Medicines 10 Flashcards
What type of inhalers can cause dry mouth symptoms?
Antimuscarinics - LAMA, SAMA - “Can’t shit, Can’t spit”
What monitoring is required with Unfractionated heparins?
Heparin-induced thrombocytopenia
Platelet counts should be measured just before treatment with unfractionated or low molecular weight heparin, and regular monitoring of platelet counts may be required if given for longer than 4 days. See the British Society for Haematology’s Guidelines on the diagnosis and management of heparin-induced thrombocytopenia: second edition. Br J Haematol 2012; 159: 528–540.
Hyperkalaemia
Plasma-potassium concentration should be measured in patients at risk of hyperkalaemia before starting the heparin and monitored regularly thereafter, particularly if treatment is to be continued for longer than 7 days.
How long can a beclometasone nasal spray be used for?
3 months as per EMC
What are the key things to remember regarding mebendazole?
if reinfection occurs can be given 14 days after initial dose.
treat all family members
Licensed for 2 years+
What age is chloramphenicol not licensed for sale?
below 2 years old
Why shouldnt you give buprenorphine patches and fentanyl patches together?
Buprenorphine is a partial agonist at the mu-opioid receptor and has a high receptor affinity. This means it binds tightly to opioid receptors but activates them less strongly than full agonists like fentanyl.
When given alongside fentanyl (a full agonist), buprenorphine can displace fentanyl from the receptors due to its higher affinity, reducing the analgesic effect of fentanyl and potentially causing withdrawal symptoms in patients who are opioid-tolerant.
What are key things to remember with Isotretinoin?
- Weight based dosing!
- Pregnancy prevention plan
- reports of erectile dysfunction and decreased libido
- Neuropsychiatric reactions
- Prescription valid for 7 days
Cautions For isotretinoin
Avoid blood donation during treatment and for at least 1 month after treatment
What is the dose of bisphosphonates in a male vs female?
Alendronic Acid - Adult (female)
10 mg once daily, alternatively 70 mg once weekly.
Adult (male)
10 mg once daily.
Risedronate
Adult (female)
5 mg daily, alternatively 35 mg once weekly.
Adult (male)
35 mg once weekly.
Ibandronic
Adult (female)
150 mg once a month, alternatively (by intravenous injection) 3 mg every 3 months, to be administered over 15–30 seconds.
Zoledronic acid
Adult
5 mg once yearly as a single dose, in patients with a recent low-trauma hip fracture, the dose should be given at least 2 weeks after hip fracture repair; before first infusion give 50 000–125 000 units of vitamin D.
How often is routine mamogram testing done and on what age groups under the NHS
The NHS Breast Screening Programme invites all women from the age of 50 to 70 registered with a GP for screening every 3 years.
Which of the SSRIs is associated with less withdrawal side effects?
Fluoxetine is associated with a lower risk of withdrawal symptoms
if stopped abruptly due to longer half-life.
What monitoring is required with minocycline?
If treatment continued for longer than 6 months, monitor every 3 months for hepatotoxicity, pigmentation and for systemic lupus erythematosus—discontinue if these develop or if pre-existing systemic lupus erythematosus worsens.
what is the max dose of the different SSRIs in over 65s?
Citalopram 20 mg once daily Higher doses increase the risk of QT prolongation.
Escitalopram 10 mg once daily Risk of QT prolongation increases with doses above 10 mg in older adults.
Fluoxetine 60 mg once daily Long half-life; lower doses are often effective.
Sertraline 200 mg once daily Generally well-tolerated in older adults.
Paroxetine 40 mg once daily More prone to cause anticholinergic effects (e.g., confusion).
What are key monitoring to remember about antipsychotic medication?
Weight should be measured at the start of therapy with antipsychotic drugs, then weekly for the first 6 weeks, then at 12 weeks, at 1 year, and then yearly.
Fasting blood glucose, HbA1c, and blood lipid concentrations should be measured at baseline, at 12 weeks, at 1 year, and then yearly. Prolactin concentrations should also be measured at baseline.
Before initiating antipsychotic drugs, an ECG may be required, particularly if physical examination identifies cardiovascular risk factors (e.g. high blood pressure), if there is a personal history of cardiovascular disease, or if the patient is being admitted as an inpatient.
Blood pressure monitoring is advised before starting therapy, at 12 weeks, at 1 year and then yearly during treatment and dose titration of antipsychotic drugs.
Expert sources advise to monitor full blood count, urea and electrolytes, and liver function tests at the start of therapy with antipsychotic drugs, and then yearly thereafter.
What is the difference between most antipsychotics?
There is little difference in efficacy between each of the antipsychotic drugs (other than clozapine), and response and tolerability to each antipsychotic drug varies.
Both first-generation and second-generation antipsychotic drugs are associated with side-effects that are common and contribute significantly to non-adherence and treatment discontinuation.
What are some key side effects to note with antipsychotics?
Extrapyramidal symptoms
Hyperprolactinaemia - increase in prolactin
Sexual dysfunction
Cardiovascular side-effects
tachycardia, arrhythmias, and hypotension
Hypotension
Hyperglycaemia and diabetes
Weight gain - Clozapine and olanzapine commonly cause weight gain
Neuroleptic malignant syndrome
