Drug management of conditions Flashcards
What is the immediate management of acute coronary syndrome?
300mg aspirin + GTN +/- O2 +/- morphine
What is the management of stable angina (immediate and long term)
GTN
b-blocker AND/OR CCB
what is the acute management of a PE? (two drug options) and what is the reason you would choose one over the other?
Anticoagulation with rivaroxaban (first line) or LMWH (dalteparin/enoxaparin).
Choose rivaroxaban mostly unless:
- needs IV/subcut
- has severe renal impairment
- anti-phospholipid syndrome
What is the management pathway for acute asthma attack in an adult or child?
- salbutamol (inhaler or neb) + oral pred (or IM methylprednisolone)
+/- ipratropium bromide neb
+/- magnesium sulphate IV
What is the management of dyspepsia?
PPI + H.pylori test + treatment
What is the treatment for H pylori infection?
PPI + Amoxicillin + clarithromycin/metronidazole (7 days)
when should you use oestrogen only HRT and what do you search to find this on BNF?
only when patient has had hysterectomy
Search estradiol and then pick the form you want
when should you use cyclical combined HRT and what do you search to find this on BNF?
if still having periods/last period was less than 12 months ago
estradiol with norethisterone (if patch look for evorel sequi and if oral look for elleste-duet)
when should you use continuous combined HRT and what do you search to find this on BNF?
if periods stopped (last one more than 1 year ago) or looking to stop bleeds
estradiol with norethisterone (if patch look for evorel conti and if oral look for elleste-duet conti)
What are some contra indications to the COC and what should you search on BNF to find it?
contraindications:
- over 35 + smoke (15+ per day)
- thromboembolic disease
-migraine with aura
- breast feeding <6 weeks post partum
- uncontrolled hypertension
- breast cancer
Look up hormonal contraceptives and ctrl f: gedarel
what are the rules around COC use and surgery?
must be stopped 1 month before hand and restarted 2 weeks after
which contraceptive types are good for heavy painful periods?
COC, IUS, implant (stops them)
which contraceptive types are more unpredictable with your periods?
POP, IUD, injection
How do you decide what anti-hypertensives to give to whom?
If age 55+ or black = amlodipine
If under 55 or diabetic = ramipril
if black and diabetic use losartan instead of ramipril
what venous thromboembolic prophylaxis would you use first line in all cases except renal failure?
And what would you use in renal failure cases?
LMWH (dalteparin)
unfractioned heparin for renal impiraiment
how do you find opioid conversions on bnf and what are some key ones?
go to prescribing in palliative care and go to the pain management with opioids section
Oral morphine to subcut morphine = divide by 2
Oral codeine to oral morphine = divide by 10
what antihistamine should be used for allergy?
certirizine
what is the pharmacological tx of choice for urge and stress incontinence?
Stress = duloxetine
urge = tolterodine, oxybutynin (not in elderly), mirabegron
who should be on a statin and whats the drug of choice?
those with CVD risk >10%,
T1DM (over 40 or had it more than 10 years, neuropathy)
over 85
atorvastatin
what is the management of CAP?
Mild mod = PO amox 5 days
sev = Amox and Doxy 5 days
what is the management of HAP?
non sev = PO amox 5 days
sev = IV amox and gent 7 days
What is the management of penumonia caused by mycoplasma?
doxycylcine
what is the management of pneumonia caused by pneumocystis
co trim
what is the management of c diff
oral vanc or if sev oral vanc and IV met
