Where Applied Therapeutics teaches through cases, DiPiro organises therapy by disease. These notes cover the conditions Gulf exams test beyond the cardiovascular and diabetes basics.
How this book helps in the exam
- Treatment goals and first-line drugs for a named disease.
- Monitoring parameters and how often to check them.
- Adverse effects that change the plan.
What the book covers
12 high-yield topics. Each has the points most often examined and links to practise them.
1Dyslipidaemia
- Statin intensity is matched to cardiovascular risk; very high-risk patients target the lowest LDL.
- Ezetimibe is added when LDL stays above target on a maximum tolerated statin.
- Check a lipid profile 4–12 weeks after starting therapy.
- Muscle pain with a raised CK needs the statin stopped.
2Thyroid disorders
- Levothyroxine is taken on an empty stomach, away from iron and calcium.
- TSH is checked 6–8 weeks after a dose change.
- Propylthiouracil is preferred in the first trimester; carbimazole later.
- Beta blockers control symptoms of hyperthyroidism while antithyroid drugs take effect.
3Peptic ulcer and H. pylori
- Eradication uses a PPI with two antibiotics (or bismuth quadruple therapy) for 14 days.
- Clarithromycin resistance is common, so local resistance guides the regimen.
- Stop or protect against NSAIDs with a PPI in patients with ulcer risk.
- Alarm features such as weight loss, dysphagia or bleeding need referral for endoscopy.
4Inflammatory bowel disease
- Aminosalicylates (mesalazine) treat mild to moderate ulcerative colitis.
- Corticosteroids induce remission but are not used for maintenance.
- Thiopurines need TPMT testing before starting.
- Biologics such as anti-TNF agents need screening for TB and hepatitis B first.
5Kidney disease
- ACE inhibitors or ARBs and SGLT2 inhibitors slow progression of proteinuric kidney disease.
- Phosphate binders are taken with meals.
- Anaemia of CKD is treated with iron and erythropoiesis-stimulating agents.
- Pause ACE inhibitors, diuretics, metformin and NSAIDs during dehydrating illness.
6Osteoporosis
- Oral bisphosphonates are taken fasting with water, upright for 30 minutes.
- Calcium and vitamin D support all bone treatments.
- Jaw osteonecrosis and atypical femur fractures are rare bisphosphonate risks.
- Denosumab should not be stopped abruptly without follow-on therapy.
7Gout
- Acute flares are treated with NSAIDs, colchicine or a short steroid course.
- Allopurinol is started low and titrated to a urate target, with flare prophylaxis.
- Allopurinol greatly raises azathioprine levels.
- Thiazide and loop diuretics raise uric acid.
8HIV and tuberculosis
- Antiretroviral therapy combines drug classes; adherence prevents resistance.
- Rifampicin is a strong enzyme inducer that lowers many drug levels, including antiretrovirals and contraceptives.
- Isoniazid causes peripheral neuropathy, prevented with pyridoxine.
- Ethambutol can cause optic neuritis; check vision before and during therapy.
9Cancer supportive care
- Highly emetogenic chemotherapy needs an NK1 antagonist, a 5-HT3 antagonist and dexamethasone.
- Febrile neutropenia is an emergency treated with broad-spectrum antibiotics within an hour.
- Tumour lysis syndrome is prevented with hydration and allopurinol or rasburicase.
- Mucositis, hand-foot syndrome and neuropathy may need dose changes.
10Parkinson's disease and dementia
- Levodopa with a decarboxylase inhibitor is the most effective treatment for motor symptoms.
- Dopamine agonists can cause impulse control disorders.
- Avoid metoclopramide and typical antipsychotics in Parkinson's disease.
- Cholinesterase inhibitors treat mild to moderate Alzheimer's disease and can slow the heart.
11Migraine and epilepsy
- Triptans are avoided in coronary disease; overuse causes medication-overuse headache.
- Propranolol, topiramate and amitriptyline are used to prevent migraine.
- Many antiepileptics interact with hormonal contraception.
- Women of childbearing age should avoid valproate where alternatives exist.
12Smoking cessation
- Varenicline and combination nicotine replacement are the most effective aids.
- Bupropion is contraindicated with a history of seizures or eating disorders.
- Stopping smoking raises levels of CYP1A2 substrates such as clozapine and theophylline.
- Behavioural support doubles the chance of success.
These are PharmaPrep's own notes on the knowledge this book teaches. No text, tables or figures are reproduced from it. Read the book for full explanations, and check doses and laws against current official sources.
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