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psa MJ > extras > Flashcards

extras Flashcards

1
Q

enzyme inhibitors (potentiate) ODEVICES

A 
Omeprazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin/Cimetidine
Ethanol (acutely)
Sulphonamides
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2
Q

enzyme inducers (decrease efficacy) - PCBRAS

A

Phenytoin
Carbamazepine

Barbiturates
Rifampicin
Alcohol (chronic)
Sulphonylureas

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3
Q

alpha 1 adrenoreceptor agonist

A

decongestgants eg phenylephrine

vasopressors eg metraminol/norad

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4
Q

alpha 1 adrenoreceptor antagonist

A

antagonist:
BPH eg tamsulosin
HTN eg doxasozin

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5
Q

beta 1 adrenoceptor agonist

A

inotropes eg dobutamine

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6
Q

beta 1 adrenoceptor antagonist

A

selective beta blockers eg bisoprolol

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7
Q

beta 2 adrenoceptor agonist

A

bronchodilators eg salbutamol

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8
Q

beta 2 adrenoceptor antagonist

A

non-selective beta blockers eg propanolol

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9
Q

dopamine agonist

A

PD eg ROPINIROLE

prolactinomas eg BROMOCRIPTINE

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10
Q

dopamine antagonist

A

antipsychotics eg HALOPERIDOL

anti-emetics eg METOCLOPRAMIDE

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11
Q

GABA agonist

A

benzodiazepines

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12
Q

GABA antagonist

A

flumazenil

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13
Q

Histamine-1 Antagonist

A

antihistamines eg cetirizine

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14
Q

Histamine-2 Antagonist

A

Antacids eg ranitidine

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15
Q

mACh agonist

A

Glaucoma eg pilocarpine

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16
Q

mACh antagonist

A

Brady eg atropine
Bronchodilators eg ipratropium
Urge incontinence eg oxybutynin

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17
Q

nACh agonist

A

Smoking cessation eg varenicicline

Depolarising muscle relaxant eg suxamethonium

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18
Q

nACh antagonist

A

Non-depolarising muscle relaxant eg atracurium

19
Q

Serotonin agonist

A

acute migraine eg sumatriptan

20
Q

Sertonin antagonist

A

Anti-emetics eg ondansetron (5HT3A antagonist)

21
Q

oral codeine or oral tramadol to oral morphine

A

divide by 10

22
Q

oral morphine to oral oxycodone

A

divide by 1.5

  • preferred in mild-moderate renal impairment (eGFR 30-60)
  • causes less sedation/vomiting/pruritus
23
Q

oral morphine to SC morphine

A

divide by 2

24
Q

oral morphine to SC diamorphine

A

divide by 3

25
Q

oral morphine to fentanyl 100 patch

A

dividie by 100 (over 24h)

26
Q

SE of opiates x3

A

nausea (transient)
vomiting (transient)
constipation (persistent)

27
Q

opiate for use if eGFR <30

A

alfentanil, fentanyl, buprenorphine

28
Q

starting tx doses for opiods in palliative care - MR morphine, IR oromorph + one more thing

A

15mg MR morphine BD (= total 30mg oral morphine)
+
1/6 of 30 = 5mg IR oromorph (for breakthrough pain)
+
laxative

29
Q

general prescribing for nauseated individual

A

1st line: cyclizine 50mg 8 hourly (except in cardiac cases as can worsen fluid retention)
2nd line: metoclopramide, 10mg 8 hourly
(avoid in PD, use domperidone instead, and avoid in young women, risk of acute dystonia)

30
Q

general prescribing in vomiting without nausea

A

cyclizine 50mg up to 8 hourly

metoclopramide 10mg up to 8 hourly

31
Q

N&V in palliative care: GASTRIC STASIS causes + drug of choice

A

causes; opiods

drugs; metoclopramide (CI - BOWEL OBSTR), domperidone

32
Q

N&V in palliative care: CHEMICAL causes + drug of choice

A

causes; opiods, hypercalcaemia, chemo

drugs; ondansetron, haloperidol, levomepromazine

33
Q

N&V in palliative care: VISCERAL/SEROSAL causes + drug of choice

A

causes; constipation, oral candidiasis

drugs; cyclizine, levopromazine

34
Q

N&V in palliative care: RAISED ICP causes + drug of choice

A

causes; cerebral metastasis

drugs; cyclizine +/- dexamethasone

35
Q

N&V in palliative care: VESTIBULAR causes + drug of choice

A

causes; motion-related, base of skull tumours

drugs; cyclizine

36
Q

N&V in palliative care: CORTICAL causes + drug of choice

A

causes; anxiety, pain, fear, anticipatory nausea

drugs; BDZ (lorazepam), cyclizine

37
Q

bony mets pain x3

A

1st - analgesia
2nd - bisphosphonates
3rd - radiotherapy

38
Q

antihistamines; target, example, indications + SE

A

target H1>M>D2
acts on CTZ, vestibular, VC

PROMETHAZINE

  • INDIC: motion sickness, labyrinth disorders, hyperemesis gravidarum, pre- and post-operatively
  • SE: dizziness, fatigue, tinnitus, sedation
39
Q

D2 receptor antagonist; examples x2

A

METOCLOPRAMIDE (avoid in BO - prokinetic), DOMPERIDONE

40
Q

D2 receptor antagonist; target, indications + SE

A

target D2»H1»>M
acts on CTZ

INDIC: GI motility disorders, uraemia, radiation sickness, cancer chemo

SE: CNS - EPSEs, drowsy, dizzy, anxiety
Endo - hyperprolactinaemia, galactorrhoea

41
Q

M receptor antagonist - target + example

A

M»>D2/H1
acts on CTZ, vestibular, VC

-Hyoscine/scopolamine + Diphenhydramine
(little effect once nausea est)

42
Q

M receptor antagonist; indication + SE

A

indication: pre-op medication, motion sickness
SE: antimuscarinic - dry mouth, mydriasis, constipation, drowsy

43
Q

5-HT3 receptor antagonist - target, example, indication + SE

A

5-HT3 receptor antagonist, 5 HT2, acts on CTZ, peripherals

ondansetron (mild nausea use alone, severe nausea combine with steroids)

indication: chemo sickness, RT sickness, post-op N&V
SE: headache, flushing, constipation

psa MJ (3 decks)

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