4th 20 Flashcards
Lithium toxicity early symptom
Restlessless
Lithium toxicity symptoms
Restlessness
D&V
Agitation
Tremor
Muscle fasciculations
When does lithium toxicity typically occur in patients on treatment?
Usually when they are ill or dehydrated
SSRI overdose and serotonin syndrome eye symptom
Nystagmus
Which drugs often cause hypokalaemia?
Loop diuretics e.g. furosemide
Why do loop diuretics cause hypokalaemia?
They block the Na/K/Cl transporter, so K+ can’t be retreived, but keeps more water in the lumen -> urine
ACEi example
Remipril
Enalapril
ACEi can cause what change in potassium?
Excretion of K+ because inhibiting retention with aldosterone. SO causes hyperkalaemia.
Theophylline is used for what?
Bronchodilation in COPD and refractory asthma
When should you check theophylline levels after commencing treatment?
5 days
Chronic heart failure with reduced ejection fraction treatment
ACEi
B blocker (unless contraindicated = bradycardia or asthma)
These drugs reduce morbidity and mortality
Can add spironolactone according to guidelines if these dont control it well enough
Clarithromycin (macrolide) and statins interact to cause what?
What may be increased in the bloods?
Rhabdomyolysis, creatinine kinase
Treatment of GORD
Omeprazole 20mg PO once daily
Verapamil hydrochloride is a …
CCB
CCB is used to…
Reduce blood pressure
CCB alongside B blocker can cause…
Collapse due to cardiac side effects (hypotension and heart block!)
This combination can cause ECG changes
Once TSH level is stable on levothyroxine, how often do you need to measure it?
Yearly
Side effects of quinolones (antibiotic such as ciprofloxacin)
Diarrhoea
Constipation
LOADS others
E.g. rendon rupture
1mg = how many mcg?
1000
After starting lithium, when should you monitor lithium levels?
12 hours later and then weekly
What should be performed before starting lithium?
ECG
How often should thyroid, calcium and U&Es be checked on lithium?
Every 6 months
Which test to monitor warfarin use?
INR
INR target in AF
2-3
Drug type that can exacerabate Parkinson’s symptoms
Dopamine antagonist
What type of drug is metoclopramide?
Dopamine antagonist
What type of drug is clozapine?
Dopamine antagonist for refractory schizophrenia
Major risk factor of clozapine
Agranulocytosis
Patient presenting over 24hr after overdose with jaundice, hepatic tenderness and a raised ALT (liver failure) which drug should be administered?
Acetylcysteine
Herpes in T1 distribution, intensely painful =
Shingles
Treatment for shingles
Aciclovir
Management of secondary pneumothorax
Chest drain insertion
Management of primary pneumothorax <2cm
Needle thoracentesis
