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IK6 - PSA and prescribing > From Questions > Flashcards

From Questions Flashcards

1
Q

In haemodynamically stable SVT what medication is used 1st line in asthmatics after vagal manoeuvres?

A

Verapamil

Adenosine is contraindicated in asthmatics

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2
Q

conversion of PO codeine → PO morphine

A

divide by 10

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3
Q

conversion of PO tramadol → PO morphine

A

divide by 10

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4
Q

conversion of PO morphine → PO oxycodone

A

divided by 1.5 - 2

*BNF says 1.5

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5
Q

conversion of PO morphine → SC morphine

A

divide by 2

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6
Q

conversion of PO morphine → SC diamorphine

A

divided by 3

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7
Q

PO oxycodone → SC diamorphine

A

divide by 1.5

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8
Q

drugs CI in peptic ulcer disease

A
  • aspirin
  • NSAIDS
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9
Q

drugs CI in CKD

A
  • NSAIDS
  • ACEi
  • drug clearance of many is slowed e.g. gentamicin, digoxin
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10
Q

drugs CI in chronic heart failure

A
  • CCB
  • negative inotropies e.g. flecainide
  • TCA
  • NSAIDs
  • corticosteroids
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11
Q

drugs CI in heart block

A
  • verapamil
  • digoxin
  • beta-blockers
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12
Q

antiplatelet for ACS (medically treatment)

A
  1. aspirin lifelong + ticagrelor 12 months
  2. if aspirin CI then clopidogrel lifelong
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13
Q

anti-platelet after PCI ACS

A
  1. aspirin (lifelong) + prasurgrel/ticagrelor (12 months)
  2. if aspiring CI then clopidogrel lifelong
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14
Q

anti-platelet for TIA and ischaemic stroke

A
  1. clopidogrel (lifelong)
  2. aspirin + dipyridamole (lifelong)
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15
Q

antiplatelet for peripheral arterial disease

A
  1. clopidogrel lifelong
  2. aspirin lifelong
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16
Q

types of rapid acting insulin

A

NovoRapid

Humalog

Actrapid

Humilin S

when prescribing must write name of specific type

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17
Q

what electrolyte abnormality is associated with heparins?

A

hyperkalaemia

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18
Q

what is target INR for day before surgery? If not what to do?

A

aim for 1.5

can give vitamin K (phytomenadione) iV or oral depending

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19
Q

what is the target when starting statin treatment?

A

aim for a > 40% reduction in non-HDL cholesterol 3/12 after starting

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20
Q

what drugs cause gynaecomastia?

A

DISCO

digoxin

isoniazid

Spironolactone

Cimetidine

Omeprazole

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21
Q

contraindications for sildenafil ?

A

nitrates

nicorandil related drugs

hypotension

recent stroke or MI (last 6/12)

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22
Q

what electrolyte imbalance precipitates digoxin toxicity?

A

low potassium

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23
Q

what electrolyte imbalance caused by digoxin?

A

high potassium

24
Q

when do you not need to stop metformin for surgery?

A
  • < 1 meal missed
  • eGFR > 60
  • low risk AKI
25
Q

what should metformin be stopped for surgery?

A
  • > 1 meal missed
  • AKI risk
26
Q

warfarin and surgery (pre-op)

A
  • aim INR 1.5
  • elective - stop 5.7 before, INR > 1.5 PO vitamin K
  • emergency, can delay 6-12 hrs → IV vitamin K
  • emergency no delay → IV vitamin K + prothrombin complex
27
Q

what anti-emetic should be avoided in PD? which to be used?

A

avoid metoclopromaide because crosses BBB

use domperidone as doesn’t cross

28
Q

when shouldn’t you prescribe cyclizine? what to give instead?

A

fluid retention

use metoclopramide

29
Q

what antibiotic to be cautious of with warfarin?

A

clarithromycin and erythromycin

30
Q

what medication used if hypotensive + arrhythmia?

A

digoxin

CCB and beta-blocker can worsen hypotension

31
Q

what drugs can cause a low neutrophil count?

A

clozapine

carbimazole

32
Q

how to differentiate types of AKI?

A
  • pre renal - urea > creatinine
  • renal urea - urea < creatinine
  • post-renal - urean < creatinine
33
Q

causes of intrinsive renal failure?

A

INTRINSIC

  • ischaemia (pre-renal → ATN)
  • nephrotoxic Abx - gent, vanc, tetracyclines
  • tablets - NSAIDS, ACei
  • radiological contrast
  • injury → rhabdo
  • negatively birefringent (gout)
  • syndromes (glomerulonephritis)
  • inflammation (vasculitis)
  • cholesterol emboli
34
Q

what ratio of AST to ALT in alcoholic hepatitis?

A

AST > ALT

35
Q

what are cholestatic drugs?

A
  • flucloxacillin
  • co-amoxiclav
  • nitrofurantoin
  • steroids
  • sulphonylureas
36
Q

INR target for warfarin

A
  • 2-3 → AF, DVT, cardioversion, cardiomyopathy, MI
  • 3-4 → recurrent VTE on warfarin, mechanical valve
37
Q

counselling for ACEi

A
  • teratogenic
  • raised potassium
  • caution with D+V
38
Q

counselling tamoxifen

A
  • Increases risk of endometrial cancer
  • Increases efficacy of warfarin à high INR
  • Side effects: hot flushes, VTE risk
39
Q

when do steroid patient need bone protection?

A

> more than 3/12 of treatment

40
Q

monitoring for statins

A
  • Risk factors → CK
  • No risk factors → ALT
    • Check LFTs at 3 and 12 months
    • Stop if taking a macrolide
  • Caution in CYP-i
41
Q

how to adjust basal/bolus insulin regiments?

A
  • High/low before breakfast / at night → increase/decrease evening** **long** **acting
  • High/low before lunch / dinner / bed → increase/decrease rapid** **acting** in **meal before
42
Q

adjusting BD pre-mixed regimens

A
  • High/low before bed AND before breakfast → increase/decrease evening insulin
  • High/low before lunch AND before evening meal → increase/decrease morning insulin
43
Q

how to mix solution for insulin infusions?

A

50 units actrapid insulin in 50mL of 0.9% sodium chloride

44
Q

what are the steroid strengths?

A

G - glucocorticoid, M - mineralocorticoid

  • hydrocortisone - G1, m1
  • prednisolone - G4, M 0.8
  • fludrocortisone - G15, M150
  • aldosterone - G0, M500
  • dexamethasone - G40, M0
45
Q

what is the topical steroid ladder?

A

Help Every (eumovate) Busy (betnovate) Dermatologist (dermovate)

  • low potency - hydrocortisone + clobetasone
  • medium potency - betamthasone
  • high - mometasone, clobetasol
46
Q

what abx should you hold statins with?

A

macrolide

e.g. clarithromycin and erythromycin

47
Q

how many mmol for:

  1. 3% potassium in 1L
  2. 15% potassium in 1L
A
  1. 3 = 40 mmol
  2. 15 = 20 mmol
48
Q

what drugs can predispose to candida infections?

A

amoxicillin

clarithromycin

prednisolone

SGLT2 potentially

49
Q

1st line for eczema topical (after emollient)

A

1% hydrocortisone cream

50
Q

management of short term constipation (Adult)

A
  1. bulk forming laxative (ispaghula husk)
  2. add/swap to osmotic laxative (lactulose)
  3. stimulant if soft stool but complaining of hard to pass (bisacodyl, senna)
51
Q

management of opioid induced constipation (adults)

A
  1. osmotic laxative + stimulant (lactulose + biscodyl/senna)
  2. naloxegol if no response

DON’T give bulk forming

52
Q

management of faecal impaction (adults)

A
  1. high dose oral macrogol if hard stool
  2. stimulant added (senna) - if soft or no response to 1
  3. no response to oral - soft stool PR bisacodyl, hard stool PR glycerol
53
Q

management of constipation in children

A
  1. conservative + behavioural measures
  2. macrogol 1st line
  3. add stimulant if unresponsive
54
Q

who can’t have ondansetron as 1st line post-op N&V?

A
  • long QTc
  • drugs that prolong QTc e.g. anti-psychotics
55
Q

what is the anti-emetic of choice for pt at risk of EPSE + QT prolongation?

A

cyclizine

IK6 - PSA and prescribing (11 decks)

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