Interactants Flashcards
What should never be coprescribed with verapamil and why
Beta blocker due to risk of severe bradycardia
What blood level is lithium toxic
Above 1.5
What can lithium toxicity be triggered by
Dehydration
Renal failure
Meds - diuretics acei arb NSAIDs and metronidazole
What are features of lithium toxicity
Course tremor Hyper reflexia Acute confusion Polyuria Seizure Coma
How to manage lithium toxicity
Mild to mod can be treated with saline
Haemodialysis may be required in severe toxicity
Sodium bicarbonate is sometimes used to increase the alkalinity of the urine to promote lithium excretion
How to monitor digoxin
A digoxin level is only monitored if suspected toxicity - is not routinely checked (take level 6 hours after a dose)
Monitor serum electrolytes and renal function.
What are the features of digoxin toxicity
Unwell lethargy N+V confusion yellow green vision arrhythmias
Gynaecomastia
What is the classic precipitant of digoxin toxicity
Electrolyte disturbances - mainly hypokalaemia
How to manage digoxin toxicity
Digibind
Correct arrhythmias
Monitor potassium
When should acetylcysteine be given due to a toxic dose of paracetamol
When dose taken is greater than 150mg/kg
How long is tamoxifen used after mastectomy
5 years
What’s the the main adverse effects of tamoxifen
Menstrual disturbance
Hot flushes
VTE
Endometrial cancer
What drug has a lower risk of endometrial cancer than tamoxifen
Raloxifene
Can topical isotretinoin be used over oral in pregnancy
No both are teratogenic
