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ICA > Falls + Drugs > Flashcards

Falls + Drugs Flashcards

1
Q

What in a patients history + investigations suggest Rhabdomyolysis?

A

Long lie
Tea coloured urine
Raised creatine kinase + myoglobin

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2
Q

What is released into the blood stream in Rhabdomyolysis?

A

Myoglobin

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3
Q

How can Rhabdomyolysis cause an AKI?
Is this pre-renal, intrinsic or post-renal cause?

A

Myoglobin is toxic to the kidneys
Intrinsic

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4
Q

Define postural hypotension

A

A drop in BP that occurs within 3 mins of standing
>20mmHg systolic or >10mmHg diastolic

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5
Q

Possible GI causes of a fall

A

Constipation
Diarrhoea
Abdominal pain

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6
Q

Possible respiratory causes of a fall

A

Breathlessness
Cough

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7
Q

Possible CVS causes of a fall

A

Chest pain
Palpitations

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8
Q

Possible neurological causes for a fall

A

Confusion
Change in sensation
Abnormal movements

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9
Q

Possible MSK causes for falls

A

Joint pain

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10
Q

Possible genitourinary causes of falls

A

Dysuria
Frequency
UTI
Nocturia
Urinary incontinence

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11
Q

Possible head and neck causes for a fall

A

Dizziness on moving head
Change in eyesight

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12
Q

What is the drug class of diazepam?

A

Benzodiazepine

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13
Q

Uses of diazepam

A

Anxiety disorders
Sedatives
Treat muscle spasms

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14
Q

What is the mechanism of action of diazepam?

A
  • Enhances GABA effects (inhibitory neurotransmitter)
  • Has a calming effect on the brain
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15
Q

How could a patient taking diazepam be at an increased risk of a fall?

A

Sedative effect > could make patient drowsy

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16
Q

What drug class is amlodipine?

A

CCB - dihydropyridine

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17
Q

What are the uses of amlodipine?

A

Hypertension
Stable angina

18
Q

What is the mechanism of action of amlopidine?

A

calcium channel blocker
- selective for peripheral vasculature
- inhibits Ca2+ influx to vascular smooth muscles
- causes vasodilation
- decreases peripheral vascular resistance + cardiac workload

19
Q

How could a patient taking amlodipine be at an increased risk of a fall?

A

Side effects of dizziness + lightheadedness
Risk of hypotension

20
Q

What class of drug is Olanzapine?

A

Antipsychotic

21
Q

Uses of Olanzapine

A

Schizophrenia
Bipolar disorder
Depression

22
Q

What is the mechanism of Olanzapine?

A

Blocks dopamine, histamine + Muscarinic receptors

23
Q

How could a patient taking Olanzapine be at an increased risk of a fall?

A

Side effects of drowsiness, dizziness + impaired coordination

24
Q

What is the class of drug of codeine?

A

Opioid agonist

25
Q

What are the uses of codeine?

A

Pain relief
Cough suppression

26
Q

What is the mechanism of action of codeine?

A
  • binds to opioid receptors in brain > alters perception to pain + suppresses cough reflex
  • CYP2D6 converts codeine > morphine > analgesic effect
27
Q

How could a patient taking codeine be at an increased risk of a fall?

A

Side effects of drowsiness, dizziness + impaired coordination

28
Q

What is the class of drug of oxybutynin?

A

Anti Muscarinic

29
Q

What are the uses of oxybutynin?

A

Urinary incontinence
Urinary frequency or urgency
Overactive bladder

30
Q

What is the mechanism of action of oxybutynin?

A

antimuscarinic
- Blocks M3 receptors in bladder > stops Ach from binding > inhibits contraction of bladder
- increased capacity + decreased involuntary contractions

31
Q

How could a patient taking oxybutynin be at an increased risk of a fall?

A

Side effects of blurred vision, constipation, dizziness + drowsiness

32
Q

What is the class of drug of tansulosin?

A

Alpha 1 adrenergic antagonist

33
Q

What are the uses of tamsulosin?

A

BPH treatment

34
Q

What is the mechanism of action of tamsulosin?

A
  • alpha 1A antagonist
  • inhibits bindings of noradrenaline to prostate
  • causes prostate smooth msucle relaxation
  • improves urinary flow
35
Q

How could a patient taking tamsulosin be at an increased risk of a fall?

A

Side effects of dizziness, constipation, diarrhoea + postural hypotension

36
Q

Describe the baroreceptors response to increase in BP

A
  • increase in afferent impulses to cardiovascular centre in medulla
  • increase in parasympathetic activity
  • decrease in sympathetic activity
  • causes vasodilation + decrease in CO
  • decrease in BP
37
Q

what are the types of syncope?

A

Neurally mediated
Orthostatic hypotension
Cardiac arrrhytmia
Structural cardiopulmonary

38
Q

What is orthostatic hypotension?

A

Decrease in systolic BP 20mmHg

39
Q

Causes of cardiac arrhytmia syncope

A

abnormal heart rhythm + rate
e.g. tachycardia or bradycardia

40
Q

When does vasovagal syncope occur?

A

Whe your ody reacts to certain triggers such as emotional distress
Neurally mediated syncope

ICA (13 decks)

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