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Common Treatment, Overdose Treatment, Disease Markers and Translocation patterns

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iliapas97's version from 2017-12-04 20:02

Disease and Common Treatment

DiseaseTreatment
Necrotizing fasciitisclindamycin, penicillin G, and vancomycin
descending aortic dissection first-line treatment Beta-blockers
Ascending aortic dissection first line treatment Surgery
Hypocalcemia IV calcium gluconate
Acute treatment of Waldenstrom's macroglobulinemia plasmapheresis
Wilson’s disease penicillamine and trientene
Primary Biliary Cirrhosisursodeoxycholic acid
seasonal affective disorder Light therapy
Severe depression in pregnancy that isrefractory to medical treatment Electroconvulsive therapy
Ischemic stroke within 3 to 4.5 hrs of onset Tissue plasminogen activator
Ischemic stroke > 4.5 hrs of onset Thrombectomy
New onset of neutropenic fever Ceftazidime (or other antibiotics with Pseudomonal coverage) add
Vancomycin if MRSA is suspected or infection is due to a contaminated port
persistent neutropenic feversadd a broad spectrum anti-fungal agent; Amphotericin B
first-line medication that should be used to treat status epilepticus Lorazepam
Second-line medication that should be used to treat status epilepticus phenytoin
Close contacts of patients diagnosed with Neisseria meningitidisrifampin or ciprofloxacin.
First line prophylaxis for traveler’s diarrhea ciprofloxacin.
H. Pylori Proton pump inhibitor (omeprazole), Clarithromycin and Amoxicillin
Quadruple therapyproton pump inhibitor, Bismuth, Metronidazole and Tetracycline
HELLP or Preeclempsia < 32 weeksBetamethasone for lung maturity and magnesium for seizure prophylaxis before delivery
HELLP or Preeclempsia > 32 weeksMagnesium and induction of labor
Treatment shown to reduce mortality in COPDsmoking cessation and supplemental oxygen therapy
Postpartum endometritis treatmentclindamycin and gentamycin
Only Loop diuretic for someone with sulfa allergyEthacrynic acid
Initial treatment for Uterine atonyBimanual massage and compression (Try to stop bleeding) (if unsuccessful give) Oxytocin (Contract uterus and constrict blood vessels)
First-Line drug to treat Uterine Atony Oxytocin
treatment of ALS Riluzole (Glutamate antagonist)
bacterial meningitis treatment for < 28 days old ampicillin, and a 3rd generation cephalosporin (or gentamicin)
Best initial therapy for bacterial meningitis 1month -60 year oldsceftriaxone, vancomycin, and steroids
bacterial meningitis in elderly, neonates, immunocompromised or pregnant add ampicillin to ceftriaxone, vancomycin, and steroids
chronic CMLimatinib (or stem cell transplant)
blast phase of CML dasatinib (or stem cell transplant)
drug of choice for endocarditis prophylaxis for dental procedures Amoxicillin
Tinea versicolor treatment of choice ketoconazole 2% cream or selenium sulfide 2.5% shampoo
Treatment of choice for congenital adrenal hyperplasia Glucocorticoids
Treatment for IgA nephritis (Berger disease) Corticosteroids and ACE/ARB
Treatment for Hep C oral ribavirin and weakly interferon alpha injections
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Ortho

Body Region Condition evaluation Classic signs
Shoulder Rotator cuff injury Most commonly due to Supraspinatus Drop arm test to evaluate supraspinatus
Knee MCL Medial knee pain ABOVE the Joint Line
Knee medial meniscus Medial knee pain at the Joint Line, Locking, Clicking + Mcmurry's Test
Knee Pes Anserine Bursa Medial knee pain Below the Joint Line
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Overdose treatment

Drugs and Electrolyte DisturbancesAntidote
Acetaminophen N-acetylcysteine
TCAs Sodium bicarbonate
Salicylates Sodium Bicarb, activated charcoal, Dialysis
β-blockers Glucagon, insulin, dextrose calcium
Ca channel blockers Glucagon, insulin, dextrose calcium
Black widow bite Calcium gluconate, methocarbamol.
Hyperkalemia.C BIG K: Calcium gluconate (drives potassium intracellularly), Insulin and Glucose , (chronic cases)) Kayexalate
Hypernatremia.Normal Saline. (if unstable vital signs; D5W or ½ NS to replace free-water loss.)
hypercalcemia.IV fluids then Furosemide (excrete excess calcium)
Acid/alkali ingestion Upper endoscopy to evaluate for stricture.
Antimuscarinic (Atropine) Physostigmine.
organophosphates, Anticholinesterases (prevent Ach breakdown leading to Ach toxicity) Atropine (Ach antagonist), pralidoxime.(inhibits anticholinesterase)
Scorpion venom Antivenom, Atropine, Phenobarbital
Opioids Naloxone or Naltrexone
BenzodiazepinesFlumazenil (can precipitate withdrawal, mainly used for acute ingestion)
Carbon monoxide 100% O2, hyperbaric O2.
Copper (Wilson's disease) Penicillamine
Iron Deferoxamine
Lead Succimer or Dimercaprol with EDTA (Severe exposure)
Arsenic Succimer , Dimercaprol
mercury Succimer, Dimercaprol
Cyanide (almond breath) (Old treatment) amyl nitrite/sodium nitrite (converts CN to cyanmetHb) Thiosulfate ((produces thiocyanate, which is excreted)
Cyanide (almond breath)(New treatment) Hydroxycobalamin (VitB12) (forms cyanocobalamin which is nontoxic)
Methemoglobin (Chocolate Blood)Methylene blue.
INH Pyridoxine (VitB6)
Digitalis Normalize K+, avoid giving Ca2+, Mg2+, or lidocaine (for torsades), anti-digitalis Fab.
Heparin Protamine sulfate.
tPA, streptokinaseAminocaproic acid.
Warfarin Vitamin K, FFP.
Methanol Fomepizole followed by Dialysis
ethylene glycol Fomepizole followed by Dialysis
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Drug Side Effects

DrugsSide Effects
ACEIs Cough, rash, proteinuria, angioedema, taste changes, teratogenic ef ects.
Amantadine Ataxia, livedo reticularis
Aminoglycosides Ototoxicity, nephrotoxicity (acute tubular necrosis).
Amiodarone Acute AV block, hypotension, bradycardia. Chronic pulmonary fibrosis, peripheral deposition leading to bluish discoloration, arrhythmias, hypo-/hyperthyroidism, corneal deposition.
Amphotericin Fever/rigors, nephrotoxicity, bone marrow suppression, anemia.
Antipsychotics Sedation, acute dystonic reaction, akathisia, parkinsonism, tardive dyskinesia, NMS.
Azoles (eg, fluconazole) Inhibition of P-450 enzymes.
AZT Thrombocytopenia, megaloblastic anemia.
β-blockers Asthma exacerbation, masking of hypoglycemia, impotence, bradycardia, AV block, CHF.
Benzodiazepines Sedation, dependence, respiratory depression.
Bile acid resins Gl upset, malabsorption of vitamins and medications.
Carbamazepine Induction of P-450 enzymes, agranulocytosis, aplastic anemia, liver toxicity.
CCBs Peripheral edema, constipation, cardiac depression.
Chloramphenicol Gray baby syndrome, aplastic anemia.
Cisplatin Nephrotoxicity, acoustic nerve damage.
Clonidine Dry mouth; severe rebound headache and hypertension.
Clozapine Agranulocytosis.
Corticosteroids Mania, hyperglycemia (acute), immunosuppression, bone mineral loss, thinning of skin, easy bruising, myopathy, cataracts (chronic).
Cyclophosphamide Myelosuppression, hemorrhagic cystitis
Digoxin Gl disturbance, yellow visual changes, arrhythmias (eg, junctional tachycardia or SVT).
Doxorubicin Cardiotoxicity cardiomyopathy
Ethyl alcohol Acidosis, renal dysfunction, CNS depression.
Fluoroquinolones Cartilage damage in children; Achilles tendon rupture in adults.
Furosemide Ototoxicity, hypokalemia, nephritis, gout.
Gemfib ozil Myositis, reversible ↑ in LFTs.
Halothane Hepatotoxicity, malignant hyperthermia.
HCTZ Hypokalemia, hyponatremia, hyperuricemia, hyperglycemia, hypercalcemia.
HMG-CoA reductase inhibitorsMyositis, reversible ↑ in LFTs.
Hydralazine Drug-induced SLE.
Hydroxychloroquine Retinopathy.
INH Peripheral neuropathy (prevent with pyridoxine/vitamin B6), hepatotoxicity, inhibition of P-450 enzymes, seizures with overdose, hemolysis in G6PD deficien y.
MAOIs Hypertensive tyramine reaction, serotonin syndrome (with meperidine).
Methanol Blindness, anion-gap metabolic acidosis.
Methotrexate Hepatic fib osis, pneumonitis, anemia.
Methyldopa Coombs test, drug-induced SLE.
Metronidazole Disulfi am reaction, vestibular dysfunction, metallic taste.
Niacin Cutaneous flushin .
Nitroglycerin Hypotension, tachycardia, headache, tolerance.
Penicillamine Drug-induced SLE.
Penicillin/β-lactams Hypersensitivity reactions.
Phenytoin Nystagmus, diplopia, ataxia, arrhythmia (in toxic doses), gingival hyperplasia, hirsutism, teratogenic effects.
Prazosin First-dose hypotension.
Procainamide Drug-induced SLE.
Propylthiouracil Agranulocytosis, aplastic anemia.
Quinidine Cinchonism (headache, tinnitus), thrombocytopenia, arrhythmias (eg, torsades de pointes).
Reserpine Depression.
Rifampin Induction of P-450 enzymes; orange-red body secretions
Salicylates Fever; hyperventilation with respiratory alkalosis and metabolic acidosis; dehydration, diaphoresis, hemorrhagic gastritis.
SSRIs Anxiety, sexual dysfunction, serotonin syndrome if taken with MAOIs.
Succinylcholine Malignant hyperthermia, hyperkalemia.
TCAs Sedation, coma, anticholinergic ef ects, seizures, QRS prolongation, arrhythmias.
Tetracyclines Tooth discoloration, photosensitivity, Fanconi syndrome, GI distress.
TrazadonePriapism
Warfarin Skin necrosis with the first week of anticoagulation therapy
Trimethoprim Megaloblastic anemia, leukopenia, granulocytopenia.
Valproic acid Teratogenicity leads to neural tube defects; rare fatal hepatotoxicity.
Vancomycin Nephrotoxicity, ototoxicity, “red man syndrome” (histamine release; not an allergy).
Vinblastine Severe myelosuppression.
Vincristine Peripheral neuropathy, paralytic ileus.
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Disease Markers and translocation patterns

Disease Markers and translocation patterns
SLEANA, Anti-dsDNA (High specificity) Anti-Sm “Anti-Smith” (High specificity)
Drug-induced SLEAntihistone
RAAnti-CCP “(Anti-cyclic citrullinated peptide)”, RF
CREST syndromeAnticentromere
Polymyositis/dermatomyositisAnti-Jo-1
Primary biliary cirrhosisAntimitochondrial
Autoimmune hepatitisAnti–smooth muscle
Systemic sclerosisAnti-Scl-70 Antitopoisomerase I
Graves diseaseAnti-TSHR
Hashimotos anti-thyroid peroxidase antibody (TPOAb) aka anti-microsomal antibodies and Anti-thyroid peroxidase antibody TgAb
Wegenerc-ANCA (perinuclear-Antineutrophil Cytoplasmic Antibodies)
microscopic polyangiitisp-ANCA (cytoplasmic-Antineutrophil Cytoplasmic Antibodies)
Mixed connective tissue diseaseU1RNP antibody
Hepatocellular carcinomaAFP
Yolk Sack tumorAFP
Choriocarcinomab-HCG >1000 IU/L
Seminomab-HCG <1000 IU/L
Ovarian tumorCA-125
mantle cell lymphoma t(11;14) bcl-1
follicular lymphomat(14;18) bcl-2
Burkitt’s lymphoma t(8;14) c-myc.
CML BCR-ABL t(9;22)
Ewing's sarcomat(11;22)
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