Clinical Pharm Treatments

Front 1

Acne rosacea: tx (2)

Back 1

o Low-dose oral tetracycline 500-1000 mg/d
o Topical metronidazole 0.75% gel: 1% gel

Front 2

Acne vulgaris: tx (2)

Back 2

o Adapalene (Differin) 0.1% Gel, apply topically at night.
o Topical benzoyl peroxide: apply in the morning.

Front 3

Anxiety: tx (4)

Back 3

o CBT – benefit in medical management and improves comorbid conditions like depression
o Medications:
Lexapro (escitolopram - SSRI) 10mg po daily or
Valium (diazepam - benzo) 10mg po daily or
Xanax (Alprazolam) 1mg po daily

Front 4

Asthma: tx

Back 4

o Albuterol
- Low dose ICS (Advair, Buesonide) - long term tx

Front 5

Atrial fibrillation: tx (2)

Back 5

o warfarin anticoagulation
o metoprolol 2.5-5mg IV bolus over 2 min, up to 3 doses,
- f/b oral metoprolol to control HR.
- discharge on warfarin and f/u weekly to monitor INR levels.

Front 6

Balanitis: tx (2)

Back 6

o Nystatin if cause is fungal – apply bid
o Bacitracin if bacteria is the cause – apply qid

Front 7

Dog bite: (2)

Back 7

o Augmentin 500mg TID x 7 days. Recheck pts wound within 24 – 48 hrs.

Front 8

Blepharitis: tx (1)

Back 8

o Start Bacitracin (500 units/g) topical ophthalmic ointment with cotton-tipped applicator.

Front 9

Bronchiolitis: (2)

Back 9

o 1 mL Nebulized Albuterol, then Nebulized dexamethasone 2 mg in 3 mL NS. Monitor and re-administer prn.

Front 10

Bronchitis (acute): tx (4)

Back 10

o Inhaled bronchodilator-beta 2 agonist taken prn such as albuterol
o acetaminophen or Ibuprofen prn
- an antitussive at night (Robitussin)

Front 11

Burns: tx (2)

Back 11

o Start IV morphine 10 mg q4hrs- be on alert for respiratory depression.
- Topical silver sulfadiazine (Silvadine) (risk leukopenia)
- PPI for stress ulcer prophylaxis

o Start fluid resuscitation: 2mL x 68kg x 5%= 6.8mL total (3.4mL first 8 hrs).

Front 12

Cellulitis (general): tx (3)

Back 12

o Admit, start on broad spectrum IV antibiotics to cover S. Aureus and Group A beta-hemolytic strep until cultures identify causative agent.
- PCN
- cephalosporins - cefaclor
- linezolid - diabetic foot ulcers

Front 13

Cellulitis (periorbital or orbital): tx (2)

Back 13

o Admit for IV ampicillin/sulbactam

Front 14

Cerumen impaction: tx, pt ed

Back 14

o Using the curette and suction, remove the cerumen. If there is still impaction and the TM does not appear to be ruptured, do a flush of the ear canal using warm H20 and a syringe.
o Consider any ototoxic meds pt may be on
o Patient education: avoid Q-Tip use and instructions for at-home flushing.

Front 15

Chlamydial pneumonia: tx (2)

Back 15

o 0.9% NS IV fluids.
o Start Azithromycin 500 mg IV q24h x2 or more days, then 500 mg PO q24h to complete 7-10 day course

Front 16

Chlamydial STD: drugs (2)

Back 16

o Azithromycin 1g po single dose
o Cefixime 400 mg po single dose for Gonorrhea.

Front 17

Common cold: tx, drugs (4)

Back 17

o Tylenol 2 500 mg tabs PO PRN fever, do not exceed 4g/day.
o Start Afrin NS 0.05% solution, 2-3 sprays in each nostril BID PRN nasal congestion.
o Chlorpheniramine 4mg QID until rhinorrhea and sneezing resolves.
o Dextromethorphan 10mg tab PO PRN cough. .

Front 18

Condylomata Acuminata (HPV): tx (2)

Back 18

o Application of 4% acetic acid (vinegar) and colposcopy.
o Imiquimod (Aldera) 5% cream to be applied once daily on 3 alternative days per week.

Front 19

Congestive heart failure: drug (2)

Back 19

o Furosemide & Lisinopril 5 mg daily

Front 20

Conjunctivitis (acute): (1)

Back 20

o Bacitracin ophthalmic ½ inch BID for 5 days due to usage of daycare

Front 21

Constipation -(1)

Back 21

o Psyllium 1 rounded tsp in 8 oz water po daily.

Front 22

Costochondritis: (2)

Back 22

o Trial of NSAIDs or continued use of acetaminophen per patient's preference.

Front 23

Crohn's dz: drugs (3)

Back 23

o Sulfasalizine 4g/d and folic acid 2mg/d to reduce risk of malignancy.
o Ciprofloxacin 500mg PO BID x 4 weeks to reduce inflammation and bacterial overgrowth.
o Loperamide (Immodium) 2mg PRN to avoid interference with daily life.

Front 24

Delirium: tx (5)

Back 24

o Normal Saline (0.9%) at 150 ml/hr for 12 hours repeated (d/c tylenol w/ codeine)
o Gentamicin 1.5 mg/kg intravenously; 3. every 8 hours for 7 days if infectious
o Lorazepam 2 mg/day IV divided bid
o Novolin R 0.5 units/kg/day
o acetaminophen 325 mg PO q 4-6 hrs
- capsaicin topical 0.05% apply affected area 3-4x daily prn??

Front 25

Dementia (reversible): Normal pressure hydrocephalus - tx (not drugs)

Back 25

o SPECIAL test: cogn. sx improve after 50 cc of CSF removal over 3 days
Counsel patient and caregiver on nutrition, personal hygiene and accident-proofing the home. Refer to surgeon for Ventriculoperitoneal shunt.

Front 26

Depression: drug (1)

Back 26

o Sertraline 50 mg po daily f/u in 2 wks

Front 27

Dermatitis (atopic): tx (2) & pt ed

Back 27

o Apply generous amounts of emollient creams on partially dried skin. Allow sun exposure for around 30 minutes if improvement shown.
- Follow up, if no improvement begin topical corticosteroids for skin and antihistamines for pruritus.

Front 28

Dermatitis (contact): tx (5)

Back 28

o OTC anti-itch medications to relieve your s&sx (Benadryl, calamine lotion).
prednisone taper at 60–80 mg/d PO, over 10–14 days
(widespread or large #of blisters)
Augmentin 500 mg bid x 10 days or topical bacitracin ointment. (bacterial infection @ rash site)

Front 29

Dermatitis (diaper): drug (2)

Back 29

o Give low-potency topical steroid (hydrocortisone 0.5- 1% t.i.d.)
- apply zinc oxide ointment or other barrier cream to the rash at the earliest sign and b.i.d. or t.i.d. (e.g., Desitin or Balmex)

Front 30

Dermatitis (seborrheic): tx (2)

Back 30

o Ketoconazole 2% shampoo (Nizoral Topical) 2x/wk.
o 1% hydrocortisone cream applied to affected area bid-qid.

Front 31

Diabetes insipidus: tx (1)

Back 31

o Central DI = Desmopressin (DDAVP) via parenteral or oral route is preferred.

Front 32

DM type 1: tx (3 steps)

Back 32

o 2 L/min of O2 via nasal cannula , start Normal Saline via established IV catheter and place patient on cardiac monitor,
- Give the patient insulin at 0.1 unit/kg/h IV unless the pts K+ is < 2.5 mg/dL
- then pt will receive 1 mEq/kg of potassium IV over one hour.

Front 33

DM type 2: drug (1+2, 3)

Back 33

o Metformin + sulfonylurea (Glipizide)
o prescribe an ACEi (captopril 25mg bid) to stabilize the patients’ blood pressure

Front 34

Diabetic ketoacidosis: tx (2 drugs), monitor

Back 34

o establish IV access, start isotonic crystalloid solution (0.9% saline)
- empirical naloxone for altered mental status.
- Administer insulin: IV infusion of regular insulin at 0.1 unit/kg/h.

Monitor: mental status, vital signs, urine output q30–60min until improved, then q2–4h every 24 h. Blood sugar q1h until <300 mg/dL, then q2–6h. Electrolytes (Na, K, HCO3) q2h. Ehosphate, calcium, magnesium q4–6h.

Front 35

Diarrhea (acute): drug (2)

Back 35

o Loperamide 4 mg followed by 2mg capsule after each unformed stool.
o Ciprofloxacin 750 mg 1 dose

Front 36

Dysmenorrhea: tx

Back 36

- Cefoxitin 2 g IV or cefotetan 2 g IV q 12h
- plus doxycycline 100 mg PO

Front 37

Dysphagia: tx (2)

Back 37

o antiacid to take prior to meals.
o Tagamet if symptoms weren’t getting better.

Front 38

Enuresis: pt ed

Back 38

o Educate and reassure patient and family members. Establish regular voiding habits, limit the amount of fluid intake and eliminate soda at lunch. Try alarm therapy, positive reinforcement, psychotherapy and family therapy

Front 39

Epididymitis: (1)

Back 39

o Ciprofloxacin 500 mg po bid for 10 days. - anti-inflammatory medications

Front 40

Epiglottitis: tx (1)

Back 40

o Empiric antibiotic tx: Cefotamime 100 mg/kg/d q8 hours for 7-10 or until the C&S results show conflicting sensitivity.

Front 41

Epitaxis: pt ed

Back 41

o Lidocaine or Oxymetazoline - stop blood loss & pain relief
- Direct pressure, lower part of nose for 15 min, seated, head tilted forward
- Nasal saline, petroleum jelly

Front 42

EBV: pt ed

Back 42

o incr. fluid intake, NSAIDs or acetaminophen for pain, and rest.
o Pt. education: If sxs worsen or has difficulty breathing pt. was instructed to RTC. Refrain from strenuous physical activity and contact sports for 3-4 wks and no kissing girlfriend

Front 43

Erysipleas: drug (1)

Back 43

o Penicillin V, 500mg PO q6h, 10-14- days

Front 44

Fever of unknown origin: labs, imaging, tx

Back 44

o Labs: CBC, peripheral blood smear, blood cultures, UA, urine culture, CMP, ESR, C-reactive protein
o Imaging: CXR, CT abdomen and pelvis
o Admit the patient if ill appearing

Front 45

Folliculitis: drug (1)

Back 45

o Mupirocin applied 2–5 times per day until the rash subsides.

Front 46

Gastritis: tx (1)

Back 46

o Discontinue NSAIDs use.
o Place pt on 14 day course of PPI therapy (if no evidence Z-E syndrome, and no evidence of hypochloremia).

Front 47

GERD: (1)

Back 47

o Omeprazole 20, once a day, 30 minutes before breakfast for 4-8 weeks.

Front 48

Gonococcal infection: drug (2)

Back 48

o Ceftriaxone, 125 mg IM in a single dose or Cefixime, 400 mg PO in a single dose plus treatment for chlamydia.

Front 49

Gout: drug, (2) CI for these drugs

Back 49

o Indomethicin 50mg PO tid until pain tolerable. May cause GI bleeding and nephrotoxicity. Contraindicated in those with known hypersensitivity.
o If hypersensitive, may use colchicine (within 24 hrs of attack) 1mg followed by 0.5mg Q2hr until asx or N/V/D develops. Do not take colchicine with grapefruit/juice (CYP3A4 inhibitor). Colchicine has anti-inflammatory properties. Contraindicated in severe renal, cardiac, and hepatic disease.

Front 50

Headache (cluster): tx (3)

Back 50

o Administer oxygen 100% at least 7-15 L/min for 15 minutes via nonrebreathing mask for acute attack.
o Zolmitriptan nasal spray 5mg PRN, do not exceed 10mg/day.
o Prednisone for prophylactic treatment: 60 mg PO x 7 days, then a 5 mg reduction q3 days until f/u in 2 weeks.

Front 51

Headache (tension): drug (1)

Back 51

o Ibuprofen (Motrin, Advil) 400–800 mg; may repeat q8h. prn.

Front 52

Hemorrhoids: tx, pt ed

Back 52

o Cortifoam ointment for pruritus and bleeding.

Front 53

Herpes (genital/simplex): drug (3)

Back 53

o Valacyclovir 1g tablets. Take 1 tab twice daily x 10 days.
o OTC: Acetaminophen 500 mg tabs prn for pain
o Valtrex, 1 g PO bid for 10 days

Front 54

Herpes zoster: drug (3)

Back 54

o Acyclovir 800 mg q4hr x 7 days
- Advil 400mg q4-6 hrs for pain
- calamine lotion to help with the itching

Front 55

Hidradenitis suppurativa: tx (2)

Back 55

o Topical chlorhexidine 4% bid to prevent infection, and an NSAID

Front 56

Hypercholesterolemia: tx (1)

Back 56

- Lovastatin 20 mg/ d PO every day for 30 days. Follow up every 6 weeks post treatment induction until goal cholesterol levels are met, then every 6 months.

Front 57

Hypertension: drug (1)

Back 57

o Start on HCTZ 6.25 mg po qd. Recheck in 6 weeks.

Front 58

Hypertensive emergency: (1)

Back 58

o Labatalol, Bolus 20–80 mg q10–15 minutes; infusion 0.5–2.0 mg/min. Titrate to lower the BP to no more than 20% in the 1st hour; then, if stable, lower to 160/100–110 in the next 2–6 hours.

Front 59

Influenza: tx (1)

Back 59

o Tamiflu - Within 48hrs of sx, rx of choice or in high risk pts.

Front 60

Interstitial cystitis: (2)

Back 60

o Oxybutynin 5 mg PO BID decrease frequency
- OTC Ibuprofen as needed for pain.

Front 61

IBS: (3)

Back 61

o increase in diet fiber (slowly increasing to 25mg/d)
- Citrucel/Metamucil (as directed on the package) to help attain the goal.
o Loperamide (Immodium) 2mg PO TID x 7d, then F/U in the office.

Front 62

Laryngitis: tx (2), pt ed

Back 62

o Place pt. on vocal rest and advise to continue using the “Ricola” lozenges prn. Recommend that the pt. increase fluid intake, drink hot lemon and honey tea and try OTC “Throat Coat”. Avoid whispering, smoke inhalation and alcohol use. Refer to ENT specialist for laryngoscopy to r/o vocal nodules.

Front 63

Laryngotracheobronchitis: tx (1)

Back 63

o L-epinephrine (less expensive than racemic and same effects) 0.5 ml/kg/per dose (max of 5 ml) of a 1:1000 dilution. Repeat as necessary, observe a minimum 3-4 hours. Use oxygen as needed.

Front 64

Low back pain: tx, pt ed,

Back 64

o Ibuprofen prn for the pain.

Front 65

Lyme dz: drugs (2)

Back 65

o Doxycycline (Vibramycin): 100 mg PO bid for 10 days (10–21)
or Amoxicillin: 500 mg PO tid for 14 d (14–21), (pediatric dose 50 mg/kg/d).

Front 66

Mastoiditis: tx (1)

Back 66

o Plain radiographs of mastoid area.
o Rocephin 75 mg/kg/day IV div q12-24h.
o Consult ENT.

Front 67

Meningitis (bacterial and viral): tx for three pathogens

Back 67

o IV antibiotic prophylaxis with ceftriaxone 4 g/day IV divided every 12 to 24 hr; maximum 4 g/day.

1. S. pneumoniae: vancomycin+ceftriaxone or cefotaxime
2. N. meningitidis: 3rd gen. cephalosporins (ceftriaxone or cefotaxime) x7days
3. L. monocytogenes: ampicillin or penicillian G

Front 68

Menorrhagia: proposed txs (3)

Back 68

o Removal of ParaGard IUD
- Discuss possibility of switching to Mirena IUD (Levonorgestrel) which can reduce blood loss >90%.
- Orth Tri-Cyclen Lo
- trial of a higher dose combination OCP

Front 69

Migraine: tx, combo tx (4)

Back 69

o Consider switching birth control pills or using a different method of birth control.
- acetaminophen (250mg), aspirin (250mg), and caffeine (65mg) in Excedrin Migraine (Take no more than 2 pills in 24 hours)
If the migraine persists = 5-HT-1 agonist

Front 70

Molluscum contagiosum: tx (3)

Back 70

o Cryotherapy: 5-10 seconds with 1-2 mm margins.
- (ineffective) Curettage under local or topical anesthesia
First line medication is Cantharidin solution 0.7–0.9%:

Front 71

Mono: tx (2), avoid

Back 71

o acetaminophen 500 mg PO q4-6h prn
o Gargling 2% lidocaine (Xylocaine) solution.

Avoid contact sports for 4-6 wks

Front 72

Motion sickness: drug (1), pt ed

Back 72

o Scopolamine transdermal patch (4 mg) behind ear at least 4 hrs before getting on boat. Replace patch every 3 days. Advise pt on semirecumbent sitting, avoid reading while on the boat, take small frequent meals and avoid ETOH

Front 73

MI: tx (4)

Back 73

o Start Oxygen 2-4L nasal cannula
- ASA 162-325 mg
- Morphine
- NTG sublingual every 5 minutes x 3 doses

Front 74

Obesity: referral, pt ed

Back 74

o Referral: Dietician
- Consult bariatric surgeon options.
- Refer to cardiologist to insure cardiovascular adequacy for exercise.
o Discuss diet & exercise, record meals/exercise/weight daily log. lifelong commitment to behavioral/lifestyle changes. Discuss complications of comorbidities. F/U within 4 wks, After 6 months of diet/exercise determine if medications are needed
o Return STAT if symptoms of comorbidities worsen.

Front 75

Onchomycosis: check? tx (1)

Back 75

o Check Baseline LFT and CBC before medication initiation
- Terbinafine 250 mg/d PO x 3 months. F/U in 4 weeks to re-check labs

Front 76

Osgood shlatter dz: (1)

Back 76

- NSAID prn
- Ice post exercise decr. swelling/pain
- refer to PT to prevent reoccurrence
- F/u 2 wk
- avoid high impact but some movement is important

Front 77

Osteoporosis - 1. first tx of fx (2), 2. then OP (2)

Back 77

o 1. Consult Orthopedic surgery for ORIF. Morphine Sulfate IV 2.5-15 mg/70 kg infused over 3-5 minutes q4hr for pain control + Cefazolin 1-2g IV prevent infection. Follow-up, DEXA scan.

2. Alendronate 10mg PO daily.
o Calcium1500 mg/d & 800 IU of vitamin D3

Front 78

Otitis externa: tx, drugs (2)

Back 78

o Cortisporin 5 drops qid. x 7 days
- NSAID for pain management inflammation 1-2 200mg tab q4-6h prn

Front 79

Otitis media: tx, drugs (3)

Back 79

o OTC ibuprofen
o Begin amoxicillin
- Claritin prn for seasonal allergies

Front 80

Paronychia (1)

Back 80

Augmentin 500 mg TID x 7d

Front 81

Peritonsillar Abscess (4)

Back 81

- IV 0.9% NS
- PCN G 2 mil. units IV q 4h
- Acetominophen 500/15mL q4h for pain & fever
D/c with
- PCN V 500 mg PO TIDx10d

Front 82

Pyelonephritis: drug (3)

Back 82

o IV Ampicillin 1g q6hrs + Gentamicin 1mg/kg until no fever for 24hrs
- Then Cipro 750mg PO q12hrs x 10-14 days.

Front 83

Perforated tympanic membrane (1)

Back 83

Amoxicillin 80 mg/kg/day PO 2 doses x 5-7days

Front 84

Pertussis (1)

Back 84

Azithromycin 10 mg/kg single dose day 1, then 5 mg/kg/d on 2-5

Front 85

Pharyngitis

Back 85

- PCN 500 mg PO BID x10d
- Acetominophen - 15-20 mg/kg q4h
(Salt water gargles, anesthetic lozenges, cool mist humidifer prn)

Front 86

Pinworms (1)

Back 86

Pyrantel Pamoate 11 mg/kg tablet single dose

Front 87

Pneumonia (bacterial & viral) (2)

Back 87

Azithromycin 500 mg PO x 1 on day 1, 250 mg PO q24hr x4days
Tylenol - 1-2 tabs PO q4-6 hrs prn for fever

Front 88

Portal HTN tx prevention of bleeding (2), tx of bleeding (3)

Back 88

Propanolol 10-20 mg/d PO BID-TID (prevent variceal bleeding) or Nadolol

Tx for acute variceal hemorrhage:
Somatostatin 250 mcg/h cont. inf. 2-5d
or
Vasopressin or Octreotide

Front 89

Prostatic Hyperplasia, benign (BPH): drug (2)

Back 89

o Terazosin 1mg/d po x 1 mo. Dispense: 30.
- Tamsulosin 0.4 mg PO daily after meals

Front 90

Proctitis: tx (mild-mod (3) vs. severe (1) vs. chronic (2)

Back 90

o Mild–moderate (up to 8 bloody stools per day):
- Topical 5-aminosalicylic acid
- topical steroids
- or the combination of oral 5-ASA (Pentasa or Asacol) & topical 5-ASA
o More severe: - Systemic corticosteroids
o Chronic :
- 6-Mercaptopurine
- azathioprine

Front 91

Postpartum depression: (3)

Back 91

o Screening using Edinburgh Postnatal Depression Scale.
o If score is significantv= SSRI.
o Refer to psychology for psychotherapy treatments & schedule f/u in 2-3 weeks.

Front 92

Psoriasis tx

Back 92

Appropriate skin care, moisturizing, cleansing
Occlusion therapy
Remove plaques after soaking
Sun exposure (small amounts)
Avoidance of triggers
F/up if no improvement

Front 93

Rhinitis, allergic: dx, tx (2)

Back 93

o Diagnostic allergen prick test & rhinoscopy
- Zyrtec 10mg capsule once a day a bedtime.
o intranasal CS spray Nasonex 1 spray in each nostril Q 12hrs.

Front 94

Restless leg syndrome: pt ed & possible med (1)

Back 94

o Begin exercise program. Pool - ideal
- Weight loss & balanced diet will benefit the patient tremendously
- Perform a CBC r/o Fe deficient anemia. + provide Fe supplement.
- If initial plan is unsuccessful, follow up and begin a dopamine agonist.

Front 95

RSV: tx (3)

Back 95

o IVF & provide O2.
o inhaled epinephrine
- mechanical ventilation.

Front 96

Respiratory Distress Syndrome, Acute (adults): management of.... (3)

Back 96

o Ensure adequate oxygenation
- Ventilatory support: endotracheal intubation
- positive end-expiratory pressure (PEEP) = incr. vol. gas remaining in lungs @ end of expiration -> decr. shunting of blood through the lungs &improve gas exchange.
o cardiorespiratory monitoring.
- Appropriate fluid resuscitation & metabolic electrolyte management.
o Maintain adequate cardiac output with the use of positive inotropic agents (e.g. Dobutamine or norepinephrine) if appropriate fluid resuscitation fails to restore perfusion.
o Prophylactic treatment is necessary for the prevention of infection pt w/ increased risk for DVT or ulcers.

Front 97

Renal failure, acute: tx (2)

Back 97

o Start IV NS (rate depends on cause of ARF)
Nephrologist

Front 98

Renal calculi: tx (1) pt ed

Back 98

- Acetaminophen PO
o Pt. Education: Increase fluid intake to 2-3 L/day
decr. salt, protein & oxalate rich foods ( spinach, chocolate) if stone does not pass within 2-4 weeks return for urologist referral

Front 99

Reiter's syndrome: drugs (2)

Back 99

o Doxycycline 100mg PO b.i.d x 7-14 d for the Chlamydia infection
o NSAIDS 400mg q4-6h prn pain.
o Consult Rheumatology

Front 100

Syphilis: tx, drug, dose, pt ed

Back 100

o Benzathine PCN G, 2.4 million units IM x 1 dose.

Front 101

Sinusitis: tx, drugs (2)

Back 101

- Acetaminophen 325mg q4-6 hrs—fever
- Phenylephrine (Afrin) nasal spray x 3days—nasal congestion

Front 102

Sepsis: tx, drug example, administration (4)

Back 102

o IV crystalloid or colloid fluid resuscitation
o Empiric Antibiotic therapy (Gram-negative coliform coverage = Ceftriaxone)
- Give IV for 3 to 4 days then switch to PO for 7 - 10 days) (pathogen specific)
- Tamsulosin 0.4 mg PO daily after meals if BPH in addition

Front 103

Seizure disorders: drugs (3)

Back 103

o Valproic Acid 10-15mg/kg/day
o Phenytoin (Dilantin) Loading dose: 10-15mg/kg IV slowly
o Carbamazepine
(Telemetry, Seizure precautions, CPP x 2 q 8 hr, EKG now and in AM, Neuro consult, 2D Echo, Carotid duplex, UA, Urine toxic screen, Home meds)

Front 104

Trigeminal neuralgia: tx (1) order what test?

Back 104

o Order a baseline CBC w/plt ct
- Carbamazepine 200 mg BID. Dispense: 60. If the pain does not subside, increase the dosage to 200mg QID.
Recheck CBC weekly for the 1st month.

Front 105

Trichomoniasis: drug (1)

Back 105

o Metronidazole 2g PO, 1 dose

Front 106

Tinea cruris: drug (1)

Back 106

o Terbinafine (1%) on affected area(s) twice daily for 1-3 wks.

Front 107

Thrombophlebitis, superficial: tx (3)

Back 107

o NSAIDS: Ibuprofen reduce pain & inflammation.
o - anticoagulant such as heparin ( reduce the risk of development of DVT)
o - 3rd gen. cephalosporin
Close follow up with a vascular surgeon

Front 108

Tendinitis: tx (2)

Back 108

o NSAIDs for acute relief
- corticosteroid injections (if NSAIDs fail)
Refer to Ortho, possible surgery

Front 109

Temporomandibular Joint Syndrome: tx (3)

Back 109

o NSAIDs x 2 weeks
- botulinum injection
- consider muscle relaxer

Front 110

Urticaria: drug (2)

Back 110

o 2nd generation H1 blocker (Childrens Claritin-Loratadine 1tab po qd prn) to avoid drowsiness.
- possible EPI pen for emergency

Front 111

Urolithiasis: (4)

Back 111

o Medications: Acetaminophen PO was
o Pt. Education:
- Increase fluid intake to 2-3 L/day
if stone does not pass within 2-4 weeks return fo urologist referral
(repeat)

Front 112

UTI (males, females): drug (1)

Back 112

o Treat outpatient: TMP-SMZ (Bactrim) 160/800 mg PO b.i.d. × 3 days. F/U in 3 days if still symptomatic.

Front 113

Urethritis: treatment depending on pathogen (2)

Back 113

o Gonorrhea: Ceftriaxone: 125 mg IM single dose
o Chlamydia: Azithro: 1 g PO single dose

Front 114

Ulcerative colitis: tx (5)

Back 114

o Sulfasalazine 6g/d
o Prednisone PO 40mg for inflammation
o Loperomide (Imodium) for diarrhea
- Daily calcium supplementation b/c of osteoporosis risk
- Colonscopy every 7 years for monitoring of Colon CA.
o Avoid OTC NSAIDs b/c it can trigger or worsen colitis, instead use tramadol 50 mg PO q 4 hrs for pain

Front 115

Vomiting: tx, med (2), doses, pt ed

Back 115

Medication: Phenergan 12.5 IM now.
Promethazine 12.5 mg PO BID.

Front 116

Warts: tx (2)

Back 116

o Combination Cantharidin, occlude lesion, wash off layer in 4 - 6 hours. Blister may form, F/u in 10 days, if

still present consider 2nd round: Combination Cantharidin or Cryotherapy.

Front 117

Vaginitis - bacterial/candidal: drug (1)

Back 117

Miconazole 2% cream intravaginally x7 days