Final pharm exam (1).docx

Cholinesterase inhibitors donepezil rivastigmine

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Cholinesterase Inhibitors -donepezil, rivastigmine, galantamine Work more for memory and attention Do not reverse cognitive loss Slow progress only to a modest degree More appropriate with mild to moderate cognitive impairment Side effects, ADEs Diarrhea, nausea, and vomiting – Bradycardia and/or hypo- tension Insomnia or other sleep disturbances NMDA Antagonists - mematins • Indicated for moderate to severe Alzheimer’s • Can be used in addition to cholinesterase inhibitors • Often added when cholinesterase inhibitors are having minimal effect • Questionable effectiveness with severe cognitive impairment • ADEs (generally less than the cholinesterase inhibitors) – Dizziness – Agitation and delusional behaviors in some patients with Alzheimer’s disease Impetigo is typically caused by: Staph aureus Strep pyogenes First line topical (for mild cases)—mupirocin (Bactroban)-tid 7-10 days First line oral antibiotics Treat for 7-10 days Cephalexin (Keflex) Dicloxacillin Augmentin (amoxicillin- clavulanate) Second line Treat for 7-10 days Different antibiotic If suspect pseudomonas—use fluoroquinolone with caution Cellulitis is typically caused by: Strep pneumo Staph aureus Must consider MRSA Treatment Cellulitis always requires oral antibiotics: First line oral antibiotics If MRSA not suspected Dicloxacillin Pen VK Augmentin (amoxicillin-clavulanate) If MRSA suspected Bactrim, Linezolid Clindamycin Doxycycline/ minocycline Second line Admission for IV abx. Seborrheic Dermatitis is typically caused by: Increased sebum production S. Malssezia (fungus) Treatment Mild—in young children: Antiseborrheic shampoos Selsun Blue Head and Shoulders Avoid contact with baby’s eyes and rinse thoroughly after use Low dose topical steroid lotion or gel (i.e. desonide lotion) to help with itching Moderate to severe: Griseofulvin—safe in young children, increases keratin resistance to fungus, N.V/D, photosensitivity, HA Monitor liver, renal, may aggravate lupus, decrease barbiturate/OCP/cyclosporine, increase warfarin Take with fatty meal Diaper Rash is typically caused by: Inflammation from contact with urine and feces Candida albicans Possible fungal component Treatment Barrier medications to protect the skin (A&D, zinc oxide, etc) Low dose hydrocortisone (Cortaid) short duration only
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o Use in the diaper area would be occlusive and cause this to be more potent. Mycostatin if infected with C. Albicans Allergic Contact Dermatitis is typically caused by: Commonly- Poison Ivy, oak, sumac Occurs within 1 to 7 days of exposure Must be allergic to have a reaction—if not allergic—will not get the rash! Treatment for localized rash Use topical steroids to control inflammation, decrease edema, and pruritus Use potency necessary to resolve the rash — may need to increase or occlude to increase absorption Use oral antihistamines, such as diphenhydramine, hydroxyzine, as needed Treatment for spreading diffuse rash 2 to 3 week course of oral steroids—1 mg/kg/d decreased by 5 mg every 2 days—
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  • Summer '17
  • Selective serotonin reuptake inhibitor, Serotonin Syndrome, cimetidine, griseofulvin

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