Flashcards in Meds Deck (39):
Steven Johnsons syndrome: disorder of the Skin and mucus membrane
Which drug should be started on low dosage?
80 year old with progressive weakness.
CBC, UA, ESR are normal
High Creatinine Kinase
Statin induced Myopathy!!!
PMR with give elevated ESR
Patient on parenteral Morphine, Increasing dose still in severe pain
DX and Tx?
Opioid induced hyperalgesia
- Morphine receptors are saturated!
- decrease morphine dose
How to minimize Lidocaine injection
Buffer with sodium bicarbonate
Guy with gynecomastia
Drug that can cause it?
Spirinolactone because it can bind to androgen and progesterone causing it
Post herpetic neuralgia
Prolong PPI Use
Urticaria: highly pruritic raised wheals on extremities and torso
H1- histamine blocker!
2nd gen are less drowsy!
Sympathomimetic decongestant like pseudoephedrine and phenlyephrine in elderly causes?
Worsen existing urinary obstruction
Iron def anemia with iron
How to improve iron absorption
Take Vit C
NSAID that least likely to increase risk of MI?
NSAID increases BP 2nd to salt and water retention properties
Meds that can cause Interstitial lung disease
Nitrofurantoin - can induce pneumonitis
What is the safest flu vaccine
Recombinant trivalent - no egg
Med that can lower the risk of pre eclampsia
Aspirin 60-80 mg daily
Preferred pain meds in ESRD?
Fentanyl - 99% hepatic metabolism
Medication with a higher risk of death due to stroke or sudden cardiac death in patients with dementia?
Seroquel ( Quetiapine)
Meds for Smoking Cessation?
Verenicline (chantix) can cause nightmares
Bupropion (Wellbutrin) - CI in seizures
Nortriptyline ( Pamelor)
Bisphophonate side effects in Osteoporosis
Can cause atypical femoral shaft fractures
- will not effect Vit D and phosphates
Class of diabetic medication that blocks glucose reabsorption by the kidneys causing GU infection?
SGLT2 inhibitors - Invokana
Patient with Hyperthyroidism with a low WBC count.
What meds can cause it?
Methimazole--> can cause agranulocytosis; can cause Inc fetal abnormalities
If pregnant, give PTU
55 y/o male with VF. Hx of antibiotic use 3 days ago
Azithromycin; can prolong QT --> VF
Medication that can be use for SVT that can be use Acutely and Long term?
Pt with terminal cancer and Hepatic dysfunction has musculoskeletal and neuropathic pain, What medications should you avoid?
Methadone: metabolized and cleared by liver
Second Generation H1 Antihistamine that is sedating?
Cetirizine (Zyrtec) - potent histamine antagonist
NOAC with reversal?
Dabigatran(Pradaxa)--> Idarucizumab (Praxbind)
Female on Methimazole.
Agranulocytosis = hepatotoxic
Meds that is most effective for Alcohol relapse
Antidepressant to avoid in the Elderly
Paroxetine --. More anticholinergic effects
1st line to give--> venlafaxine , Bupropion ( also good for smoking cessation), Mirtazapine
Patient with Gout attack and CKD stage 4!
1st line: NSAID: Indomethacin -- but PT has CKD, Colchicine, Corticosteroids
Allopurinol and Probenacid are NOT advisable for Acute treatment; may be use to prevent attacks
44 y/o male started on Lisinopril
Has facial, lip and tongue edema
1. Angiodedema from Increased bradykinin not histamine!
2. Give Bradykinin receptor antagonist --> Icatibant (Firazyr)
Drugs that cause Bronchiolitis Obliterans Organizing Pneumonia?
Amiodarone + Bleomycin + Gold + MTX
Meds for travelers diarrhea if going to:
India?(S.Asia and SEA)?
South and Central America?
Azithromycin for SEA : for campylobacter
Cipro for Central America
Patient with DM
Found out to have low Vit B12
What meds caused it?
Metformin- decrease absorption by 30%
Patient with PE 2 weeks after surgery for uterine fibroids, no significant PMX
How long should the patient be on anticoagulant therapy?
Antiemetic drug that blocks domaine stimulation in the chemoreceptors trigger zone for gastroenteritis?
Drug that decreases Vit D levels in long term use
Phenytoin- increases metabolism of Vit D
Thiazides will increase Vit D
Side effects of colchicine?
Nausea, vomiting, diarrhea
Patient with Fibromyalgia.
What muscle relaxant can be used and why?
Med that can improve sleep, pain and well being?
Cyclobenzaprine- structurally like TCA; can increase inhibitory of serotonin and norepinephrine
Tramadol can be use for sleep, pain and well being