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GP, derm, palliative, PH > Geris/PC > Flashcards

Geris/PC Flashcards

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Dermatology Board Prep flashcards
1
Q

Which drugs are associated with osteoporosis?

A 
Corticosteroids
Heparin
Cyclosporin
Methotrexate, and
Cytotoxic therapy.
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2
Q

List some of the causes of dementia

A 
Syphilis
Vitamin B12 deficiency
Folate deficiency
Pellagra
Vascular disease
HIV
Multiple sclerosis
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3
Q

Which drugs increase the risk of hypothermia?

A

chlorpromazine/benzodiazepines

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4
Q

What dose would you give for paracetamol?

A

Paracetamol
– 1g QDS (4 hourly) – maximum 4g in 24 hours
– Reduce to 500mg QDS if <50kg, renal/liver failure

PRN codeine 30-60 mg

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5
Q

What dose would you give for an NSAID?

A

NSAID
– Ibuprofen 400mg TDS max 2.4g/day
– Think about gastric protection, renal impairment, CV, bleeding risk, asthma

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6
Q

What dose would you use for codeine?

A

Codeine
– 15mg QDS up to maximum of 60mg QDS (24 mg of morphine/day)
– PLUS Laxative senna 7.5-15 mg BD

PRN morphine 2.5-5 mg 2-4 hrs
If N/V haloperidol 0.5-1.5 mg PO (SC if vomiting)

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7
Q

What dose would you use for morphine sulphate immediate release (oromorph)?

A

Morphine sulphate
– 5-10mg every 4 hr starting dose (10-20 mg if moving from step 2 to 3 WHO) during day.
– 10 mg/ 5ml
– double dose at night
– Usually after WHO step 2 opioid analgesic but if opioid naïve 2.5mg immed/rel starting dose PRN up to hourly

– once stable on 4 hrly doses can change to 12 hrly MST (morphine slow release tablet)
– PRN = 1/6 daily dose of long acting for breakthrough pain

– take care if patient has renal failure

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8
Q

What are the different types of morphine sulphate?

A

Morphine sulphate immediate release e.g.“Oramorph”
• Onset: ½ hour,
• lasts: 4 hours
• Liquid (does come in tablets – Sevredol)

Morphine sulphate modified release e.g. “Zomorph”
• Onset: 2-6 hours,
• lasts: 12 hours (regular twice daily dosing)
• Capsules

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9
Q

How do you convert codeine/dihydrocodeine to morphine?

A

Divide by 10

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10
Q

How do you convert tramadol to morphine?

A

Divide by 10

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11
Q

How do you convert morphine PO to morphine SC?

A

Divide by 2

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12
Q

How do you convert morphine PO to oxycodone PO?

A

Divide by 1.5 (divide by 3, times by 2)

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13
Q

How do you convert oxycodone PO to oxycodone SC?

A

Divide by 1.5 (divide by 3, times by 2)

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14
Q

How do you convert morphine PO to fentanyl patch?

A

morphine in mg/24hrs divided by 3 to get fentanyl patch ug/hr

Conversion ratio morphine:fentanyl 100:1

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15
Q

Which drugs can reduce peripheral sensitisation?

A

corticosteriods

NSAIDS

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16
Q

Which drugs reduce pain by blocking sodium channel conduction?

A

carbamazepine
lidocaine
mexiletine

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17
Q

Which drugs reduce pain by blocking calcium channel conduction?

A

gabapentin
pregabalin
ziconotide

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18
Q

Which drugs reduce pain by enhancing descending inhibition?

A

nefopam
antidepressants
tapentadol
tramadol

19
Q

Which drugs reduce pain by reducing central prostaglandin transmission?

A

NSAIDs
paracetamol
corticosteroids

20
Q

Which drugs reduce pain by reducing central sensitisation?

A

ketamine
methadone
magnesium

21
Q

Which drugs can reduce pain due to cancer related oedema?

A

corticosteroids

22
Q

Which drugs can reduce malignant bone pain?

A

bisphosphonates

23
Q

Which drugs can reduce pain from skeletal muscle spasms?

A

baclofen

benzodiazepines

24
Q

Which drugs can reduce pain from smooth muscle spasms?

A

antimuscarinics (e.g Hyoscine butylbromide)
nifedipine
nitrates

25
Q

When is a syringe driver indicated?

A
  • persistent N & V
  • dysphagia
  • bowel obstruction
  • coma
  • patient preference
26
Q

What proportion of people over 80 yrs experience a fall each year?

A

up to 50%

27
Q

What’s the prognosis following a hip fracture?

A
  • only 50% of patients return home

- 30% will die as a consequence

28
Q

By what mechanisms do drugs cause falls?

A
  • sedation
  • hypotension
  • bradycardia
29
Q

What blood pressure is associated with an increase risk of falls?

A

less than 110 mmHg systolic or lower in old people

30
Q

When do ACEi and B blockers have a survival benefit?

A

When someone has systolic cardiac failure. Most old people have diastolic failure.

31
Q

How do antidepressants and antipsychotics cause falls?

A

orthostatic hypotension

32
Q

Which score assesses ADL?

A

Barthel index

Feeding
Bathing
Grooming
Dressing
Bowels
Bladder
Toilet use
Transfers
33
Q

What are the 5 geriatric giants?

A 
Immobility
Instability
Incontinence
Impaired mental state
Iatrogenic- polypharmacy
34
Q

What score do you use to assess delirium? What is the criteria?

A

CAM confusion assessment method

Need 1 and 2 and one of 3 and 4

  1. Acute/fluctuating: change from baseline
  2. Inattention: can’t keep track of what’s being said
  3. Disorganised thinking: speech rambling/incoherent/illogical
  4. Altered consciousness: lethargy/hyper-alert
35
Q

What are the risk factors for delirium?

A 
Severe illness
Urinary retention
New environment
Dementia/previous delirium
Old age
Writhing in pain
Neuropsych condition previously
Ears/eyes
Rx anti-ACh, poly pharmacy
Sleep deprivation/surgery
36
Q

Which drugs can cause anorexia?

A

PPPD SCSC LLIFT Me Now

Phenytoin
PPIs
Potassium supplements
Digoxin
SSRIs
CCBs
Spironolactone
Chemo
Lithium
Levodopa
Ipratropium
Furosemide
Theophylline
Metronidazole
Narcotics
37
Q

Which drugs affect taste and smell?

A

DEAN’s a Happy Person

Dexamethasone
Enalapril
Amitriptyline
Nifedipine
Hydromorphine
Phenytoin
38
Q

What is used to screen for malnutrition?

A

MUST score (malnutrition universal screening tool)

Weightloss
Illness >5 days
BMI

39
Q

Which drugs increase warfarin effect?

A

SOFA DEVICE

Sulphonamides
Omeprazole/cimetidine
Fluconazole/ketoconazole/metronidazole
Allopurinol/amiodarone

Disulfiram
Ethanol (acute intoxication)
Valproate
Isoniazid
Ciprofloxacin/clarithromycin
Erythromycin

Grapefruit juice

40
Q

Which drugs decrease the effect of warfarin?

A

P CARBS

Phenytoin
Carbamazepine
Alcohol
Rifampicin
Barbiturates
Sulphonylureas
41
Q

What can cause oesophageal erosions?

A

Alendronate

42
Q

Erythromycin + ? can cause rhabdomyolysis?

A

Statin

43
Q

Which drugs can cause SIADH?

A

Thiazides
TCAs
Cyclophosphamide
Carbamazepines

44
Q

What scores are used to assess risk of pressure scores?

A 
Braden score (higher=better)
Waterlow score

GP, derm, palliative, PH (7 decks)

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