liveonearth (liveonearth) wrote,

On Pharm exam and best primary care meds

RX: name of drug and dose
Disp: how many and in script too so it can't change
Sig: how pt is to be instructed to take the med
Refills: how many or none

what is a wicket?

male and female hormones
corticosteroids, potency, delivery
whaddayado first if you have addisons and hypothyroid
immune modulating
anesthetic agents, local, general
how to determine potency of inhaled anesthetic
he says this is the easiest one
matching q 4 to match if you get the first one wrong it's a sticky wicket


top choice but beware pennicilin allergy
just this pneumo, sinus, UTI
skin infx except MRSA

trimethoprine sulfa
trouble getting it on formulary
not naturally derived
cotrim, septra, bactrim
ds double str is DrM's mc written
1 pill bid x5 days for UTI
10 days renal infx
get UA culture and sensitivity for renal infx or UTI in males
abuse? bubble baths?

good for peds
150-500mg dose until age 5 then 250-500 tid
OM, sinusitis
UTI's in PDX 60% of E Coli resistant to amox

a quinolone
good for sinus, lung, bladder

erythromycin, viaxin, zpac, another
2 pills 1st day and 1 pill each day after
1gram dose for std's
community aquired pneumo
covers mc cause of outpt young adult pneumo: mycoplasm
vessicles in ear is suggestive

supposedly we should do: diuretic, then beta blocker, then ace inhbitor
but most docs are going to ace inhibitors first
diuretics are cheapest and most effective
spironolactone, aldactone, K sparing, qd dosing 25-100mg
hydrochlorthiazide or lasix good choice
12.5 mg hydrochlorothiazide during day they don't even know they're peeing more

ace inhibitor
so darned effective
esp if they have diabetes, saves nephrons, stops sclerosis
20-40mg qd
not too many side effects
the cough, niggling
pts may not have same cough with different ace inhibitor
arbs are much more expensive
use low dose for pts with diabetes and not HTN, microalbuminemia
check for microalb with anyone whose A1C is high
may retain potassium on this med so use potassium wasting (NOT aldactone)

calcium channel blocker

beta blockers
high pulse rate with HTN, sweat and anxiety
inderal is $4/mo
can cause ED, anorgasmia, change dreams
mc se of anti HTN drug: hypotn

cardioselective beta blocker
dose 12.5-25-50-100mg/day
may not have side effects
may make asthma worse, COPD but DrM hasn't seen that
you might not know if you were hypoglycemic"
low blood sugar-->sweat, N, jitters dt epi signal

beta agonist
inexpensive for asthma, COPD
rumex for his cough, he says its his first non-veterinary breakthrough (homeopathic)
questions about new propellant, costs more

much longer acting
24 hours
works well but it's so darned expensive
even generic is high

*prednisone like not for acute
yes for chronic tx

he doesn't like the SSRIS
but if he had to pick one
it would be wellbutrin, norepi and dopa reuptake inhibitor
easier to get people on it and off it

want some kind of thyroid med
be prepared for boards to move between dosing of cytomel, armour, etc
westthroid, naturethroid, compounded

easy to use cream or injx
need DEA number for this drug, codeine and other controlled substances

bad idea

biest and triest
natural or bioidentical hormones from yam
synthesize pregnenolone from yam then make est from that

micronized, compounded

warnings re host of se's
for short term use
severe acute tonsilitis, give 40-50mg
bacterial or if think it's mono
not for strep
also he gives for really bad poison oak
he thinks it can spare pts from surgery
use under 10 days risk of adrenal suppression is low
wean down to 10mg for a few days and then 5mg

his 1st through 4th choice of med for DM2
write for the slow release form, less N/V
it's exquisite
expect B12 def



breast cancer link from AC
Tags: boards, my practice, pharmacology

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