the ages for the Hib vaccine

1. 2 months
2. 4 months
3. 12-15 months

124

What is a good chemotherapy treatment option for pancreatic cancer

gemcitabine
either alone or in combination with erlotinib

125

What are the ages for the pneumococcal vaccine

1. 2 months
2. 4 months
3. 6 months
4. 12-15 months

126

What is the glucose to A1C conversion estimates

A1C of 7 = Glucose of 150;
A1C of 6 = Glucose of 120;
A1C of 5 = Glucose of 90

127

What are the ages for the inactivated poliovirus

1. 2 months
2. 4 months
3. 6-18 months
4. 4-6 years

128

What are the major causes of microhematuria

TIGHTS: Trauma, Infection, Glomerulonephritis, HTN, Tumor, Stones

129

What are the ages that the measles mumps and rubella vaccine administered

1. 12-15 months
2. 4-6 years

130

What requires more energy: Diastole or Systole

Diastole requires more energy.
Systole (contraction) is a downhill gradient while diastole requires ATP - ST Segment changes on an EKG is due to diastolic changes - 1st symptoms of an MI is due to diastolic dysfunction

131

When should the varicella virus vaccine be administered

1. 12-15 months
2. 4-6 years

132

What is the bruce protocol?

Protocol used for an echo stress test.
Treadmill is increased 2 degrees. Max heart rate is 220-age. The target on a stress test is 85% of max

133

When should the HEP A vaccine be administered

1. 12-24 months
2. 6-18 months after initial dose

134

Where do the majority of blood clots in the heart form

Atrial septal Appendage

135

How do you treat low magnesium and low potassium in the hospital setting

2 grams magnessium sulfate over 4 hours and 20 mEq q4hrs X 4 doses

136

What large group of people is blood thinners relatively contra-indicated

All patients with a fall hazard potential.

137

Erythematous Nodosum

A delayed Hypersensitivity reaction to antigens producing nodules that are typically located in the pretibial region.

138

What is Beyes theorem

Pretest probability = post test probability; With low pretest probability you will do nothing, while with high pretest probability you will do everything

139

What may dig toxicity induce

PAT (Paroxysmal Atrial Tachycardia)

140

What are the key drugs excreted by the kidneys

NSAIDs
(add others here)

141

What is the treatment options for reducing prostate size

1st line is Alpha blockers,
2nd line 5-a-reductase inhibitors

142

What additional benefit my statins serve to the male population

prostate protective (finnish study)

143

How does testosterone correlate to CAD

Low testosterone may increase risk

145

Why is BUN elevated in GI bleeds

blood is digested in the GI tract forming Urea

146

Name the gram negative rods

E. Coli
Enterobacter
Citrobacter
Morganella
Pseudomonas
Serratia

147

What is the only carbapenem that does not cover pseudomonas

ertapenem

148

What is the best medication for abdominal anaerobes

metronidazole

149

What is the best medication for anaerobic strep

clindamycin

150

What antibiotic medications have no anaerobic coverage

aminoglycosides
aztreonam
fluoroquinolone

151

What is the treatment for HCV

ribavarin and interferon

152

What is the treatment for Chronic Hepatitis B

lamivudine
interferon
adefovir
tenofovir
entecavir
telbivudine

153

What is the treatment for candida infection

fluconazole

154

What is voriconazole used to treat against

candida
aspergillus

155

What is an adverse effect of voriconazole

visual disturbance

156

Name the echinocandins

caspofungin
micafungin
anidulafungin

157

What are the echinocandins used to treat

neutropenic fever

* DOES not cover cryptococcus *

158

What are the adverse effects of amphotericin

Renal toxicity
hypokalemia
metabolic acidosis
fever, shakes, and chills

159

How is the duration of treatments determined for osteomyelitis

sedimentation rate

90% of patients will not have fever or an elevated WBC.

Treatment for osteomyelitis requires IV antibiotics