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bnf > Blood/nutrition > Flashcards

Blood/nutrition Flashcards

1
Q

What common drugs have risk of haemolysis in G6PD deficient patients?

A

Nitrofurantoin, quinolones, rasburicase, sulfonamides

Possible - aspirin (usually not under 1g), chloroquine, quinine, sulfonylureas.

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2
Q

What type of anaemia are corticosteroids used?

A

Hypoplastic or hemolytic

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3
Q

What is used in aplastic anaemia?

A

Antilymphocyte immunoglobulin

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4
Q

What anaemias is pyridoxine indicated?

A

Hypoplastic, hemolytic and sideroblastic

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5
Q

What monitoring is needed with epoetins?

A

Hypertensive crisis and pure red cell aplasia have occurred - consider testing ethropoetin antibodies with latter.
Monitor blood pressure, retuculocyte counts, haemoglobin and electrolytes. Monitor for deficiencies.

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6
Q

What advice should be given with oral Iron preparations?

A

Better absorbed on an empty stomach but taking after food can reduce gastro side effects. May discolour stools.

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7
Q

What are megaloblastic anaemias usually a result of?

A

Lack of vitamin b12 or folate.

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8
Q

What can occur if folic acid is given alone in undiagnosed megaloblastic anaemia?

A

Neuropathy precipitation. Administer with b12 concurrently

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9
Q

Is hydroxocobalamin or cyanocobalamin more suitable for prescribing?

A

Hydroxocobalamin

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10
Q

What should be given in iron overload?

A

Dexferrioxamine. Can add ascorbic acid if no cardiac dysfunction 1 month after.

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11
Q

What treatment options are there for idiopathic thrombocytopenic purpura?

A

Usually self limiting in children
Corticosteroids
Immunoglobulins to raise platelet counts rapidly
Antineoplastic drugs
Tranexamic acid to reduce severity of haemorrhage
Splenectomy

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12
Q

Who is at risk of essential thrombocytopenia?

A

Over 60yo. Platelets greater than 1000 x 10^9/L. History of thrombohaemorrhagic events

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13
Q

When is compensation for potassium loss especially necessary?

A

Digoxin or antiarrhythmics
Secondary hyperaldosterism (cirrhosis, Nephrotic syndrome, severe heart failure)
Losses in faeces due to diarrhoea or laxatives

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14
Q

When are smaller doses of potassium given?

A

Renal insufficiency which is common in elderly

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15
Q

What else can be given instead of potassium salts with losses, and why might other options be preferred?

A

Often poor compliance due to nausea and vomiting so potassium sparing diuretics preferred.

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16
Q

What is given if potassium levels are above 6.5mmol/l?

A

Calcium gluconate 10%

Soluble insulin or salbutamol

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17
Q

When should rehydration occur slower than the usual aim of 3-4hours?

A

If hypernatreamic

18
Q

When should sodium products be cautioned?

A

Salt restricted diet - C/I with bicarbonate
Dilutional Hyponatreamia
Oedema
Hypertension

19
Q

What calcium intake should be recommended in osteoporosis?

A

Double normal recommendations

20
Q

When is calcium deficiency common?

A

Childhood, pregnancy, lactation, elderly (increased demands or poor absorption)

21
Q

Which drugs promote Hypercalcaemia?

A

Thiazides, vitamin D compounds

22
Q

What drugs can be given in Hypercalcaemia?

A

Bisphosphonate, corticosteroids, calcitonin

23
Q

What condition may be causing Hypercalcaemia?

A

Hyperparathyroidism

24
Q

What is given in idiopathic hypercalciuria

A

Increased fluid and bendroflumethiazide

25
Q

What conditions may worsen upon hypocalcaemia?

A

QT interval prolongation, seizures, congestive heart failure.

26
Q

What are the symptoms of hypermagneseamia?

A

Nausea, vomiting, flushing, thirst, hypotension, drowsiness, loss of tendon reflex, slurred speach, arrhythmia.

27
Q

What drug groups are unsafe with acute porphyria?

A

Anabolic steroids, antidepressants, barbiturates, hormonal contraceptives, HRT, triazole&imidazole antifungals, non nucleoside reverse transcriptase inhibitors, progestogens, protease inhibitors, sulfonamides, sulfonylureas, taxanes.

28
Q

What common drugs are unsafe in acute porphyria?

A

Alcohol, amiodarone, carbemazepine, clindamycin, diltiazem, erythromycin, hydralazine, Indapamide, nitrazepam, nitrofurantoin, phenytoin, pivmecillinam, pizotifen, rifampicin, rispeidone, Spironlolactone, tamoxifen, trimethoprim, valproate and Verapamil.

29
Q

What should be determined before treatment with Eliglustat?

A

CYP2D6 metabolised status

30
Q

Enzymes are used in different blood disorders. What can occur with these preparations?

A

Infusion related reactions

31
Q

A patient experiences gastric irritation when taking zinc acetate. How can this be reduced?

A

Take first dose mid morning or with protein.

32
Q

Most vitamins are given daily in TPN, which aren’t and when are they given?

A

Hydroxocobalamin IM single dose unless nutrition continues for many months.
Folic acid 15mg once or twice weekly.

33
Q

What should be done if high glucose amounts are given by TPN?

A

If over 180g in a day, monitor blood glucose. Insulin may be required.

34
Q

What sweetener effects the control of phenylketonuria?

A

Aspartame.

35
Q

What results from a deficiency in vitamin a?

A

Ocular defects and increase susceptibility to infections

36
Q

When is vitamin a deficiency most common?

A

Preterm neonates, liver disease (as less absorption of fat soluble), biliary obstruction

37
Q

When may vitamin b6 deficiency occur?

A

Isoniazid or penicillamine treatment

38
Q

What vitamin may be given in chronic alcoholism?

A

B. Pabrinex and thiamine.

39
Q

What extra conditions in children can be treated with vitamin B preparations?

A

Mitochondrial disorders, maple syrup urine disease (thiamine), congenital lactic acidosis.

40
Q

What are vitamin c supplements used for?

A

Scurrvy
Increase excretion of iron
Metabolic/mitochondrial disorders

Not proven for colds or wound healing.

41
Q

What are the symptoms of vitamin D overdose?

A

Anorexia, nausea, vomiting, diarrhoea, constipation, sweating, headache, thirst, raised calcium and phosphate in urine.

42
Q

What are the risk factors for neural tube defects?

A

Maternal folate/b12 deficiency, history of infant with defects, smoking, diabetes, obesity, antiepileptics. Also sickle cell.

bnf (15 decks)

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