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AMK style questions > Lily's PSA Cards > Flashcards

Lily's PSA Cards Flashcards

1
Q

Which drugs inhibit clopidogrel activation?

A

omeprazole and esomeprazole

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2
Q

In what condition would you NOT give aspirin?

A

atrial fibrillation

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3
Q

What are the advantages of DOACs?

A

no INR monitoring needed, fewer interactions, simpler

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4
Q

What are the three main type of beta lactam antibiotics?

A

penicillins, carbapenems and cephalosporins

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5
Q

Why would fentanyl be chosen over morphine?

A

fentanyl more lipophilic and has faster onset

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6
Q

Investigations for suspected paracetamol overdose?

A

paracetamol level sample 4h post ingestion or at time of ptn. + FBC, U&E, creatinine, LFTs, PTT (liver failure), blood glucose, ABG (acidosis)

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7
Q

Which antibiotics can cause torsades de pointes?

A

macrolides
e.g erythromycin, roxithromycin, azithromycin and clarithromycin.

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7
Q

Which drug class can worsen symptoms of patients suffering from peripheral vascular disease?

A

beta blockers

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8
Q

Which type of diuretics cause sexual dysfunction?

A

thiazide-like, like indapamide

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8
Q

Ion abnormality associated with thiazide diuretics?

A

Hyponatraemia

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9
Q

First line antihypertensive in pregnancy?

A

Labetalol

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10
Q

Women at high risk of developing pre-eclampsia should take?

A

75mg OD aspirin from 12 weeks gestation until birth

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11
Q

Which recreational drug causes placental abruption?

A

Cocaine

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11
Q

Most common causes of delerium?

A

Mneumonic DELERIUM

Drugs and Alcohol
Eyes, ears and emotional state
Low output state
Infection
Retention (urine or stool)
Ictal
Underhydration/nutrition
Metabolic
Subdural/sleep deprivation

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12
Q

Drugs used for secondary prevention of ACS?

A

mneumonic DABS

Dual antiplatelet therapy
ACEi
Beta blocker
Statin

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13
Q

Nitrates for ACS are contraindicated in?

A

Hypotension

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14
Q

How to convert a codeine dose to morphine?

A

Divide by 4

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15
Q

Respiratory disease caused by amiodarone?

A

pulmonary fibrosis

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16
Q

Precautions needed to take POP and antibiotics together?

A

Nil

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17
Q

Which antibiotic causes red-orange discolouration of body fluids?

A

Rifampicin

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18
Q

Drugs that can cause acute pancreatitis?

A

-Steroids
-Azathioprine, mesalazine
-Bendroflumethiazide, furosemide
-Sodium valproate

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19
Q

Contraindications of alpha blockers (like doxasocin)?

A
  • Postural hypotension
  • Micturition syncope in BPH
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20
Q

Risk of alpha blocker use in eye surgery?

A

Floppy iris syndrome

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21
Q

Risk of first dose of alpha blockers like doxasocin?

A

Hypotension - give first dose at night/lower dose

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22
Q

Caution giving alpha blockers for HTN in?

A

Heart failure and pregnancy

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23
Q

Tests done for amioderone?

A

Prior to treatment - TFT, LFT, U&E, CXR prior to treatment

Every 6 months - TFT, LFT

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24
Q

Why shouldn’t you prescribe trimethoprim with methotrexate?

A

Bone marrow suppression and pancytopenia due to both being anti-folate

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24
Q

Most common ACEi side effects?

A

A - Angiooedema
C - Cough
E - Elevated potassium

I - 1st dose hypotension

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25
Q

Side effects of loop diuretics?

A

hypotension
hyponatraemia
hypokalaemia, hypomagnesaemia
hypochloraemic alkalosis
ototoxicity
hypocalcaemia
renal impairment (from dehydration + direct toxic effect)
hyperglycaemia (less common than with thiazides)
gout

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26
Q

Enzyme inhibitors

A

3 As
1. antibiotics - ciprofloxacin, clarithro/erythromycin
2. allopurinol
3. Amiodarone

isoniazid
cimetidine,omeprazole
imidazoles: ketoconazole, fluconazole
SSRIs: fluoxetine, sertraline
ritonavir
sodium valproate
acute alcohol intake
quinupristin

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27
Q

Drugs to be careful prescribing alongside warfarin?

A

enzyme inhibitors (like erythromcyin)

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28
Q

Steroid side effects?

A

Mnemonic = STEROIDS

Stomach ulcers
Thin skin
oEdema
Right and Left heart failure
Osteoporosis
Infection (including fungal)
Diabetes
Cushing’s Syndrome

and corticosteroids cause insomnia

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29
Q

NSAIDs cautions?

A

NSAID mnemonic

No urine (renal failure)
Systolic dysfunction (Heart failure)
Asthma
Indigestion
Dyscradia (clotting abnormality)

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30
Q

Which antihypertensivesw can cause bradycardia?

A

Beta blockers and some CCBs

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31
Q

Antihypertensives that can cause electrolyte abnormalities?

A

ACEi and diuretics

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32
Q

Side effects of beta-blockers?

A
  • Bradycardia
  • Hypotension
  • Wheeze in asthmatics
  • Worsen acute heart failure (helpful in chronic heart failure)
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33
Q

Side effects of calcium channel blockers?

A
  • Hypotension
  • Bradycardia
  • Peripheral Oedema
  • Flushing
  • Chronic Heart Failure
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33
Q

Side effects of diuretics?

A
  • Hypotension
  • Electrolyte abnormalities
  • Renal failure
  • Gout (thiazides)
  • Gynaecomastia (spironolactone and other potassium-sparing)
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34
Q

Which drugs should patients be given information on taking alongside levothyroxine?

A

Iron/calcium carbonate tablets can reduce absorption of levothyroxine, should be given 4 hours apart

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35
Q

When should you NOT give normal saline as replacement fluid?

A
  • Hypernatraemia - give 5% dextrose
  • Hypoglycaemia - give 5% dextrose
  • Has ascites - give human albumin solution
  • Bleeding and shocked - blood
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36
Q

Enzyme inducers?

A
  • Antiepileptics: phenytoin, carbamazepine
  • Steriods
  • Barbiturates: phenobarbitone
  • Rifampicin
  • St John’s Wort
  • Chronic alcohol intake
  • Griseofulvin
  • Smoking (affects CYP1A2, reason why smokers require more aminophylline)
37
Q

How much sodium is in a bag of 0.9% saline?

A

154 mmol

38
Q

Drugs cautioned in ischaemic heart disease?

A
  • Oestrogens
  • NSAIDs
  • Varenicline
39
Q

Can ACEi be used in pregnancy?

A

Nope, teratogens

39
Q

Drugs to be used with caution in asthma?

A

NSAIDS
Beta-blockers
Adenosine

40
Q

Drugs that increase serum potassium? (5)

A

ACEi
ARBs
Spironolactone
Potassium-sparing diuretics (amiloride)
Potassium supplements

41
Q

Drugs that decrease serum potassium?

A

Thiazide diuretics
Loop diuretics
Acetazolamide

42
Q

Can you breast feed on amiodarone?

A

No

43
Q

Opioids of choice in significant renal impairment?

A

Buprnorphine or fentanyl

44
Q

Which class of diabetes medications are contraindicated in heart failure?

A

Thiazolidinediones (pioglitazone)

45
Q

Which regular mediciations must be stopped when macrolides are started?

A

Statins, due to increased risk of myopathy

46
Q

Which antibiotics are enzyme inhibitors?

A

Ciprofloxacin and calrithro/erythromycin

47
Q

GLP1 inhibitors are used for diabetics with what co-morbidity?

A

obesity (ozempic is a glp-1 inhibitor)

48
Q

Which diabetes drugs are contraindicated in ketoacidosis?

A

DPP4i, sulfonylureas, SGLT2-i

49
Q

Contraindications of metformin?

A
  • Acute metabolic acidosis
  • eGFR <30
  • underweight (give sulfonylurea instead)
50
Q

Side effects of metformin?

A

GI upset - try modified release before switching drugs

51
Q

Side effects of DPP4i diabetes drugs (gliptins)?

A

Acute pancreatitis

52
Q

What effect does renal impairment have on insulin?

A

none, fine in any eGFR (doesnt matter if it did, massive hyperglycaemia is gonna kill a patient before renal failure)

53
Q

Can patient become hypoglycaemic on metformin?

A

nah babes

54
Q

Contraindication of gliptins?

A

ketoacidosis

55
Q

CI of pioglitazone?

A

HF
Bladder Ca (inc. previous)
uninvestigated macroscopic haematuria
avoid in fluid overload

56
Q

Side effects of pioglitazone?

A

Increased risk of HF, bladder cancer and fractures

57
Q

Sulfonylureas (Gliclazide) CIs?

A

Ketoacidosis and pregnancy

58
Q

SEs of sulfonylureas

A

weight gain, hypos

59
Q

SGLTi (flozins) contraindications?

A

CI in ketoacidosis, less effective when eGFR <45

60
Q

Which class of diabetic medications cause hypos?

A

insulin and sulfonylureas

60
Q

SEs with SGLTi (flozins)?

A

euglycaemic DKA - check urinary ketones
hypoteniosn
increased risk of UTIs and genital infections

61
Q

Metoclopramide cautions?

A

parkisons
young women - increased risk of dyskinesia

62
Q

Best choices antiemetic?

A

cyclizine (but causes fluid retention)
Metoclopramide (not in PD, good for HF)
Ondansetron (not best prn, not in constipation)

63
Q

methtrexate + NSAIDs?

A

= caution - increased risk of nephrotoxicity

64
Q

Stop methotrexate when?

A

active infection

65
Q

When not to give trimethoprim

A

on methotrexate

66
Q

Regular pain relief best prescription?

A

no pain - no prescription
mild - paracetomal 1g 6 hourly
severe - co-codamol 30/5000 2 tablets 6 hourly oral

(obvs like exemptions but good rule of thumb from textbook)

67
Q

Best pain relief neuropathic pain?

A

amitryptiline 10mg oral nightly
pregabalin 75mg oral 12 hourly
duloxetine - diabetic neuropathy

68
Q

High INR (5-8) and no bleeding?

A

omit wafarin for 2 days then reduce dose

69
Q

INR 5-8, minor bleeding?

A

Omit warfarin and give 1-5mg IV vitamin K

70
Q

INR 8+, no bleeding?

A

Omit warfarin and give 1-5mg po vitamin K

71
Q

INR 8+ minor bleeding

A

omit warfarin and give 1-5mg IV vitamin K

72
Q

Major bleed on wafarin?

A

Stop warfarin
5-10mg IV vit K
prothrombin complex

73
Q

GI bleeding mgmt?

A

2 large bore cannulae
catheter and strict fluid monitoring
crystalloid bolus
cross match 6 units blood
correct clotting abnormalities
camera
stop culprit drugs
?call surgeons

74
Q

Correcting clotting abnormalities: If PT/aPTT more than 1.5x normal range, give?

A

FFP unless caused by warfarin - give prothrombin complex

75
Q

if platelets under 50 + actively bleeding?

A

give platelets

75
Q

Fluids in DKA?

A

1l normal saline stat
1l normal saline over 1 hour
1l normal saline over 2 hours
then 4
then 8

76
Q

Potassium in DKA?

A

K over 5.5 - add nothing
if 4-5.5 add 20mmol kcl
if less than 4 add 40mmol kcl

76
Q

Bacterial Meningitis treatment?

A

high-flow oxygen
4-10mg dexamethasone IV unless severely immunocompromised
LP (+/- CT Head)
2g cefotaxime IV (and if over 55 or severely immunocompromised give 2g ampicillin)

77
Q

When glucose under 14 in DKA

A

add 10% dextrose at 125ml/hr

78
Q

Insulin in DKA

A

fixed rate (actrapid) at 0.1 units/kg/hr

79
Q

fluids in aki

A

500ml stat then 1l 4 hourly

80
Q

What does 1% drug concentration mean?

A

1g in 100ml

81
Q

Common SEs of gent and vanc?

A

nephrotoxicity and ototoxicity

82
Q

Which abx are most likely to cause c dif colitis

A

broad spectrums like cephlosporins and ciprofloxacin

83
Q

Digoxin side effects?

A

N+V+D
Blurred vision
confusion
drowsiness
xanthopsia including halo vision

84
Q

interaction between digoxin and potassium?

A

digoxin acts at a NaKATPase - low levels augment digoxin activity, high limit

85
Q

Heparin ADRs?

A

haemorrhage, especially in renal failure or <50kg
heparin induced thrombocytopenia

86
Q

Amiodarone ADRs?

A

Pulmonary fibrosis
thyroid disease
grey skin
corneal deposits

87
Q

Lithium ADRs?

A

early - tremour
intermediate - tiredness
late - arrythmias, seizures, coma, renal failure, diabetes insipidus

88
Q

Fludrocortisone ADRs?

A

hypertension, sodium and fluid retention

89
Q

What happens if you prescribe beta blockers with verapamil?

A

hypotension and asystole, especialy IV verapamil

90
Q

Drugs to stop before surgery?

A

COCP
enoxaparin
aspirin
insulin - convert to sliding scale
metformin - stopped day before, risk of lactic acidosis
Lithium

91
Q

Main SE of oral magnesium replacement?

A

Diarrhoea

AMK style questions (8 decks)

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