Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PSA > high value stuff > Flashcards

high value stuff Flashcards

1
Q

what are the common CYP450 inducers

A

These are the SCRAPB ones that keep going
Sulphonyureas
Carbamezapine
Rifampacin
Alcohol (chronic)
Phenytoin
Barbituates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the common CYP 450 inhibitors

A

AO DEVICES

Allupourinol
Oemeprazole
Disulfarim
ETOH (acute, think competing)
Valproate
Isoniazid (with macrolides think TB!)
Ciprofoxacin
erythromycin
Sulphonamides (Abx)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

FTU

A

finger tip unit that is use or topical Tx and is enough to cover one side of an adult hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What drugs should be stopped pre-operatively

A

I LACK OP

Insulin (often day of? take pt experiece)
lithium (day before)
Anticoags/platelets
COCP/HRT
K+ sparing diuretics

Oral hypoglycaemics
Perindopril and other ACEi

Blleding drugs
glucose drugs
K+ increasing drugs
Lithium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what complication occurs when stopping A?metformin and B? other oral hypoglycaemics and insulin when a patient is NBM

A

A) metabolic lactic acidosis

B) hypoglycaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

when reviewing ACEi what parameter should be checked

A

Serum potassium and stop/hold if high and avoid fluid containing K+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

when reviewing a prescription what should be checked per drug

A

PRrSCRIBER

Pt details (Name DOB and Hospital number)
Reactions and allergies
Sign the front of the answers
Contraindications for each drug
Route
IV fluids needed?
Blood clot prophylaxis needed?
anti-Emetic needed?
pain Relief needed?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Glucocortidoid side effects

A

STEROIDS

Stomach ulcers
Thin skin
oEdema
Right and left heart failure
Osteoperosis
Infections
Diabetes
cushings Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

common NSAID side effects

A

Lungs: asthma
Heart: HF
GI: ulcers/dyspepsia, bleeds
Renal: pre-renal AKI
Blood: bleeds and anaemias / dyscrasias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

which antihypertensive causes gout?

A

thiazide diuretics
(they increase PCT uric acid resorption)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

which antihypertensive causes gynaecomastia

A

Spironolactone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

side effects of antihypertensives

A

hypotension
bradycardias - BB, rate slowing CCB
electrolyte disturbances - ACEi, diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

NBM and medications?

A

they should usually continue to receive oral medications ? If Safe swallow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

crystalloid vs colloid in acute resus?

A

crystalloid. colloid (which has proteins with similar levels to blood to prevent intravascular fluid depletion by keepign oncotic pressure high) has increased risk of anaphylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

fluid replacement in ascites

A

HAS
useful as it maintains oncotic pressure preventing third spacing. useful before therapeutic paracentesis when ascites may compress vessels so when uncompressed there will be intravascular depletion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

maximal rate of potassium administration

A

nothing more than 10mmol/hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

fluid bolus for resus/dehydration if hypotensive or tachycardic

A

500ml STAT IV 0.9% SODIUM CHLORIDE

(250ml if Hx of HF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

fluid replacement if oliguric?

A

ENSURE THERE IS NO URINARY OBSTRUCTION

give 1L over 2-4 hours and then reassess

(if only oliguric/anuric: 500ml fluid depletion, if oliguric/anuric + tachy: 1L fluid deficit, if oliguric/anuric + tachy + hypotensive >2L fluid depletion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

daily maintanence luid requirements

A

3L over 24 hours for adults (can be 2 for elderly)

One 0.9% NaCl and then 2 5% dextrose (all over 8 hours if 3 bags or 2 hours if 2 bags)

40mmol potassium per day (!!!!if there is normal potassium!!!) usually 20mmol KCl over 2 bags

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what should you check before prescribing fluids

A

Fluids status: JVP, lung fields, sacral and peripheral oedema, BP, mucous membranes and skin turgor

is there any indication there is Era
obstruction
Hx HF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

CI of VTE compression stockings

A

Signs of PAD or ABPI <0.6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

CI of metoclopromide

A

works through dopamine receptor antagonism. this should be avoided in parkinson’s patients (worsening) or young women (dyskinesias especailly acute dystonia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Analgesia of painful diabetic neuropathy

A

duloxetine 60 mg PO OD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Analgesia of neuropathic pain

A

amitryptilline or pregabalin
then amitryptilline and pregabalin
refer to specialist with tramadol in the interim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

morphine sulphate routes and strength

A

oral oramorph < SC < IV but they should ALL be prescribed as oramorph

26
Q

maximum paracetamol dose in patients <50Kg

A

500mg 6 hourly (total 2g) as opposed to 1g 6 hourly (total 4g) if >50kg

27
Q

which diuretics

raise potassium

lower potassium

A

raise: ACEi/ARB, potassium sparing diuretics

Lower: loop/thiazides

28
Q

causes of hypernatraemia

A

dehydration
drips -> Na rich fluids or too much saline
Drugs
DI (dehydration)
hyperldosteronism

29
Q

hyponatraemia causes

A

hypovolaemic: fluid loss -> darrhoea, vomiting, diuretics, addisons

euvolaemic: Psychogenic polydipsia, hypothyroidism, SIADH

hypervolaemic: HF, renal failure (no resorption)

30
Q

nephrotoxic ABx

A

gentamycin, vancomycin, tetracyclines

31
Q

how should you titrate thyroxine doses for hypothyroidism

A

use the TSH aiming for 0.5 - 5 mIU /L and use the smallest increment offered

<0.5 reduce the dose

0.5 - 5 no change

> 5 increase the dose

32
Q

cholestatic drugs

A

CAPS
COCP
Antibiotics: flucloxacillin, co-amoxiclav, erythromycin
Phenothiazines (Chlorpromazine, prochlorpromazine)
Sulphyonylureas

33
Q

gentamicin montoring and adjustmenet

A

you want gent to be above a threshold level when given and to fall to low levels between doses

If the gentamicin is a divided daily dosing regime
-reduce dose if the dose an hour after administration is too high
-increase the interval between doses if the dose is too high in the trough (just before next administration)

If gentamicin is on a once daily regimen:
-use the nomogram (check it’s the right one for the dose) and plot the gent level in the blood at the hours after administration. If beow 24 hour line all good. if above 24 hours but under 36 hours line change dose to 36 hourly. if above 24 hours but below th e48 hour line change dose to 48 hourly. if above the 48 hour line hold until serum gent level <1.0

34
Q

loads of side effects including Dry mouth or constipation? what drug class should you consider

A

antimuscarinics

Oxybutinin
Amitriptyline
cyclizine

35
Q

Drugs that raise ALT in hepatitic pattern

A

PASS
Paracetamol
Alcohol
Sodium Valproate
Statins

36
Q

when do you stop COCP before an op and restart it after

A

stop 4 weeks before and restart 2 wees after

37
Q

starting morphine dose for pain in palliative care

how should it be increased

A

oral modified release morphine or oral immediate release morphine with 5mg breakthrough pain

increase basal pain by 30-50% steps

38
Q

formula relating dose, conc and volume

A

dose = conc x volume

39
Q

unit conversions g, mg, mcg

A
40
Q

when are ACEi taken

A

nightly as they can cause postural hypotension.

Perindopril erbumine and perindopril arginine are the only exceptions

41
Q

what should never be given with azathioprine

A

allopurinol
both xanthine oxidase inhibitors with risk of bone marrow suppression

42
Q

co-amoxiclav which component is better to serach for reactions of

A

the clavalunic acid has far more many interactions (atorvastatin)

43
Q

Advice for patient taking subcut insulin into a lumpy area

A

be aware that injections can cause lipodystrophy, cutaneous amyloid and other skin reactions which reduce the efficacy of insulin injected into them

to avoid hypoglycaemia they should see a Dr before switching sites and closely monitor blood sugars after switching

44
Q

What do you do about an insulin dose due after a hypo?

A

do NOT Stop (info on hypoglycaemia page)

restart IV when blood glucose >3.5 and with dextrose and review dosage

stopping can cause reflex hyperglycaemia

45
Q

artificial tears

A

hypromellose
sodium hylarunate

46
Q

COCP

A

combined is oral progesterone and oestrogen

usually 21/7 but can be taken 21/4 or 63/7

47
Q

Common COCP brand

A

microgynon

48
Q

POP

A

Only preogesterone

Norithisterone
levonorgestrel
Desogestrel (cerelle)

Take continuous and strict missed pill rules

49
Q

contraceptive info

A

Starting advice on drug pages and formulations in medicinal forms

General doses etc on the contraceptives, hormonal (tableheaded preparation choice)

50
Q

monophasic vs multiphasic hormonal contraceptiion

A

Monophasic: always same dose in each tablet, doesnt matter if the order is mixed, fewer side effects of changing hormone levels

Mulitphasics: hormone dose per tablet changes to mimic the natural menstrual cycle and tablets must be taken in a strict order. Reduces overall hormone exposure
(if asked to prescirbe mutlipahsic they are under contraceptive hormonal, multiphasic table and are in the order they are taken)

51
Q

missed pill

COCP

POP

A

COCP:
-1 missed pill (>24 hours) take missed when you rememebr and continue.
-2 or more take the last missed pill and abstain or barrier contraception for 7/7
-missed pill in the last week, continue the active pills to make sure there are 7 uninterrupted days of cover (omit inactive or pill free break)

POP:
3 hour window except for
-missed <3 hours take missed pill straight away
-missed pill >3 hours take missed pill straight away and abstain or use barrier contraception 2/7
-IF DESOGESTREL SAME BUT 12 HOUR WINDOW

emergency contraception if UPSI during not protected time

52
Q

Diarrhoea or vomiting after pill

A

Vomiting <2 hours after must be repeated
If diarrhoea for >24 hours the pill must be considered missed until diarrhoea is no longer severe

53
Q

Risks of COCP vs POP

A

COCP: VTE, MI, Stroke, Breast and cervical cancer

POP: ovarian cyst and breast cancer

both breast
COCP Cervical

54
Q

endometriosis

A

Norethisterone
Specific Indication

55
Q

Decision tree for HRT

A
56
Q

drug monitoring

A

Beneficial response -> what you want the drug to do!! e.g. digoxin HR

Adverse effects -> risk of side effects (e.g. digoxin -> renal and electrolytes)

57
Q

miinimum sertraline dose

A

50mg

58
Q

steroid equivalence tables

A

glucocorticoid treatment summary

59
Q

paeds fluids
shock
rehydration
maintanence

A

Shock:
Bolus

Rehydration:
-5% is 50ml/kg/24 hours
-10% is 100ml/kg/24hours

Maintenence:
fluids over 24 hours
100ml per kg first 10 kg
50ml per kg next 10 kg
20ml per kg every kilo thereafter

60
Q

ICS

ICS LABA

LAMA LABA

ICS/LAMA/LABA

A

Beclomethasone

Symbicort

LAMA LABA = glycopyrronium + Indacetarol

Trelegy

61
Q

paediatric bolus

A

10ml/kg (10 letters in paediatric)

PSA (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions