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SDCEP, IADT Guidelines > Drug prescribing > Flashcards

Drug prescribing Flashcards

1
Q

What are the key signs of Anaphylaxis?

A
  • Marked upper airway oedema and bronchospasm
  • Stridor and wheezing
  • Tachycardia (HR > 110 per min) and increased respiratory rate
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2
Q

What are the symptoms of Anaphylaxis?

A
  • Abdominal pain
  • Vomiting
  • Diarrhoea
  • Sense of impending doom
  • Flushing but also pallor can happen
  • Mild allergy symptoms
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3
Q

What is the management of patient in anaphylaxis?

A
  • Assess patient
  • Call ambulance
  • Secure pt airway
  • Help restore BP by laying pt flat and raising feet
  • Remove source of anaphylaxis if known (use suction)
  • Oxygen/adrenaline
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4
Q

What is the oxygen dose for anaphylaxis?

A
  • 100% oxygen with flow rate of 15litres/minute
  • Same for adults and children
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5
Q

What is the adrenaline dose for anaphylaxis?

A
  • 0.5ml (1:1000) i.m. injection repeated after 5 mins if needed (12-adult)
  • 0.3ml for 6-11years
  • 0.15ml for 6months-5years
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6
Q

What are the key signs of mild allergy?

A
  • Urticaria and rash, particularly of chest, hands and feet
  • Rhinitis and conjunctivitis
  • Mild bronchospasm without evidence of sever shortness of breath
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7
Q

What are the 3 management options for mild allergy?

A
  • Cetrizine
  • Chlorphenamine
  • Loratadine
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8
Q

What is the management of mild allergy with Cetrizine?

A
  • 1 Cetrizine tablet 10mg
  • 6-11years use 5mg
  • Drowsiness is rare but advise don’t drive
  • Caution in pt with hepatic impairment or epilepsy
  • Not licensed for under 2years
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9
Q

What is the management of mild allergy with Chlorphenamine?

A
  • 1 tablet 4mg 12 and above
  • 1 tablet 2mg 6-11years
  • Oral sol 1mg 2-5years
  • Can cause drowsiness, don’t drive
  • Caution with patients with hepatic impairment, prostatic hypertrophy, epilepsy, urinary retention, glaucoma or pyloroduodenal obstruction
  • Avoid in children with severe liver disease
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10
Q

What is the management of mild allergy with Loratadine?

A
  • 1 tablet 10mg 2 and above
  • 1 tablet 5mg if <30kg
  • Drowsiness rare but don’t drive
  • Caution in pt with hepatic impairment or epilepsy
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11
Q

What is the management of mild allergy with signs of mild bronchospasm?

A
  • Salbutamol inhaler 4 puffs (100mg per actuation) through large-vol spacer
  • Repeat as needed
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12
Q

What are the signs of life threatening asthma?

A
  • Cyanosis or respiratory rate <8 per min
  • Bradycardia (HR <50per min)
  • Exhaustion, confusion, decreased conscious level
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13
Q

What are the signs of acute severe asthma?

A
  • Inability to complete sentences in one breath
  • Respiratory rate >25 per min
  • Tachycardia
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14
Q

When should a pt suffering asthma attack be transferred to hospital?

A
  • If life-threatening signs immediately
  • If not responding to bronchodilators within 5 mins of severe episode
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15
Q

What is the management of asthma attack?

A
  • Assess pt
  • Sit pt upright
  • 100% oxygen 15litres/min
  • Pt own bronchodilator 2 puffs
  • If not available then salbulatmol inhaler 4 puffs 100mg per actuation through large vol spacer
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16
Q

What is the key sign of angina and MI?

A
  • Progressive onset of sever crushing pain in centre and across front of chest
  • May radiate to shoulders and down arms, into neck and jaw
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17
Q

What are the symptoms of angina and MI?

A
  • Shortness of breath
  • Increased respiratory rate
  • Skin becomes pale and clammy
  • Nausea and vomiting are common
  • Pulse might be weak and blood pressure might fall
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18
Q

What is the management of angina or MI?

A
  • 100% oxygen 15litres/min
  • GTN (glyceryl trinitrate) 2 puffs 400mg per dose sublingually , repeat after 3mins if chest pain remains
  • Call ambulance if does not respond
  • Aspirin 300mg orally
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19
Q

What are the keys signs of Cardiac arrest?

A
  • Loss of consciousness
  • Absence of normal breathing
  • Loss of pulse
  • Dilation of pupils
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20
Q

What is the management of cardiac arrest?

A
  • BLS and call ambulance
  • 100% oxygen 15litres/min
  • Defibrillation
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21
Q

What are the key signs of epilepsy?

A
  • Sudden loss of consciousness
  • May become rigid, fall and become cyanosed
  • Jerking movements of limb and tongue bitten
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22
Q

What are the symptoms of epilepsy?

A
  • Brief warning or aura
  • Frothing from mouth or urinary incontinence
23
Q

What is the management of epilepsy?

A
  • Assess
  • Don’t restrain convulsive movements
  • Ensure not at risk of injury
  • Secure airway
  • 100% oxygen 15litres/min
  • 10mg midazolam 2ml oromucosal solution
24
Q

What are the key signs of faint?

A
  • Faint, dizzy, light-headed
  • Slow pulse rate
  • Loss of consciousness
25
Q

What are the symptoms of faint?

A
  • Pallor and swelling
  • Nausea and vomiting
26
Q

What is the management for faint?

A
  • Assess pt
  • Lay flat and loosen tight clothes around neck
  • 100% oxygen 15litres/min
27
Q

What are the key signs of hypoglycaemia?

A
  • Aggression and confusion
  • Sweating
  • Tachycardia
28
Q

What are the symptoms of hypoglycaemia?

A
  • Shaking and trembling
  • Difficulty in concentration/vagueness
  • Slurring of speech
  • Headache
  • Fitting
  • Unconsciousness
29
Q

What if the management of hypoglycemic pt?

A
  • Assess pt
  • 100% oxygen 15litres/min
  • If conscious and co-op oral glucose (10-20g) repeat if needed 10-15mins
  • If unconscious of un co-op glucagon 1mg i.m. injection then oral glucose when conscious
30
Q

What are the key signs of a stroke?

A
  • Facial weakness, one eye droops or can only move one side of mouth
  • Arm weakness
  • Slurred speech
  • Unable to understand what is being said
31
Q

What is the management of stroke?

A
  • Patient to hospital immediately
  • 100% oxygen 15litres/min
  • If unconscious secure airway and place in recovery position
32
Q

What are signs and symptoms of aspiration and choking?

A
  • Cough and splutter
  • Difficulty breathing
  • Breathing noisy and stridor
  • May develop paradoxical chest movements
  • May become cyanosed and lose consciousness
33
Q

What is the management of someone choking?

A
  • Confirm choking
  • Encourage cough vigorously
  • Remove any vis foreign bodies
  • Black blows and abdominal thrusts
  • I f become unconscious BLS and hospital
34
Q

What is the drug management of anxiety?

A
  • 1 tablet diazepam 5mg
  • Label as 1 table before procedure
  • Halve dose for elderly
  • Advise Don’t drive and need escort
35
Q

What is the management of dental abscesses?

A
  • First treat local measures
  • If any pus present then drain by extraction of tooth or through root canals
  • If pus present in soft tissue attempt to drain by incision
  • If local measures ineffective or evidence of spreading infection or systemic involvement antibiotics can be prescribed?
36
Q

What is the drug management of dental abscess with amoxicillin?

A
  • 5 day regime
  • 15 capsules 500mg
  • Label 1 capsule three times daily
  • Don’t prescribe to pt with history of anaphylaxis, urticaria penicillin allergy
37
Q

What is the drug management of dental abscess with Phenoxymethypenicillin?

A
  • 40 tablets 250mg
  • Label 2 tablets 4 times daily
  • Don’t prescribe to pt with history of anaphylaxis, urticaria or penicillin allergy
38
Q

What is the drug management of dental abscess with patients with penicillin allergy?

A
  • Metronidazole 200mg
  • 15 tablets
  • Label 1 tablet 3 times daily
  • Avoid alcohol
  • Don’t prescribe for pt taking warfarin
39
Q

What is the drug management of severe infection when first line antibiotics don’t respond?

A
  • Clindamycin capsules 150mg
  • 20 capsules
  • Label 1 capsule 4 times swallowed with water
  • Co-amoxiclav 150/125 tablets
  • 15 tablets
  • Label 1 tablet 3 times daily

Clarithromycin tablet 250mg
- 14 tables
- 1 tablet 2 times daily

40
Q

How do you treat necrotising ulcerative gingivitis ?

A
  • Local measures of removing supra-gingival and sub-gingival deposits and provide oral hygiene advice
  • 3 days regime of Metronidazole 200mg 9 tablets , 1 tablet 3 times a day
  • or Amoxicillin capsules 500mg 9 capsules 1 capsule three times a day
41
Q

How do you treat pericoronitis?

A
  • Carry out irrigation and debridement
  • Metronidazole 200mg 9 tablets 3 times a day
  • Amoxicillin 500mg 9 capsules 1 capsule 3 times a day
42
Q

Who shouldn’t you prescribe metronidazole to?

A
  • Pt taking Warfarin
43
Q

What is the treatment of Sinusitis?

A
  • Local measures first of use steam inhalation
  • If persistent symptoms and/or purulent discharge lasting 7 days or symptoms severe use
  • Ephedrine nasal drops 0.5% 10ml 1 drop each nostril up to 3 times daily
  • Amoxicillin 500mg 21 capsules 1 capsule 3 times a day
44
Q

What is the treatment for pseudomembranous candidosis and Erythematous candidosis?

A
  • Local measures first advise pt who use corticosteroid inhaler to rinse their mouth with water or brush teeth immediately after using inhaler
  • Fluconazole 50mg 7 capsules 1 a day
  • Miconazole oromucosal gel 20mg/g apply pea sized amount after food 4times a day
  • If taking Warfarin or statin prescribe nystatin oral suspension 100,000 units/ml
45
Q

When should you not prescibe fluconazole or miconazole?

A
  • pt taking warfarin or statins
46
Q

What is the treatment for denture stomatitis?

A
  • Local measures first and advise pt to
  • Brush palate daily
  • Clean dentures by soaking in chlorhexidine mouthwash or sodium hypochlorite(acrylic dentures only) for 15mins twice daily
  • Leave dentures out as often as poss during treatment period
  • Fluconazole 50mg 7 capsules 1 a day
  • Nystatin oral suspension 100,000 units ml 30ml 1ml after food 4times a day if pt taking warfarin or statin
47
Q

What is the treatment of angular chelitis?

A
  • Miconazole cream 2% 20g tube apply to angles of mouth twice a day
  • If unresponsive then Miconazole 2% and hydrocortisone 1% cream
48
Q

What is the treatment for herpes simplex infections?

A
  • Avoid dehydration and use analgesics and chlorhexidine mouthwash 0.2% rinse mouth 1 minutes with 10ml twice daily
  • Aciclovir 200mg 1 table 5 times daily
  • Aciclovir cream 5% for herpes labialis
49
Q

What is the treatment for Varicella-Zoster infections?

A
  • Aciclovir tables 800mg 1 table five times daily for 7 days (shingles treatment pack)
50
Q

What is the treatment of trigeminal neuralgia?

A
  • Carbamazepine 100mg 1 table twice a day for 10 days
51
Q

What is the treatment for temporomandibular dysfunction?

A
  • Diazepam 2mg 1 tablet 3 times a day for 5 days
52
Q

What is the treatment for dry mouth?

A
  • Take frequent sips of cool drinks, suck ice or use sugar free chewing gum to provide symptomatic relief
  • Artificial saliva gel 50g apply to oral mucosa as required
  • Artificial saliva oral spray 100ml as required
53
Q

What is the prescription for high fluoride toothpaste?

A
  • Sodium fluoride toothpaste 0.619% 2800ppm
  • Brush teeth 1 min after meals using 1cm, before spitting out twice daily

SDCEP, IADT Guidelines (8 decks)

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