Data interpretation Flashcards
what drug classes are contraindicated in asthma?
- NSAIDs
- beta-blockers
- mild - cholingeric drugs, ACEi
what drugs are associated with low neutrophils?
clozapine (anti-psychotic)
carbimazole (anti-thyroid)
what drugs are associated with thrombocytopenia?
- number of drugs can reduce production but penicillamine especially (RA Tx)
- heparin - increases destruction
what sort of drug considerations are there for sodium disturbance?
- low sodium - see if diuretics
- high sodium - consider if too much IV saline, IV preparations with high sodium or effervescent medications
what medications are associated with potassium disturbance?
- hypokalaemia - loop and thiazide diuretics
- hyperkalaemia - potassium sparing diuretics and ACEi
what drugs are assocaited with AKI?
- antibiotics esp. gentamicin, vancomycin, tetracyclines
- ACEi
- NSAIDS
what drugs are associated with hepatitis/cirrhosis?
- paracetamol OD
- statins
- rifamipcin
what drugs cause cholestasis?
- flucloxacillin
- co-amoxiclav
- nitrofurantoin
- steroids
- sulphonylureas
how to alter levothyroxine dose?
- TSH < 0.5 mIU/L - decrease dose
- TSH 0.5 - 5 mIU/L - no change in dose
- TSH > 5 mIU/L - increase dose
what some common drugs have a narrow therapeutic window and therefore need monitoring?
- Digoxin
- Theophylline
- Lithium
- Phenytoin
- Antibiotics - gentamicin, vancomycin
what are features of digoxin toxicity?
Confusion, nausea, visual halos, arrhythmias
features of lithium toxicity
Early - tremor
Intermediate - tired
Late - arrhythmias, seizures, coma, renal failure, diabetes insipidus
features of phenytoin toxicity
Gum hypertrophy, ataxia, nystagmus, peripheral neuropathy, teratogenicity
features of gentamicin and vancomycin toxicity
Ototoxicity, nephrotoxicity
summarise gentamicin prescribing
- renal function + weight to get dose
- healthy - 5 -7 mg/kg OD
- renal failure - 1mg/kg 12 hourly
- endocarditis - 1mg/kg 8 hourly
summarise monitoring for once daily gentamicin regimes
uses nomogram - different ones for different doses
- Changing dose depending on nomogram plotting
- Point in q24h area → keep dose every 24 hours
- Point in q36h area → change to 36 hourly dosing
- Point in q48h area → change to 48 hourly dosing
- Point over q48h area → repeat gentamicin level, only re-dose when concentration is < 1mg/L
what are the nomograms for OD gentamicin regimes?
- 7mg/kg - Hartford
- 5mg/kg - Urban and Craig
summarise monitoring divided dose regimes of gentamicin treatment
use peak (1hr after) and trough ( just before next dose)
managing raised INR on warfarin
MAJOR BLEED
- stop warfarin
- 5-10 mg IV vitamin K
- Prothrombin complex
INR 5-8
- not bleeding - omit warfarin for 2 days and then reduce dose
- minor bleeding - omit warfarin + 1-5 mg IV vit. K
INR > 8
- not bleeding - omit warfarin + PO 1-5mg vit. K
- minor bleeding - omit warfarin + 1-5 mg IV vit. K
