Foster Drug Info⚕️
@NotableDrugInfo
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Random but Noteworthy Pharmacotherapeutic Info.
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🫁Community-acquired
#Pneumonia
:
#Empiric
#Outpatient
#Antibiotic
Selection
‼️No first-line
#Regimen
has been clearly shown to be superior to another.
💢Antibiotic selection depends on:
➤ Likelihood of
#Antibiotic_Resistance
➤
#Comorbidities
➤ Potential
#Adverse_Effects
0
14
69
#Silver_Sulfadiazine
1% cream and silver-containing
#Dressings
:
❌Contraindications
➖
#Burns
near
#eyes
➖
#Pregnancy
➖
#Breastfeeding
➖
#Newborns
<2months
➖
#Allergic
to
#sulfonamides
⭕️Adverse effects
➖
#Skin
#hypersensitivity
➖
#Neutropenia
➖
#Leukopenia
➖
#Methemoglobinemia
0
6
21
🤰
#Severe_Depression
in
#Pregnancy
: Choosing SSRI
💊If the patient has not previously used
#Antidepressants
:
✅
#Sertraline
✳️Alternatives:
✔︎
#Citalopram
✔︎
#Escitalopram
⚠️The
#SSRIs
that are often avoided as the initial treatment:
❎
#Fluoxetine
❎
#Paroxetine
❎
#Fluvoxamine
🤰
#Severe_Depression
in
#Pregnancy
:
#Antidepressants
✅Patients who were successfully treated with antidepressants before pregnancy:
➤Receive the same drug
✅Patients who have not used antidepressants:
➤
#SSRIs
as the initial treatment
❎
#MAOIs
are not used during pregnancy
2
0
10
2
4
20
💢
#ERECTILE_DYSFUNCTION
: Drugs that may induce
✅
#Antidepressants
✔︎
#SSRIs
✅
#Antihypertensives
✔︎
#Chlorthalidone
✔︎
#Beta_Blocker
✔︎
#Guanethidine
✔︎
#Clonidine
✅Anti-androgens
✅Other
✔︎
#Spironolactone
✔︎
#Methyldopa
✔︎
#Ketoconazole
✔︎
#Cimetidine
2
3
17
💊Chronic Low-dose
#Methotrexate
: Risk Factors of
#Hepatotoxicity
During Therapy
📌Hepatotoxin exposure e.g
#Alcohol
,
#NSAIDs
,
#DMARDs
,
#Retinoids
& other
#hepatotoxic
medications
📌Daily rather than intermittent dosing
📌Lack of supplementation with
#Folic_acid
or
#Leucovorin
#Methotrexate
:
Delayed
#hepatic
#toxicity
in the form of
#fibrosis
or
#cirrhosis
after 2 years or more of low-dose use and a total dose of at least 1.5 g can be
#fatal
. Cases of fibrosis have also been reported in
#rheumatoid_arthritis
(RA) patients receiving regular
#folic_acid
.
0
0
7
2
1
17
🍯
#Honey
:
#Cough
😷Reviewing 14 trials revealed that honey is a superior intervention in children ≥1 year & adults with
#Upper_Respiratory_Tract_Infections
compared to
#placebo
,
#Diphenhydramine
&
#Dextromethorphan
.
🐝1/2 to 1 teaspoon as needed
🌽
#Corn_Syrup
is an alternative
2
5
16
💊PDE-5 inhibitors are:
✅Typically well tolerated in patients taking
#antihypertensive
drugs
#ACEIs
#ARBs
#CCBs
#Beta_blockers
#Diuretics
❌Should not routinely be taken with alpha-blocking agents due to concerns of
#hypotension
❌
#Contraindicated
in patients taking
#Nitrates
.
0
3
15
💢
#Tamsulosin
should be taken 30 mins after the same meal every day:
✔️Food decreases their
#bioavailability
➡️Reduces the peak
#Serum
level➡️Lowers risk of
#hypotensive
#adverse_effects
.
💢Tamsulosin is well tolerated
in patients with controlled
#hypertension
.
#Flomax
0.4mg
0
0
14
💊
#Drugs
that cause
#Constipation
✅NSAIDs
✅Anticholinergics
#Antihistamines
#Antispasmodics
#Antidepressants
#Antipsychotics
✅Cations
#Iron
#Aluminum
#Barium
#Calcium
✅Neurally actives
#Opiates
#Antihypertensives
#Ganglionic_blockers
#Vinca_alkaloids
#CCBs
#5HT3_antagonists
2
2
13
❤️🩹
#Propranolol
:
#Emotional_Memory
🔔The results of a meta-analysis showed that:
✅Emotional memories have been successfully
#weakened
by administration of propranolol before or shortly after new learning or the recall of established memories.
#PTSD
🔗
"Preclinical studies have shown that propranolol has the capacity to selectively block the protein synthesis required for the storage of aversive (emotional) memory while sparing declarative memory (factual memory)"
0
0
0
3
1
15
🥴Prolonged
#HICCUPS
(>48 hours): 💊
#Pharmacotherapy
(Oral)
✅
#PPIs
Empiric
#Antireflux
treatment for 3-4 weeks
✅
#Baclofen
5-10mg TDS
Max= 45mg/day
✅
#Gabapentinoids
:
#Gabapentin
100-400mg TDS
✅
#Metoclopramide
10mg QDS
✅
#Chlorpromazine
(also IM & IV)
25mg TDS
Max= 50mg TDS
0
5
15
💊
#Methotrexate
(
#MTX
) &
#NSAIDs
Interaction:
❌NSAIDs use during high-dose MTX
#therapy
may increase and prolong serum MTX levels. (
#Risk_D
)
❌ Use with
#Caution
when administering NSAIDs or
#Salicylates
with lower doses of methotrexate for
#Psoriasis
&
#Rheumatoid_Arthritis
.
1
3
15
🤰
#Levonorgestrel
1.5mg ➕
#Piroxicam
40mg (Oral):
✅
#Prostaglandins
facilitate several
#reproductive
processes. Therefore, It’s possible that an
#CycloOxygenase
enzyme inhibitor (
#COX
), act synergistically with oral EC to improve their efficacy.
🔗
🤰
#Emergency_Contraception
: Methods
✅
#Intrauterine_devices
🔸
#Copper
380mm2
🔸
#Levonorgestrel
52mg
✅Oral
🔸
#Ulipristal_acetate
30mg
🔸
#Levonorgestrel
(LNG) 1.5mg
🔸
#Mifepristone
10 to 25mg
🔸Combined oral 100mcg of
#ethinyl_estradiol
and 0.5mg of LNG Repeat dose in 12 hours
0
2
5
2
4
15
🥸
#Bimatoprost
:
#Eyelash
#Hypotrichosis
👁️Bimatoprost 0.03% solution is the only
#FDA_approved
#prostaglandin
analog for eyelash growth.
👀Increases
#Eyelash_Growth
, thickness & pigment.
💧Apply evenly along the skin of the upper
#eyelid
at base of eyelashes only at bedtime.
3
2
15
🌞
#Vitamin_D
: Increased
#Catabolism
✅These drugs increase
#P450_enzyme
activity, which metabolizes
#calcidiol
to inactive vitamin D metabolites:
💊
#Phenytoin
💊
#Phenobarbital
💊
#Carbamazepine
💊
#Oxcarbazepine
💊
#Isoniazid
💊
#Theophylline
💊
#Rifampin
Half of the adults with epilepsy showed vitamin D deficiency, and patients with enzyme-inducing antiepileptic drugs had lover levels. A daily dose of 6,670 IU cholecalciferol successfully led to the correction.
#epilepsy
@EpiDisorders
@fabnascimen
1
13
44
2
2
15
💢
#Statins
:
#Helicobacter_pylori
Eradication
✔️Addition of statin therapy (e.g.
#Simvastatin
20mg) to “triple therapy” as
#Adjunctive_Therapy
has been associated with a reduction in H. pylori mediated
#inflammation
and an increase in
#eradication
rates.
1
3
15
🍼
#Domperidone
:
#Breast_Milk
🤱Domperidone is a
#prokinetic
agent that can be used as a
#galactagogue
✔️It blocks D2 receptors in the
#lactotrophs
of the anterior
#pituitary
#gland
increasing the release of
#prolactin
which in turn increases
#lactation
💊Dosing:
Up to 20mg TDS
0
4
15
💊
#Pill_Esophagitis
: Prevention
🚰Drinking fluid:
>4 ounces with any pill
>8 ounces with the culprit medication
↗️Patients should remain upright:
>10 min after taking any pill
>30 min after the culprit medication
🥃Use liquid formulation of the
#culprit_medication
if possible.
💊Pill-induced
#Esophagitis
: Most Common drugs
✅Antimicrobials
➤
#Lincosamides
➤
#Macrolides
➤
#Penicillins
➤
#Sulfonamides
➤
#Tetracyclines
➤
#Metronidazole
/
#Tinidazole
➤
#Rifampin
➤
#Zidovudine
✅
#Bisphosphonates
✅
#NSAIDs
✅Others
➤
#Caffeine
➤
#Isotretinoin
➤
#Warfarin
3
3
14
1
2
14
💊Pill-induced
#Esophagitis
: Most Common drugs
✅Antimicrobials
➤
#Lincosamides
➤
#Macrolides
➤
#Penicillins
➤
#Sulfonamides
➤
#Tetracyclines
➤
#Metronidazole
/
#Tinidazole
➤
#Rifampin
➤
#Zidovudine
✅
#Bisphosphonates
✅
#NSAIDs
✅Others
➤
#Caffeine
➤
#Isotretinoin
➤
#Warfarin
0
40
144
3
3
14
🤢
#Pyridoxine
(B6):
#Pregnancy
#Nausea
🤰
#B6
is suggested as the initial pharmacotherapy of mild/moderate Nausea in
#pregnant
women
🤮B6 does not reduce
#vomiting
⚠️
#Sensory_Neuropathy
has been reported with pyridoxine intake at doses >500mg/day
💊Dosing: 10-25mg 3-4 times/day
1
3
12
💢
#SSRI
-induced
#Sexual_dysfunction
:
#Adjunctive_Drugs
with Little to no demonstrated benefit
#Amantadine
#Bethanechol
#Buspirone
#Cyproheptadine
#Ephedrine
#Ginkgo_biloba
#Granisetron
#Mirtazapine
#Olanzapine
#Yohimbine
#Dextroamphetamine
#Methylphenidate
#Pemoline
#Flibanserin
0
2
14
🫁
#Formoterol
:
#Rescue_Spray
‼️Formoterol is a
#LABA
(Long-acting beta-2 agonist) but due to
#rapid
#onset_of_action
of formoterol, a combination
#budesonide
-formoterol (e.g.
#Symbicort
)
#inhaler
can be used both for
#daily_controller
therapy and for
#quick_relief
of symptoms.
2
2
13
🦷
#Antibiotic
regimens (options) for prevention of
#Endocarditis
prior to
#Dental
#procedures
:
✅
#Amoxicillin
2 g
✅
#Cephazolin
1g
✅
#Ceftriaxone
1g
✅
#Cephalexin
2g
✅
#Azithromycin
500mg
✅
#Clarithromycin
500mg
✅
#Doxycycline
100mg
❌
#Clindamycin
is no longer recommended.
0
0
11
🤯
#Acute_migraine
:
#Antiemetics
✅
#Metoclopramide
IV &
#Prochlorperazine
IV/IM can be used along with other agents or as
#monotherapy
.
✳️IV
#Diphenhydramine
(12.5 to 25 mg every hour for 2 hours) can be given with these drugs to prevent
#Akathisia
and acute
#Dystonic_reactions
.
2
3
14
🐶
#Animal_Bite
#Wounds
:
#Antibiotic_Prophylaxis
✅Preferred
#Antibiotic
:
#Amoxicillin
-
#Clavulanate
❌Agents lacking
#in_vitro
activity against P.
#multocida
should be avoided.
THESE INCLUDE:
❎1st Generation
#Cephalosporins
❎
#Penicillinase
-Resistant
#Penicillins
❎
#Macrolides
0
3
14
💢
#Macrolids
&
#Statins
Co-administration:
✔️A few studies reported cases of
#Rhabdomyolysis
✔️May Increase Cmax of Simvastatin ~5fold.
✔️The risk for
#hospitalisation
or death in patients using
#Clarithromycin
increased with age and CVD but was not associated with Statin use.
@NotableDrugInfo
Co-administration of clarithromycin and Statins (especially simvastatin) is not recommended.
Clarithromycin can increase the serum concentration of Simvastatin. This can lead to increase the risk of muscle disorders, such as myopathy and rhabdomyolysis.
You didn’t mention it.
0
0
2
0
3
13
#Anaphylaxis
:
✔️
#Albuterol
(
#salbutamol
)
#Nebulizer
: 2.5 to 5mg
#MDI
: 2 to 3 puffs
✔️H1
#Antihistamine
(for
#urticaria
&
#itching
only)
#Cetirizine
10 mg IV
#Diphenhydramine
25 to 50 mg IV
✔️H2 Antihistamine
#Famotidine
20 mg IV
✔️
#Glucocorticoid
#Methylprednisolone
125 mg IV
0
3
12
#Photoaging
: Complementary Therapies
#Moisturizers
containing
✅
#Antioxidants
➤
#Niacinamide
(
#vitamin_B3
)
➤
#Ascorbic_acid
(
#vitamin_C
)
➤
#Coenzyme_Q10
➤
#Vitamin_E
➤
#Retinyl_esters
,
#retinol
,
#retinaldehyde
,
#oxoretinoids
➤
#Alpha_lipoic_acid
1
1
12
💢
#Hypertension
:
#Nonpharmacologic
Therapy
☑️
#Lifestyle_modification
should be prescribed for all patients with elevated
#blood_pressure
.
☑️The recommended Modifications:
➤
#Weight_loss
➤
#DASH
-type
#dietary_pattern
➤
#Reduction
of
#Alcohol
and
#Salt_intake
➤
#Physical_activity
1
3
13
🫁β-Blockade:
#Airways_Resistance
✅Increased airways resistance is less likely to occur with #βblockers with ISA or beta-1 selectivity.
❇️Beta-1 selectivity may diminish at higher doses.
❎All β-blockers should be avoided in patients with severe
#bronchospastic_disease
.
0
4
13
🍺
#Alcoholic_Hepatitis
✅
#Glucocorticoids
#Prednisolone
40mg daily
#Methylprednisolone
32mg daily IV
✅
#Pentoxifylline
400mg TDS
❇️Possibly effective
N-
#acetylcysteine
(
#NAC
)
#GCSF
❎Ineffective
➤Anti-TNF
#antibodies
#Etanercept
#infliximab
➤
#Anabolic_Steroids
#oxandrolone
0
0
13
💉
#Anaphylaxis
in adults:
#Epinephrine
(1 mg/mL)
✅0.3 to 0.5 mg IM in the mid-outer
#thigh
✅Repeat every 5 to 15 minutes, as needed.
✅Most patients respond to 1, 2, or at most, 3 doses of IM injection
✅If symptoms are not responding:
prepare IV epinephrine for
#infusion
.
0
2
13
💊
#Fluoxetine
: the Best time to take
➤
#Bipolar
I disorder & treatment-resistant
#Depression
: Once daily in the evening
➤
#Major_Depressive_Disorder
&
#Obsessive_Compulsive_Disorder
: Once daily in the morning
OR
twice daily, morning & noon
➤
#Bulimia
: Once daily in the morning
0
0
13
💢
#Bisphosphonates
(
#BPs
) are known as first-line therapy for
#postmenopausal
women and for men with primary
#osteoporosis
.
✅
#Alendronate
initial choice of oral BPs.
Alternative ➤
#Risedronate
✅
#Zoledronic_acid
IV
For patients with contraindications or intolerance to oral BPs
0
1
13
🪱
#Pinworm
(
#Enterobiasis
): Treatment Options
✅
#Albendazole
:
400mg orally once
✅
#Mebendazole
:
100mg orally once
✅
#Pyrantel_pamoate
:
11mg/kg, max. 1g once
➤preferred option in
#pregnancy
❇️All above regimens should be repeated in two weeks
❌
#Piperazine
is no longer used
2
1
13
💢
#Tamsulosin
have been reported to have 6 years of durable response.
✔️
#Patients
should continue taking the drug as long as they respond to them.
✔️Increasing the dose of tamsulosin to 0.8mg/day produces inconsistent improvements in effectiveness but increases
#adverse_effects
.
1
4
13
💊
#Alosetron
: the FDA
#drug_safety
✔️Indicated only in
#women
with severe chronic
#diarrhea
-predominant
#IBS
.
✔️Currently, the
#FDA
has ensured that the benefits outweigh the risks of
#ischemic_colitis
and serious complications of
#constipation
.
@NotableDrugInfo
Wasn't alosetron removed from the market? So, why is it still part of the treatment guidelines?
0
0
2
1
3
13
Avoidance of
#Aspirin
(100mg/d) as part of an
#antithrombotic
regimen that included a
#vitamin_K
#antagonist
in patients supported with an
#LVAD
resulted in a significant decrease (34%) in major
#nonsurgical
#bleeding
events and no significant increase in
#thromboembolic
risk.
0
2
11
💢
#Supplementation
which Reduce
#Blood_pressure
(BP):
✅
#Magnesium
✅
#Fish_oil
Only in High-dose
✅
#fiber
✅
#Protein
Replacing
#carbohydrate
intake with protein
✅
#Folate
5 mg/day or more
#Folic_acid
reduces systolic BP
✅
#Flavonoids
#Fruits
,
#vegetables
,
#tea
, &
#Cocoa
1
1
11
#Scabies
: Management
Topical
#Permethrin
and oral ivermectin are the most common first-line treatments.
Other topical therapeutic options include
#Benzyl_benzoate
(10 or 25%)
#Sulfur
2 to 10%
#Ivermectin
1%
#Spinosad
0.9%
#Crotamiton
10%
#Lindane
1%
0
2
11
💢
#Proton_pump_inhibitors
(
#PPIs
) may reduce the absorption of
#Levothyroxine
from the intestine due to suppress
#intragastric
pH and thereby make it less effective.
💢Early
#Morning
and
#Night
-time administration of PPIs have similar effect on
#Thyroid
function test‼️
0
3
11
🫦
#Cleft_Lip
and/or
#Cleft_Palate
:
💊Drugs that may be associated:
✔️
#AntiSeizure_agents
➖
#Phenytoin
➖
#Sodium_Valproate
➖
#Topiramate
✔️
#Folic_acid_antagonist
➖
#Methotrexate
✔️
#Ondansetron
✔️
#Diazepam
✔️
#Fluoroquinolones
➖
#Nitrofurantoin
✔️
#Corticosteroids
0
1
10
🧴PROPER USE OF
#SUNSCREENS
➤To achieve the full
#Sun_Protection_Factor
(SPF) value, the amount of sunscreen necessary to cover
#skin
of an adult when on a
#beach_vacation
is approximately 30 to 45ml.
☀️ Using only half of the proper amount would provide one third of the
#SPF
.
1
3
10
☀️
#Photosensitizers
: Common MEDs
💊Antibiotics:
✔︎
#Tetracyclines
✔︎
#Fluoroquinolones
✔︎
#Sulfonamides
💊AntiFungals:
✔︎
#Griseofulvin
✔︎
#Voriconazole
💊
#NSAIDs
💊
#Psoralens
💊
#Retinoids
💊
#Phenothiazines
💊Other:
✔︎
#Hydrochlorothiazide
✔︎
#Metformin
✔︎
#Amiodarone
1
2
12
💊
#Sulfonylureas
and β-blockers: concomitant use
✅Concomitant use of sulfonylureas &
#Beta_blocker
was associated with an increased risk of severe hypoglycemia compared with
#Sulfonylurea
alone
✅
#Cardioselectivity
of #βblockers did not seem to play a major role in this regard
🫁β-Blockade:
#Airways_Resistance
✅Increased airways resistance is less likely to occur with #βblockers with ISA or beta-1 selectivity.
❇️Beta-1 selectivity may diminish at higher doses.
❎All β-blockers should be avoided in patients with severe
#bronchospastic_disease
.
0
4
13
3
4
12
🫁
#Rescue_Inhaler
:
#Quick_relief
of
#Asthma
symptoms
✅SABA
#Albuterol
#Levalbuterol
#Terbutaline
✅SABA/SAMA
Albuterol/
#Ipratropium
✅ICS/SABA
Albuterol/Budesonide
✅LABA
#Formoterol
(FORM)
✅ICS/LABA:
#Budesonide
/FORM
#Beclomethasone
/FORM
#Fluticasone
/FORM
#Mometasone
/FORM
2
2
11
#Chlamydia_trachomatis
:
#Regimens
✅Preferred:
☑️
#Doxycycline
100 mg twice daily for 7 days
✅Alternatives:
☑️
#Azithromycin
1 g single dose
✔️Preferred regimen for
#pregnant
individuals.
☑️
#Levofloxacin
500 mg once daily for 7 days
☑️
#Amoxicillin
500 mg 3 times daily for 7 days
2
4
12
🐝
#Bee
,
#yellow_jacket
,
#wasp
, and other
#Hymenoptera
#STING
: Large local reactions (>5cm)
✅
#Prednisone
: a single dose of 40-60mg
✅
#NSAIDs
to reduce
#Pain
✅
#Antihistamines
and topical
#Corticosteroids
for
#Pruritus
‼️PREVENTION:
✅Prednisone 20-60 mg within 2h of the sting
0
3
12
Long-term use of
#Metformin
has been associated with reversible
#vitamin
#B12
deficiency and subsequent
#anemia
and
#neuropathy
.
Risk factors:
~Duration of therapy
~Inadequate B12 stores, poor underlying
#nutrition
, and inadequate
#calcium
intake or absorption.
0
4
10
💢
#Benzodiazepines
(BZD): Use in the
#elderly
⚠️Numerous studies of BZD use have found an increased risk of:
✅
#Falls
✅
#Fractures
✅
#Cognitive_Dysfunction
✅
#Overdose
death when combined with
#opioids
‼️BZD use has been linked with an increased risk of all-cause mortality.
Guidelines discourage using benzodiazepines with opioid medications in older adults, but it still happens. So how often does it occur and what are the consequences? Researchers identified 80 PA-PSRS reports of adverse drug reactions and examined the risks:
0
1
2
4
2
11
💢
#IBS
-C: PHARMACOLOGIC THERAPY
✅
#Osmotic_Laxatives
➤
#PEG
up to 34g/day
✅
#Lubiprostone
8mcg BID
✅
#Guanylate_cyclase_agonists
➤
#Linaclotide
290mcg once daily
➤
#Plecanatide
3mg once daily
✅
#NHE3_inhibitor
➤
#Tenapanor
50mg BID
✅5-HT4 agonists
➤
#Tegaserod
(withdrawn)
3
2
11
🤰
#Bacterial_Vaginosis
:
#Pregnant
patients
✅Oral treatment is effective and has not been associated with Adverse
#Obstetric
/
#Fetal
Effects.
❇️Preferred Therapeutic Options:
➖A 7-day Regimen of
✔️
#Metronidazole
500mg BID
✔️
#Metronidazole
250mg TDS
✔️
#Clindamycin
300 mg BID
USPSTF Recommendation: Screening for Bacterial Vaginosis to Prevent Preterm Delivery
1
0
2
2
0
11
🤰
#Gestational_Diabetes_Mellitus
(GDM):
#Pharmacotherapy
📌Indications:
✔️
#Glucose_levels
above the target range
✔️
#Fetal_Overgrowth
📌Options:
❇️
#Insulin
:
✔️Mostly the preferred option especially if the patient is willing
❇️Oral
#Antihyperglycemics
:
✔️
#Metformin
✔️
#Glyburide
0
3
10
💢
#Drug_holiday
(briefly interrupting treatment) may possibly be useful for
#sexual_dysfunction
induced by
#SSRIs
other than
#Fluoxetine
.
✔️In a study of weekend drug holidays of
#Sertraline
&
#Paroxetine
,
#Libido
,
#Orgasm
&
#sexual_satisfaction
improved in 50% of the
#patients
.
0
4
11
#Neuropathic_Pain
: Recommended First-line of therapy (maximum dose)
✅
#Gabapentinoids
✔️
#Gabapentin
(3.6g/day)
✔️
#Pregabalin
(300-600mg/day)
✅
#SNRIs
✔️
#Duloxetine
(120mg/day)
✔️
#Venlafaxine
(225mg once daily)
✅
#TCA
✔️
#Nortriptyline
(150mg/day)
✔️
#Amitriptyline
(150mg/day)
0
3
11
💢
#Calcium_carbonate
requires an acid environment for optimal absorption and is poorly absorbed in patients taking
#proton_pump_inhibitors
(
#PPIs
),
#H2_blockers
.
💢We usually recommend
#calcium_citrate
as a first-line
#calcium
supplement in these patients.
0
1
11
The
#HPV
types 16 & 18 cause about 70% of all
#cervical
#cancers
(types 31, 33, 45, 52, & 58 cause 20%).
Types 16 & 18 cause nearly 90% of
#anal
cancers and a proportion of
#oropharyngeal
,
#vulvar
,
#vaginal
, &
#penile
cancers.
Types 6 & 11 cause about 90% of
#anogenital
#warts
.
4
0
6
😓
#CHROMHIDROSIS
(
#Colored_Sweat
):
#Medications
,
#Metals
&
#Dyes
🟠Orange
✔︎
#BetaCarotene
✔︎
#Clofazimine
✔︎
#Quinine
🟡Yellow-orange
✔︎
#Tartrazine
-coated
#bisacodyl
🟢Yellow-Green
✔︎
#Fluorescein
🔵Blue
✔︎
#Copper
✔︎
#Methylene_blue
✔︎
#Silver
🔴Red
✔︎
#Rifampin
1
1
10
🤮
#ONDANSETRON
: Risk factors of
#QT_prolongation
➤Doses above 16 mg
➤Personal or family history of
#Long_QT_Syndrome
➤
#Hypokalemia
/
#Hypomagnesemia
➤
#Heart_failure
➤Administration of concomitant
#Medications
that lead to QT prolongation
➤Multiple doses or IV Ondansetron
0
0
11
💊
#Paroxetine
: the Best time to take
➤Administration with food may decrease
#Gastrointestinal
side effects.
➤Administer preferably in the
#morning
.
➤When used for
#vasomotor
symptoms of
#menopause
, administer at
#bedtime
.
#Paxil
#Pexeva
0
0
11
💢
#Levodopa
:
#Protein
Interaction
✔️Large neutral AAs (e.g.
#phenylalanine
,
#tyrosine
, &
#tryptophan
) compete with L-dopa for absorption into the
#brain
.
⚠️Avoid high protein diets.
✅Distribute dietary protein throughout the day to avoid
#fluctuations
in levodopa absorption.
1
5
10
🫁
#Asthma
:
#NSAID
use
✅Selective COX-2 inhibitors (
#Celecoxib
&
#Etoricoxib
) are well tolerated by most N-ERD patients
✅NSAIDs with weak inhibitory action toward COX-1 & preferential COX-2 inhibitors given at pharmacological
doses, do not usually cross-react with other NSAIDs
NSAIDs are contraindicated in Asthma.
NSAIDs work by inhibiting both COX-1 and COX-2, leading to decrease in production of prostaglandins.
Prostaglandins have various effects in body, including promoting inflammation. In people with asthma,
Continue👇
5
70
256
0
3
11
💢
#Essential_Tremor
: Max. Dose
✅First-Line
➤
#Propranolol
320mg
➤
#Primidone
500mg
➤Other
#beta_blockers
#Atenolol
150mg
#Metoprolol
150mg
✅Second-Line
➤Propranolol+Primidone 260mg/day+1000mg
➤
#Gabapentin
1200mg
➤
#Topiramate
400mg
➤
#Alprazolam
3mg or
#Clonazepam
6mg
0
5
11
⚠️Which drugs have been associated with an increased risk of
#VENOUS_THROMBOSIS
❓
➤
#Oral
&
#Transdermal
#Contraceptives
➤
#Hormone_Replacement_Therapy
➤
#Testosterone
➤
#Tamoxifen
➤
#Bevacizumab
➤
#Glucocorticoids
➤
#Antidepressants
➤
#Tranexamic_acid
#DVT
#Pulmonary_Embolism
2
0
10
💢
#Benzodiazepine
(BZD):
#Tapering
🔶
#Taper_Rate
: 25 to 50% every 1 to 2 week over a period of 6 to 10 weeks.
🔶
#Options
:
✔️The BZD that the patient is already taking
✔️Switching the BZD to a long-acting agent to complete the taper (i.e.
#Diazepam
or
#Chlordiazepoxide
)
💢
#Benzodiazepines
(BZD): Use in the
#elderly
⚠️Numerous studies of BZD use have found an increased risk of:
✅
#Falls
✅
#Fractures
✅
#Cognitive_Dysfunction
✅
#Overdose
death when combined with
#opioids
‼️BZD use has been linked with an increased risk of all-cause mortality.
4
2
11
2
3
10
💢
#Helicobacter_pylori
#Eradication
:
#Probiotics
#Adjunctive_Therapy
➤Studies have shown benefits in addition of Probiotics to
#Regimens
:
✅Increased
#Cure_rates
~2fold
✅Reduced the
#Antibiotic
#side_effects
by 1/3
⚠️Studies were at high risk of bias!
0
2
9
💢
#Amitriptyline
2% Vs.
#Lidocaine
2%: comparison of
#Anesthetic
&
#Analgesic
Effect
‼️Amitryptiline gel showed a better control of symptoms than the current drug of choice for
#local_anesthesia
(Lidocaine) in
#Dental_Surgery
.
0
3
10
⚠️
#Anabolic_Steroids
:
#Mortality
Among Users
💀Anabolic Steroids are associated with more than 2 times increase in risk of
#Death
(by both natural & unnatural causes) in users comparing control participants.
✔︎
#Performance_Enhancing_Drugs
✔︎
#Doping
🔗
💢
#Anabolic_Steroid
–induced
#hypogonadism
✔️ Anabolic-androgenic steroid users commonly report side effects such as
#testicular_atrophy
,
#fluid_retention
,
#acne
,
#gynecomastia
, and
#alopecia
.
#Sexual_dysfunction
was reported by 25% of users.
0
1
8
1
1
10
👩🏻
#PMS
/
#PMDD
: SSRI Regimens
✅
#SSRIs
are suggested as the first-line options for
#women
with moderate to severe
#premenstrual_syndrome
.
❇️SSRIs can be administered as:
1️⃣Continuous daily therapy
2️⃣
#Luteal_phase
-only treatment (starting on cycle day 14)
3️⃣Symptom-onset therapy
2
2
10
#Levonorgestrel
: Efficacy based on
#body_mass_index
(
#BMI
)
Use as an
#emergency_contraceptive
may be less effective in patients with higher BMIs.
🤰Pregnancy risk:
BMI ≥30 kg/m2=5.8%
BMI 25 to 29.9=2.5%
BMI ≤25 kg/m2=1.6%
0
2
10
💢
#Calcium_Carbonate
: Administration
✅Take with
#food
Food may increase
#calcium
#absorption
✅Limit intake of foods high in
#oxalates
, or whole grain cereals that may decrease calcium absorption
✅Doses>600mg elemental calcium per day should be divided for optimal absorption
0
1
10
Bulk-forming
#Laxatives
:
🌾
#Fiber_supplements
can be used as first-line in patients with
#mild_chronic
#Constipation
.
✅
#Psyllium_seed
❎
#Methylcellulose
❎
#Calcium_polycarbophil
❎
#Wheat_dextrin
⚠️Avoid if there is documented slow transit constipation as aggravation is likely.
0
0
10
💤
#Insomnia
disorder:
#Benzodiazepine
receptor agonists (BZRAs) with
#regulatory_approval
✅
#Nonbenzodiazepine
#BZRAs
: ➤
#Eszopiclone
➤
#Zaleplon
➤
#Zolpidem
✅
#Benzodiazepine
#hypnotics
:
➤
#Estazolam
➤
#Flurazepam
➤
#Temazepam
➤
#Triazolam
➤
#Quazepam
0
2
10
💢
#Trimipramine
vs
#Imipramine
✅Trimipramine enhanced
#rapid_eye_movement
(
#REM
)
#sleep
and
#slow_wave
#sleep
, but imipramine suppressed REM sleep and showed no effect on slow wave sleep.
✅In contrary to Imipramine, Trimipramine decreased
#Nocturnal
#cortisol
#secretion
.
0
0
9
#Novo_Nordisk
announcement:
a double-blinded
#trial
in 17,604 aged 45 years or older with
#Overweight
or
#Obesity
Once-weekly
#Subcutaneous
injection of 2.4mg
#Semaglutide
showed a 20% reduction in major
#Adverse
#Cardiovascular
events for up to 5 years in patients.
#Wegovy
1
3
9
💢
#Acute
#Migraine
:
#NSAIDs
with reported efficacy
✔️
#Aspirin
up to 1000mg
✔️
#Ibuprofen
up to 600mg
✔️
#Naproxen
up to 825mg
✔️
#Diclofenac
up to 100mg
✔️
#Diclofenac_epolamine
65mg
✔️
#Tolfenamic_acid
200mg
✔️
#Dexketoprofen
50mg
✔️
#ketorolac
30mg IV/60mg IM
✔️
#Acetaminophen
1000mg
0
2
9
💢
#Antacids
: Max. Daily Dose
✅
#Calcium_carbonate
8g/day
✅
#Sodium_bicarbonate
2.6g every 4 hours
✅
#Aluminum_hydroxide
640mg 6 times daily
✅
#Magnesium_carbonate
420mg QID
✅
#Magnesium_hydroxide
1.2g (15 mL) QID
✅
#Magnesium_trisilicate
56.8mg QID
✅
#Magnesium_oxide
400mg BID
0
1
10
🤰
#Severe_Depression
in
#Pregnancy
:
#Antidepressants
✅Patients who were successfully treated with antidepressants before pregnancy:
➤Receive the same drug
✅Patients who have not used antidepressants:
➤
#SSRIs
as the initial treatment
❎
#MAOIs
are not used during pregnancy
2
0
10
💢
#Hydrochlorothiazide
: off-label use
✔️
#Calcium
#Nephrolithiasis
, prevention:
➤25mg once daily. up to 100mg/day in 1 to 2 doses
➤Titrate based on
#tolerance
and
#urinary
#calcium
levels.
✔️
#Diabetes_insipidus
,
#Nephrogenic
: to help reduce
#polyuria
.
➤25mg 1 or 2 times daily
0
4
10
🐟
#Omega3
: beyond TG-Lowering
✅Current hypotheses include
#pleiotropic_effects
mediated by EPA & downstream
#Antiinflammatory
&
#Antithrombotic
effects.
✅
#EPA
has been shown to mitigate
#Atherosclerosis
by diminishing markers of
#inflammation
.
🔗
1
1
10
#CROUP
(
#Laryngotracheitis
):
💢
#Glucocorticoid
therapy is recommended for
#Children
with mild croup who are seen in the
#outpatient
setting and all children with moderate to severe Croup.
➤Oral Single Dose of:
#Dexamethasone
0.15 to 0.6 mg/kg
max=16 mg
OR
#Prednisolone
1 mg/kg
0
0
7
👁️
#Hordeolum
(
#Stye
):
#Management
💢Most
#hordeola
resolve spontaneously over 1 to 2 weeks.
♨️
#Massage
and gentle wiping of the affected
#eyelid
after the
#warm_compress
can aid in
#drainage
.
💢Frequent hordeola may respond to
#topical
#Antibiotic
/
#Corticosteroid
#ointment
.
0
0
9
🦴
#Bone_Loss
Reduction (
#postmenopausal
): Lifestyle Measures
✅Optimal Diet
➤
#Calcium
(1.2g)
➤
#Vitamin_D
(800IU)
➤
#Protein
(0.8g/kg/day)
✅Exercise
➤
#Weightbearing
~>30 mins, 5-6 days/week
➤Muscle-strengthening &
#posture_exercise
~2-3 days/week
❌
#Smoking
❌
#Heavy_alcohol
With osteoporosis breaking a bone is often the first sign
#KnowYourRisk
Take
#quiz
#OsteoporosisMonth
#unbreakable
0
15
20
2
2
10
💢
#Calcium
#Supplements
:
#Pregnancy
and
#Breastfeeding
🍼Calcium is required for
#milk
production. The amount of calcium in
#breast_milk
is regulated
#homeostatically
.
✔️Calcium requirements are NOT increased in
#lactating
and
#pregnant
women.
0
1
9
😴
#Beta_blocker
:
#Nightmares
🟢
#Lipophilic
β-blockers and those with higher
#Serotonin
#5HT1A_Receptor
affinity, shorter half-lives, and lack of α-blockade i.e:
✅
#Propranolol
✅
#Metoprolol
✅
#Pindolol
are more likely to cause nightmares.
1
2
10
⁉️
#Methotrexate
(MTX) and
#Folate
supplements
💢
#Folic_acid
or
#Folinic_acid
reduces side effects and the incidence of MTX
#toxicity
.
‼️Although daily use of folic acid does not appear to affect MTX efficacy, dosing of folinic acid close to MTX, may hinder MTX efficacy.
0
0
10
💢
#Ondansetron
:
#Serotonin_Syndrome
Risk
#Serotonin
#Syndrome
has been reported following
#5HT3_antagonists
overdose and also when used in combination with other
#Serotonergic
agents:
✔️
#SSRIs
✔️
#SNRIs
✔️
#MAOIs
✔️
#Mirtazapine
✔️
#Fentanyl
✔️
#Lithium
✔️
#Tramadol
✔️
#methylene_blue
@Shadihaddadi
@NotableDrugInfo
That’s true! Constipation and diarrhea are both side effects of 5HT3 antagonists but Constipation is more Frequent.
Diarrhea occurs more in cases of overdose and Serotonin syndrome.
0
0
2
1
3
10
In patients with preexisting
#Cardiovascular_Disease
and
#Overweight
/
#Obesity
but without
#diabetes
, weekly SC
#Semaglutide
at a dose of 2.4 mg was superior to placebo in reducing the incidence of
#Death
from
#cardiovascular
causes,
#Nonfatal
#MI
, and non-fatal
#stroke
.
@NEJM
0
1
10
💢
#PPIs
given once daily are effective in most Gastro-esophageal
#reflux
disease (
#GERD
) patients.
💢In patients
#refractory
to this consider twice-daily dosing, the doses being given before
#breakfast
and
#dinner
.
0
5
10
#Claudication
: Pharmacological Therapy
✅Beneficial
#Cilostazol
#Naftidrofuryl
✳️Benefit not firmly established
#Statin_therapy
#Antiplatelet_agents
#Pentoxifylline
❎Ineffective
#Anticoagulants
#hormone_replacement_therapy
#Ginkgo_biloba
#Padma_28
#Garlic
#Vitamin_E
0
0
8
#Fluoxetine
#Prozac
90mg
Delayed release (once-weekly formulation):
Immediate-release fluoxetine 20 mg/day = delayed-release fluoxetine 90 mg/week.
#Social_anxiety_disorder
#SSRI
#Antidepressant
0
2
9
💢
#Cold_Sores
:
#Recurrent_infections
Episodic treatment must be initiated quickly to be effective (<48h).
✅
#Acyclovir
(400mg TDS for 5 days)
✅
#Famciclovir
(750mg BID for 1 day or 1500mg as a single dose)
✅
#Valacyclovir
(2g BID for 1 day)
✔️We do NOT use topical antivirals.
1
2
9
💢Approximation for the
#Spectrum
of activity for commonly used
#Antibiotics
and common
#Pediatric
#Infections
.
✔️Exact sensitivities will change with different resistance patterns.
0
1
9
💉
#Zilebesiran
:
#Angiotensinogen
inhibition
✅In a phase 2 trial, SC Zilebesiran doses of 150, 300, or 600 mg every 6 months decreased
#systolic
BP at 3 and 6 months vs placebo.
✳️Non-serious drug-related
#adverse_events
occurred in 16.9% of patients.
🖇️
0
0
7
💢Coadministration of Various
#Calcium
Formulations (
#Calcium_Carbonate
,
#Calcium_Citrate
, and
#Calcium_Acetate
) in doses containing 500 mg
#elemental
calcium significantly reduces
#Levothyroxine
absorption by about 20%–25% compared with levothyroxine given alone.
0
0
9
👃
#Intranasal
#Varenicline
:
👁️
#Dry_Eye_Disease
✔️An
#FDA
-approved treatment for dry eyes.
✔️A
#nicotinic
#acetylcholine
#receptor
#agonist
.
✔️The suspected mechanism of action is by activating the
#trigeminal
#parasympathetic
pathway to stimulate natural
#tear_production
.
0
1
9
Recent-Onset
#Constipation
in
#infants
: Interventions
➤
#Lactulose
(1ml/kg/day)
➤
#Glycerin
suppositories (A tip of the pediatric suppository)
➤
#Rectal_stimulation
with a lubricated rectal
#thermometer
➤
#Sorbitol
-containing
#juices
(eg,
#apple
,
#prune
, or
#pear
)
0
0
9
💢
#Kidney_Stone
: Preventive Measures
✅increase
#Fluid
intake
➤ produce at least 2L urine/day
✅Limit
#Sodium
intake
➤ Enhances
#Calcium
reabsorption
✅Increase
#Fruit
and
#Vegetable
intake
➤ increases
#Citrate
excretion &
reduce
#Calcium_Oxalate
stone formation
✅
#Lose_Weight
0
2
9