DRUGS OF CHOICE[Pharma]

CNS:-
1. GAD- buspirone for chronic Rx (ssri first line Rx)
2. PMDD- ssri
3. OCD- ssri

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4. Trigeminal/facial neuralgia- TCA

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5. Nocturnal enuresis- TCA
6. Acute anxiety state- benzodiazepine

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7. Panic disorder- alprazolam
8. Phobia- alprazolam/clonazepam

C
9. Muscle spasticity (muscle strain/cerebralPalsy/MS)diazepam
10. Induction of anesthesia-thiopental,midazolam,methohexital
y
11. Insomnia caused by inability to stay asleep= temazepam
ud
12. Insomnia with diff going to sleep- triazolam
13. Benzodiazepine antag= flurazepam
St

14. Opiod constipation= senna + docusate

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ic

BLOOD:-
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1. Acute aron intoxication= deferoxamine

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2. Chronic iron intoxication= if genetic= phlebotomy,if acquired=

deferoxamine/deferasirox
3. Pernicious anemia/anemia caused by gastric resection=
hydroxocobalamin/cyanocobalamin
4. Anemia associated with renal failure & anemia due to
myelosuppression/cancer chemotherapy= epoetin alfa
5. Thrombocytopenia after cancer chemotherapy= oprelvikin (IL11)
6. Idiopathic thrombocytopenia (which has failed to respond to
conventional treatment)= romiplostim

Shared By: Ussama Maqbool(N61)

7. Anticoagulant used in DVT,P.E,CEREBRAL EMBOLISM,prevention of clot
in extra corporeal circulation during hemodialysis/by pass surgery=
HEPARIN (chronic anticoagulation= WARFARIN)
8. Prevention of stroke in patient of atrial fibrillation= Aspirin
(immediately), warfarin (for chronic therapy) other drugs are rivoxaban
(oral direct factor 10A inhib)..dabigatran (oral direct thrombin inhib)
9. Rx of HIT= discontinue heparin & administer ARGATROBAN (direct
thrombin inhibitor)
10. Percutaneous coronary angioplasty= BIVALIRUDIN
11. Anticoagulant used in pregnancy= HEPARIN

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12. Prevention of thrombi in cancer patients= LMWH
13. P.E with hemodyanamic instability,severe DVT (eg superior vena caval

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syndrome), ascending thrombophlebitis of ileofemoral vein/within 3hrs
of acute MI= FIBRINOLYTICS (eg alteplase)

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14. Primary prophylaxis of MI= Aspirin 325mg
15. Primary prophylaxis of thromboemboli in patients with prosthetic heart
y
valves = dipyridamole + warfarin
ud
16. Secondary prevention of ischemic stroke= dipyridamole + aspirin
17. Intermittent claudication= cilostazol,pentoxifylline
St

18. Prevention of throboemboli in patient with coronary stent=

TICLODIPINE + ASPIRIN
al

19. To reverse anticoagulant effects of excess warfarin= large doses of vit K

(phytonadione)
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20. To prepare patients with mild hemophilia A/von willibrand factor for
ed

elective surgery= desmopressin acetate (v2 receptor agonist)

21. Prevention/management of acute bleeding episodes in patients of
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hemophilia/other bleeding disorders= aminocaproid acid/ tranexamic

acid
22. Primary chylomicronemia (chylomicrons,vldl inc,deficiency in LPL or
apoCII= niacin,fibrate
23. Familial hypertriglyceridemia(inc vldl,chylomicrons)= niacin,fibrate
24. Familial combined hyperlipoprotenemia : vldl
inc=niacin,fibrate,statin….ldl inc= niacin,statin,ezetimibe…both vldl,ldl
inc=niacin,statin

Shared By: Ussama Maqbool(N61)

 25. Familial dysbetalipoprotenemia (vldl remnants,chylomicron remnants
inc,def in apoE)= fibrate,niacin
26. Familial hypercholesterolemia(ldl inc,defect in ldl recep)=
heterozygous=
statin,resin,niacin,ezetimibe…homozygous=niacin,atorvastatin,rosuvast
atin,ezetimibe
27. Mild to moderate pain esp pain of musculoskeletal inflammation &
arthritis= NSAIDS other than aspirin (iboprufen,naproxen etc)
28. Headache= = NSAIDS other than aspirin (iboprufen,naproxen etc)

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29. Dysmenorrhea= NSAIDS other than aspirin (iboprufen,naproxen etc)
30. Closure of patent ductus arteriosus= iboprufen (indomethacin can also

en
be given)
31. To reduce risk of colon cancer= non selective NSAIDS

C
32. NSAIDS with reduced risk of GIT bleed= cox2 selective inhib
(celecoxib,rofecoxib,valdecoxib)
y
33. Fever in children with viral infections= acetaminophen
ud
34. Rx of Acute gouty arthritis= Indomethacin/glucocorticoid
35. Prophylaxis of gout in person with history of such attacks= colchicines
St

36. Chronic gout Rx= uricosuric (probenecid,sulfinpyrazone),xanthine

oxidase inhib (allopurinol,febuxostat)
al

37. Management of familial medeterranian fever= colchicines

38. To slow uric acid formation in cancer patients= allopurinol as adjunct
ic

to cancer chemo
ed
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GIT:-
1. Peptic ulcer,GERD,erosive gastritis= proton pump inhib
2. Otc for symptomatic relief of heart burn= Antacids
3. Gastric parieses (eg in diebetics)= domperidone/metoclopromide
(erythromycin useful but tolerance develops)
4. Colonic pseudo obstruction in hospitalized patients= neostigmine
5. IBS with diarrhea in women= alosetron

Shared By: Ussama Maqbool(N61)

 6. IBS with constipation in women= lubiprostone
7. Prevention of chemotherapy induced & post operative nausea & vomiting
= 5HT3 antagonist (eg
ondensetron,granisetron,dolasetron),aprepitant(NK1 antag)
8. Antiemetic iv cocktails contain = dexamethasone
9. Antiemetic in motion sickness= scopolamine
10. Bowel prep for endoscopy= Mg(OH)2 & other non-absorbable salts &
sugars
11. Non specific, non infectious diarrhea= loperamide
12. Travelers diarrhea = antibiotics,colloidal bismuth compounds

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13. Mild IBD= 5.amino salicylate,antibiotics,budesonide,topical
corticosteroids

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14. Moderate IBD= azathioprine/mercaptopurine, antag of

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TNF,methotrexate,oral corticosteroids
15. Severe= cyclosporine,natalizumab,surgery,iv corticosteroids
y
16. Pancreatic insufficiency due to cystic fibrosis,
ud
pancreatitis,pancreatectomy= pancrelipase
17. Gall stones in patients refusing or not eligible for surgery= ursodiol
St

18. Carcinoid tumor= phenoxybenzamine,cyproheptadine

19. Pruiritis= cyproheptidine
al

20. Diebetic diarrhea= clonidine

ic
ed

ENDO:-
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1. GH deficiency replacement,increase final height in syndromic

children,short bowel syndrome,wasting in HIV= Somatropin
2. Anti aging program = somatropin(recombinant human GH)
3. Replacement in IGF-1 deficiency not responsive to exogenous GH=
mecasermin (recombinant form of IGF-1)
4. Acromegaly,several other hormone sec tumors= octreotide
5. acute control of bleeding from esophageal varices= octreotide,
vasopressin

Shared By: Ussama Maqbool(N61)

 6. Nesidioblatosis (WDHA syndrome)= octreotide
7. Diabetic diarrhea= octreotide,clonidine
8. Scintigraphy for localization of neuroendocrine tumors= octreotide
9. In women from disorder (eg uterine leiomyoma,endometriosis) that
benefits from Ovarian supression, controlled ovarian
hyperstimulation,central precaucious puberty= leuprolide(LH analog)
10. advanced prostate cancer= leuprolide(LH analog),abarelix,degarelix
11. Prevention of premature LH surges during controlled ovulation
hyperstimulation= ganirelix(GnRH antag)
12. Hyperprolactinemia Rx= bromocriptine (D2 agonist)

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13. Induction & augmentation of labour = oxytocin
14. Control of uterine hemorrhage after delivery= oxytocin

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15. Tocolytics= b2 agonists (ritudrine,terbutaline),atosiban,mgSO4,nifedipine
16. Hemophilia A & von willebrand disease= desmopressin

C
17. Pituitary D.Insipidus= desmopressin,vasopressin
18. Dilutional hyponatremia (SIADH)= Conivaptan,demeclocycline
y
19. Hypothyroidism = levothyroxine(T4), liothyronine (T3)
ud
20. Hyperthyroidism= PTU,Methimazole, radioactive iodine I131
21. Prep for surgical thyrodectomy= lugol’s soln,potassium iodide
St

22. Thyroid storm = propanolol

23. Medical abortion= mifepristone (RU-486), misoprostol
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24. Hirsuitism= combined oral contraceptive, spironolactone, flutamide, GnRH

agonist
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25. Oral hormonal contraceptive= ethinyl estradiol

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CHEMO:-
1) Acute pharyngitis/ tonsillitis= pen G/pen v
2) Strep endocarditis= benzyl penicillin
3) Enterococcal endocarditis= penicillin g /ampicillin + aminoglycoside
4) Pneumoccal pneumonia= pen G/v,ampicillin,amoxicillin
5) Otitis media & chronic bronchitis = ampicillin/amoxicillin
6) Gonococci= ceftriaxone, procaine penicillin divided & given at two sites IM
and then probenecid given po,spectinomycin (back up drug)

Shared By: Ussama Maqbool(N61)

7) Meningococcal meningitis= pen iv,ceftriaxone,cefotaxime
8) Syphilis= benzathine pen
9) Actinomyces= pen g
10) Clostridial infect= pen g
11) Enterococcal= amoxicillin
12) Hemophilus= ampicillin,cefamandole,cefuroxime,cefaclor
13) Bacteriods fragilis & serratia=
doc=metronidazole,others=cefoxitin,cephamycins
(cefotetan,cefmetazole),ceftizoxime,moxalactam, metronidazole
14) Psud.aerogenosa= ceftazidime,cefoperazone

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15) Activity against MRSA= ceftaroline,ceftobiprole
16) Pneumonia= cefuroxime

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17) Enteric fever(typhoid)=
ciprofloxacin,ceftriaxone/cefepime,ampicillin,chloramphenicol

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18) Surgical prophylaxis (clean surgery)= cefazolin
19) Elective bowel surgery= oral neomycin + poorly absorbed formulation of
y
erythromycin
ud
20)Bowel perforation = 2/3 gen cephalo
21) Acute otitis media = ceftriaxone,amoxicillin
St

22) Skin soft tissue,uti= cephalexin

23) MRSA= vancomycin, tigecycline,linezolid
al

24)VRE= tigecycline,daptomycin,linezolid
25) VRSA= daptomycin,linezolid,
ic

26)Atypical pneumonia= tetracyclines

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27) Leptospirosis= doxycycline

28)Rx of acne= doxycycline
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29)Prophylaxis against infect in chronic bronchitis= tetracyclines

30)Meningococcal carrier stage= minocycline,fluoroquinolones,rifampicin
31) Syphilis + gonorrhea= azithromycin
32) Pertusis & diphtheria= erythromycin
33) Pneumonia in pregnancy= erythromycin
34)Chlamydial urethritis= azithromycin,7 day course of ofloxacin
35) Legionellosis= azithromycin
36) UTI= ciprofloxacin,ofloxacin,triple sulfa,sulfisoxazole (uncomplicated uti=
b-lactams)

Shared By: Ussama Maqbool(N61)

37) Ocular infections(bacterial conjunctivitis)= sulfacetamide
38)Burn infect= mafenide,silver sulfadiazine
39) Toxoplasmosis= oral sulfdiazine + pyrimethamine + folinic acid
40) Bacterial diarrhea= ciprofloxacin
41) Bone & joint infect= fluoroquinolones
42)Resp tract infect in patients with systemic fibrosis= resp fluoroquinolones
(sparfloxacin,levofloxacin)
43)Rx & prophylaxis of anthrax= ciprofloxacin
44) Empiric Rx for Fever in granulocytopenic patient of cancer chemo =
ciproflox + amoxicillin (if no response then amphotericin B)

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45)Lyme’s disease= doxycycline
46) Enterococcal endocarditis= streptomycin + pen g

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47) Plague & tularemia= streptomycin + pen g
48) Elimination of bowel flora = neomycin

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49) Mite/lice= lindane
50)Scabicide= crotamiton,permethriny
51) Pediculosis = permethrin,malathion
ud
52) Leprosy= dapsone + rifampin +/- clofazimine
53) Prophylaxis if cd4 count less than 50ul= clarithromycin/azithromycin +
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rifabutin
54)Rocky mountain spotted fever= tetracycline (if allergic= chloramphenicol)
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55) Nocardiosis = TMP-SMZ,sulfadiazine

56) Prophylaxis of pneumocystis jeroveci in AIDS= TMP-SMZ,sulfadiazine
ic

57) Cmv= ganciclovir,valganciclovir

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58)HSV,VZV= acyclovir (famciclovir,penciclovir,valacyclovir)

59) HBV= IFN-a,lamivudine
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60) HCV= IFN-a

61) Influenza= oseltamivir
62)Maj antiretroviral = (NRTI= zidovudine, NNRTI= delavirdine, protease inhib=
indinavir, CCR-5 antagonist= maraviroc, fusion inhib= enfuvirtide)
63) Prophylaxis & Rx in areas without resistant falciparum,Rx of vivax & ovale
= chloroquine
64) Resistant falciparum(Rx + prophylaxis) = mefloquine
65) Rx of resistant falciparum= quinine
66) Eradication of liver stages of vivax & ovale= primaquine

Shared By: Ussama Maqbool(N61)

67) Prophylaxis & Rx of muldi drug resistant malaria= antifolate,atorvaquone-
proguanil(malarone)
68) Rx of MDR malaria= artesunate,artemether
69) Leishmania= sodium stibogluconate
70) Trypanosoma= melarsoprol,nifurtimox
71) Ascaris (round worm)= albendazole/mebendazole/pyrental pamoate
72) Ancylostoma (hook worm)= pyrental pamoate,albendazole,mebendazole
73) Strongyloides (threadworm)= ivermectin
74) Schistoma= praziquental
75) Cysticercosis & hydatid disease= albendazole

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76) Taenia= praziquental,niclosamide
77) Hodgkin lymphoma= ABVD regimen

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(adriamycin,bleomycin,vincristine,dacarbazine) + prednisolone
78) Non-hodgkin lymphoma= CHOP =

C
cyclophosphamide,doxorubicin,vincristine,prednisolone)
y
79) Testicular Ca= PEB regimen= cisplatin,etoposide,bleomycin
ud
80) Prostate Ca= leuprolide ,abarelix, flutamide
81) Lung Ca= paclitaxel
St

82)Cryptococcal meningitis= fluconazole

83)Fungal systemic infection by blastomyces,sporothrix,chromomycosis=
al

itraconazole
84) Fungal meningitis= amphotericin B (intrathecal adm)
ic

85)Mycotic corneal ulcers & keratitis = amphotericin B

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86) Systemic mycoses= amphotericin b

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87) Invasive aspergillosis= voriconazole (salvageRx= posaconazole)

88) Dermatophytes = nystatin,griseofulvin,terbinafine,ketoconazole
89) Esophageal & oropharangeal candiasis= fluconazole
90) Oncomycosis= terbinafine, griseofulvin,
91) Eradication of GIT fungi= nystatin
92)Mucormycosis = posaconazole
93) Ectopic pregnancy= methotrexate
94) Chronic HBV= INFa
95) Acute HCV (prevention from getting chronic)= INF a + Ribavarin

Shared By: Ussama Maqbool(N61)

 96) Chronic HCV= (pegylated INF + ribavarin)
97) Kaposi sarcoma= IFNa
98) HPV= INF a
99) Prevent of herpes zoaster in cancer pt= INFa
100) Reduce CMV shedding after renal transplant= INF a

CVS:-

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1. Post recent MI arrhythmia = lidocaine (then bretilium)

en
2. PSVT= adenosine (then esmolol)
3. Ventricular tachycardia & ventricular fibrillation= amiodarone
4. Atrial fibrillation associated heart failure= digitalis

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5. diebetes me type 1 me insulin dete he(mixture of short & long acting
y
forms),pramlintide can be given pareterally(control post prandial
ud
glu)....type 2 me initially monotherapy with metformin then later on
combination of secretagogues/insilun + agents augmenting insulin
St

action(metformin,thiazolidinediones,alpha glucosidase inhib)

chf me start with diuretics & Ace inhib..if not useful then digitalis....beta blokers
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not in acute condition,use when patient is stable

ic

use pde inhib for short term in very severe cardiac failure,long term causes high
mortality
ed

sympathomimetics (dobutamine/dopamine) use= post cardiac surgery heart

failure,post MI heart failure leading to shock,before heart transplant..use them
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intermittently

Shared By: Ussama Maqbool(N61)