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PLM-CM BATCH 2016

Pharmacology/Medical Therapeutics Academic Session


Lecturer: Dr. Torres May 30, 2015

I. Gastrointestinal Drugs
DISEASES/CONDITION RATIONAL DOC DOSE/FORMULATION MOA/CLASS OTHER REMARKS FROM DOC TORRES LECTURE
Peptic Ulcer Disease Omeprazole 10 40 mg cap Proton pump inhibitor
(Stress or NSAID induced) Nizatidine 75 150 mg H2 Blocker Long half life
Clarithromycin:
Clarithromycin + o Broad spectrum antibiotic for anaerobic
Macrolide + Antibiotic
Metronidazole infection; also used for protozoan infection
H. Pylori induced
o CI in pregnancy: replaced by Amoxicillin
gastric/duodenal ulcer
Abortifacient
Misoprostol Best for ulcer according to Dr. Torres but was
not used due to its adverse effects
Gastroparesis Erythromycin 250 500 mg tab Macrolide
Domperidone 10 mg tab Pro-kinetic NOT Metoclopramide (Plasil)
GERD/Dyspepsia/Heart Burn
Omeprazole Pro-kinetic
Senna
Constipation
Bisacodyl
Chloride channel If Lactose intolerant: Osmotic diarrhea ->
Loperamide 2 mg tab/cap
Non-infectious diarrhea activator treatment: STOP lactose intake
Lubiproston Inhibition of dopamine Adverse effect: Parkinsonism
IBS:
Partial serotonin
IBS with constipation Tegaserod 2-4 mg tab o Due to inflammation only
inhibitor
o Most common cause: STRESS
IBS with diarrhea Alosetron 0.5 1 mg tab Anti-Serotonin 3
Emesis: Most commonly due to Post-operative
Ondansetron 4 24 mg tab procedure, CA chemotherapy, or post-
Emesis
radiation
Aprepitant New drug available
Mesalamine 5-ASA derived
IBD
Budesomide Glucocorticosteroid
(Crohns Disease/
Given intravenously
Ulcerative Colitis) Infliximab
To prevent fistula in chronic ulcerative colitis
Surgery (Choledocholithectomy) indicated
Gallstone dissolution 100-20 mg tab
Ursodiol for patients with high recurrence rate post-
(Choledocholithiasis) 250 mg cap
medication
Beta-blocker, non-
Propanolol 10-40 mg tab
selective
Portal HPN
More efficacious than Vasopressin
with Esophageal Varices 100-500 mcg/tab Affects splanchnic
Octreotide Common adverse effect: Decrease Vit. B12
1 ml ampule IV circulation
which may result to MEGALOBLASTIC ANEMIA
10 mg tab
Post-partum Lactation Domperidone 1 mg/ml: 36-50 mL
suspension
10 mg tab
HNBB (Hyocine N
Colic/Dysmenorrhea 5 mg 5 ml
Butyl Bromide)
suspension: 60 mL
10 mg / 250 to 500
Lactulose + mg enema (Best
Hepatic Encephalopathy High Ammonium in the brain (Porto-systemic)
Neomycin mode of
administration)
II. Dermatologic Drugs
DISEASES/CONDITION RATIONAL DOC DOSE/FORMULATION MOA/CLASS OTHER REMARKS FROM DOC TORRES LECTURE
Calcipotriene 50 mcg Vitamin B3
Psoriasis (Mild plaque)
+ Coal Tar 5 %, 130 ml For scalp
2.5-10 mg tab
Methotrexate Immunosupressant
2.5-100mg/mL vial
Psoriatic Arthritis 50 mg SC 2 x
Etanercept weekly for 3 Anti-TNF
months
Acne Vulgaris/ Acne Rosana Retinoic Acid + 0.1 % cream/gel + You can also use erythromycin or tetracycline,

(Male and Female) Metronidazole 10 % cream/gel in place of metronidazole
Cause: Propyenobacterium
Drosperinone + E. Aldosterone antagonist
Acne Vulgaris: with pus 3.0 mg + 0.03 mg Used as OCP, not use like spironolactone
Acne Rosana: no pus Estradiol (OCP) + OCP
Dermatophytosis
Terbinafine 1% cream 3.15 g
(Ringworm)
100 mg cap
Onychomycosis (nail) Itraconazole
10 mg/ml solution

Transcribed by: Arenbi and Jess Page | 1


PLM-CM BATCH 2016
Pharmacology/Medical Therapeutics Academic Session
Lecturer: Dr. Torres May 30, 2015
100,000 units/ gel
Nystatin or cream
Vagina Candidiasis
Suppository Vaginal tablet:
500,000 units/tab
Non-pruritic, vesicular lesion
Condyloma Acuminata
Imiquimod 5 % cream Only applicable if the genital warts are few
(Genital Warts)
For severe cases -> Electrocauterization
3 % ointment, 200-
Acyclovir 800 mg tab, 25 Anti-viral
Herpes simplex 1 or 2/
mg/ml
Herpes Zoster
Pencyclovir 1 % cream Anti-viral
Fluorhexidine Vaginal antiseptic wash
Atopic dermatitis is one of the most pruritic
0.05 1 %
Atopic Dermatitis Pimecrolimus Immunosuppresant skin lesion
ointment
Pimecrolimus: Derivative of tacrolimus
5% cream
Eczematous Dermatitis Doxepin
10 mg/ml conc.
Seborrheic Dermatitis/ 200 mg tab
Ketoconazole
Pityriasis Versicolor 2% cream/shampoo
1-5 % lotion/
Permethrin
Scabies/ Pediculous capitis/ shampoo
Pediculous pubis 5-25 % lotion, 60-
Benzyl alcohol
120 ml
Hyperpigmentation Hydroquinone 1 % lotion
Trioxsalen + UVA
Common adverse effects: Melanoma, Skin
Hypopigmentation (Vitiligo) therapy (320-400 Oxidizing agent
CAA, Cataract
NM)
Sunblock (PABA,
Sunburn SPF 15-50
Benzophenones)
Actinic Keratosis 5-FU (Fluorouracil) 1-5 % cream/gel
0.05 % cream /
Allergic Contact Dermatitis Clobestasol
shampoo
Alopecia Areata /
Minoxidil 2.5 % lotion
Androgenic Alopecia
Intralesional
Keloids/ Hyperthropic scar
corticosteroids
2 20 %
Hyperkeratosis / Humectant Urea
cream/lotion
Halobestasol 5 mg/ml
Inevitably inhibits Anti-trichogenic
Hirsutism (Female) Elflornithine 1 % cream/lotion
ornithine carboxylase Also used for African Sleeping sickness
Cutaneous T-cell Lymphoma Bexarotene
Erythema Nodosum
Thalidomide 50-200 mg cap Anti-angiogenic To prevent metastasis; very effective in CA
leprosum
III. Random Notes
DISEASES/CONDITION Treatment of Choice OTHER REMARKS FROM DOC TORRES LECTURE
Ibuprofen
Celecoxib
Acute Rheumatoid Arthritis
Naproxen
Diclofene
Chronic Rheumatoid Arthritis
SLE
Acute Gout Colchicine
Allopurinol
Chronic Gout
Pebuxostat
Opioid overdose Naloxone
Relapse in Opioid addiction Naltrexone
Chronic Alcoholism Acamprosate
Dextromethophan
Stubborn Cough Sutamirate
Citrate
Gambling Addiction MAO inhibitors
Malignant Hyperthermia Dantrolene Hyperthermic syndrome due to General anesthesia (Succinylcholoine)
Diazepam Hyperthermic syndrome due to Antipsychotic (due to blockade of
Neuroleptic Hyperthermia
Dipenhydramine Dopamine receptors)
Diazepam Hyperthermic syndrome due to S2 blocker
Serotonin Syndrome
Cyproheptidine
Shivering Meperidine

Transcribed by: Arenbi and Jess Page | 2


PLM-CM BATCH 2016
Pharmacology/Medical Therapeutics Academic Session
Lecturer: Dr. Torres May 30, 2015
III. Herbal Medicines/ Vitamins/Supplements
DISEASES/CONDITION/INDICATION TREATMENT OTHER REMARKS FROM DOC TORRES LECTURE
Xeropthalmia Vitamin A
Wernickes Korsakoff Psychosis Thiamine
Adverse effect: Vasodilation acanthosis
Hypercholesterolemia Niacin
nigricans
Infant sudden death syndrome Biotin
Peripheral neuropathy (ex. Carpal Tunnel) Pyridoxine
INH Overdose Vitamin B6
Vitamin B12
Replacement treatment
Megaloblastic Anemia Folic acid
Leucovorin calcium Prophylaxis to prevent Megaloblastic anemia
Nutritional Rickets Type I Calcitriol
Anti-aging Tocopherol
Hemorrhagic Diathesis Vitamin K1 (Phytonadione)
Hypocalcemic Tetany Calcium Gluconate
Osteoporosis Vitamin D
Pagets Disease Calcitonin
Idiopathic hypercalciuria Hydrochlorothiazide
Acne Vulgaris Retinoic Acid
Marasmus-Kwashiorkor High protein diet
Hepatitis Silybum Marianum (Milk Thistle)
BPH Saw Palmetto
Depression St. Johns Wort
Hypertension/ Ischemic Heart Disease Co-q-10? (Ubiquinone)
Atherosclerosis Allium Gativum (Garlic) 600-900 mg/day = 1 clove; DOH approved
Anti-stress Ginseng
Vasodilation? Gingko Biloba
Cough Vitex Negundo (Lagundi)
Hyperglycemia Ampalaya
Breastfeeding Malunggay
Gout Piperonia pellucide (Pancit-pancitan)
For Sexual Tone Royal Jelly Tonic; CI: asthma
Anti-helminthic Niyoy-niyugan
Diarrhea Tsaang Gubat
IV. Endocrine System Drugs
DISEASES/CONDITION/INDICATION TREATMENT OTHER REMARKS FR. DOC TORRES LECTURE
Growth Hormone Deficiency (Dwarfism) Mecasermin/Somatomedin C.
Prader Willis/ Turners Syndrome Somatotrophin
Acromegaly Pegvisomant
rHcg
Ovulation induction/ Infertility
rHmg (Menotropins)
Infertility / OHSS / Endometriosis/ Leiomyoma/

AdenoCA of the Prostate
Control of OHSS Ganirelix
Bromocriptine
Hyperprolactinoma
Pramipezole
Oxytocin
PPH
M-ergonovine
Pituitary Diabetes Insipidus (T1) Desmopressin
Nephrogenic Diabetes Insipidus (T2) Hydrochlorothiazide
Hypothyroidism / Myxedema/ Cretinism Sodium Levothyroxine
Propylthiouracil (PTU)
Hyperthyroidism / Graves Disease PTU DOC for pregnant patients
Methimazole
Toxic Nodular Goiter RAI-I3I
Propanolol
Hashimotos Thyroiditis NSAIDs
Steroids
Propanolol 10 mg 40 mg tab
Thyroid Storm
Diltiazem 30, 60, 120 mg tab
Hydrocortissone
Addisons Disease
Fludrocortisone
CAH Hydrocortisone + Prednisone + Fludrocortisone
Dexamethasone Suppression Test for
Diagnosis
Cushings syndrome
Bethamethasone for premature lung
maturation
Pregnant Cushings syndrome Metyrapone

Transcribed by: Arenbi and Jess Page | 3


PLM-CM BATCH 2016
Pharmacology/Medical Therapeutics Academic Session
Lecturer: Dr. Torres May 30, 2015
Primary Ovarian Failure Estrogen, Progesterone, Vitamin D
Post-menopausal hormone replacement Estrogen, Progesterone
Oral contraceptive pills (Sequential, Mini-pill, post-
Ovulation control coital)
E. Estradiol
Post-menopausal Osteoporosis Raloxifene
Alendronate 10-70 mg tab (Biphosphonate) d/t prolonged use of steroids
Male Osteoporosis
Denosumab 60 mg/mL SC q 6 months Monoclonal antibody
Ovulation induction GnRH agonist Goserilin/ Nafarelin
Androgen replacement Testosterone (Nandrolone) 40 mg cap
Finasteride Decrease rate of enlargement
Benign Prostatic Hyperplasia Tamsulosin Control urinary symptoms
Finasteride + Tamsulosin Combination
Hirsutism & Satyriasis (male) Cyproteron
Nilutamide: To prevent metastasis post-op
AdenoCA of the prostate Flutamide/ Bicalutamide/ Nilutamide
MC site of metastasis BONE
Growth stimulator (Delayed Puberty) Methyl-testosterone
Regular Insulin
DM Type I Lispro Human Analog U100 + Pramlintide vial 0.5
1 mg/mL SC (Amylate Analog)
Metformin 500 mg tab TID
DM Type II
Gliclazide 30-80 mg tab With anti-platelet aggregating effect
Hydration and electrolytes fluid
Diabetic Ketoacidosis
Insulin regular Humulin IV
Rehydration electrolytes
Hyperosmolar Hyperglycemic syndrome
Regular insulin
D50/50 50%, 5 mL vial IV
Hypoglycemic Shock
Glucagon IV 1 mg powder IM/IV/SC
Beta Blocker Overdose Glucagon IV 1 mg powder IV
Calcium gluconate (IV)
Hypocalcemia
Calcium Carbonate (Oral)
Hypoparathyroidism Vitamin D 400-50,000 IU/unit 3 x / week
Cinacalcet
Hyperparathyroidism o + Phosphate (Adult)
o + Vitaminn D (Children)
Hyperphosphatemia Sevelamer 400-800 mg capsule
Enteric Oxaluria Ca CO3
V. Central Nervous System Drugs/ Anesthetic/Psychiatric Drugs
DISEASES/CONDITION/INDICATION TREATMENT OTHER REMARKS FR. DOC TORRES LECTURE
Phenytoin A.E. Gingival Hyperplasia
Epilepsy (GTCS/Grand-mal Seizures) Lamotrigine (NEW)
Levetiracetam (NEW)
Trigeminal Neuralgia Carbamazepine A.E. Aplastic Anemia
Febrile Convulsion Phenobarital
Neuropathic Pain / Post-herpetic Neuralgia Gabapentin
Severe myoclonic epilepsy in Infancy Stiripentol

--> Dravets Syndrome Valproate
Lamotrigine
Lennox-gestrots Syndrome Topiramide
Rufinamide
Ethosuximide A.E. Steven Johnsons Syndrome
Absence Seizures
Valproate Na: alternative A.E. Hepatotoxic
Epilepsy in pregnancy & menstruating Acetazolamide -> Carbonic anhydrase inhibitor
Status Epilepticus Diazepam
Infantile spasm Clonazepam
Medical/Situational Insomnia Zolpidem/ Eszopidone
Geriatric Insomnia Triazolam Most potent
Anxiety Neurosis Buspirone
BDZ overdose/ toxicity Flumazenil
Ethanol
Methanol toxicity
Fomepizole
Propofol
Femoral to popliteal bypass surgery
Fentanyl
OPD minor surgery Ketamine
Isoflurane
Major surgery without CV risk
Enflurane
Local anesthesia if with cardiotoxicity Lidocaine Transient neuronal syndrome
Local anesthesia if w/o cardiotoxicity Bupivacaine

Transcribed by: Arenbi and Jess Page | 4


PLM-CM BATCH 2016
Pharmacology/Medical Therapeutics Academic Session
Lecturer: Dr. Torres May 30, 2015
Levidopa & Carbidopa + Entacapone Not anymore the DOC
Parkinsonism
Bromociptine (Dopamine agonist) Current DOC
Methamphetamine-induced Parkinsonism Rasagiline
Haloperidol
Huntingtons Disease
Olanzapine
Tics Haloperidol/ Pimozide/ Clonidine
Wilsons Disease N-Acetyl Penicillamine
Mania Lithium
Haloperidol
Schizophrenia
Risperidone
Valproate
Bipolar Disorder
Lamotrigine
Endogenous Depression SSRIs (e.g. Fluoxetine)
Bulemia Nervosa Fluoxetine
Obsessive Compulsive Disorder Clomipramine
Social Anxiety Disorder Venlafaxine
Milnacipram
Chronic Pain Disorder
Duloxetine
Pre-menstrual Dysphoric Disorder Sertraline
Smoking Cessation Bupropion / Clonidine
Anorexia Nervosa Refeeding
Imipramine
Enuresis in children
Duloxetine
Sedation Tradozone

Transcribed by: Arenbi and Jess Page | 5