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SAPE October 2015 > Pharm > Flashcards

Pharm Flashcards

1
Q

What drug class should be used for Stage 1 uncomplicated HTN?

A

diuretic

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2
Q

What drug class should be used for Stage 2 uncomplicated HTN?

A

diuretic + ACE/ARB/CCB

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3
Q

What drug class should be used for a diabetic with HTN?

A

ACEI or ARB

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4
Q

What drug class should be used for a chronic kidney dz pt with HTN?

A

ACEI or ARB

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5
Q

What drug class should be used for a heart failure pt with HTN?

A

diuretic + ACE +/- BB

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6
Q

What drug class should be used for an MI pt with HTN?

A

BB +/- ACEI

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7
Q

What drug class should be used for a pt with recurrent stroke and HTN?

A

diuretic + ACE or ARB

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8
Q

What drug class should be used for a coronary dz pt with HTN?

A

BB +/- ACE or ARB

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9
Q

What drug class decreases LDL cholesterol best?

A

statnis

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10
Q

What drug class decreases TG best?

A

fibric acids

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11
Q

What drug class increases HDL best?

A

nicotinic acid

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12
Q

How is acute MI treated? (list)

A
  • oxygen 2-4 L/min
  • IV NTG
  • aspirin or clopidogrel
  • heparin for anticoagulation
  • BB within 24 hours
  • antiarrhythmics as needed
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13
Q

In CHF patients, what can be used to reduce preload?

A
  • decrease sodium intake

- diuretics

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14
Q

In CHF patients, what can be used to increase contractility?

A

-digitalis

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15
Q

In CHF patients, what can be used to reduce afterload?

A
  • ACEI

- nitrates

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16
Q

How is acute pulmonary edema in a CHF pt treated?

A
  • sit patient up
  • oxygen
  • nitro
  • diuretics
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17
Q

How is cellulitis treated?

A
  • PO or parenteral abx
  • PenG 1-2 million units IV q6h
  • also oral dicloxacillin, cephalexin, clindamycin or IV cefazolin, nafcillin
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18
Q

How is tinea cruris/corporis treated?

A

topical antifungals (ketoconazole) for 7 days or until lesion resolves

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19
Q

How is tinea pedis treated?

A

antifungal cream BID up to 4 weeks

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20
Q

How is tinea versicolor treated?

A
  • remove scales with soap and water

- selenium sulfide or ketoconazole shampoo

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21
Q

Treatment for Erythema Infectiosum (5ths Disease/Slapped Cheek)

A

symptomatic

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22
Q

Treatment for Measles

A

supportive: antipyretics, antitussives, fluids

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23
Q

Treatment for HSV 1 and 2

A
  • symptomatic

- oral antiviral

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24
Q

Treatment for Herpes Zoster

A
  • rest
  • oral antivirals
  • analgesics
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25
Q

Treatment for Impetigo (honey colored crusts stuck on)

A

-systemic or topical abx: erythromycin, cephalexin, dicloxacillin

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26
Q

Treatment for Oral Candida

A
  • antifungal rinses or cream

- dental hygiene

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27
Q

Treatment for Candida Vulvovaginitis

A

-topical miconazole (monistat) or fluconazole (150 mg PO x1)

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28
Q

Treatment for Lice/Pediculosis

A

-Nix (permethrin) or RID

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29
Q

Treatment for Scabies

A
  • permethrin/Nix

- anti-pruritic

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30
Q

Treatment of Eczema

A
  • hydration
  • oatmeal baths
  • limited steroid use
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31
Q

Treatment for Atopic Dermatitis

A
  • children outgrow
  • oatmeal baths
  • Eucerin
  • limited topical steroids
  • antihistamines for pruritis
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32
Q

Treatment for Psoriasis

A
  • emollients BID
  • UVB therapy
  • topical steroids
  • systemic methotrexate
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33
Q

Treatment for Actinic Keratosis

A
  • sun protection
  • 5 fluorouracil
  • excision
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34
Q

Treatment for Folliculitis

A

-topical antifungal or abx cream

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35
Q

Treatment for Mild Acne

A

-topical retinoid +/- topical antimicrobials, salicylic acid, azelaic acid

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36
Q

Treatment for Moderate Acne

A

-topical retinoid + oral abx +/- benzoyl peroxide

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37
Q

Treatment for Severe Acne

A

isotretinoin (Accutane)

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38
Q

Treatment for Rosacea

A
  • topical metronidazole
  • low dose oral TCN
  • NO steroids
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39
Q

Treatment for Condylomata Acuminata

A
  • imiquimod cream

- cryotherapy or laser surgery

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40
Q

Treatment for Syphilis (all stages)

A

-parenteral Pen G is DOC

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41
Q

What are some rapid acting insulins?

A

aspart and lispro (3 hours)

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42
Q

What is a short acting insulin?

A

Regular (Novolog/Humalog) 6 hours

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43
Q

What is an intermediate insulin?

A

NPH (12 hours)

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44
Q

What are long acting insulins?

A

Detemir and Glargine (up to 24 hours)

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45
Q

What type of DM med should lean patients with high blood sugar take?

A

sulfonylureas (glyburide)

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46
Q

What type of DM med should lean pts and pts with variable meal schedules take?

A

meglitinides (repaglinide)

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47
Q

What type of DM med should obese pts and pts with dyslipidemia take?

A

-biguanide (metformin/glucophage)

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48
Q

Treatment Options for Hyperthyroidism

A
  • radioactive iodine (CI BF or pregnant)
  • methimazole or propylthiouracil (PTU)
  • surgery
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49
Q

Treatment for Thyroid Storm

A

-BB

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50
Q

Treatment for Hypothyroidism

A

Levothyroxine/Synthroid (T4)

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51
Q

Treatment for Hashimoto’s Thyroiditis

A

-lifelong replacement iwth thyroid hormones

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52
Q

Treatment for Cushing’s

A
  • adrenal or pituitary adenoma resection

- adrenal inhibitors

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53
Q

Treatment of AOM

A
  • APAP or ibuprofen for pain
  • watchful waiting in some cases
  • amoxicillin 7-10 days 80-90 mg/kg divided bid/tid
  • severe AOM or tx failure: amox-clav 90 mg/kg/day and 6.4 mg/kg/day
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54
Q

Treatment for Otitis Externa

A
  • bacterial: topical abx and corticosteroids

- fungal: topical antiyeast

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55
Q

Treatment for Strep Pharyngitis (bacterial)

A
  • supportive: analgesic, rest, fluids
  • adults: penicillin 500 mg BID x10 days
  • kids: penicillin 250 mg BID x10 days
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56
Q

Treatment for Sinusitis

A
  • nasal saline
  • decongestants
  • analgesics
  • nasal steroids
  • don’t treat until 7 days of sxs or severe: amoxicillin 500 mg BID adults
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57
Q

Treatment for URI

A

-symptomatic: water, rest, decongestants, expectorant, antitussives

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58
Q

Treatment for Mono

A
  • APAP, NSAIDs, lozenges

- steroids if enclosing throat

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59
Q

Treatment for Allergic Rhinitis

A
  • antihistamine (loratidine/Claritin, diphenhydramine/Benadryl)
  • decongestant
  • intranasal corticosteroid (fluticasone/Flonase)
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60
Q

Treatment for Cataracts

A

-surgical

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61
Q

Treatment for Hordeolum/Sty

A
  • warm pack, gentle massage 5-10 min QID

- antibiotic ointment

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62
Q

Treatment for Chalazion

A
  • warm pack, massage 5-10 min QID
  • steroid injection
  • excision if large
63
Q

Treatment for Conjunctivitis

A
  • proper hygiene
  • viral (non HSV): vasoconstrictor/antihistamine
  • bacterial: self-limiting
64
Q

Treatment for Acute Angle Closure Glaucoma

A
  • emergent consult to lower IOP

- BB, diuretics

65
Q

Treatment for Primary Open Angle Glaucoma

A
  • facilitate aqueous outflow: prostaglandin analog, parasympathomimetics
  • reduce vitreous volume: BB, alpha 2 adrenergic agonists, carbonic anhydrase inhibitor
66
Q

Treatment Uncomplicated Gallstones

A

-analgesices

67
Q

Treatment Complicated Gallstones

A
  • analgesics
  • IV fluids
  • anti-emetics
  • surgery
68
Q

Treatment for Cholecystitis

A
  • admit
  • IV fluids
  • IV abx: pip-tazo or amp-sulbactam
  • surgical consult
69
Q

Treatment for Gastritis

A
  • antacids
  • H2RA
  • sucralfate
  • prostaglandins
  • PPI
  • avoid NSAIDs
70
Q

Initial Treatment for GERD

A
  • antacids PRN

- OTC PPI or H2RA x2 weeks

71
Q

Treatment for Phase I GERD

A
  • lifestyle and diet changes

- H2RA or PPI in Rx doses

72
Q

Treatment for PUD

A
  • H2RA x8 weeks
  • PPI x4 weeks (PPIs are best)
  • duodenal = 4 weeks, gastric = 8 weeks
73
Q

Treatment for H. Pylori PUD

A

-triple therapy x14 days
-amox 1 g BID x5 days then clarithromycin 500 mg + tinidazole 500 mg BID x5 days
then PPI

74
Q

Tx Diverticulitis

A
  • bowel rest
  • increase fiber and water
  • broad spectrum abx: metronidazole and cipro
75
Q

Treatment for IBD

A
  • abx: cipro, metronidazole
  • 5-ASA agents
  • corticosteroids: azathioprine (imuran) and 6-MP
76
Q

Treatment for IBS

A
  • constipation: change diet, osmotic or other laxatives, tegaserod for women
  • diarrhea: change diet, loperamide, alosetron for women
  • pain: change diet, anticholinergics, TCAs, analgesics
77
Q

Treatment for Appendicitis

A
  • prophylactic abx
  • pain control
  • surgery
78
Q

Treatment for Diarrhea

A
  • stool culture

- non-infectious can use antimotility (imodium) and antisecretory (pepto bismol)

79
Q

Treatment for Constipation

A
  • fiber, veggies, fruits
  • water
  • acute: stimulant (dulcolax)
  • chronic: emollient laxative (colace)
80
Q

Tx for Iron Deficiency Anemia

A
  • oral or parenteral iron

- ferrous sulfate 325 mg PO TID

81
Q

Tx for Vit B12 Deficiency

A

vit B12 1-2 mg PO qd

may need cyanocobalamin IM if severe deficiency

82
Q

Tx for Folate Deficiency

A

-oral folic acid 1-5 mg PO qd

83
Q

Treatment for von Willebrand Dz

A
  • desmopressin DDAVP
  • FFP and cryoprecipitate
  • vWF and factor VIII concentrates
84
Q

Tx for Factor V Leiden

A
  • asymptomatic pts do NOT need anticoagulation
  • LMWH
  • warfarin
85
Q

Tx for Lyme Dz Early

A

PO abx x14 days (doxy 100 mg PO BID or amox if

86
Q

Tx for Lyme Dz Late

A

IV abx 14-28 days

87
Q

Tx for Influenza

A
  • rest, fluids, saline nasal drops, hand washing
  • analgesics, cold/cough meds, antipyretics
  • antivirals in 1st 48 hours: rimantadine, oseltamivir
88
Q

Tx for Pertussis

A
  • supportive care

- DOC: erythromycin or other macrolide

89
Q

Tx for Varicella Chicken Pox

A

-symptomatic: antipyretics, local antipruritics

90
Q

Tx for C. Diff

A

-metronidazole 500 mg PO TID

91
Q

Tx for MRSA

A

-vanco 1 g IV q12h

92
Q

Tx for Uncomplicated UTI

A
  • TMPSMX 1 DS po BID x3 days

- cipro 250 mg po BID x3 days

93
Q

Tx for Osteoarthritis

A
  • weight reduction and exercise

- APAP, salicylates, intra-articular steroids

94
Q

Treatment for RA

A
  • PT
  • NSAIDs, aspirin
  • DMARDs: methotrexate, sulfasalazine, hydroxychloroquine
95
Q

Tx for Gout

A
  • elevation, rest, ice, NSAIDs
  • allopurinol to prevent further attacks
  • colchicine to reduce inflammatory response
96
Q

Tx for Carpal Tunnel

A
  • wrist splint to prevent flexion
  • NSAIDs
  • steroid injections
  • surgery
97
Q

Tx for Lateral Epicondylitis

A
  • RICE, NSAIDs
  • PT
  • steroid injection
98
Q

Tx for Stroke

A
  • IV tPA within 3 hours of sx onset
  • ASA, warfarin, O2
  • control hyperglycemia, monitor cardiac rhythm
99
Q

Absolute CI for tPA Therapy

A
  • hemorrhage
  • previous hemorrhagic CVA
  • prolonged CPR
  • intracranial neoplasm or aneurysm
  • pregnancy
100
Q

Relative CI for tPA Therapy

A
  • recent trauma or surgery
  • poorly controlled HTN
  • active PUD
  • previous CVI
  • known hemorrhagic dz
  • hepatic insufficiency
101
Q

Tx for TIA

A

-ASA or clopidogrel

102
Q

Abortive Tx for Migraines

A
  • simple analgesics + caffeine
  • NSAIDs
  • sumatriptan
  • cafergot
103
Q

Prophylactic Tx for Migraines

A
  • BB
  • TCA
  • VPA
104
Q

Tx for Cluster Headaches

A
  • 100% O2 at 7-10 L for 10-15 mins
  • sumatriptan SQ or nasal spray
  • cafergot
105
Q

Tx for Tension HA

A

-mild analgesics: NSAIDs, ASA, APAP

106
Q

Bacterial Meningitis Empiric Tx for

A

-ampicillin and cefotaxime

107
Q

Bacterial Meningitis Empiric Tx for 1 month to 50 years

A

-ceftriaxone and vancomycin

108
Q

Bacterial Meningitis Empiric Tx for >50 years old

A

-ceftriaxone, vanco, ampicillin

109
Q

Meningitis Group B Strep or N. meningitidis Tx

A

-pen G 14-21 days

110
Q

Meningitis H flu Tx

A

ceftriaxone 7-10 days

111
Q

Meningitis S. pneumo MIC

A

pen G 10-14 days

112
Q

Meningitis S. pneumo MIC 0.1-1 Tx

A

ceftriaxone 10-14 days

113
Q

Meningitis S. pneumo MIC >2 Tx

A

vanco + ceftriaxone 10-14 days

114
Q

Bacterial Meningitis Prophylaxis Tx for Close Contacts

A

-rifampin 600 mg PO q12hr x4

115
Q

Tx of Chronic Seizures

A

-AEDs: phenytoin (Dilantin), carbamazpeine (Tegretol), valproic acid (Depakote), gabapentin (Neurontin)

116
Q

Tx of Acute Bronchitis

A
  • NO abx

- symptomatic/OTC cold meds

117
Q

Tx of CAP

A

-abx: macrolide (Azithro zpak 500 mg PO x1 then 250 mg qd x4 days), doxycycline, respiratory quinolone (levofloxacin)

118
Q

Step-Wise Asthma Treatment (class used for each of the 6 steps)

A
  1. SABA prn
  2. low dose ICS
  3. low dose ICS + LABA
  4. medium dose ICS + LABA
  5. high dose ICS + LABA
  6. high dose ICS + LABA + oral corticosteroids
119
Q

What SABA might be prescribed for asthma?

A

-albuterol (Proventil)

120
Q

What ICS might be prescribed for asthma?

A

-fluticasone (Flovent)

121
Q

What LABA might be prescribed for asthma?

A

-salmeterol (Seravent)

122
Q

Stage I COPD Tx

A
  • reduce risk factors
  • flu vaccine
  • SABA PRN
123
Q

Stage II COPD Tx

A
  • SABA PRN and LABA PRN

- rehabilitation

124
Q

Stage III COPD Tx

A
  • SABA, LABA

- inhaled glucocorticosteroids

125
Q

Stage IV COPD Tx

A
  • SABA, LABA, inhaled glucocorticosteroids
  • long term O2
  • consider surgery
126
Q

Tx of Pulmonary Embolism

A
  • emergent hospitalization

- heparin, warfarin

127
Q

Tx of Pulmonary Edema

A
  • admit
  • O2
  • NTG
  • diuretics
128
Q

Tx of TB

A
  • isoniazid, rifampin, pyrazinamide, ethambutol

- DOT: direct observed therapy

129
Q

Tx for Menopausal Hot Flashes

A

-gabapentin

130
Q

Tx for Osteoporosis

A
  • calcium, vitamin D
  • aerobics, weight bearing, resistance exercise
  • smoking cessation
131
Q

Tx for Endometriosis

A
  • NSAIDs for pain

- OCPs, progestins, GnRH agonists

132
Q

Tx for Bacterial Vaginosis

A
  • metronidazole 500 mg PO BID x7 days

- topical metronidazole or clindamycin

133
Q

Tx for Trichomonas

A

-metronidazole 500 mg PO BID x7 days or 2 g x1

134
Q

Tx for Candida

A
  • fluconazole 150 mg PO x1

- topical miconazole qHS 1-7 days

135
Q

Tx of Gonorrhea

A

-ceftriaxone (Rocephin) 125 mg IM x1

136
Q

Tx for Chlamydia

A

-doxy 100 mg PO qd x7 days or azithro 1 g PO x1

137
Q

Tx of Syphilis

A

benzathine PenG 2.4 million units IM x1

138
Q

Tx of PID Inpatient

A

-cefoxitin 2 g IV q6h OR cefotetan 2 g IV q 12hr + doxy 100 mg IV/PO q12hr

139
Q

Tx of PID Outpatient

A

-ceftriaxone 250 mg IM + doxy 100 mg PO BID +/- metronidazole 500 mg PO BID x14 days

140
Q

A pt on OCPs presents with increased spotting, early cycle BTB, and hypomenorrhea. How should her OCP dose be adjusted?

A

there is an estrogen deficiency so increase estrogen dose

141
Q

A pt on OCPs presents with late BTB and amenorrhea. How should her OCP dose be adjusted?

A

progestin deficiency –> increase progestin dose

142
Q

A pt on OCPs presents with melasma, HTN, migraine headache, and breast fullness/tenderness. How should her OCP dose be adjusted?

A

-excess estrogen –> decrease estrogen dose

143
Q

A pt on OCPs presents with tiredness, weight gain, hair loss, acne, depression and breast regression. How should her OCP dose be adjusted?

A

excess progestin –> decrease progestin dose

144
Q

What effect do OCPs have on anticoagulants?

A

can increase or decrease anticoag effects

145
Q

What effect to OCPs have on TCAs, BBs, corticosteroids?

A

increase the effects of these

146
Q

How are OCPs affected by CYP450 inducers (CBZ PHT, protease inhibitors, barbiturates)?

A

CYP450 inducers decrease the effect of OCPs

147
Q

CI for OCPs

A
  • hx of DVT/PE/CVA/MI/PVD
  • DM with target organ damage
  • breast CA
  • pg/lactation
  • migraine HA with focal aura
  • major surgery with prolonged immobilization
148
Q

Non-Pharm Tx for Major Depressive Disorder

A
  • psychotherapy
  • well-balanced diet
  • exercise
  • relaxation
149
Q

1st Line Pharm Tx for Major Depressive Disorder

A

-SSRIs: sertraline, paroxetine, citalopram

150
Q

Pharm Options for Major Depressive Disorder

A
  • TCAs: amitriptyline
  • 5HT/NE reuptake inhibitors: venlafaxine
  • bupropion, mirtazapine, trazodone, MAOI
151
Q

Pharm Tx for Bipolar Disorder

A
  • 1st line: mood stabilizer (VPA, lithium)

- CBZ, lamotrigine, AEDs, antipsychotics

152
Q

Pharm Tx for Generalized Anxiety Disorder

A
  • 1st line: SSRIs, SNRIs
  • benzos: alprazolam, lorazopam, diazapam
  • TCAs
  • BBs
153
Q

Pharm Tx for Panic Disorder

A
  • SSRI
  • TCA
  • benzos
154
Q

Tx for Alcohol Abuse/Dependence

A

-treat acute sxs if in withdrawal: naltrexone, topiramate

SAPE October 2015 (12 decks)

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