Diseases and Managment Therapy

                         Cardiovascular Disorders
Hypertension
A. Lifestyle modification
  • Weight reduction
  • Adopt eating plan
  • Dietary sodium reduction
  • Physical activity
  • moderation of alcohol consumption
B- Medicines
o    Diuretics.
o    ACE inhibitors.
o    Angiotensin-II Receptor Blockers (ARBs).
o    Beta blockers.
o    Calcium channel blockers.
Hypercholesterolemia (High Blood Cholesterol in Adults )
  1. Statins
  2. Cholesterol absorption inhibitors – Ezetimibe (Zetia)
  3. Fibrates (gemfibrozil, clofibrate, fenofibrate)
  4. Bile acid sequestrants
  5. Nicotinic acid
  6. Probucol
Angina Pectoris
  1. Nitrates
  2. Beta blockers
  3. Calcium channel blockers
  4. ACE inhibitors.
Heart Failure Caused by Systolic Dysfunction
A. Lifestyle modification
  • Cessation of smoking
  • Salt restriction
  • Water restriction
  • Weight reduction
  • Cardiac rehabilitation
B- Medicines
o    ACE inhibitors and other vasodilators.
o    Beta-blockers.
o    Digoxin (Lanoxin)
o    Diuretics
o    Spironolactone

Atrial Fibrillation (cardiac rhythm disturbance.)

A- Medicines (Anticoagulant drugs)
  1. Heparin
  2. Warfarin
  3. Aspirin.
Gastrointestinal Disorders

Gastro esophageal Reflux Disease (GERD)
(Reflux of gastric contents with or without esophageal inflammation.)
A. Lifestyle modification
  • not eating within 3 hours of bedtime
  • avoidance of tight-fitting clothing
  • Smoking cessation.
  • avoidance of the supine position after meals
B- Medicines
1-Histamine2-blockers
  • Cimetidine (Tagamet), 800 mg twice daily;
  • Ranitidine (Zantac), 150 mg four times daily;
  • Famotidine (Pepcid),40 mg twice daily; and
  • nizatidine (Axid), 150 mg twice
2-Proton pump inhibitors (PPIs)
  • Esomeprazole Nexium--------20 mg or 40 mg, 30 minutes b/f the first meal of the day.
  • Lansoprazole – Prevacid------30 mg,30 minutes b/f the first meal of the day.
  • Omeprazole - Prilosec, generic---20 mg /day, 30 minutes b/f the first meal of the day.
  • Pantoprazole – Protonix------------40mg PO, 30 minutes b/f the first meal of the day.
  • Rabeprazole – Aciphex-------------20 mg /day, 30 minutes b/f the first meal of the day.
3- Surgical treatment

Helicobacter Pylori Infection and Peptic Ulcer Disease
1.
  • Omeprazole (Prilosec), 20 mg two times daily or
  • Lansoprazole (Prevacid), 30 mg two times daily plus
  • Metronidazole (Flagyl), 500 mg two times daily or
  • Amoxicillin, 1 g two times daily plus
  • Clarithromycin (Biaxin), 500 mg two times daily
2.
  • Ranitidine bismuth citrate(Tritec), 400 mg twice daily plus
  • Clarithromycin, 500 mg twice daily or
  • Metronidazole, 500 mg twice daily plus
  • Tetracycline, 500 mg twice daily or
  • Amoxicillin, 1 g twice daily 92 (RMA)
Constipation
Treatment of refractory constipation
A. Saline cathartics,
B. Lactulose
C. Lavage solutions (CoLyte, GoLYTELY)
D. Combination therapy
E. Enemas
F. Stool impaction.
G. Surgery.
Chronic Diarrhea
a. Trial of lactose withdrawal.
b. Trial of an antibiotic (metronidazole)
c. Trial of fructose avoidance.
Acute Diarrhea
A. Fluid and electrolyte resuscitation
  • 1. Oral rehydration.
  • 2.Intravenous hydration
B. Diet.

Pulmonary Disorders
Allergic Rhinitis
  • Corticosteroid Nasal Sprays
  • Oral H1-receptor Blockers
  • Leukotriene Modifier
  • Antihistamines
Allergic Conjunctivitis
  • Mast cell stabilizers
  • Antihistamines
  • antihistamine/vasoconstrictor combinations
  • Olopatadine (Patanol)
  • Corticosteroids
Acute Bronchitis
  • Protussives and antitussives
  • Bronchodilators
  • Antibiotics
  • Bronchodilators

Asthma
  • Beta2 agonists
  • Salmeterol (Serevent),
  • Formoterol (Foradil)
  • Inhaled Corticosteroids
  • Leukotriene Modifiers
  • Mast Cell Stabilizers
  • Phosphodiesterase Inhibitor
Chronic Obstructive Pulmonary Disease
  • Bronchodilators
  • beta2 agonists
  • inhaled corticosteroids,
  • Theophylline
  • Pneumococcal and influenza vaccination
  • Methylprednisolone (Solumedrol)
Neurologic Disorders

Migraine Headache
A.5-HT1D receptor agonists ("Triptans")
  • NSAIDs
  • Ergot Alkaloids
  • Butalbital combinations
  • Isometheptene combination
  • Opioid Analgesics
B-Prophylaxis against migraine
  • Beta-adrenergic blocking agents
  • Tricyclic antidepressants
  • Valproate (Depakote),
Vertigo
  • Antihistamines
  • Mono aminergic agents
  • Benzodiazepine
  • Phenothiazine
Seizure Disorders and Epilepsy
  • Carbamazepine (Tegretol)
  • Oxcarbazepine (Trileptal)
  • Phenytoin (Dilantin),
  • Divalproex (Depakote)
  • Monotherapy versus polytherapy
  • Felbamate (Felbatol)
  • Gabapentin (Neurontin)
  • Lamotrigine (Lamictal)
  • Tiagabine (Gabitril)
  • Topiramate (Topamax)
  • Levetiracetam (Keppra)
  • Zonisamide (Zonegran)
Alzheimer's Disease
  • Cholinesterase Inhibitors.
  • Vitamin E
  • N-methyl-D-aspartate (NMDA) receptor antagonists
Endocrinologic and Hematologic Disorders

Diabetes
  • Sulfonylureas
  • Meglitinides
  • Biguanides
  • Alpha-glucosidase inhibitors
  • Thiazolidinediones
  • Choice of agent
  • Lispro insulin
Urologic Disorders
Prostatitis
  • Trimethoprim-sulfamethoxaz ole (Bactrim, Septra)
  • Doxycycline (Vibramycin)
  • Ciprofloxacin (Cipro)
  • Norfloxacin (Noroxin)
  • Ofloxacin (Floxin)
Psychiatric Disorders

Depression
  • Selective Serotonin Reuptake Inhibitors (SSRIs)
  • Secondary Amine Tricyclic Antidepressants
  • Tertiary Amine Tricyclics
  • Miscellaneous
Anxiety Disorder
  • Antidepressants
  • Benzodiazepines.
  • Buspirone (BuSpar)
Insomnia
  • Benzodiazepine receptor agonists
  • Hypnotic Medications.
Dermatologic Disorders

Acne Vulgaris
  • Topical tretinoin (Retin-A),
  • Adapalene (Differin 0.1% gel),
  • Tazarotene (Tazorac, 0.05% and 0.1% gel),
  • Benzoyl peroxide
  • Azelaic acid (Azelex 20% cream),
  • Tetracycline
  • Minocycline ( Minocin )
  • Oral isotretinoin
  • Comedone extraction
  • corticosteroid injection.
Hematologic and Rheumatologic Disorders
Anemia
Iron deficiency anemia
  • Ferrous sulfate
  • Ferrous gluconate
  • Ferrous fumarate (Hemocyte)
Vitamin B12 deficiency anemia
  • Folic acid (Folvite)
  • Cyanocobalamin injection
Folate deficiency anemia
  • Folic acid

Osteoarthritis
  • Acetic acids
  • Cyclooxygenase-2 (COX-2) inhibitors
  • Propionic acids
  • Nonacidic agents
  • Local analgesics.
  • Intra-articular corticosteroid injections.
Gout
  • NSAIDS
  • Corticosteroids
  • Urate-lowering agents
  • Probenecid (Benemid)
  • Allopurinol (Zyloprim)..
Low Back Pain
  • (NSAID)
  • histamine H2 antagonist
Infectious Diseases
Influenza
  • Amantadine and rimantadine
  • Neuraminidase inhibitors
Pneumonia
Oral therapy
  • Macrolides
  • Betalactam/ betalactamase inhibitor
  • Quinolones
  • Tetracycline
  • Sulfonamide
Intravenous Therapy
  • Cephalosporin’s (2nd n 3rd generation)
  • Aminoglycosides
  • Vancomycin
  • Betalactam/ betalactamase inhibitor
  • Quinolones
Tuberculosis
    • Isoniazid (INH)
    • Rifampin (Rifadin)
    • Pyrazinamide
    • Ethambutol (Myambutol)

Sinusitis
Antibiotic therapy for sinusitis (10- to 14-day course)
  • Amoxicillin (Amoxil):
  • Trimethoprim/sulfamethoxazole (Bactrim, Septra)
  • Erythromycin/sulfisoxazole (Pediazole):
Broader-spectrum agents
  • Amoxicillin/clavulanate (Augmentin):
  • Azithromycin (Zithromax):
  • Clarithromycin (Biaxin):
  • Cefixime (Suprax):
  • Cefpodoxime (Vantin)
  • Cefprozil (Cefzil)
  • Loracarbef (Lorabid)
  • Levofloxacin (Levaquin)
Infectious Conjunctivitis
Topical broad-spectrum antibiotics
  • Erythromycin ophthalmic ointment,
  • Bacitracin-polymyxin B (Polysporin)
  • Trimethoprim-polymyxin B (Polytrim),
Conjunctivitis due to H. influenzae,
  • ceftriaxone (Rocephin)
Chlamydial conjunctivitis
  • doxycycline (Vibramycin)
  • erythromycin