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Drug of Choice for MTZ

1. Drug of Choice for MTZ – resistant giardiasis ------------ Nitazoxanide (Izato ®)
2. Drug of Choice for Resistant – HTN ------------- Spironolactone (bcz it is mostly due to
increased level of aldosterone)
3. Young age HTN is due to hyperreniemia (increased level of renin in blood)
4. Most potent H2 receptor blocker is “Famotidine” & least potent is “”Cimetidine”.
5. Alzheimer’s disease can cause “Euphoria”, Chronic / Cancer pain can cause “Depression”,
Vit.B12 deficiency can cause “Feeling of Guilt”.
6. Gonorrhea, DOC for non-resistant strain is Ceftriaxone + Doxy/Azithro, while DOC for the
resistant strain is Spectinomycin.
7. Shocks: DOC for cardiogenic shock is Dopamine / Adrenaline and if there is Oliguria with it
then only Dopamine, DOC for Distributive shock is Nor-adrenaline, DOC for Anaphylactic
shock is Adrenaline and if not fully controllable then add anti-histamines, DOC for Shock
due to adrenal in-sufficiency is Corticosteroids, DOC for septic shock is Broad spectrum
antibiotics + nor-adrenaline, DOC for hypovolemic shock is I.V fluids (crystalloids).
8. Vasopressor of choice in pregnancy is Ephedrine, due to B2 mediated vasodilation it does not
interfere with placental blood circulation.
9. Hypertensive emergency, DOC is I.V nicardipine, DOC in pregnancy is I.V labetalol.
10. Hypertensive urgency, DOC is oral clonidine.
11. DOC for Mountain sickness (Acute/Chronic) is Acetazolamide.
12. DOC for Morning Sickness is Doxylamine + Pyridoxine.
13. DOC for Motion Sickness is Scopolamine.
14. DOC for Chemotherapy induced Nausea and Vomiting (CINV):
a) Early onset ------ Ondansetron
b) Late onset ------- Aprepitant + Dexamethasone
c) Refractory ------- Dronabinol
d) Breakthrough ------- Olanzapine / Metoclopramide
e) Anticipatory -------- BZDs e.g. Lorazepam or Alprazolam.
15. Hyperemesis Graviderum ---------- Doxylamine + Pyridoxine / Metoclopramide, if severe
then use Prochlorperazine and add I.V fluids.
16. Acute vomiting ------- Dimenhydrinate / Prochlorperazine (severe)
17. Chronic Vomiting --------- TCAs, Gabapentin etc.
18. Cyclic Vomiting (Abdominal Epilepsy) ---------- Oxcarbamazepine.
19. Vertigo induced vomiting (Acute ---- Dimenhydrinate, Chronic ----- Cinnarizine)
20. Migraine induced vomiting ----------- Prochlorperazine.
21. Gastroparesis related vomiting --------- Metoclopramide.
22. Anti-Parkinson drugs (Levodopa/Carbidopa) induced vomiting ------- Domperidone.
23. Post-operative Vomiting (PONV) ------- Ondansetron
24. Spasmodic abdominal pain with vomiting -------- Dicyclomine.
25. Bilious Vomiting -------- Treat underlying cause ASAP because it can be life-threatening e.g.
intestinal stenosis etc.
26. Psychogenic vomiting, includes Habitual post-prandial vomiting + Irregular vomiting and
mostly are associated with major depression or anxiety for these the DOC is Escitalopram
27. Untraceable vomiting -------- Dexamethasone.