Communicating Information Flashcards
What should be monitored after starting an ACEi?
Monitor renal function + Electrolytes following initiation - 1/2 weeks
Give 3 things Tamoxifen increases the risk of
Increases risk of endometrial cancer
Increases efficacy of Warfarin, can lead to High INR readings
Increases risk of DVT/PE
Metformin increases risk of what?
Lactic acidosis
Gliclazide increases risk of what?
Hypoglycemia
Should be taken with meals and meals should not be missed
What biochemical markers should be monitored in a patient taking methotrexate?
FBC - Neutropenia
LFTs - Liver cirrhosis
(1-2 weekly whilst initiating therapy, then 2-3 monthly)
Patients taking methotrexate should report what immediately?
Signs/Symptoms of infection, especially sore throat.
Due to risk of severe infection/neutropenic sepsis
What should be prescribed alongside methotrexate? When should it not be taken?
Folic acid
Should NOT be taken on the same day
What is used to treat methotrexate toxicity?
Folinic acid
What is the major adverse effect of Warfarin?
Increased risk of bleeding
What affect does Alcohol have on Warfarin metabolism?
Acute intoxication - Inhibits Warfarin Metabolism
Chronic alcohol excess - Increases Warfarin Metabolism
(Drinking should be modes and spread out)
When should patients taking Warfarin have blood tests?
Weekly when initiating
Monthly thereafter
What effect to macrolides have on Warfarin?
Enzyme inhibitors - Increase effects of Warfarin
What dietary change can alter Warfarin metabolism?
Increase in vitamin K - Increase INR
(Cranberry/Grapefruit/Pomegranate juice)
Steroids (prednisolone) can increase the risk of what? (4)
Increase risk of hyperglycaemia and diabetes
Increase the risk of osteoporosis (consider bisphosphonate)
Increase risk of gastric irritation/ulceration (consider PPI)
Increased risk of hypertension (monitor BP)
Why should long courses of Steroids (prednisolone) not be stopped abruptly?
Can cause Addisonian Crisis due to adrenal suppression
Taper dose if pt needs to come off steroids
Give 3 potential side effects of Citalopram (SSRI)
Nausea
Dry mouth
Photosensitivity
How should hypoglycaemia ideally be treated?
Oral glucose tablets
How often is HbA1c measured in diabetics?
Every 3 months
Failure to rotate insulin injection sites can cause what?
Lipodystrophy
When and how should bisphosphonates (alendronic acid) be taken? (3)
30 minutes before food/other medication
Take with a full glass of water and stay upright for 30 mins after.
Take one dose daily in the morning
Bisphosphonates commonly cause what?
Oesophageal irritation
Bisphosphonates increase the risk of what? (3)
Atypical fracture (consider bisphosphonate holiday)
Osteonecrosis of the jaw (regular check ups/good dental hygiene)
Osteonecrosis of external auditory canal (report ear pain/discharge)
What should not be taken at the same time as bisphosphonates? Why?
Calcium supplements.
As can reduce absorption
Outline some key points regarding the risk of breast cancer in patients taking HRT (4)
Risk of breast cancer is related to the duration of use (not the age at which HRT is started)
Risk of breast cancer is higher in combined HRT (esp continuous) when compared to Oestrogen Only HRT
Risk of breast cancer decreases after stopping HRT
Vaginal only HRT does NOT increase risk of breast cancer
