Medicine Sick Day Rules

Question 1

🤕 What are medicine sick day rules?

Answer 1

This is basically when certain medications are ** temporarily stopped** when a person becomes ill and dehydrated as the risk of dehydration and potentially serious side effects is greater than the benefits of continuing the medication whilst the patient is still ill

Question 2

What are the symptoms that warrant sick day rules?

Answer 2

If the patient is at risk of dehydration 💧 and :
- fever 🥵
- sweats 😥
- shakes 🫨
- diarrhoea 💩
- vomiting 🤮

Question 3

When can patients restart their medications after the imposing of sick day rules?

Answer 3

📅 24 - 48hrs after they start eating and drinking normally 🥘 🥤

Question 4

Should patients make up for their missed doses whilst ill, once they start eating and drinking normally?

Answer 4

NO

Question 5

What are the 3 classes of drugs that should be stopped as per sick day rules?

Answer 5

• 💊 NSAIDS
• 🫀 anti - hypertensives
• 🍫 anti - hyperglycaemic drugs

Question 6

Why should NSAIDS be stopped in dehydration/sickness as part of sick day rules?

Answer 6

• they further increase the risk of dehydration

Question 7

Which antihypertensives should be stopped as per sick day rules and why?

Answer 7

• 🫘 ACE inhibitors - increase the risk of AKI in dehydration
• 🫘 ARBS - increase the risk of AKI in dehydration
• 😥 Diuretics - increase the risk of dehydration further when ill

Question 8

Which drug diabetes drugs should be stopped as per sick day rules and why?

Answer 8

• 🍋 metformin- increased risk of lactic acidosis in dehydration
• 💊 SGLT - 2 inhibitors - increased risk of dehydration 😥, and also increased risk of acidosis in dehydration 🍋

Question 9

Do we ever stop INSULIN as part of sick day rules?

Answer 9

NO