common drug knowledge Flashcards
A patient who has recently been started on antibiotics has experience flushing, headache, nausea, vomiting, sweating, and increased thirst whilst at the pub. What medication have they taken?
metronidazole
what is the management for H.pylori for someone with or without a penicillin allergy?
normal tripple therapy: PPI + clarithromycin + amoxicllin
pen allergy: PPI + clarithromycin + metronidazole
what medication accounts can cause neutrophillia ( raised wbc’s predominantly neutophils)
Glucocorticoid treatment (steroids)
what are 2 adverse affects of betabockers ?
confusion and bradycardia
what is the DVT prophylaxis dose of dalteparin?
5000 units
what is the recommended first line treatment for patients with PCOS?
COCP
How is GTN spray to be taken and when should an ambulance be called?
Spray it under the tongue and close the mouth.
Repeat in 5 minute intervals and if the pain persists 5 minutes after taken the second dose call ambulance.
common side affects headache and lightheadedness.
drugs that cause QT prolongation
Citalopram and escitalopram
How to manage a high InR
Less than 5 - nothing
No bleeding
INR: 5-8 -Withold warfrin
INR>8 - Vit K 1-5mg ORAL
Bleeding
minor - Vit K 1-3mg IV
major- Vit k 5mg IV
+ dried prothrombin complex
if not available FFP
Major bleeding (e.g. variceal haemorrhage, intracranial haemorrhage)
how does haliperiodol affect hallucinations
makes them worse.
what is LMWH commonly associated with
LMWH (Dalteparin sodium) is common or very commonly associated with immune-mediated, drug induced thrombocytopenia.
how many hours after giving digoxin should you monitor?
6 hours
How to manage hypoglycaemia ?
mild hypo (patient conscious)
- A-E
-consume fast acting carbs (e.g. glucose tablet, a small can of coke, sweets or fruit juice0
-consume some slow-acting carbs after (e.g. toast)
- AVOID CHOCOLATE
severe hypo (e.g. seizures/ patines unconscious)
- A-E
- Administer 200ml of 10% dextrose IV
- IF no IV access administer 1mg/kg of glucagon IM (wont work if hypo is caused by alcohol because of drug mechanism)
medications that exacerbate heart failure
verapamil
thiazolidinediones
NSAIDS/ gluticorticoids - should be used with caution as may cause fluid retention
are ACE inhibitors safe to use in pregnancy?
no they are teratogenic?l
what are the 3 main drug types that should not be used/used with caution in patients with asthma?
NSAIDS
beta-blockers
adenosine
what should you give for hyperthyroidism for pregnant ladies or people who cant have carbimazole (teratrogenic)
propylthiouracil
what are the two main side effects of calcium channel blockers?
headaches and odema/ankle swelling
what is the medication treatment for acute dystonia?
Procyclidine hydrochloride
(an anti-muscanaric)
what are the main adverse reactions for these drugs?
ACEi
Amlodipine
Amiodarone
Carbamazepine
ACEi – cough, hyperkalaemia
Amlodipine – oedema
Amiodarone – pulmonary fibrosis, thyroid dysfunction
Carbamazepine – hyponatraemia
what are the main adverse reactions for these drugs?
Clozapine
Gliclazide
Metformin
Statins
Clozapine – agranulocytosis
Gliclazide – hypoglycaemia
Metformin – lactic acidosis
Statins – myalgia
what are the daily maintenance fluid requirements?
25-30ml/kg
1mmol/kg of Na and K
how do you take cyclical hrt (withdrawal bleed) as opposed to continuous (no withdrawal bleed)?
You’ll usually be recommended to take sequential (cyclical) combined HRT if you have menopause symptoms but still have periods.
It comes as tablets or patches.
There are 2 types:
monthly HRT if you’re having regular periods – you take oestrogen every day, and take progestogen alongside it for the last 10 to 14 days of your menstrual cycle every month
3-monthly HRT if you’re having irregular periods – you take oestrogen every day, and take progestogen alongside it for around 10 to 14 days every 3 months
You should have a period at the end of each progestogen cycle.
Continuous combined HRT
Continuous combined HRT is usually recommended if you’re post-menopause. This is when you have not had a period for 1 year.
Continuous combined HRT involves taking oestrogen and progestogen every day without a break.
If you’ve had a hysterectomy and take oestrogen-only HRT, you’ll take it every day.
what is the drug of choice for treating C DIFF
Vancomycin
what are some side-effects of SSRIs?
High risk of bleeding
confusion
fluid resuscitation/ fluid bolus for kids amount?
10ml/kg
signs someone needs a fluid resucitation
If a patient has signs of hypovolaemic shock – (poor perfusion, tachycardia, drowsy, tachypnea, poor urine output, hypotension, hypotonia)
anytime you are about to click and option to prescribe penicillin what do you need to check for?
penicilin allergy
how should insulin be given the day before surgery?
the patients usual dose should be given as normal apart from their once daily long acting insulin analogues, which should be reduced by 20%.
what is a major side effect of sodium valporate and so what is put in place?
teratrogenic therefore cautioned in women of child bearing age.
what does 1 in 1000 mean in adrenaline
1g of adrenaline in 1000 ml
what fluids should you give a diabetic going into surgery?
45% Nacl/potassium 0.15/0.3%/ glucose 5%
roughly 100ml over 8-12 hours (normal maintenance amounts)
what is the optimal treatment and dose for giant cell arteritis
methylprednisolone sodium succinate 1g IV
What is the application route of creams?
topical
roughly how much fluids does a patient need a day and how many salty how many sweet?
3L - Normal adult (1L 6hrly)
2L - Elderly (2L 8hrly)
1 salty 2 sweet
what is a contraindication for giving compression socks?
peripheral arterial disease
two types of patients to avoid metoclopramide in
patients with parkinsons (makes symptoms worse)
young women (risk of dyskinesia)
for antiemetics cyclizine is a good first-line treatment for almost all cases except?….
cardiac cases
what should bp be before given alteplase
less than 185/110
what type of laxative is first line in children?
osmotic laxatives
how often do u give a dose of ondansetron?
8 or 12 hrly
what drug is contraindicated in peripheral vascular disease and why ?
beta blockers as they cause peripheral vasoconstriction
main drugs that predispose patients to vaginal candida?
antibiotics and steroids
drugs that cause hyperkalemia 5
Ace inhibitors
spironolactone
NSAIDS
Heparin
digoxin
what to do if statins cause raised CK
if more than 5 x the UL then stop the statin and if symptomps resolce and ck levels return to normal then the statin should be reintroduced at a lower dose.
Drugs that cause urinary retention 4
opiods
NSAIDS
benzos
calcium channel blockers
when do you use methylprednisolone over prednisolone and at what dose/
methylprednisolone is preferred with patients who have visual loss associated with gca.
dose 0.5-1g IV for 3 days initially.
if no access to IV medication then 60-100mg prednisolone oral for 3 days intitially.
what drugs may need dose adjustment in the context of smoking ceasation
clozapine and theopphylline/aminophylline
because smoking reduces their effects so when a person stops smoking the dose may need to be decreased because they have a narrow therapeutic window.
Two drugs that cause congenital heat defects in pregnancy
Lithium and fluoxetine/paroxetine
Which painkiller should not be continued peri opperatively
Ibuprofen
Bone marrow suppresion sore thorat after staring..
Carbimazole… check fbc
What drug should be stopped 1 week before surgery
Aspirin
Out of allopurinal and aspirin which should be held in aki
Allopurinol
When should nitrofunintonin be avoided
Egfr less than 45
What should inr be before surgery
Less than 1.5
If higher use vit k
What to do if creatinine rises in aki
A small rise in createnine (less than 20%) is expected when starting an ace inhibitor and does not require investigation or change in prescription
Measure of efficacy in heart failure drugs
Exercise tolerance
