MAU Flashcards
Before administering ACEi what blood test(s) should be performed and what else should be monitored
U&Es should be measured then monitored alongside blood pressure.
Name 5 renal toxic drugs
ACEi, NSAIDs, lithium, gentamicin and IV contrast
Name 3 common anti-emetics and their doses
Cyclizine 50mgTDS
Metaclopramide 10mg TDS
Ondansetron 4-8mg TDS
Name 6 strong opioids
Morphine, diamorphine, methadone, pethadine, fentanyl and alphentanyl
What’s a typical morphine dose and what should be prescribed alongside if it will be used for sustained periods
PO 5-20mg 4 hourly titrated to control pain
PO slow release 10-30mg 12 hourly
IV 2.5-10mg 4 hourly
Prescribe with a laxative if to use for >24hr
Name 3 weak opioids
Codeine
Dihydrocodeine
Tramadol
What level of urine output is worrying
0.5mL/kg/hr
What is a typical maintenance fluid regimes for a healthy adult?
1x 1L 0.9% saline
2x 1L 5% dextrose with 20mmol KCl
Over 24 hours
How is a child’s maintenance fluid regime calculated?
100mL/kg for 10kg
50mL/kg for 10kg
20mL/kg from that point onwards.
For example a 38kg child needs:
10x100 + 10x50 + 18x20
=1000 + 500 + 360
= 1860mL every 24hr
What dose of morphine should be prescribed for breakthrough pain compared to maintenance
1/6
If I patient is not controlled on regular co-codamol 30/500 at max dose what shuld be used next in pain management
A strong opioid e.g. Morphine with paracetamol
*consider an anti-emetic and laxative
What medications are commonly prescribed alongside morphine to control it’s side effects
An anti-emetic e.g. Cyclizine and a laxative e.g. Senna or docusate
What would be a typical starting daily dose of morphine for opioid naive patients
20-30mg
What would be a typical starting dailiy dose of morphine for patients switching from a weak opioid
40-60mg
In morphine titration how much can the dose be increased by
50% of the previous daily dose
What is the management of the dopanergic side effect of metaclopramide
Acute dystonic reactions subside within 24 hours of stopping the drug and can be aborted using procyclidine
What direct factor X inhibitor can be prescribed in AF. What dose is used and what are a few common side effects
Rivaroxaban 20mg OD with food
Common side effects include nausea and vomiting and haemorrhage
What is the management of hyperkalaemia
Stop any sources of Potassium
Put on high flow O2
Get an ECG!
- any changes give 10mL of 10% calcium gluconate
10 units of insulin in 50mL of 50% dextrose
5mg neb salbutamol
Consider calcium resonium
What are the criteria for diagnosing SIADH
Concentrated urine >500mosm/kg Dilute blood 20mmol/L No recent diuretics Euvolaemic Normal thyroid and adrenal gland - TSH and short synactin test
What dose of morphine is equivalent to 8mg codeine
1mg
What is senakot and what is a typical dose
Senna - stimulating laxative
Normal dose 10-20mg ON
