Communicating information Flashcards
1
Q
which antihypertensive is not suitable in any stage of pregnancy
A
ACEi - particularly teratogenic in first trimester
2
Q
tamoxifen key facts
A
- tamoxifen increases risk of endometrial cancer
- increases efficacy of warfarin
- flushing a common side effect
- increases risk of VTE
3
Q
glicazide (sulphonyureas)
A
- risk of hypoglycaemic episodes
- should be taken in morning at breakfast - taking at night increases risk of nocturnal hypoglycaemia
4
Q
methotrexate
A
- taken once weekly (will cause neutropenia)
- regular monitoring of WBC required
- folate antagonists such as trimethoprim and co-trimoxazole
- folic acid should be co-prescribed to reduce toxicity to the bone marrow
5
Q
warfarin
A
- major adverse effect is bleeding
- alcohol: need to be careful because acute binge will cause enzyme inhibition, causing increased INR, chronic drinking will cause enzyme induction. Therefore if patient is to drink then it should be moderate and spread out over the week
- weekly blood tests are only required until INR is stable e.g. 2.5 or 3.5
6
Q
ACEi
A
- can increase risk of hyperkalaemia
- can cause try cough -> start ARB like losartan
- can cause renal failure
- important to monitor renal function - 1-2 weeks after starting
- beware if develop D+V -> can increase risk of AKI
7
Q
steroids
A
- can caus hyperglycaemia and diabetes
- increase risk of osteoporosis so shoudl be giving prophylactic bisphosphonates if prescribed for longer than 3 months
- increased risk of gastric irritation and uilcers -> give PPI
- should never stop suddenly- addisonian crisis
- should be monitored for incresed BP
8
Q
SSRIs
A
- can take up to 6 weeks to improve symptoms
- can cause photosensitivty
- can cause increased feelings of suicide
- can cause seratonin syndrome: agitation, temperature, hallucinations
- can cause dry mouth
9
Q
insulin
A
- when unwell, blood glucose increases -> higher basal doses required -> can cause DKA
- failure to rotate sites can cause lipodystrophy
10
Q
alendronic acid
A
- once a week
- calcium salts reduce absorption of bisphosphonates and should not be taken at the same time (this is why calcium and vit d are corrected before starting)
- food should be avoided 2 hours after taking aldendronic acid to reduce absorption
- tablets should be swallowed with a full glass of water and remain upright for 30 mins afterwards
11
Q
HRT and cancer
A
- risk of breast cancer is higher for combined HRT than oestrogen only
- risk of endometrial cancer is reduced with combined HRT
- excess risk of breast cancer persists for more than 10 years after stopping
- risk of breast cancer is related to the duratio of use and not age when started
- continous HRT will stop breakthrough bleeding
12
Q
metformin
A
be aware of symptoms of lactic acidosis
13
Q
SGLT2 inhibitors e.g. gliflozins
A
Be aware of increased risk of DKA
14
Q
A
15
Q
A
16
Q
isotretinoin
A
17
Q
lithium
A
- pt should report signs and symptoms of lithium toxicity/ hypothyroidism and renal dysfunction (polyuria and polydipsia)
- benign intercranial hypertension (persistent heafache and visual disturbance)
- maintain adequate fluid intake
- avoid dietary changes which reduce or increase sodium intake
- avoid nsaids
21
Q
A
- all women with sickle cell should be on 5mg throughout pregnancy
- 400mcg daily up to 12 weeks in those at low risk of neural tube defects
- 5mg daily up to 12 weeks in those at high risk of neural tube defects
22
Q
nicotine replacement patches
A
