Pharmacology and Therapeutics
Core concepts
Know the indications, mechanisms, and adverse effects of drugs commonly used in podiatric practice: NSAIDs, antibiotics, antifungals, corticosteroids, and analgesics. Understand antibiotic selection for common foot infections and the importance of culture-directed therapy. Know the risks of NSAIDs (GI bleeding, renal impairment, cardiovascular risk) and corticosteroids (hyperglycemia, infection, tendon rupture). Familiarize yourself with local anesthetics and their maximum doses, and with the principles of anticoagulation management around surgery.
Traps in questions
A common trap is choosing an antibiotic without considering culture results or local resistance patterns. Another is overlooking drug interactions-NSAIDs with anticoagulants, corticosteroids with diabetes. Know that corticosteroid injections can worsen hyperglycemia and increase infection risk, and that tendon rupture is a risk with local steroid use.
Rule of thumb
Match the drug to the organism and the host: culture when possible, avoid NSAIDs in renal impairment, and use caution with steroids in diabetic patients.
Worked example
A diabetic patient with a foot infection and a history of MRSA should receive culture-directed antibiotics; empiric therapy should cover MRSA until cultures return.