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Medications Flashcards

1
Q

Minor anaphylaxis against transfusion?

A

antihistamine

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2
Q

Major anaphylaxis against transfusion?

A

Im adrenaline

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3
Q

TACO?

A

transfusion associated circulatory overload

IV furosemide

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4
Q

iron overload reduction e.g. in transfusion therapy for thalassaemia / haemachromatosis

A

desferoxamine (chelator)

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5
Q

chronic sickle cell disease?

A

hydroxyurea - increases HbF levels and helps reduce frequency and duration of crises

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6
Q

minimal change disease (nephrotic syndrome child) tx

A

prednisolone

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7
Q

Central diabetes inspidus

A

intranasal desmopressin

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8
Q

nephrogenic diabetes insipidus

A

thiazide diuretic

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9
Q

drugs causing urinary retention

A

amitriptyline

opioids

(retain urine then causes overflow incontinence)

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10
Q

(2nd line) drug mx for stress incontinence if pelvic physio doesnt work

A

Duloxetine

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11
Q

drug mx for urge incontinence of conservative mx isnt working

A

antimuscuranic e.g. oxybutynin

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12
Q

why may oxybutynin need to be stopped in the frail?

A

Usually given 2nd for urge incontinence but can increase risk of falls

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13
Q

In a patient with hypercalciuria and renal stones, calcium excretion and stone formation can be decreased by

A

thiazide diuretics

e.g. bendroflumethiazide

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14
Q

pain relief for renal colic?

A

Diclofenac

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15
Q

1st + 2nd line drugs for ankylosing spondylitis

A

1- NSAIDs (+ physio)

2 - infliximab (anti TNF)

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16
Q

1st line for SLE + S/E

A

hydroxychloroquine

  • visual acuity testing due to risk of visual loss

+- steroids if skin or organ involvements

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17
Q

Levothyroxine side effect

A

Osteoporosis (important to consider in post meno women)

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18
Q

What medication can affect levothyroxine absorption?

A

Iron (ferrous sulphate) , take levothyroxine first 2-4 hrs before

other medics include calcium, digoxin, HRT

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19
Q

Carbimazole for hyperthyroid C/I pregnanacy, use what instead?

A

Propylthiouracil in 1st trimester

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20
Q

For gastroparesis?

A

Metoclopramide (pro kinetic to help the gastric emptying)

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21
Q

Painful diabetic neuropathy

A

Duloxetine 1st line

Amitriptyline, gabapentin, pregabalin 2nd line

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22
Q

Who would you avoid amitriptyline in?

A

px with BPH - can cause urinary retention

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23
Q

Drug mx rate control Atrial fibrillation

A

Propranolol OR a CCB

CCB can be diliatezem or Verapamil (but verapamil cannot be used with beta blocker)

2nd line - for sedentary px is digoxin

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23
Q

Drug mx rate control Atrial fibrillation

A

Propranolol OR a CCB

CCB can be diliatezem or Verapamil (but verapamil cannot be used with beta blocker)

2nd line - for sedentary px is digoxin

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24
Whats given before elective DC cardioversion for AFib?
DOAC - apixiban
25
Which drugs can be used to assess for brugada syndrome?
Flecainide or Ajmaline can make ECG changes more apparent
26
Drug for those not suited to parathyroidectomy for primary hyperPTH
cinalcalcet
27
Osteoporosis mx?
Bisphosphonates e.g. Alendronate S/E = upper gi (give risedronate if Alendronate not sitting well) Consider 2nd line denosumab for post meno women
28
For limb claudication (ABPI 0.5-0.9) if conservative mx for pain doesnt work (exercise regime + smoking cessation) what drug can be given?
Vasodilator = naftidrofuryl oxalate
29
oral Vasodilator for mx of venous ulcers?
oral pentoxifylline = peripheral vasodilator which improved healing rate of ulcer
30
Aortic dissection can be type A (ascending) or type B (descending aortia) Type B uses medical mx?
Conservative management , IV Beta blocker Labetalol to reduce BP
31
What anti coag do mechanical heart valves require?
32
What anti coag do mechanical heart valves require?
Warfarin ( with mitral valves having a higher INR target than aortic)
33
Warfarin is 2nd line after DOACs for thromboembolism e.g. PE, for this what are the INR targets?
target INR = 2.5 if recurrent thombotic event despite on warfarin = 3.5 atrial fibrillation target = 2.5
34
Warfarin side effects / contraindication?
Haemorrhage teratogenic - breast feeding mothers however CAN use skin necrosis
35
Severe eczema?
Systemic immunosuppressive agnet = oral ciclosporin ( after tried emollients, then hydrocortisone topical cream )
36
cellulitis first line
flucloxocillin if allergic - clarithromycin (erythromycin if preggies)
37
Malaria
Chloroquine / hydroxychloroquine if strain is resistant consider artemisinin therapy
38
eczema herpiticum
IV acyclovir
39
encephalitis
( like eczema herpticum, complication of HSV) also IV acyclovir
40
What is ivabradine used for?
heart failure if the patient has sinus rhythm > 75/min and a LVEF < 35% and have not responded to ACE-inhibitor, beta-blockers and aldosterone antagonist therapy.
41
Bisoprolol is given (alongside an ACEi) for heart failure px, when does this need to be stoppedd?
42
(Epidimytis, what to give after empirical ceftriaxone) due to UTI? (if px is 35+)
ciprofloxacin (for e-coli)
43
(epididimytis, what to give after empirical ceftriaxone) due to STI (if px is under 35)
doxycycline to cover chlamidya as well if gonorrhoea is suspected keep it is ceftriaxone
44
1st and 2nd line for BPH
1st - Tamsulosin, alpha 1 blocker ( postural HTN, retrograde EJ) 2nd - Finasteride (low libido + erection, gynaecomastia, low PSA)
45
analgesia anal fissure
topical lidocaine
46
1st line chronic anal fissure meds after conservative tx
GTN ointment 2nd line - Diltiazem
47
If women with breast cancer have oestrogen receptor positive breast cancer?
Tamoxifen ( an E2 receptor antagonist) = used in pre-menopausal women or Anastrazole ( aromatase i ) = used in post menopausal women
48
Mild haemophilia A?
Desmospressin, can trigger release of vWF from endothelial cells increasing factor 8 plasma concentration
49
essential thrombocythaemia tx?
hydroxycarbamide = reduce platelet count antiplatelet therapy - aspirin to reduce risk
50
1st line drug anxiety 2nd line drug anxiety
1st line = SSRI e.g. sertraline 2nd line = SSRIs (different), SNRI e.g. duloexetine / venlafaxine if neither work try pregabalin
51
1st line depression? if that doesnt work
SSRI .e.g citalopram or sertraline Can give SNRI e.g. venaflaxine, duloxetine, MAO inhibibtors, amitriptlyline
52
SSRI of choice in children and adolescents for depression?
Fluoxetine
53
SSRI of choice in px post MI for depression?
Sertraline
54
delirium tremens?
Acute alcohol withdrawel, px will have hallucinations + fluctuating consciousness (long acting benzodiazepine) chlordiazepoxide + pabrine
55
Hyperactive delirum? (agitated px)
1st line antipsychotics e.g. haloperidol / respiradone C/I in parkinsons so use lorazepam instead
56
opiate overdose?
IV naloxone (also used for investigation to see reversal of symptoms)
57
how to classify aspirin overdose?
salicylate levels mild = <300 mg/L moderate = 300-700 mg/L severe = >700 mg/L
58
Aspirin overdose?
Activated charcoal within the hr sodium bicarbonate - alkalizes urine
59
tricyclic antidepressant overdose features
convulsions, dry hot skin, dilated pupils, prolonged QT, agitation, blurred vision
60
tricyclic antidepressant overdose drug mx?
IV sodium bicarbonate
61
paracetamol overdose if staggered mx?
Do not wait or check for paracetamol levels just give N acetylcysteine
62
which drugs cause peptic ulcers?
NSAIDs Biphosphonates (aldendronic acid) Corticosteroids
63
which drugs can cause acute pancreatitis?
Sodium valproate Steroids Thiazides Aziathoprine Mesalazine
64
C diff?
1st line - vancomycin 2nd line - oral fidaxomicin if life threatening = oral vancomycin AND IV metronidazole, consider surgery
65
cholera abx
doxyclycline or co-trimoxazole
66
Staph Aureus caused Infective endocarditis on native valve abx? On prosthetic valve?
- Flucloxacillin - Flucloxaclillin + rifampcin + gentamicin
67
Staph epidermidis caused Infective endocarditis abx? ( usually under 2 months post valve op )
vancomycin ( as the usual flucloxacillin wont work this organism is resistant )
68
Infective endocarditis post dental procedure abx?
Organism is Strep viridans --> benzylpenicillin
69
for stroke - Aspring 300mg 2 weeks then clopidogrel, if clopidogrel not tolerated?
Aspirin +modified release dipyridamole
70
Non op patients who have colorectal cancer?
oxaliplatin / irinotecan plus folinic acid + fluorouracil chemotherapy
71
prolactinoma?
cabergoline 1st 2nd bromocriptine
72
2nd line mx for acromegaly?
somatostatin analogue - octreotide
73
Addisons glucocorticoid and mineralcorticoid replacement therapy?
Hydrocortisone , 2/3 doses for 20-30mg per day (glucocorticoid helps with cortisol) -> Fludrocortisone (mineralcorticoid helps with aldosterone) * if px is sick double the hydrocortisone
74
Addisons medical mx
Metyrapone - steroid synthesis pathway blocker Can also use Ketoconazole (adrenolytic) * can cause liver damage Mifepristone (glucocorticoid antagonist) Pasireotide (binds to samostostatin receptors)
75
Lamotrigine derm S/E
Steven johnson
76
Medication for HTN in T2 diabetic?
ACEi or ARB then add CCB / thiazide diuretic
77
Medication in Non diabetic, under 55 white person with HTN?
ACEi or ARB
78
Which HTN patients need a CCB first?
Age 55+, Black * as long as they are not diabetic
79
Status epilepticus?
Hospital -> IV lorazepam Other setting -> IM diazepam 2nd line -> phentoin
80
generalised seizures?
Sodium valproate EXCEPT childbearing age women* 2nd line - ethosuximide ( first for absence seizure) for these women* = lamotrigine
81
focal seizures?
Carbemazepine (S/E - SIADH) or lamotrigine
82
essential tremor
Observe if mild, if not: 1st - propronolol 2nd - gabapentin
83
Parkinsons with motor difficulties?
levodopa
84
levadopa The patient is experiencing symptoms towards the end of her dose and prior to the next dose, known as the ?
wearing off phenomenon
85
Alzheimer's 1st line Alzheimer's 2nd line
1 - Donepezil (acetylcholine i) Galantamine if hallucinating 2 - Memantine (NMDA antagonist)
86
Whaat drug can you not give trimethoprim (UTI abx) for?
Methotrexate
87
if a px has calcium oxalate kidney stones as well as surgical evacuation what medication should be given?
Thiazide diuretics
88
acute bronchitis if abx indicated, which one given
doxycycline
89
What is contraindicated if a patient is on a macrolide?
Statin
90
acute exacerbation COPD meds?
Amoxilcillin allergic: clarithromycin / doxycycline
91
SVC obstruction (+ pembertons test) immediate medical mx?
dexamethasone
92
amitriptyline S/E
Constipation
93
depending on PT when is Vitamin K given when is FFP given?
PT time 14s+ = VK PT time 20s+ = FFP

Year 3 (14 decks)

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