💊A proper medication (drug) history is important as part of the patient assessment.
💊In this blog post, we will cover some of the most commonly prescribed medications and their indications/mechanisms of action.
Commonly Prescribed Medications
Dentowesome 2020📝
References: 2020 firstaidforfree.com
🤒Clinical Features:
This is the most dangerous of the malarias and patients are either ‘killed or cured’. The onset is often insidious, with malaise, headache and vomiting. Cough and mild diarrhoea are also common. The fever has no particular pattern.
🦗Neurological
- Coma
- Hypoglycaemia
- Seizures
- Cranial nerve palsies
- Opisthotonus (a type of abnormal posture where the back becomes extremely arched due to muscle spasms)
Disconjugate gaze due to cranial nerve palsy
🦗Optic fundi
Malaria Retinopathy with Roth’s spots
🦗Respiratory
- Pulmonary edema
- Secondary bacterial pneumonia
🦗Cardiovascular
- Shock
- Cardiac failure (‘algid malaria’)
- Dysrhythmias with Quinine
🦗Renal
- Acute renal failure
- Severe haemolysis results in haemoglobinuria (black water fever)
🦗Abdomen
- Hepatic dysfunction & haemolysis lead to Jaundice
- Tender liver edge with hepatitis
- Pain in left upper quadrant with splenomegaly
🦗Blood
- Parasitaemia
- Anaemia – Normocytic Normochromic
- Thrombocytopenia
- Coagulopathy
Ring form in RBC
Dentowesome 2020
@dr.mehnaz🖊
References: Davidson’s Principles and Practice of Medicine Textbook; Image source: ResearchGate, Quizlet
🔗Refer Asthma First Aid & Prevention tips on Page 2‼️
ASTHMA
Mild intermittent
💊 Short acting β2-agonists (e.g. Salbutamol, Terbutaline) inhalations when needed.
Alternative drugs/Treatments
💊 Anticholinergics (e.g. Ipratropium, Tiotropium) inhalations when needed, alone or in addition to beta-2 agonists
💬 Patient is asymptomatic between the dyspnoea episodes, so no daily medication required!
ASTHMA
Mild persistent
💊 Short acting β2-agonists (e.g. Salbutamol, Terbutaline) inhalations ➕ Corticosteroid inhalation (low dose)
Alternative drugs/Treatments
💊 Short acting β2-agonists ➕ Mast cell stabilizer or Leukotriene antagonist or Theophylline sustained release
💬 Beta-2 agonist inhalation is needed every day, so once daily corticosteroid inhalation if given for asthma control.
ASTHMA
Moderate persistent
💊 Long acting beta-2 agonists (e.g. Salmeterol, Formeterol) inhalations ➕ Corticosteroid inhalation (low to high dose)
Alternative drugs/Treatments
💊 Long acting beta-2 agonist tablets or Theophylline sustained release ➕ Corticosteroid inhalation (medium dose)
💬 The dose of corticosteroid inhalations depends on the severity of symptoms.
ASTHMA
Severe persistent
💊 Long acting beta-2 agonists (e.g. Salmeterol, Formeterol) inhalations ➕ Corticosteroid inhalation (high dose) ➕ Corticosteroid tablets/syrup
Alternative drugs/Treatments
💊 Long acting beta-2 agonist tablets or Theophylline sustained release ➕ Corticosteroid inhalation (high dose) ➕ Corticosteroid tablets/syrup
💬 Systemic corticosteroids have significant adverse effects, so after adequate asthma control, are gradually withdrawn.*
ASTHMA
Acute severe asthma
💊 Oxygen 60% ➕ Nebulized beta-2 agonists (e.g. Salbutamol) in high dose ➕ Systemic corticosteroids
💬 An emergency condition, earlier called as status asthmatics. Aminophylline is no longer recommended.
* After adequate control of severe persistent asthma, systemic corticosteroids are withdrawn, and the patient then would be managed as moderate persistent type. This is called "step down" approach of management. In this approach, it is considered better to manage patients assuming in the next higher type and then, after reviewing in 1-6 months, to step-down, instead of "step-up" after failure in asthma control.
Aspirin induced
asthma
💊 Leukotriene antagonists (e.g. Montelukast, Zafirlukast)
Exercise induced
asthma
For Prophylaxis: Mast cell stabilizers or beta-2 agonists or Leukotriene antagonists💊
COPD
- For smoking cessation: I line: Behaviour therapy; II line: Nicotine replacement therapy; III line: Antidepressants e.g. Bupropion
- For respiratory infections: Antibiotics
- For bronchodilatation: I line: Anticholinergics; II line: beta-2 agonists; III line: Theophyline
- For hypoxemia: I line: Ambulatory oxygen; II line: Long term oxygen therapy
Dry cough
💊 Cough suppressants (e.g. Dextromethorphan) + Treat the cause e.g. post nasal drip by antihistaminics and decongestants.
Productive cough
💊 Expectorants (e.g. Pot iodide) &/or Mucolytics (e.g. Acetylcysteine) ➕ Treat the cause e.g. allergy by antihistaminics and bacterial infection by antibiotics
References: CLASSIFICATION OF DRUGS WITH DRUGS OF CHOICE 3RD EDITION BY VIKAS SETH
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Dr. Mehnaz Memon🖊
References: Davidson’s Principles and Practice of Medicine Textbook
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References:
Davidson’s Principles and Practice of Medicine Textbook
Careful examination of the oral cavity mayreveal findings indicative of an underlyingsystemic condition, and allow for early diagnosisand treatment. Examination should includeevaluation for mucosal changes, periodontalinflammation and bleeding, and general
condition of the teeth.


































