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Roflumilast is typically used in patients with severe COPD and chronic bronchitis who continue to have frequent exacerbations despite optimal inhaler therapy. It’s an oral anti-inflammatory medication added to reduce flare-ups, especially when inflammation plays a major role. Due to potential side effects like weight loss and GI symptoms, it’s best suited for select patients who can tolerate it.
The most important intervention in slowing the progression of COPD.
Ursodeoxycholic acid is a non-surgical option for dissolving small cholesterol gallstones in patients who are unable or unwilling to undergo surgery. This method works gradually by altering bile composition, and typically requires several months of daily treatment to see results. It is best suited for non-calcified stones and is generally well tolerated. While not a quick fix, it offers a useful alternative when surgery isn’t feasible.
Cholecystostomy is a temporary, minimally invasive procedure used to drain the gallbladder in critically ill patients who cannot safely undergo surgery. It helps control infection and inflammation caused by gallstones or cholecystitis, often buying time until the patient is stable enough for definitive treatment.
Azelastine is a preferred nasal antihistamine for moderate to severe allergies, providing fast and effective symptom relief when oral medications aren't enough. It has a notably bitter taste, but many users adapt to it with continued use.
Duloxetine is a first-line SNRI for fibromyalgia, especially effective in patients with both pain and mood symptoms. It improves pain, function, and quality of life when non-drug treatments are insufficient. However, it carries a higher risk of side effects like nausea, fatigue, dry mouth, sexual dysfunction, and withdrawal symptoms if discontinued abruptly.
My first line therapy for asthma. Great for acute disease, and if the asthma is not severe, it can be used for intermittent exacerbations.
For allergic rhinitis, one of the first line therapies by treating histamine receptors.
Although it is not comfortable, it helps improve clear the mucus, allows topical medications to get to the mucosa, and potentially reduces the severity of the disease.
Tranexamic acid is an antifibrinolytic used in von Willebrand disease to reduce mucosal bleeding by preventing clot breakdown. It is often used with desmopressin or vWF replacement and is available as oral tablets, solution, IV, or topical rinse. It’s generally safe but should be used cautiously in patients with kidney disease or clotting risk.
Amoxicillin is a first-line antibiotic in pediatrics, commonly used for infections like acute otitis media, sinusitis, and strep pharyngitis. High-dose amoxicillin (80–90 mg/kg/day) is recommended for conditions like otitis media and sinusitis to effectively target resistant Streptococcus pneumoniae. It is preferred for its broad coverage, good safety profile, and palatability, making it ideal for children.
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