Treatment Of Different Diseases
Question 1. Discuss Management Of Case Of Amoebiasis?
Answer:
Amoebiasis is an infection caused by Entamoeba histolytica.
It causes clinical syndromes from dysentery to abscess of organs such as the liver.
The infection is due to the ingestion of cysts from contaminated water, hands, and food.
Amoebiasis Treatment
1. Asymptomatic carrier
Tab Diloxanide furoate 500 mg orally TDS for 10 days.
Or
Iodoquinal 650 mg orally TDS for 20 days.
Read And Learn More: Pharmacology Question And Answers
2. For intestinal amoebiasis
Tab Metronidazole 400 mg orally TDS for 7 to 10 days
+
Tab Diloxanide furoate 500 mg orally TDS for 7 to 10 days.
3. For severe amoebic dysentery and extraintestinal amoebiasis
Metronidazole 500 mg as IV infusions till the patient starts oral
therapy.
Orally following drugs should be started:
Tab Metronidazole 400 mg orally TDS for 10 days
+
Tab Diloxanide furoate 500 mg orally TDS for 10 days.
4. Hepatic amoebiasis
Tab Metronidazole 800 mg orally TDS for 7 days
+
Tab Diloxanide furoate 500 mg orally TDS for 7 days.
Question 2. Write A Short Note On The Drug Treatment Of Migraines.
Answer:
Migraine is a disorder which is characterized by pulsating headache which is usually restricted to one side.
It is associated with nausea, vomiting, sensitivity to light and sound, loose motions, and other symptoms.
Drug Treatment Of Migraine
Acute Attack Of Migraine
Acute attck is treated with soluble aspirin, i.e. 600 to 900 mg/ day, or paracetamol 1 gm/day with or without antiemetics, i.e. metoclopramide or prochlorperazine.
In Mild Migraine
- Tab. Paracetamol 1000 mg stat orally.
In Moderate Migraine
- Tab. Ibuprofen 400 mg stat orally.
- Tab. Metoclopramide 10 mg stat orally.
In Severe Migraine
- Inj. Sumatriptan 6 mg SC stat
- Inj. Metaclopramide 10 mg IV
- Tab. Propranolol 100 mg oral daily for 6 months.
Question 3. Discuss Management Of Case Of Enteric Fever.
Answer:
Management Of Typhoid
Drug Treatment
- Several antibiotics are effective in typhoid but anyone can be given.
- Ciprofloxacin 500 mg BD or 750 mg BD in severe cases for 10 to 14 days.
Or - Levofloxacin 500 mg daily for 10 to 14 days.
Or - Oral or IV chloramphenicol 500 mg QID in the first week followed by 500 mg TID for two more weeks.
Or - Amoxicillin 1 gm QID for 10 to 14 days.
Or - Ceftriaxone 4 gm daily for first two days followed by 2 gm daily for 3 days.
- If intestinal complications are absent prednisolone 30 to 60 mg/day in divided doses is given with antacids.
- Paracetamol 500 mg SOS is given.
Migraine General Care
- Fluid and electrolyte replacement should be done.
- In diet, 3000 calories per day should be given.
- If abdominal distention is present sugar is omitted and the amount of milk is reduced.
- If fever is high sponging is done with ice water.
Question 4. Describe Drugs For Acute Malaria.
Answer:
- For acute malaria oral chloroquine is the drug of choice.
- Chloroquine 600 mg orally followed by 300 mg 6 hr later first day
- Chloroquine 300 mg orally—Second day
- Chloroquine 300 mg orally—Third day
- Paracetamol SOS – 500 mg
- A to Z multivitamins.
Question 5. Write A Short Note On Drugs On Maniac Cases Treatment.
Answer:
Lithium carbonate is the drug of choice in maniac case treatment.
- It has got evidence for both the safety and efficacy in the treatment of mania and in the prevention of recurrent attacks of bipolar manic depressive illness.
- The most successful alternative and adjuncts to it today are anticonvulsant carbamazepine, lamotrigine, and valproic acid.
- On the basis of compelling evidence of efficacy sometimes it is used as an alternative to adjunct to antidepressants in severe, especially melancholic, recurrent depressants as a supplement to antidepressant treatment in acute major depression including in patients not present clinically with only mild mood elevations or hypomania or as an adjunct when later response to an antidepressant alone is satisfactory.
Question 6. Write A Short Note On Drug Treatment Of Enzyme Inducers.
Answer:
Drug treatment of enzyme inducers
- Phenobarbitone which causes induction of CYP3A and CYP2D6 isoenzymes causes rapid clearance of jaundice and so it is used in congenital nonhemolytic anemia.
- Phenytoin which is a microsomal enzyme inducer is used in Cushing’s syndrome to reduce the manifestations.
- The enzyme inducers are also used in chronic poisonings.
- They are used in liver diseases.
Question 7. Outline The Precaution And Management Prior To Tooth Extraction If The Patient Is Suffering From Moderate Hypertension.
Answer:
Precaution and Management prior to tooth extraction if the patient is suffering from moderate hypertension.
- While managing a hypertensive patient in the dental office, the dentist must take an effort to perform the dental procedures with optimum pain control and reduced stress, and anxiety.
- Appointments can be minimized and preferably planned in the morning.
- Blood pressure should be monitored before and after the administration of local anesthesia.
- The aseptic condition should be maintained by giving antibiotics prior to extraction.
- Patients should have to take antihypertensive drugs because of the commencement of the treatment.
- Administration of dental local anesthesia with epinephrine in these patients is considered risky. Use of dental local anesthesia containing epinephrine in hypertensive patients two 1.8 ml cartridges of lignocaine containing 1:100,000 epinephrine (0.036 mg) assures a safe control in patients with hypertension.
- The use of oral sedatives the night before or during the procedure is also considered effective.
Question 8. Outline The Precaution And Management Prior To Tooth Extraction If The Patient Is Suffering From Diabetes Mellitus.
Answer:
Precaution and Management Prior Tooth Extraction If the patient is suffering from diabetes mellitus
- Patients should be told to continue with their normal eating and injection regimen. Morning appointments are recommended because cortisol levels are highest at this time and will provide the best blood glucose level. The morning meal should not be skipped.
- Type 1 patients should not be scheduled immediately after an insulin injection because this may result in a hypoglycemic episode. If hypoglycemia appears to be developing, dental treatment should be terminated and glucose administered.
- No more than 2 capsules of lidocaine 1:100,000, prilocaine HCL (1:200,000), or bupivacaine with 1:200,000 epinephrine should be delivered for anesthesia.
- An antibiotic should be prescribed following therapy.
- Prior to surgery, the patient’s food intake should include the proper caloric content and protein/carbohydrate/fat ratio to maintain glucose balance.
- Type 2 diabetics should have their regular oral hypoglycemic drugs prior to surgery.
- Prior to the surgery blood sugar levels should be monitored and then only the tooth extraction should be planned.
Normal blood sugar levels in fasting should be from 70 to 120 mg/dl and postprandial reading should be less than 140 mg/dl. The random blood sugar level should be 80 to 140 mg/dl.
Question 9. Write A Short Note On Pharmacotherapy Of Status Epilepticus.
Answer:
Pharmacotherapy Of Status Epilepticus
- Diazepam 10 mg IV is given and can be repeated after 10 minutes if required.
- Diphenylhydantoin 25 to 50 mg/min IV in a drip till 1000 mg total or till the seizures stop.
- Phenobarbitone 200 mg IM or IV diluted in 50 ml normal saline for 10 minutes.
- Paraldehyde 5 ml IM should be given.
- If seizures still persist general anesthesia with neuromuscular blockade is done.
- Once the epilepsy is controlled Phenytoin 4 to 7 mg/Kg/d is given.
Question 10. Write A Short Note On Congestive Cardiac Failure And Its Management.
Answer:
Inadequate cardiac output or adequate cardiac output only at the expense of an elevated filling pressure characterized by signs and symptoms of:
- Low cardiac output
- Pulmonary congestion
- Systemic venous congestion
Clinical Features (Signs And Symptoms)
- Due to low cardiac output: Fatigue, lists, cold peripheries, low blood pressure, oliguria, and low blood pressure.
- Due to pulmonary vascular congestion: Breathlessness, orthopnea, paroxysmal nocturnal dyspnea
- Right heart failure features: Tender hepatomegaly, ascites, pedal edema, and pleural effusions.
- Chronic heart failure: Cardiac cachexia
Congestive Cardiac Management
- General Measures
- Good nutrition, reduce obesity, and high-salt foods. Alcohol should be stopped
- Smoking is stopped
- Regular moderate exercise should be done
- Drug therapy
-
- Digoxin 0.5 mg 6 hourly is given.
- Diuretics, i.e. furosemide 40 mg IV and spirinolactone 50 mg/day
- Vasodilators, i.e. nitrates, and hydralazine is given
- ACE inhibitors, i.e. captopril 12.5 mg 8 hourly, enalapril 2.5 mg 12 hourly.
- Angiotensin II receptor antagonists, i.e. losartan 50- 100 mg daily
- Beta-blockers, i.e. propranolol are given.
- Antiarrhythmic, i.e. amiodarone is given.
- Revascularization
- Coronary artery bypass surgery
- Heart transplantation.
Question 11. Briefly Describe The Pharmacotherapy Of Oral Candidiasis.
Answer:
Topical treatment: Topical treatments are preferred because they limit systemic absorption, but the effectiveness depends entirely on patient compliance. The following are the most commonly used topical treatment.
- Clotrimazole: It is an effective topical treatment (10 mg tablet) when dissolved in the mouth five times daily.
- Nystatin preparation: Nystatin oral pastille is available as a 200,000-unit oral pastille, one or two pastilles dissolved slowly in the mouth five times a day. Nystatin oral suspension 100,000 units/cc, 1 teaspoon of which is mixed with 14 cups of water and used as an oral rinse.
- Amphotericin B: Amphotericin B 0.1 mg/ml is effective. 5 to 10 ml of oral solution is used as a rinse and then expectorated three to four times daily.
- Mycostatin cream: 1 lack unit or lactose-containing vaginal tablet keeps under the tongue. The addition of absorbable corticosteroids and antibiotic agents to Mycostatin cream and ointment accelerates the symptomatic effect. Mycostatin can be used as a rinse for 7 to 10 days 3 to 4 times a day.
Question 12. Briefly Describe The Pharmacotherapy Of Excessive Bleeding Dental Procedures.
Answer:
Hemostatics in their application control bleeding following dental procedures. Some important styptics are:
- Oxidized Cellulose: It is treated with nitrogen dioxide and it stops bleeding by forming a clot on moistening.
- Human Fibrin Foam: An alternative absorbable agent which is packed into the socket and sutured if required.
- Gelatin Sponge: It is used to treat bleeding sockets and can remain in position for 2 weeks and later on absorbed completely.
- Vasoconstrictor Agents: They include adrenaline and noradrenaline 1:10000 solution of adrenaline-soaked in sterile cotton used in the tooth socket.
- Aluminum Chloride Solution: Aluminium chloride solution of 5–10% has been used and produces some hemostasis.
- Ferric Sulphate Solution: It is applied with cotton pellets.
- Gingival Retraction Cord: Cords impregnated with local hemostatic agents such as epinephrine, aluminum chloride, and ferric sulfate.
Question 13. Write Short Note On Drugs Used In Chloroquine Resistant Malaria.
Answer:
Drugs used in chloroquine-resistant malaria:
- Quinine should be given 600 mg TDS for 3 days followed by doxycycline 100 mg BD for 7 days or pyrimethamine 25 mg + Sulfadoxine 500 mg
- Meflquine 15 mg/kg single dose
- Artemisinin: 100 mg BD on fist day, 50 mg BD for next 5 days.
Chloroquine Resistant Malaria Prophylaxis
- Mefloquine: 250 mg weekly; start 1 week before and continue for 4 weeks after leaving the area.
- Doxycycline: 100 mg weekly; start 2 weeks before and continue for 4 weeks after leaving the area.
Question 14. Name Antidote Of Diazepam, Oral Anticoagulant, Paracetamol And Morphine.
Answer:
The antidote for diazepam is flmazenil. Flumazenil competes with benzodiazepines agonist as well as inverse agonist for benzodiazepine receptor and reverses their depressant or stimulant effcts.
- The antidote for oral anticoagulant is vitamin K1 specific antidote, i.e. phytonadione. It acts more rapidly, the dose depends on the severity of hypoprothrombinemia and bleeding.
- The antidote for paracetamol is n-acetyl cysteine. N-acetyl cysteine replenishes the glutathione stores of the liver and prevents the binding of toxic metabolites to other cellular constituents.
- The antidote for morphine is naloxone. Naloxone 0.4–0.8 mg IV repeatedly every 2–3 min till respiration picks up. It has a short duration of action. Injection should be repeated every 1–4 hours later on.
Question 15. Write Down The Drug Treatment Of Schizophrenia.
Answer:
Medications that are thought to be particularly effective in treating positive symptoms of schizophrenia include olanzapine risperidone, quetiapine, ziprasidone, aripiprazole, paliperidone, asenapine, lurasidone, and iloperidone. These medications are the newer group of antipsychotic medications, also called second-generation antipsychotics.
- Mood-stabilizer medications like lithium, Divalproex, carbamazepine, and lamotrigine can be useful in treating mood swings that sometimes occur in individuals who have a diagnosable mood disorder in addition to psychotic symptoms.
- Antidepressant medications are the primary medical treatment for the depression that can often accompany schizophrenia. Examples of antidepressants that are commonly prescribed for that purpose include serotonergic (SSRI) medications that affect serotonin levels like fluoxetine, sertraline, paroxetine, citalopram, and escitalopram; combination serotonergic/adrenergic medications (SNRIs) like venlafaxine and duloxetine.
Question 16. Write Drug Treatment Of Rheumatoid Arthritis.
Answer:
Following is the drug treatment for rheumatoid arthritis:
- Local injection of long-acting steroids such as methylprednisolone acetate 20–80 mg for large joints and 4–10 mg for small joints.
- NSAIDs such as aspirin for pain and anti-inflammatory agents such as phenylbutazone, indomethacin, ibuprofen, and diclofenac can be given.
- Immunomodulators such as azathioprine can be given.
- Slow-acting anti-rheumatic drugs such as hydroxyl chloroquine sulfate, sulphasalazine 500 mg/day, and methotrexate can be given.
Question 17. Write Short Note On Drug Therapy Of Periapical Abscess.
Answer:
In periapical abscess following drugs are given:
- Amoxycillin with Clavulanic acid 375 or 625 mg twice daily for 5 days.
- Metronidazole 200 mg twice daily for 5 days
- NSAIDs such as Diclofenac sodium or Ibuprofen thrice daily for 5 days.
Question 18. Describe The Drug Therapy For Uncomplicated Lower Urinary Tract Infection.
Answer:
Following is the drug therapy for uncomplicated lower urinary tract infection:
- Ciprofloxacin 100 mg twice daily
- Ofloxacin 200 mg twice daily
- Trimethoprim-sulfamethoxazole 160/800 mg twice daily
- The above regimen should be given for 3 days.
Question 19. Write About The Management Of Gingivitis.
Answer:
Gingivitis is the inflammation of gingiva.
Gingivitis Management
- Local irritants should be removed.
- Plaque control should be done by scaling and polishing.
- Chlorhexidine mouthwash should be used for the short term.
- Gumpaint should be given to patients in cases of painful and bleeding gums. Gumpaint should be applied topically.
Question 20. Write Short Note On The Treatment Of Iron Deficiency Anemia.
Answer:
Following is the treatment for iron deficiency anemia:
- Oral iron therapy: Ferrous sulfate 200 mg TID is given in between meals. If after taking the drug there is any abdominal pain, nausea, vomiting, or constipation, the salt is changed to ferrous gluconate or ferrous fumarate. Oral iron therapy should be given for 6 months.
Or
- Iron sorbitol citric acid complex 1.5 mg/kg body weight is given as IM or IV iron dextran in 5% glucose is given.
Question 21. Write About Drug Therapy For Sputum Positive Pulmonary Tuberculosis.
Answer:
Following is the drug therapy of sputum positive pulmonary tuberculosis:
Drug Therapy Of Sputum Initial Phase
Four drugs—isoniazid, rifampin, pyrazinamide + ethambutol, or streptomycin are given daily or thrice weekly for two months.
Drug Therapy Of Sputum Continuation Phase
- Two drugs, i.e. isoniazid and rifampin for 4 months or isoniazid or ethambutol for 6 months are given.
- When both isoniazid and rifampin are used thrice weekly regimen should be given.
- Under RNTCP thrice weekly treatment with isoniazid and rifampin is given for 3 months.
Question 22. Write Short Note On Treatment Of Acute Attack Of Malaria.
Answer:
Following is the treatment for acute attack of malaria:
- P. vivax and other malaria are treated with chloroquine 600 mg of base followed by 300 mg in 6 hours and then 150 mg twice a day for 3 days.
- Chloroquine-resistant falciparum malaria is treated with quinine sulfate 600 mg thrice daily orally for 5 days. This regimen is followed by a single dose of sulphadoxine 1.5 gm combined with pyrimethamine 75 mg.
Question 23. Describe Briefl Swine Flu And Its Management.
Answer:
Swine Flu
- Swineflisalsoknownasswineinflenza, hogfland pigfl.
- It is an infection of the host animals by anyone of the several specific types of microscopic organisms known as the swine influenza virus.
- Swine flu is a strain of influenza (N1H1-the ’H‘and ‘N’ in the names of the viruses indicate the types of two proteins they possess) which is most commonly found in pigs.
- It can be transmitted to people most often those who work with livestock.
- Swine flu symptoms are just like a strain of fl-fever with chills, body aches, fatigue, headache, and sore throat associated with sinusitis; ocular symptoms i.e. photophobia, burning sensation, pain in motion; weakness and severe fatigue; cough and respiratory symptoms. In children, nausea and diarrhea are also common.
- This disease is airborne and contagious.
- Exposure to someone with swine flu could lead to infection, especially if they are coughing or sneezing. One could also catch swine flu by direct contact or touching someone who is sick.
- In laboratory investigations leucopenia and relative lymphopenia are typical findings.
Swine Flu Management
- Critical measures: Avoid crowding patients together; hand hygiene should be maintained; wear personal protective.
- Basic supportive care should be given to the patient.
- The patient should be hydrated IV fluids should be given.
- Antiviral treatment should be started, i.e. Cap. Oseltamivir 75 mg BD for 5 days. The drug should be started within 48 hours of symptom onset.
- For chemoprophylaxis, anti-viral treatment should be given as Cap. Oseltamivir 75 mg OD for 10 days.
- Analgesics and antipyretics should be given to the patient.
- Cough suppressants, i.e. codeine is given to the patient.
- Vaccine: Injectable vaccine takes 3 weeks for antibodies to develop. Till then high-risk patients should take precautionary measures.
Question 24. Write Down Drug Therapy For Myocardial Infarction.
Answer:
Following is the drug therapy for myocardial infarction:
- Oxygen 4 to 6 L/min.
- Aspirin 150 to 300 mg which is to be chewed.
- Sublingual glycertrinitrate 0.4 to 1 mg.
- IV morphine 5 mg with metoclopramide 10 mg.
- IV beta-blockers, i.e. metoprolol 5 mg in every 2 to 5
minutes in 3 doses. - Inj. Streptokinase 2,50,000 units as IV infusions for 1 hour.
- Inj. Metoprolol 2 mg IV.
Question 25. Write Down Drug Therapy For Noninsulin Dependent Diabetes Mellitus.
Answer:
Following is the drug therapy for noninsulin-dependent diabetes mellitus:
Diabetes Mellitus First Generation
- Tolbutamide 500 to 3000 mg 6 to 12 hourly in 2 to 3 doses.
- Chlorpropamide 100 to 500 mg in a single dose for 24 to 72 hours.
- Tolazamide 500 mg BD for 16 to 24 hours.
Diabetes Mellitus Second Generation
- Glipizide 2.5 to 40 mg for 1 to 2 doses for 12 to 24 hours.
- Glibenclamide 1.25 to 20 mg in 1 to 2 doses for 16 to 24 hours.
- Glicazide 80 to 250 mg in 1 to 3 doses for 10 to 12 hours.
- Glimepiride 1 to 8 mg OD for 12 to 24 hours.
Diabetes Mellitus Meglitinide
Repaglinide 1 to 16 mg before meals.
- Nateglinide 180 to 360 mg TID.
Diabetes Mellitus Biguanide
- Metformin 1 to 3 gm BID or TID for 6 to 12 hours.
Diabetes Mellitus Alpha Glucosidase Inhibitors
- Acarbose 75 to 300 mg TID
- Miglitol 75 to 300 mg TID
- Voglibose 0.2 to 0.6 mg TID.
Diabetes Mellitus Thiazolidinediones
- Rosaglitazone 2 to 8 mg BD or OD for 12 to 24 hours
- Pioglitazone 15 to 45 mg OD for 24 hours.
Question 26. Describe Briefl Management Of Gastric Ulcers.
Or
Write Short Note On Drug Therapy Of Peptic Ulcers.
Answer:
Following is the management of gastric ulcers:
1. H. pylori-associated ulcer
- Tab. Omeprazole 20 mg orally twice daily.
- Tab. Clarithromycin 500 mg twice daily.
- Cap. Amoxycillin 1000 mg orally TDS.
All the above drugs are given for 14 days.
2. H. pylori-negative ulcer
- Omeprazole 20 mg OD orally for 4 to 6 weeks.
Question 27. Write A Short Note On The Treatment Of Thyrotoxicosis Crisis.
Answer:
Following is the treatment for thyrotoxicosis crisis:
- Plenty of fluids and saline should be given to the patient.
- Broad-spectrum antibiotics are given to treat infections. i.e. Inj. Ceftriaxone 2 gm IV twice daily
- Beta-blockers: Propranolol 60 to 80 mg 8 hourly orally or 1 to 5 mg IV 6 hourly.
- Iodine therapy: Sodium iodate 500 to 1000 mg per day orally or Sodium iodate 0.25 gm IV 6 hourly.
- Anti-thyroid drugs: Carbimazole 15 to 20 mg 8 hourly or Propylthiouracil 600 mg as the leading dose followed by 200 mg 6 hourly.
- Corticosteroids: Inj. Dexamethasone 2 mg IV six hourly.
Question 28. Write A Short Note On The Management Of Aphthous Ulcers.
Answer:
Following is the management of aphthous ulcers:
Aphthous Ulcers In Mild Cases
- Topical protective emollient base.
- Topical tetracycline mouthwash. Use four times daily for 5 to 7 days.
- Topical corticosteroid preparation, i.e. triamcinolone acetonide.
- Replacement therapy with vitamin B12, ferritin, folate, and iron.
- Topical application of tetracycline.
- Chlorhexidine mouthwash is to be used as a gargle twice daily.
Aphthous Ulcers In Severe Cases
- Fluocinolone gel, clobetasol cream or beclomethasone spray.
- Injection of corticosteroid directly into the lesion.
- Chlortetracycline as a mouth rinses to be flushed over the affected region.
- In some cases, dapsone or thalidomide can be used.
- Interferon alpha, nicotinic tablets, and colchicine can be used.
Question 29. Write Short Note On The Management Of Gastroesophageal Reflux Disease.
Answer:
Following is the management of gastroesophageal reflux disease:
- Antacid gel [Al (OH)3 + Mg (OH)2] 10 to 15 ml orally 4 to 6 times a day.
- Cap. Omeprazole 20 mg OD orally for 4 weeks.
- Tab. Domperidone 10 mg TID orally for 4 weeks.
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