3. Data Interpretation Flashcards
INR <6?
Reduce warfarin dose
INR 6-8
Omit warfarin for 2 days then reduce dose
INR >8
Omit warfarin and give 1-5mg oral vitamin K
INR >5 + Minor bleeding
Give IV Instead of oral vitamin K 1-3mg
What drugs cause Hyperkaliemia
Aldosterone Antagonist (Spirololactone) + ACE-Inhibitors
Drugs causing hypokalemia and hyponatremia?
Thiazide diuretics (Bendroflumethiazide, chlorthalidone, indapamide) + loop diuretics (Furosemide, bumetanide)
Eg of thiazide diuretics
Bendroflumethiazide, chlorthalidone, indapamide)
Eg loop diuretics
Furosemide, bumetanide
Eg of ACEI-inhibitors
Ramipril, Lisinopril
Eg of CCB
Amlodipine
Diltiazem
Nifedipine
Verapamil
Side effect of ACE-I
Dry cough
Side effect of BBlocker
Worsens asthmatics
Side effect of CCB
Peipheral oedema and flushing
Side effect of loop diuretic
Gout
Side effect of K sparing
Gynecomastia
Effects of NSAID (ibuprofen) on kidney?
raised urea, creatinine and potassium!!!!!!
Ibuprofen decreases renal blood fow by inhibiting prostaglandins that normally dilate blood vessels flowing into the kidney, especially if the patient has renal artery stenosis. Reduced blood flow to the kidney mimics hypotension and prerenal failure, which if prolonged causes intrarenal failure
Effect of Erythromycin on INR?
erythromycin is an enzyme inhibitor, i.e. reduces
warfarin breakdown and thereby increases its plasma level, INCREASING INR
What is neutropenic sepsis?
Any source of sepsis (in this case pneumonia) with neutrophils <1
ABx for neutropenic sepsis?
START PIPERACILLIN WITH TAZOBACTAM IV, GENTAMICIN IV AND PARACETAMOL
how does carbamazepine effect sodium?
carbamazepine can also cause
hyponatraemia (through SIADH)
What condition to with hold digoxin?
Slow AF
Circumstances to increase steroids?
When Addisonian patients become sick they should increase their intake of steroids (so-called ‘sick day rules’)
to provide adequate cortisol for the stress response
Drugs that can trigger an asthma attack?
Ibuprofen is an NSAID which can trigger an asthma attack
Bisoprolol is a beta-blocker. Its side effects are bronchospasm (which would cause wheeze)
What circumstance would you withhold salbutamol inhaler?
When also using nebulized salbutamol
Treatment of acute heart failure?
40mg IV Furosemide
What is fast AF?
AF with HR >100bpm
first line Abx for gut infections?
Metronidazole is typically used for gastrointestinal infections because of its good effects on anaerobes which
colonize the gut
Skin infection first line Abx?
FLUCLOXACILLIN 500MG, 6-HOURLY FOR 7DAYS
Abx for severe celluitis?
FLUCLOXACILLIN 1G, IV STAT
Abx for bone infections?
E CLINDAMYCIN 500MG, 6-HOURLY FOR 7DAYS
Two drugs that can cause antimuscarinic side effects?
Cyclizine and amytriptiline
Side effect of carbimazole?
carbamazepine (Gabapentin alternative)
Carbimazole
Hydroxocobalamin
vitamin b12
drugs that can precipitate parkinsonism?
Both metoclopramide and haloperidol are dopamine antagonists and can precipitate parkinsonian symptoms, even in patients who do not have
Parkinson’s disease.
Antiemetic that can be used in Parkinsonism?
It is useful to know that domperidone, another dopamine antagonist licensed for the treatment of nausea, is safe to use for patients with Parkinson’s disease as it does not cross the blood-brain barrier
