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Medications Flashcards

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1
Q

Meniere Disease

A

1) HCTZ 25mg OD
1) HCTZ/Amiloride 50/5mg OD
1) ICTZ/Triamterense 25/50mg OD

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2
Q

Otitis Externa without fungal infection

A

1) Dex/Framycetin/Gramicidin 3 drops tds for 7 days (SOFRADEX)
1) Flumethoasone/Clioquinol - 3 drops tds for 7 days (Locorten Vioform)

AVOID AMINOGFLYCOSIDES IF ?PERF

Use ciprofloxacin/hydrocort - 3 drops BD for 7 days (CiproHC - ~$50)

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2
Q

Otitis Externa with fungal infection

A

DEBRIDE AND AURAL TOILET

1) flumetheasone/clioquinol - 3 drops tds 7 days (locorten Vioform)
1) Triamcinlone/neomycin/gramicidin/nystatin - 3 drops tds 7 days (Otocomb)

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3
Q

Tonsilitis

A

1) Phenoxymethylpenicillin 500mg BD for 10 days

For children (preference for liquid formulation)
1) Amoxicillin 1g (50mg/kg) OD for 10 days
1) Amoxicillin 500mg (25mg/kg) BD for 10 days

Penicillin sensitivity
- Cefalexin 1g (25mg/kg) BD for 10 days if nonsevere allergy
- Azithromycin 500mg (12mg/kg) OD for 5 days

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4
Q

Otitis media

A

Amoxicillin 500mg (15mg/kg) TDS for 5 days
OR
Amoxicillin 1g (30mg/kg) BD for 5 days

IF PENICILLIN ALLERGY
1) Cefuroxime 500mg (15mg/kg) BD for 5 days
2) Trimethoprim + Sulfamethoxazole 160+800 (4+20kg/mg) BD for 5 days

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5
Q

Non responsive Otitis media (After 48-72hrs of treatment)

A

1) Augmentin 875+125mg (22.5+3.2mg/kg) for 5-7 days

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6
Q

Chronic Ottorhoea / Chronic suppurative Otitis media

A

Augmentin PO 875+125mg (22.5+3.2mg/kg) BD for 5-7 days

PLUS

Ciprofloxacin 0.3% ear drops 5 drops into affected ear BD until middle ear free of discharge for at least 3 days

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7
Q

Mild to moderate croup

A

1) Prednisolone PO 1mg/kg (Up to 50mg) as single dose

OR

2) Dexamethasone PO 0.15mg/kg (up to 12mg) as a single dose

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8
Q

Severe croup

A

Adrenaline 0.1% (1:1000 1mg/ml) solution 5ml by inhalation via nebuliser

PLUS
1) Prednisolone 2mg/kg (50mg MAX) then 1-2mg/kg (50mg MAX) PO 24hrs later
1) Dexamethasone 0.6mg/kg (12mg MAX) as a single dose
1) Dexamethasone 0.6mg/kg (12mg MAX) IM or IV as single dose (if nauseous)

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9
Q

Migraines
(Non-Pharmacological)

A
  • Cold packs over the forehead or back of the skull
  • Hot packs over the neck and shoulders
  • Neck stretches and self-mobilisation
  • Rest in a quiet dark room
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10
Q

Migraines Acute pharmacological management - non-opioids

A

1) Aspirin soluble 900-1000mg PO, repeat 4-6hrly (Max 4g in 24hr)
1)Ibuprofen 400-600mg, PRN 4-6hrly (Max 2.4g in 24hr)

2) Diclofenac sodium 50mg PO, 4-6hrly PRN (Max 200mg in 24hr)
2) Naproxen 500-750mg PO 4-6hrly (Max 1250mg in 24hrs)
2) Paracetamol 1g PO QID PRN (Max 4g in 24hr)

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11
Q

Migraines Acute antiemetic

A

1) Metoclopramide 10mg PO TDS PRN (Max 30mg/day)

2) Domperidone 10-20mg TDS PRN (Max30mg/day)
2) Ondansteron 4-8mg TDS PRN (Max 16mg/day)
2) Prochlorperazine 5-10mg TDS PRN (Max 30mg/day)

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12
Q

Migraines acute pharmacological - triptans

A

1) Eletriptan 40-80mg PO, wait at least 2hrs before repeating dose (Max 160mg/24hr)

1) Naratriptan 2.5mg PO, wait 4 hrs before repeating dose (Max 5mg/24hr)

1) Rizatriptan 10mg PO, wait 2hrs before repeating dose (Max 30mg/day)

1) Sumatriptan
- PO 50-100mg, wait 2hrs (Max 300mg/day)
- Intranasal 20mg, wait 2hrs (Max 40mg/day)
- SC 6mg, wait 1 hr (12mg/24hr)

1)Zolmitriptan 2.5mg PO, wait 2hrs (Max 10mg/24hr)

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13
Q

Migraine management during pregnancy

A

NON-OPIOID ANALGESIA
Paracetamol 1g QID

AVOID NSAIS/aspirin in the first trimester and after 30 weeks

Can sparingly use codeine if not responsive to paracetamol

ANTIEMETIC
Metoclopramide

SEVERE REFRACTORY MIGRAINE
Prednisolone 50mg PO OD for 2 days then cease

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14
Q

Status Migrainosus

A

1) Sumatriptan 6mg SC
- Only if triptan has not been given in the last 2 hrs

2) Ketorolac 30mg by slow deep injection IM
- Only if PO NSAID has not been given in the last 4-6hrs

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15
Q

Migraine prophylaxis

A

1) Amytriptyline 10mg PO NOCTE
1) Candesartan 4mg PO OD
1) Nortriptyline 10mg PO NOCTE
1) Pizotifen 0.5mg PO NOCTE
1) Propanolol 20 PO NOCTE
1) Sodium valproate 200 PO NOCTE
1) Topiramate 25mg PO NOCTE
1) Verapamil SR 90mg PO OD

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16
Q

Tinea (Topical)

A

1) Terbinafine 1% cream or gel OD-BD for 1-2 weeks

2)
- Bifonazole 1% cream OD for 2-4 weeks
- Clotrimazole 1% cream BD-TDS for 2-4 weeks
- Econazole 1% cream BD-TDS for 2-4 weeks
Ketoconazole 2% cream OD-BD for 2-4 weeks
- Miconazole 2% cream BD for 2-4 weeks

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17
Q

Tina Oral therapy (Not scalp or nails)

A

1) Terbinafine 250mg OD for 2 weeks

2) Fluconazole 150mg once weekly for 6 weeks

3) Itraconazole 100mg PO OD, 2 weeks for tinea cruris/corporis // 4 weeks for tinea pedis

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18
Q

Tinea Oral therapy (Scalp)

A

1) Terbinafine 250mg OD for 4 weeks

If Microsporum species identified
- Griseofulvin 500mg PO OD for 6-8 weeks

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19
Q

Shingles (Antivirals)

A

Should be commenced within 72hrs of rash onset

1) Valaciclovir 1g PO TDS for 7 days

1) Famciclovir 500mg TDS for 7 days (10 days if immunocompromised)

2) Aciclovir 800mg PO 5 times daily for 7 days

If immunocompromised with disseminated disease
- Aciclovir 10mg/kg IV TDS

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20
Q

Pain associated with singles (herpes zoster)

A
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21
Q

Herpes zoster ophthalmicus

A

Consult Ophthal for ALL cases
Topical aciclovir has NO role in the initial management

1) Valaciclovir PO 1g TDS for 7 days

2) Famciclovir 500mg PO TDS for 7 days

2) Aciclovir 800mg PO 5 times daily for 7 days

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22
Q

Medications for Palliative care (Syringe driver)

A
  • Morphine (Pain/Dyspnoea)
  • Clonazapam/Midazolam (Agitation/Dyspnoea)
  • Glycopyrronium/ Hyoscine butylbromide (Resp tract secretions)
  • haloperidol (Agitation/ N/V)
  • Metoclopramide (N/V)
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23
Q

Cellulitis/Erysipelas WITHOUT systemic features
- Suspecting S.pyogenes
(Nonpurulent, recurrent or spontaneous, rapid spreading cellulitis)

A

1)
- Phenoxymethylpenicillin 500 mg (child: 12.5 mg/kg up to 500 mg) orally, 6-hourly for 5 days
- procaine benzylpenicillin 1.5 g (child: 50 mg/kg up to 1.5 g) intramuscularly, daily for at least 3 days.

Delayed non-severe hypersensitivity to penicillin
- cefalexin 500 mg (child: 12.5 mg/kg up to 500 mg) orally, 6-hourly for 5 days.

Immediate/delayed severe hypersensitivity to penicillin
- clindamycin 450 mg (child: 10 mg/kg up to 450 mg) orally, 8-hourly for 5 days

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24
Cellulitis/Erysipelas WITHOUT systemic features - Suspecting S.aureus (Penetrating trauma / associated ulcer)
1) dicloxacillin 500 mg (child: 12.5 mg/kg up to 500 mg) orally, 6-hourly for 5 days 1) flucloxacillin 500 mg (child: 12.5 mg/kg up to 500 mg) orally, 6-hourly for 5 days. Delayed non-severe hypersensitivity to penicillin - cefalexin 500 mg (child: 12.5 mg/kg up to 500 mg) orally, 6-hourly for 5 days. MRSA risk / immediate/delayed hypersensitivity to penicillins 1) trimethoprim+sulfamethoxazole 160+800 mg (child 1 month or older: 4+20 mg/kg up to 160+800 mg) orally, 12-hourly for 5 days 2) clindamycin 450 mg (child: 10 mg/kg up to 450 mg) orally, 8-hourly for 5 days
25
Cellulitis/Erysipelas WITH systemic features
If suspecting S pyogenes - benzylpenicillin 1.2 g (child: 50 mg/kg up to 1.2 g) intravenously, 6-hourly. If suspecting S.aureus - flucloxacillin 2 g (child: 50 mg/kg up to 2 g) intravenously, 6-hourly MRSA concerns: - vancomycin intravenously OR consider Clindamycin IV // Lincomycin IV If Penicillin hypersensitivity - cefazolin 2 g (child: 50 mg/kg up to 2 g) intravenously, 8-hourly.
26
Streptococcal pharyngitis/Tonsilitis
1) phenoxymethylpenicillin 500 mg (child: 15 mg/kg up to 500 mg) orally, 12-hourly for 10 days Amoxicillin preferred for children if needing liquid formulation: - 50 mg/kg up to 1 g orally, daily for 10 days; - 25 mg/kg up to 500 mg orally, 12-hourly for 10 days If difficulty adhering to 10 day regime: - benzathine benzylpenicillin intramuscularly Delayed nonsevere penicillin allergy - cefalexin 1 g (child: 25 mg/kg up to 1 g) orally, 12-hourly for 10 days Immediate/delated severe penicillin allergy - azithromycin 500 mg (child: 12 mg/kg up to 500 mg) orally, daily for 5 days.
27
Periorificial Dermatitis - If perioral may leave a clear rim around the mouth Treat as per rosacea
Consider - Ceasing topical corticosteroids - Ceasing occlusive cosmetics/creams - Use emollient soap free cleanser Mild: 1) ivermectin 1% cream topically, once daily 2) metronidazole 0.75% gel or cream topically, once or twice daily Severe: 1) doxycycline 50 to 100 mg orally, once daily until a response is seen (usually 3 to 4 weeks, but can be up to 8 weeks) - AVOID in 2nd/3rd trimester pregnancy 2) erythromycin 250 to 500 mg orally, twice daily until a response is seen (usually 3 to 4 weeks, but can be up to 8 weeks)
28
Trigeminal neuralgia
1) Carbamazepine MR 100mg PO BD 2) Oxcarbazepine 300mg PO BD 3) - Baclofen 5mg PO BD - Gabapentin 300mg PO NOCTE
29
Indications for abx treatment for Otitis media
- <6 months - <2yo with BL otitis media - Systemically unwell - Otorrhoea present - Children at high risk of complications - Certain populations of ATSI children (remote areas, perf, history of CSOM)
30
Painful peripheral neuropathy
1) Amytriptyline 25mg PO NOCTE 2) - Duloxetine 60mg PO OD - gabapentin 300mg PO OD - Pregabalin 75mg PO BD
31
Narcolepsy
1) Modafinil 20mg PO MANE 2) Armodafinil 150-250mg PO MANE
32
Allergic Rhinitis
Oral Antihistamines - Cetirizine 10mg PO OD - Desloratadine 5mg PO OD - Fexofenadine 120-180mg PO OD - Loratadine 10mg PO OD Intranasal antihistamines - Azelastine 1mg/ml, 1 spray into each nostril, BD - Levocabastine 0.5mg/ml, 2 sprays into each nostril, BD-QID - No benefit from combining PO / IN antihistamines Intranasal corticosteroids - Mometasone 100mcg, 1 spray each nostril OD - beclomethasone 100mcg, 1 spray BD Montelukast - used in combo with antihistamine + IN corticosteroid
33
Allergic conjunctivitis eye drops
Antihistamine/Mast cell stabiliser eye drops: - Azelastine 0.05% eye drops, BD-QID - Ketotifen 0.025% eye drops, BD - Olopatadine 0.1% eye drops, BD
34
Essential tremor
- Propanolol 10mg PO BD (Can increase up to 160mg daily in divided doses) - Primidone 62.5mg PO NOCTE (up to 250mg)
35
Parkinsons
1) Levodopa+Benserazide 50+12.5mg PO TDS 1) Levodopa+Carbidopa 50+12.5mg PO TDS 2) Pramipexole 0.125mg PO TDS 2) Pramipexole MR 0.375mg PO OD 2) Rotigotine 2mg transdermal OD for 24hrs AVOID METOCLOPRAMIDE AND PROCHLORPERAZINE - Instead use domperidone
36
Salivary gland hypofunction / Xerostomia
Symptomatic management - Adequate hydration - Oral lubricants (Olive oil, Biotene, Oral 7, Xylimelts) Saliva stimulation - Chewing sugar free gum - Pharmacological (Pilocarpine) - Electro-stimulating devices General advice - reduce exposure to irritants (alcohol, smoking, spicy foods) - Ensure adequate fit of denture - Regular dental visits
37
2 month vaccinations
- DTP, hep B, polio, Hib - Rota virus - Pneumococcal ATSI - Meningococcal B - prophylaxis with paracetamol recommended
38
4 month vaccinations
- DTP, hep B, polio, Hib - Rota virus - Pneumococcal ATSI - Meningococcal B
39
6 month vaccinations
- DTP, hep B, polio, Hib Children with risk factors - Pneumococcal ATSI - Pneumococcal - Meningococcal B Annually from 6 months to 5yo - Influenza (initially minimum of 2 doses spaced 1 month apart)
40
12 month vaccinations
- Meningococcal ACWY - MMR - Pneumococcal ATSI - Meningocccal B
41
18 month vaccinations
- Hib - MMRV - DTP ATSI - Hep A
42
4 year vaccinations
- DTP, polio Children with risk factors - Pneumococcal ATSI - Pneumococcal - Hep A
43
Mild to Moderate Asthma
Child 1-5yo - Salbutamol (100mcg) MDI 2-6 actuations, repeat as required Adult/6yo+ - Salbutamol (100mcg) MDI 4-12 actuations, repeat as required
44
Severe asthma
Child 1-5yo - Salbutamol 6 actuations via MDI/spacer, repeat every 20min for 1st hour PLUS - Ipratropium bromide 4 actuations via MDI/spacer, repeat ever 20min for 1st hour Adult/6yo+ - Salbutamol 12 actuations via MDI/spacer, repeat every 20min for 1st hour PLUS - Ipratropium (21mcg) 8 actuations via MDI/spacer, repeat every 20min for 1st hour Can also consider nebs (<6yo/>6yo) - Salbutamol 2.5/5mg via intermittent neb every 20min for 1st hour - Ipratropium 250/500mcg via intermittent neb every 20min for 1st hour
45
Life threatening asthma
Salbutamol 2.5/10mg at a time via continuous neb PLUS Ipratropium 250/500mcg added to neb solution every 20min for 1st hour (<6yo/>6yo) Other things to consider: - IV Magnesium sulfate - IM Adrenaline 1mg/kg (1:1000) solution - 0.01mg/kg up to 0.5mg
46
Steroid therapy for asthma
ADULTS 1) Prednisolone 37.5-50mg PO within 1hr, continue for 5-10 days 2) Dexamethasone 16mg PO within 1 hr, repeat dose once the next day Children 1)Prednisolone 1ng/kg (MAX 50mg) OD for 3 days 2) Dexamethasone 0.6ng/kg (MAX 16mg) OD for 2 days If unable to tolerate oral - IV hydrocortisone OR - IV methylprednisolone
47
Impetigo (localised skin sores)
Mupirocin 2% ointment or cream to crusted areas TDS for 5 days
48
Impetigo (multiple skin sores or recurrent infection)
1) Dicloxacillin 500mg QID for 7 days 1) Flucloxacillin 500mg QID for 7 days In children can consider cefalexin due to liquid formulation Penicillin allergy: - Trimethoprim + Sulfamethoxazole 160+800mg BD for 3 days
49
Impetigo in endemic settings
1) Benzathine benzylpenicillin IM as single dose 1) Trimethoprim
50
Bronchiectasis (Not colonised with P aeruginosa)
1) Amoxicillin 1g TDS for 14 days 1) Doxycycline 100mg BD for 14 days Give Augmentin if suspecting: - B-lactamase-producing strain of H influenzae - Moraxella catarrhalis
51
Bronchiectasis (Colonised with P aeruginosa)
Should initially manage with Amox or Doxy If Pseudomonas identified use: Ciprofloxacin 750mg PO BD for 14 days
52
Mycoplasma pneumonia - Young person with dry cough / headache / fever - May have ill defined opacities on CXR - Not responsive to amoxi/augmentin
1) Doxycycline 100mg BD for 7 days 2) Azithromycin 500mg OD for 3 days 2) Clarithromycin 500mg BD for 7 days
53
Uncomplicated Chlamydia - Genital or pharyngeal infection
1) Doxycycline 100mg PO BD for 7 days 2) Azithromycin 1g PO STAT - Consider if poor compliance with daily treatment
54
Chlamydia - Anorectal infection
1) Doxycycline 100mg PO BD for 7 days if asymptomatic (21 days if symptomatic) 2) Azithromycin 1g PO STAT, repeat in 12-24 hrs
55
Gonnorhoea - Uncomplicated genital and anorectal infection
Ceftriaxone 500mg IMI STAT in 2ml 1% lignocaine PLUS Azithromycin 1g PO STAT
56
Gonnorhoea - Uncomplicated pharyngeal infection
Ceftriaxone 500mg IMI STAT in 2ml 1% lignocaine PLUS Azithromycin 2g PO STAT
57
Adult gonococcal conjunctivitis
Ceftriaxone 1g IMI STAT in 2ml 1% lignocaine PLUS Azithromycin 1g PO STAT
58
Early syphilis (primary, secondary, early latent)
Benzathine benzylpenicillin 2.4 MU (1.8 g) IMI, Stat, given as 2 injections containing 1.2 MU (0.9 g)
59
Late syphilis or syphilis of unknown duration (late latent > 2 years)
Benzathine benzylpenicillin 2.4 MU (1.8 g) IMI, given as 2 injections containing 1.2 MU (0.9 g) weekly for 3 weeks
60
Trichomoniasis
Metronidazole 400 mg PO with food, BD for 7 days
61
Symptomatic bacterial vaginosis
Metronidazole 400 mg PO, BD with food for 7 days. OR Metronidazole 0.75% gel 5 g, intravaginally nocte for 5 nights (not on PBS). OR Clindamycin 2% vaginal cream 5 g, one applicator intravaginally nocte for 7 days (not on PBS).
62
Genital herpes
Valaciclovir 500mg PO - Initial episode: BD for 5- 10 days - Recurrence: BD for 3 days - Suppressive therapy: OD for 6 months - Suppression in pregnancy: BD from 36 weeks til birth
63
Q fever (Coxiella burnetti)
Doxycycline 100mg BD for 2 weeks
64
Leptospirosis (Leptospirosa interrogans)
Doxycycline 100mg BD for 1 week

GP Medications (1 decks)

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