General notes Flashcards
Explain risks of breast cancer in woman taking HRT
Low with oestrogen only
Name risks associated with HRT
Breast cancer
Endometrial cancer
VTE
Stroke / CVD
Who do the risks of HRT not apply to
Women < 50 years old
No increased CVD risk with oestrogen only HRT
Who do you not give HRT to
Women > 60 years old
Risks outweigh benefits
Name 5 CI to HRT
Undiagnosed endometral bleeding
Endometrial cancer
Breast cancer
Uncontrolled HTN
VTE
Active angina or MI
Pregnancy
How long is the Mirena coil licensed for endometrial protection
4 years
When is the risk of stroke / CAD increased
If taken > 10 years after menopause - combined
How is the risk of breast cancer affected by stopping HRT
Declines once stopped and normal in 5 years
Name 5 adverse effects of antimuscarinics
Confusion
Dry mouth
Tachycardia
Dilated pupil
Loss of accommodation
What occurs if Methotrexate and Trimethoprim are co-prescribed
Pancytopenia
Neutropenic sepsis
Name the presentation and ECG signs for Hypercalcameia
Renal stones
Bone pain
Abdominal groans
Psychiatric overtones
Short QT interval
What medications should be cautioned in patients taking Methotrexate
PPI
NSAIDs
Ibuprofen - risk of nephrotoxicity
Name the adverse effects of anticholinergics
cosntipation
dry mouth
blurred vision
urinary retention
Name 3 anticholinergic drugs
Oxynutinin
Atropine
Tiotropium
Name 3 drugs that effect lithium excretion
ACEi
Diuretics
NSAIDs
Name 5 drugs causing agranulocytosis
Carbamazepine
Name 5 drugs causing agranulocytosis
Carbamazepine
clozapine
colchicine
carbimazole
Which opioids are safe in CKD
Oxycodone
alfentanil
fentanyl
Name 5 drugs that cause C.diff infection
PPI
Clindamycin
Co-amox
CIprofloxacin
Cephalosporin
Name drugs that prolong QTc
A - Antidepressants (SSRI / TCA)
A - Antipsychotics
A - Antibiotics
A - Anti arrhythmics
A - Antifungals
A - Antiemetics
D - Diuretics
What is the minimum treatment length with steroids to require prophylactic bisphosphonates
3 months
How do you assess the response to Abx in penumonia
1 - O2 stats / ABG
2 - Resp rate
What are the contraindications to the COCP
Breastfeeding and <6 post partum
Migraine with aura
>35 and smoking >15/day
VTE
Active cancer
What drugs do statins interact with
Macrolides
Grapefruit juice
Which drugs cause urinary retention
Opiods
NSAIDs
Anticholinergics
Antihistmaies
TCA
General anaesthetics
Alpha adrenoreceptors agonists
NSAIDs
CCB
Alcohol
What are the risks assosciated with PPIs
Low sodium
Low magnesium
Osteoperosis
fracture
Micoscopic colitis
C.difficile
What drugs should you stop during sick day rules
ACE
ARB
Diuretics
NSAIDs
SGLT-2i
Metformin
What do you monitor for the adverse effects of ACEi
Serum Cr
Which group of drugs should be avoided in severe PVD - critical ischaemia
ACEi
Name 5 adverse effects of statins
Myalgia
Myositis
Rhabdomyolysis
Headache
Sleep disturbance
GI disturbance
Name 5 drugs causing haematemesis
NSAIDs - Ibuprofen
Aspirin
Bisphosphonates
Name 2 adverse effects of aspirin use
Dyspepsia
IDA
Drugs causing confusion
Anticholinergics - TCA
Opiates
BDZ
Antipsychotics
Antidepressants
Anti-epileptics
Antihistmaies
Digoxin
Beta blockers
Steroids
NSAIDs
Drugs increasing falls risk in elderly
Antidepressants - TCA / SNRI / MAOi
Opiods
Anti-epileptics
Antipsychotics
Sleeping pills
Diuretics
alpha blockers
ACEi
SU / Gliclazide - Check BM
When should SSRIs be cautioned
Poorly controlled epilepsy
PUD
What do you avoid prescribing in IHD
NSAIDs
What do you avoid prescribing in IHD
NSAIDs
Oestrogens
What increases the risk of Methotrexate toxicity
PPI
When should you degrease the dose of SGLT-2 inhibitors
When eGFR decreases
Name 4 causes of constipation
Antidepressants
Anticholinergics
Opioids
Antiemetics - Ondansetron
When should a diabetic patient be prescribed antihypertensives
Albumin:Cr > 3 –> ACEi or ARB
When should ACEi be avoided
Renal artery stenosis
PVD - Critical
eGFR < 30
Long term treatment post ACS
CRABS
C - Clopidogrel
R - Ramipril
A - Aspirin
B - Beta blocker
S - Statin
Name 5 drugs that worsen seizure control
Alcohol
Tramadol
Lithium
Clozapine
Ciprofloxacin
Aminophylline
Mefanamic acid
Name 4 drugs to avoid in Heart failure
Pioglitazone
Verapamil
NSAIDs
Steroids
Flecanide
Name 4 drugs to avoid prescribing in renal failure
NSAIDs
ACEi
Metformin
Lithium
Digoxin
Name 6 drugs to avoid prescribing in pregnancy
Tetracycline
Amingoglycosides
Sulphonamides / Trimethorpim
Quinolones
Warfarin
Sulphonyurea
Statins
Cytotoxics
Name 6 drugs to avoid in breastfeeding patients
Ciprofloxacin
Sulpjonamides
Lithium
BDZ
Aspirin
Carbimazole
MXT
SU
Amiodarone
What effect do quinolones have on the heart
Lengthen QT interval
What condition are aminoglycosides CI in
Myasthenia gravis
What is the management of PVD
Antiplatelet + Statin (high dose)
What is the baseline monitoring and treatment moniotring required for aminophylline
Baseline - LFT
Treatment - U+E
In what patients should you prescribe with caution / are CI to NSAIDs
Asthma
AKI / CKD
Elderly
Gastric ulcers
CCF
When should you take:
- ACEi
- Loop diuretics
Morning - avoid postural hypotension
Evening
What is a side effect of a PPI
Gynaecomastia
When is cyclizine CI
HF
When is metocloprmaide CI
PD
Post gastrectomy
Bowel obstruction
Management of acute asthma in the community
For an adult, give 4 puffs initially, followed by 2 puffs every 2 minutes according to response, up to 10 puffs.
Repeat every 10-20 minutes if clinically necessary.
For a child, give a puff every 30–60 seconds, up to 10 puffs.