HARD LEARN THIS Flashcards
what drug would you stop if theres a bleeding ulcer
stop NSAID
what drug would you stop in kidney failure
ACE inhibitor
what drug would you stop in hyponatraemia
anti depressant
when should you stop statins
when short life expectancy
what does amlodipine cause
oedema
when do you stop loperamide or codeine phosphate in
- for treatment of diarrhoea of unknown cause (risk of delayed diagnosis)
- may exacerbate constipation with overflow diarrhoea
- may precipitate toxic megacolon in inflammatory bowel disease
- may delay recovery in unrecognised gastroenteritis
- for treatment of severe infective gastroenteritis i.e. bloody diarrhoea, high fever or severe systemic toxicity
- risk of exacerbation or protraction of infection
when do you stop prochlorperazine or metaclopramide (dopamine agonists)
parkinsonism
when do you stop stimulant laxatives (senna, bisacodyl)
intestinal obstruction (risk of bowel obstruction)
when do you start PPIs
for severe gastro-oesophageal acid reflux disease or peptic stricture requiring dilatation; consider referring to GP for follow-up in community
-for patients over 80 years old on anti-platelets and SSRIs
with aspirin and warfarin in combo
when do you start fibre supplements
chronic, symptomatic diverticular disease with constipation
when do you start an ACEi
in CHF/ post MI
when do you start warfarin/ DOACs
chronic AFib
DVT/ PE if benefits outweigh risks
how do you convert oral to scut morphine
half dose:
Oral morphine 10mg
≈ subcutaneous morphine 5mg
SCUT morphine is twice as strong as ORAL morphine
palliative anticipatory prescribing:
pain/SOB
morphine 2mg scut hrly
palliative anticipatory prescribing:
distress
midazolam 2mg scut hrly
