DRUGS OF CHOICE:-

DRUGS OF CHOICE:-
1. Paracetamol-poisoning :- acetyl cysteine
2. acute bronchial- asthma :- salbutamol
3. acute gout :- NSAIDS
4. acute hyperkalemia:- calcium gluconate
5. severe DIGITALIS toxicity :-DIGIBIND
6. acute migraine :- sumatriptan
7. cheese reaction :- phentolamine
8. atropine poisoning :- physostigmine
9. cyanide poisoning :- amyl nitrite
10. benzodiazepine poisoning:- flumazenil
11. cholera :- tetracycline
12. KALA-AZAR :- lipozomal amphotericin- B
13. iron poisoning :- desferrioxamine
14. MRSA :- vancomycin
15. VRSA :- LINEZOLID
16. warfarin overdose :- vitamin-K
17. OCD :- fluoxetine
18. alcohol poisoning :- fomepizole
19. epilepsy in pregnency :- phenobarbitone
20. anaphylactic shock :- Adrenaline

Fistula Test

How are the results of Fistula test interpreted?

1. In fistula over the dome of the lateral semicircular canal: Increase pressure causes conjugate horizontal deviation of the eyes towards the normal side. As pressure is maintained, jerk nystagmus develops with fast component towards the affected ear. As pressure is released, eyes return to normal

2. Fistula of the lateral semicircular canal (anterior to the ampulla) causes deviation of eyes, to the affected side

3. Vestibular erosion causes rotatory horizontal nystagmus towards the diseased ear

4. Fistula of the posterior semicircular canal causes vertical movement of eyes.

Peripheral signs of AR:

Peripheral signs of AR:

large-volume, 'collapsing' pulse also known as:
Watson's water hammer pulse
Corrigan's pulse (rapid upstroke and collapse of the carotid artery pulse)
low diastolic and increased pulse pressure
de Musset's sign (head nodding in time with the heart beat)
Quincke's sign (pulsation of the capillary bed in the nail; named for Heinrich Quincke)
Traube's sign (a 'pistol shot' systolic sound heard over the femoral)
Duroziez's sign (systolic and diastolic murmurs heard over the femoral artery when it is gradually compressed with the stethoscope)
Also, these are usually less detectable in acute cases.

Less used signs include:

Lighthouse sign (blanching & flushing of forehead)
Landolfi's sign (alternating constriction & dilatation of pupil)
Becker's sign (pulsations of retinal vessels)
Müller's sign (pulsations of uvula)
Mayen's sign (diastolic drop of BP>15 mm Hg with arm raised)
Rosenbach's sign (pulsatile liver)
Gerhardt's sign (enlarged spleen)
Hill's sign - a ≥ 20 mmHg difference in popliteal and brachial systolic cuff pressures, seen in chronic severe AI. Considered to be an artefact of sphygmomanometric lower limb pressure measurement.
Lincoln sign (pulsatile popliteal)
Sherman sign (dorsalis pedis pulse is Quickly located & unexpectedly prominent  age>75 yr)
Ashrafian sign (Pulsatile pseudo-proptosis)
Cor en sabot(boot shaped heart)- TOF
Cor bovinum- 3° syphilis. N chronic AR..

Dermatology

1...ectyoma gangrenosa is dt??? pseudomonas

2...paracetamol causes ???photoTOXICITY

3...wavelength f uv-A???
   250- 280 nm
4..vit d produced max in???  stratum basale

5...in acne comadone lenoleic acid level??? decrease....

6...carpet track sign seen in??? DLE

Drugs

drugs used in hypertensive emergency-nitroprusside
nitroglycern
clevidipine
nicardipine
fenoldopam
labeatalol
esmolol
hydralazine
enalaprilat
phentolamine
(mostimp - nifedipine not used..)


Drugs causing disulfiram like action.
Metronidazole
Sulfonamides(CTX)
Cefoperazone
Cefotetan
Cefamandole
Griseofulvin
Moxalactam
Chlorpropamide
Procarbazine
Phenylbutazone
Furazolidone

SOME PRODRUGS AND ACTIVE FORMS
1. LEVODOPA ------------------- dopamine
2. ENALAPRIL ------------------- enalaprilat
3. SULINDAC --------------------- sulfide metabolite
4. BECAMPICILLIN –---------- ampicillin
5. SULFASALAZINE –---------- 5 – aminosalicyclic acid
6. PREDNISONE ----------------- prednisolone
7. ZIDOVUDINE ----------------- zidovudine triphosphate
8. CYCLOPHOSPHAMIDE --- aldophosphamide

DRUGS CAUSING GYNAECOMASTIA
1. spironolactone
2. ketoconazole
3. estrogens
4. testosterone
5. digitalis
6. clomiphene
7. phenytoin
8. griseofulvin
9. calcium channel antagonists
10. reserpine
11. isoniazid
12. methyldopa
13. ethionamide


Drugs causing Fatty liver
1. Antiarrythmics - Amiodarone
2. Antibiotic - Tetracycline ( high-dose, intravenous )
3. Anticonvulsant - Valproic acid
4. Antiviral - Dideoxynucleosides ( eg: Zidovudine ), protease inhibitors ( indinavir, ritonavir )
5. Oncotherapeutics - Asparginase, Methotrexate .

Drugs of choice in Psychiatric disorders

Drugs of choice in Psychiatric disorders
1. Body dysmorphic disorder - Fluoxetine
2. Obsessive Compulsive disorder - Fluoxetine/Clomipramine
3. Depression with cardiac disease - Fluoxetine, Mianserine.
4. Trichotillomania - Fluoxetine
5. Nocturnal enuresis - Imipramine
6. Panic disorder - Imipramine
7. Panic attack/disorder - Imipramine
8. Suicidal depression - ElectroConvulsive Therapy (ECT)
9. Catatonic Schizophrenia - ElectroConvulsive Therapy (ECT)
10. Manic depressive psychosis (Bipolar disorder) - Lithium carbonate
11. Pregnancy with Bipolar disorder - Carbamazepine
12. Rapid cycling Bipolar disorder - Sodium valproate
13. Gilles de la tourette syndrome - Haloperidol
14. Attention Deficit Hyperactivity Disorder (ADHD) -Methylphenidate
15. Narcolepsy - Methylphenidate (amphetamine)
16. Monosymptomatic hypochondriacal psychosis - pimozide.
17. Somatization disorder - amitriggtilline
18. Depression with acid peptic disease - doxepin
19. Generalized Anxiety Disorder (GAD) - Benzodiazepines,Buspirone
20. Borderline Personality Disorder - Antidepressants,Fluoxetine
21. Phobias - MAO inhibitors, Paroxetine
22. Delusional disorder - Antipsychotics

NM blocker

Longest acting NM blocker               ----------> PANCURONIUM
Shortest & fastest acting NM blocker ------------> Succinyl choline
Shortest acting competitive blocker -------------> Mivacurium
Fastest acting competitive blocker   -------------> Rocuronium
Maximal vagal block is seen in ------------------> Pancuronium
Max ganglionic blockade         -------------------> dTc
vagal and ganglionic stimulation -----------------> Succinyl choline
Mc muscle relaxant used for routine surgery ---> Vecuronium
Most potent skeletal muscle relaxant ------------> Doxacurium
least potent S.M.R                     ------------------>Sch
Least potent compititive blocker   -----------------> Rocuronium
only comp. blocker metabolized by plasma cholinesterase -->Mivacurium