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Rural GP - Coggle Diagram

- - - - Serum ferritin
      - Transferrin saturation
- - - - Drowsiness
      - Dizziness
      - Confusion
      - Risk of seizures
    - - Orthostatic hypotension
      - Exacerbation of HF
      - Risk of MI / stroke
  - - - Inhibition of reuptake of serotonin and norepinephrine
      - H1, muscarinic receptor antagoists
- - - - Weight loss
      - Avoid alcohol + sedatives
    - - CPAP
    - - Uvulopalatopharyngoplasty
      - Maxillomandibular advancement
      - Tonsillectomy
      - Adenoidectomy
    - - MADs - Mandibular advancement devices
- - - - MOA
        
        Inhibition of dihydrofolate reductase
        Interes with DNA synthesis and reduces immune cell proliferation
      - SE
        
        Hepatotoxicity
        
        Myelosuppression - risk of pancytopenia
        
        Pulmonary toxicity
        Pneumonitis
        Interstitial fibrosis
        
        GI:
        N+V+D
        Stomatitis
      - Monitoring
        
        LFTS
        FBCs
        U&Es
        
        Baseline and periodic for hep b,c and TB
      - Indications
        
        Psoriasis
        
        Rheumatoid arthritis
        
        Crohns
        
        Lupus
    - - Indications
        
        Psoriasis
        
        Atopic dermatitis
        
        Chronic spontaneous urticaria
      - MOA
        
        Inhibition of Calcineurin
        Reduced IL-2 production
        Decreased T-cell activation
      - SE
        
        Nephrotoxicity
        AKI / CKI
        
        Hypertension
        
        Increased risk on infection
      - Monitoring
        
        Blood pressure
        
        Bloods
        Renal, LFT, Lipids, Electrolytes
        
        Screening TB and Hepatitis
- - - - Compression stockings
    - - Weight loss
      - Exercise
      - Leg elevation
      - Avoid prolonged standing sitting
    - - EVA - Endovenous ablation techniques
      - Sclerotherapy
      - High ligation and stripping
      - Phebectomy
- - - - Acute onset
      - Middle ear effusion
      - Bulding tympanic membrane
      - Otorrhoea
      - Erythema
    - - Strep pneumoniae
      - H. Influenae
      - Morexella catarrhalis
    - - Abx - Amoxicillin + Analgesia
  - - - Refer to ENT
      - Grommets
        Fluid in the middle ear 4/5 times in 6 months