Managing Conditions Flashcards
What should a patient in mild pain receive?
Paracetamol 1g 6-hourly PO
Codeine 30mg up to 6 hourly PO
What should a patient in severe pain receive?
Cocodamol 30/500, 2 tablets 6 hourly PO
Morphine sulphate 10mg up to 6-hourly PO as required
What is the initial management of all cardiovascular emergencies?
ABC
15L oxygen via non-rebreathe mask
How is a STEMI managed, as opposed to an NSTEMI?
300mg PO aspirin 5-10mg IV morphine 10mg IV metoclopramide GTN spray/tablet Primary PCI 5mg PO atenolol
NSTEMI given clopidogrel 300mg PO and enoxaparin 1mg/kg BD SC instead of primary PCI.
Morphine, metoclopramide, GTN, and IV furosemide, form the management of which patient?
Acute heart failure
In patients with acute heart failure, what other management can be tried?
Isosorbide dinitrate infusion
CPAP
In which patients with VT should a synchronized DC shock be given, followed by 300mg IV amiodarone?
Signs of shock
Syncope
MI
HF
What are the differentials for broad complex VT?
Irregular: AF w/ BBB
Regular: VT
What are the differentials for narrow complex VT?
Irregular: AF
Regular: SVT
What is the treatment of anaphylaxis?
ABC and 15L O2 IM adrenaline 500mcg of 1:1000 IV chlorphenamine IV hydrocortisone Asthma tx if wheeze
What is the treatment of an acute exacerbation of asthma?
Oxygen Salbutamol NEB Hydrocortisone IV/Prednisolone PO Ipratropium NEB Theophylline
What is the difference in management in acute exacerbation of COPD and asthma?
They are the same, except COPD patients receive antibiotics if an infective cause is suspected.
Also, oxygen is used with caution.
What is the management of PE?
ABC and oxygen
IV morphine
IV metoclopramide
LMWH/thrombolysis
What fluid is prescribed in patients with GI bleeding?
Crystalloid
Cross match 6 units
If prothrombin time or APTT is >1.5x normal range, what is given?
FFP
Unless on warfarin - give prothrombin complex
What threshold of platelets is used to guide platelet transfusions?
<50x10^9, unless critical bleeding
What antibiotic is prescribed for bacterial meningitis?
IV cefotaxime 2g
What is the management of status epilepticus?
IV lorazepam x3
Phenytoin infusion
RSI with sodium thiopentol
What rate of insulin is given in DKA?
0.1IU/kg/hour
What is the treatment threshold in hypertension?
135/85
What medications are used in chronic HF?
ACEI and BB
ARB/hydralazine and isosorbide mononitrate
Furosemide
What are the components of the CHAD2DS2-VASc score?
CCF Hypertension Age>75 (2) DM Stroke/TIA (2) Vascular disease Age 65-74 Female sex
What is the treatment threshold of the CHAD2DS2-VASc score?
0 - no tx
1 - antiplatelet/anticoag
2- anticoag
In which AF patients is rhythm control (cardioversion or amiodarone/flecainide) used?
Young
Symptomatic
First episode
Reversible cause
Which AF patients undergo cardioversion?
Presented less than 48h
Haemodynamically unstable
What is the rate control management of AF?
BB or diltiazem
Combine with digoxin
What is the management of angina?
GTN spray
Secondary prevention
One anti-anginal drug such as BB or CCB (amlodipine or diltiazem)
What is the treatment of absence seizures?
Sodium valproate or ethosuximide
What is the treatment of GTC seizures?
Sodium valproate
What is the treatment of partial seizures?
Carbamazepine or lamotrigine
What should be checked before starting azathioprine?
TPMT levels
What is the maximum amount of paracetamol that can be prescribed in 24h?
4g
Name an osmotic laxative?
Lactulose
Name a stool softener and what it is good for?
Docusate sodium
Good for faecal impaction
How much fluid does a typical adult require per day?
3L IV maintenance fluids
8-hourly bags
How much fluid does an elderly patient require per day?
2L IV maintenance fluids
12-hourly bags
How much potassium is required per day when nil by mouth?
40-60mmol
Why do colloids maintain blood pressure for longer?
They stay intravascularly
What is a contraindication to lactulose?
Bloating
What is a contraindication to senna/bisacodyl?
Cramps
Name a stimulant laxative.
Senna
Name an osmotic laxative.
Lactulose
What is a disadvantage of isphagula husk?
May take days to have an effect
Name a prokinetic anti-emetic.
Metoclopramide
What drug class is cyclizine and ondansetron?
Cyclizine: anti-histamine
Ondansetron: 5HT3 antagonist
What anti-emetic is preferred in bowel obstruction?
Decompression with NG tube.
Which drug is the best choice for acute severe pain, and an exception.
Morphine
Unless regular pain is being controlled with a different drug
How much potassium is required for a NBM patient per day?
1mmol/kg
