Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y6 PSA > Difficult prescriptions > Flashcards

Difficult prescriptions Flashcards

1
Q

How do you adjust insulin

A

TOTAL DAILY DOSE = long acting + short acting
100/TDD = correction factor

the correction factor is how much 1U of insulin decreases blood glucose by

THEN: (actual glucose - target glucose)/ correction factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is target glycaemic index during the day

A

5-7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how do you change insulin if patient is sick

A

YOU DONT

Continue normal insulin but with more monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What do you do if patient is NBM to insulin

A

continue basal insulin

omit bolus insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Name of oestrogen HRT you can prescribe (oral / transdermal / gel)

A

Estradiol
Oral: Elleste solo
Transdermal: Evorel
PV gel: sandrena

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what adjunct progesterone can you gve for HRT

A

IUS (Mirena)

PO (Provera)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what formulation of HRT do you need to give if peri-menopausal / wants period

A

OESTROGEN + PROGESTERONE (cyclical / sequential commbined)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

name of oral HRT to give if peri-menopausal / wants period

A

Estradiol with norethisterone

Elleste duet ORAL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

name of transdermal HRT to give if peri-menopausal / wants period

A

Evonorel sequi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what anti contipation meds can you give

A
  • OSMOTIC
    STIMULAANT
    BULKING
    PROKINETI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the front line stimulant algorithm to give

A
  1. Osmotic

2. Add Stimulant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

give examples of ossmotic laxative

A

lactulose, movicol, phosphate enema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how does an osmotic laxative work

A

it draws water intto stool > softtens stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

containdication of osmotic laxatve

A

bloating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

give examples of stimulants

A

senna

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how do stimulants work

A

stimulate GI nerves > stimulate movement of bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

contraindications of sttimulants

A

colitis
cramps
bowel obstruction
colostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

which laxative is good for patients on opioids

A

stimulant laxative

because they counteract the slowing down of gut movement caused by opioid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what anti-diarrhoeal meds can you give (NOT if INFECTIVE=

A

Loperamide – take after each loose movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the steroid ladder?

A

Help Carol Beat Medicine

Hydrocortisone
Clobetasone
Betamethhasone
Mometasone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

when do you need to weane a patient off steroids (rather than stopping abruptlu)

A

> 40mg pred for 1 week
3 weeks of treatment
repeated course

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what situation is it okay to abruptly withdraw steroids

A

if giiven for emergency (COPD/asthma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What time of day should you take simvastatin

A

in the evening (as cholesterol metabolism is in the evening)

24
Q

commonest side effect of statins

A

muscle pains

25
Q

when should you stop statins following LFTT monitoring=

A

stop statins if AST/ALT >3 x ULN

continue statin otherwise

26
Q

when must you stop statins in muscle myopathy

A

if CK elevated (>5ULN) or severe muscular sx > STOP STATIN

resume at lower dose once CK has returned to normal

27
Q

Why is warfarin and statins a concernign combination

A

because they will lead to a high INR

due to competitive inhibition of CYP by statin

28
Q

Outline WHO pain ladder

A
  1. Non opioid (NSAID, paracetamol)
  2. Weak opioid
  3. Strong opioid
29
Q

list some weak opioids

A

codeine
tramadol
morphine (oromorph PO, modiphied release morphine)

30
Q

what are strong opioids

A

morphine
diamorphine
fentanyl
oxycodone

31
Q

How do you convert codeine / tramadol to oral morphine=

A

DIVIDE by 10

32
Q

How do you convert oral morphine to subcut morphine

A

DIVIDE by 2 (subcut is STRONGER than oral)

33
Q

convert oral morphone to oxycodone

A

DIVIDE by 2 (oxycodone is stronger than morphine)

34
Q

which opioids can you give in. CKD

A

Oxycodone (GFR >30)

Fentanyl, alfentanyl, buprenorphinie (GFR<30)

35
Q

how does warfarin work

A

inhibits vit K epoxide reductase > reduces levels of 2, 7, 9. 10

36
Q

what is INR target for AF, cardioversion, MI

A

2-3

37
Q

what is INF target for mechanical heart valve

A

3-4

38
Q

what does 1% mean in terms of mg in mL

A

10mg in 1mL

39
Q

how do you change / adapt COCP if surgery?

A

stop COCP 4 weeks beforee surgery
restart COCP 2 weeks post surgery
consider POP in interim

40
Q

what kinds of laxatves are good for HAEMORRHOIDS?

A

bulk forming laxative

41
Q

give examples of bulk formming laxative

A

ispaghula hysk

methylcellulose

42
Q

when can biphosphonates be deprescrbed

A

when taken for more than 10 years

as there is no evidence that they still work

43
Q

what unit can you use for topical meds

A

fingertip units (FTU)

44
Q

is aspirin technically an NSAID? what must you keep in mind

A

yes it is technically an NSAID

but because it exists at a much lower dose, it is not necessarily subject to same level of caution

45
Q

what is the only situation when cyclizine is contraindicated

A 
if HF (as it worsens fluid retention) 
give metoclopramide instead
46
Q

what is the max dose of paracetamool they can take

A

4g a day

47
Q

how much paracetamol does one tablet cocodamol 30/500 contain

A

500mg

48
Q

which drug type causes HYPOkalaemia

A

THIAZIDE diuretic

49
Q

give an example of a THIAZIDE diuretic

A

bendroflumethazide

50
Q

give an example of a THIAZIDE LIKE diuretic

A

indapamie

51
Q

how do THIAZIDE diuretics work

A

INHIBIT sodium and chloride resorption > low Na, Cl

+ increase calcium reabsorption> high CA

52
Q

how doo THIAZIDES cause HYPOKALAEMIA

A

later in the nephron transporters attempt to resorb sodium

in doiong this they excrete pootassium

53
Q

which diuretics cause hypokalaemia

A

loop and thiazie

54
Q

which diuretics cause HYPERkalaemia

A

aldosterone antagoniists
ACEi
ARB

55
Q

what is the action of NSAIDs on the kidneys

A

cause renal artery constriction> reduce renal perfusion

56
Q

what must you give for extrapyramidal sx e.g. dystonia

A

procyclidine

57
Q

what must you do if discontinuing statin due to muscle pains / raised CK?

A

wait until muscle pains stop

then re start at lower dose

Y6 PSA (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions