499

MVST 1B (Subject) / MoDA (Lesson)

This lesson was created by eckhard.

Learn lesson

This lesson is not released for learning.

back  |  next 9 / 10

• Ceftriaxone Use: Meningococcal meningitis prophylaxis, surgical prophylaxis Spectrum: Sensitive Gram-(+) and Gram-(-) bacteria; H. influenzae MoA: 3rd generation cephalosporin antibiotic; inhibition of cell wall synthesis SE: GI upset, hypersensitivity reactions incl Stephen-Johnson syndrome →cefalexin/cefaclor; cefuroxime, ceftazidime, cefotaxime
• Carbapenems Class includes: Imipenem, meropenem, ertapenem Use: severe hospital aquired infections Spectrum: broad including pseudomonas, excl. MRSA MoA: β-lactamase resistant β-lactam antibiotic SE: GI upset, rash, headache
• Azithromycin Use: LRTI (atypical, penicicllin allergic), uncomplicated chlamydia Spectrum: Similar to penicillins MoA: Macrolide antiobiotic, blocking ribosomal exit tunnel SE: GI upset, headache, dizziness, flatulence → clarithromycin, erythormycin
• Tinidazole Use: Anaerobic infections, protozoal infections (e.g. giardia), bacterial vaginosis, surgical prophylaxis → metronidazole
• Nystatin Use: Skin candida; oral fungal infections MoA: binds ergosterol → membrane leakage SE: local irritation, hypersensitivity ~ amphotericin B, → fluconazole, miconazole, ketoconazole, itraconazole; griseofulvin
• Artesunate Use: falciparum malaria treatment → chloroquine, quinine, fansidar
• Quinine Use: falciparum malaria treatment → chloroquine, artesunate, fansidar
• Flucloxacillin Use: Staph aureus skin and soft tissue infections (cellulitis, impetigo, osteomyelitis), infective endocarditis, S. aureus pneumonia Spectrum: Gram-(+), ESBL-sensitive MoA: β-lactam penicillin antibiotic; inhibits cell wall synthesis; MRSA: lactam insensitive TP/TG; resistance: mecA and fem genes SE: GI upset, hypersensitivity reactions →ampicillin/amoxicillin/com-amoxiclav, penicillin V+G, piptaz
• Piptaz ~ Tazocin Use:Hospital-acquired pneumonia, septicaemia, complicated intra-abdominal infections, complicated infections involving the urinary tract or skin and soft tissues Spectrum: broad, including pseudomonas aeruginosa MoA: Piperacillin (extended spectrum β-lactam antibiotic) + tazobactam (β-lactamase inhibitor) SE: GI upset, hypersensitivity reactions → ampicillin/amoxicillin/co-amoxiclav; penicillin G + V, flucloxacillin
• Hydrocortisone* Use: Acute inflammatory and allergic reaction; acute asthma; adrenal insufficiency MoA: Corticosteroid, gluco > mineralo SE: Cushing's incl osteoporosis/-necrosis, diabetes, cataracts, hypertension Dose: Acute: 100-500mg IM or slow IV, 3-4 times in 24h as required HRT: 20-30mg PO in divided doses; steroid card! → fludrocortisone, prednisolone, dexamethasone
• Advertisement
• Nateglinide Use: Type 2 diabetes mellitus; only with metformine MoA: novel antibiabetic, ↑insulin secretion SE: hypoglycaemia, hypersensitivity reaction → metformin, sulfonylureas, glitazones, DPP-4 inhibitors, GLP-1 analogues
• Oral contraceptives ??
• Vaccines Influenza HiB Streptococcal MenB
• Allopurinol Use: Gout maintenance, prophylaxis of urate and calcium oxalate renal stones MoA: Xanthine oxidase inhibiotor, ↓uric acid synthesis SE: rashes (→withdraw; hypersensitivity rare), GI upset, headache, malaise → febuxostat; NSAIDs, colchicine
• Alendronate Use: Osteoporosis, -penia MoA: Bisphosphanate SE: Oesopheal reaction, GI upset,, osteonecrosis of the jaw; take once weekly before breakfast; dntal check-up's → raloxifene; steroids, methotrexate
• Calcium supplement Use: Calcium deficiency, hyperphosphataemia MoA: Milk, cot liver oil, direct supplement SE: GI disturbance → calcium gluconate in hyperkalaemia, vit D (Cholecalciferol, ergocalciferol, calcitriol)
• Vitamin D supplement Colecalciferol, ergocalciferol, calcitriol CKD, osteoporosis/-paenia Sun light, hydroxylation in liver & kidney; role of PTH →cot liver oil
• Packed red cells ??
• Dextrose* Use: Hypoglycaemia, fluid replacement, provision of energy MoA: Direct glucose/fructose replacement SE: extravasation, hyperglycaemia Dose: Hypoglycaemia: 50ml glucose 20% IV (or IM →glucagon) Fluid replacement w/o electrolytes: glucose 5% Energy: --
• 0.9% Sodium chloride Use: Rehydration, Na+/Cl- imbalance, fluid challenge MoA: Direct effect SE: Central pontine myelinolysis (too quick correction of hyponatraemia) Doses: Maintenance: 2L saline, 1L glucose 5%, 60mmol K+, better 1.5 - 2.5L, electrolytes as needed Fluid challenger: 250ml as fast as possible → responder?, shock?
• Colloids* includes Gelofusine, Volplex Use: low blood volume MoA: volume expanders SE: hypersensitivity, transient increase in bleeding time Doses:--
• Hartmann's* Use: Electrolyte imbalance, fluid replacemet MoA: Ca2+ 2, K+ 5, Na+ 131, Cl- 111mmol/litre (more physiological than 0.9% NaCl) SE: sodium accumulation, oedema, hyperchloraemic acidosis Dose: 1. - 2.5 litres / day
• Ferrous sulphate Use: Iron deficiency anaemia MoA: Iron replacement SE: GI upset (→switch to other salt), iron overload (e.g. thalassaemia); overdose (→desferrioxamine)
• Folate Use: Folate deficiency, pregancy MoA: Direct folic acid supplement SE: never given w/o checking/correcting B12; rare;y GI upset Dose: Folate deficiency: 5mg OD PO for 4 months, up to 10mg in malabsorption Pregnancy: 400mcg (low risk), or 5mg (high risk) → folinic acid/leucovorin
• Sando-K, Sando-phos Use: Electrolyte imbalance: K+/Phosphate depletion; maintenance MoA: oral supplements SE: Overdose; GI upset
• Vitamin B12 = Hydroxycobalamin Use: vitamin B12 deficiency (→peripheral neuropathy, subacute combined degeneration of the cord); pernicious anaemia, cyanide poisoning MoA: Direct supplement of hydroxycobalamin SE: nausea, headache, dizziness; fever, hypersensitivity reactions (including rash and pruritus); injection-site reactions; hypokalaemia and thrombocytosis during initial treatment; chromaturia Dose: regular IM injections depending on neurological involvement
• Vitamin K Use: Warfarin over-anticoagulation, fat-malabsorption (biliary obstruction, hepatic disease), neonates MoA: cofactor for synthesis of factor II, VII, IX, X SE: -- Dose: 10-40mg menadiol sodium phosphate
• Pyridoxine (Vit B6) Use: Drug-induced neuropathy (TB→isoniazid, Wilson's→penicillamine), deficiency states, premenstrual syndrome MoA: prevents peripheral neuropathy SE:sensory neuropathy in extended overdose Dose:10-400mg depending on indication
• To learn pain ladder w/ conversion factors drug counselling: digoxin, warfarin, steroids P450 inducers, inhibitors, substrates Smoking, alcohol: screening, cessation advice Fundoscopy, visual acuity Cancer drugs Hepatic encephalopathy Malaria IBD H. pylori Haemochromatosis, Wilson's WHO drug list → mark in flash card °, ¤, †, ◊, ∴ Core conditions: Dx, Sx, SSx, Ix, Mx
• EMLA Lignocaine creme for venepuncture etc.
• Advertisement
• Procyclidine Use: Drug-induced parkinsonism, excl. tardive dyskinesia; Parkinson's disease; dystonia MoA: Anticholinergic SE: dry mouth, constipation/urinary retention, blurred vision, confusion, etc. → benzatropine
• Cefadroxil Use: UTI in pregnancy MoA: 1st generation cephalosporin; inhibiting cell wall synthesis Spectrum: Sensitive Gm+,- SE: GI upset, hypersensitivity, PMC → trimethoprim, nitrofurantoin, amoxicillin→ cefalexin/cefaclor; cefuroxime, ceftriaxone, cefotaxime; ceftazidime
• Felodipine Use: Gestational hypertension, angina prophylaxis MoA: DHP-Ca2+ channel blocker SE: flushing, ankle oedema, head ache → amlodipine, nifedipine; methyldopa, hydralazine, labetalol
• Finasteride Use: BPH, male patttern baldness, prostate cancer MoA: Androgen receptor antagonist →Dutasteride
• Febuxostat Use: Long-term control of gout MoA: xanthine oxidase inhibitor → allopurinol
• Isoflurane Use: induction & maintenance of aneasthesia MoA: Volatile liquid anaesthetic SE: Malignant hyperthermia (→dantrolene) →halothane, ketamine, propofol
• Bupivacaine Use: Lacal anaesthetic (surgery & acute): epidural, field, nerve blocks MoA: Na+ channel blocker SE: CNS and CVS toxicity → lidocaine, procaine
• Ephedrine Use: hypotension during surgery MoA: sympathomimetic amine potentiating noradrenaline at postsynaptic α- and β-adrenergic receptors SE: GI upset, tachycardia, arrhythmias
• Hyoscine butylbromide = buscopan Use: symptomatic relief of gastro-intestinal or genito-urinary disorders characterised by smooth muscle spasm →hyoscine hydrobromide / scopolamine
• Hyoscine hydrobromide = scopolamine hydrobromide Use: Motion sickness; hypersalivation associated with clozapine therapy; excessive respiratory secretions MoA: Anticholinergic SE: constipation, bradycardia, urinary retention, mydriasis & photophobia, dry mouth → metoclopromade/domperidone; ondansetron; cyclizine;
• Calcium gluconate Use: Severe acute hyperkalaemia > 6.5mmol/l with ECG changes MoA: Stabilizes unstable mycocardium SE: Arrythmias → insulin + dextrose; salbutamol; sodium bicarbonate; exchange resins;
• Ribavirin Use: Severe RSV bronchiolitis in chilren; chronic HCV hepatitis (+ peginterferon α); vrial haemorrhagic fevers MoA: guanosine/adenosine analogue → hypermutation in RNA viruses SE: anaemia with → zidovudine → other antivirals
• Docetaxel Use: Prostate cancer, breast cancer MoA: Taxane antineoplastic → paclitaxel
• Protamine sulphate Use: Overanticoagulation with →heparin (extr. pathway, APTT)
• Hydroxybarbamide Use: Sickle cell disease; chronic myeloid leukaemia; cervical cancer MoA: ribonucleotide reductase inhibitor SE: legion
• Blood products Fresh Frozen Plasma Platelets Packed Red Cells Whole Blood Cryoprecipitate Thrombin Complex Concentrate
• Mupirocin Use: Bacterial skin infections; MRSA supression MoA: t-RNA synthetase inhibitor SE: local reactions including urticaria, pruritus, burning sensation, rash → chlorhexidine
• Podophyllum Use: Soft, non-keratinised, external anogenital warts keratinised, solitary → cryotherapy, physical ablation
• Chlorhexidine Use: MRSA suppression, bladder irrigation MoA: Desinfectant SE: Occassionally sensitivity →mupirocin
• Pancreatin Use: Cystc fibrosis, chronic pancreatitis, pancreatectomy, pacreatic obstructiion MoA: Pancreatic enzymes, incl amylase to break down starch SE: GI upset, hypersensitivity

back  |  next 9 / 10