Medicines 5 Flashcards
What are some signs of vitamin C deficiency?
Swollen, bleeding gums: Gums that are swollen, bleed easily, and may become purple and spongy
Skin that bruises easily: Skin that bruises easily
Red or blue spots on the skin: A “scurvy rash” that appears as red or blue spots on the skin, usually on the legs and feet
What is hyponatraemia and which common medications can cause it when in combination or by themselves
Hyponatraemia is a condition characterized by a low concentration of sodium in the blood
Thiazide and thiazide-like diuretics inhibit sodium chloride reabsorption in the distal tubules [Saeed, 2014].
Loop diuretics may also cause hyponatraemia, but this is more likely to occur when they are taken in combination with medications, such as angiotensin converting enzyme (ACE) inhibitors or spironolactone
Selective serotonin reuptake inhibitors (SSRIs) — SSRIs (especially citalopram)
Antipsychotics (such as haloperidol and phenothiazines).
Carbamazepine — the incidence varies widely from 4.8–41.5% depending on the population studied.
Less common causes include [Saeed, 2014] [BMJ, 2019] [Jones, 2019]:
Drugs that increase the production, or potentiate the action, of ADH (SIADH):
Opioids.
ACE inhibitors and angiotensin-II receptor antagonists (AIIRAs).
Proton pump inhibitors (such as omeprazole and lansoprazole).
Anticonvulsants (such as sodium valproate, lamotrigine, and leviteracetam).
Amiodarone.
Theophylline.
Dopamine antagonists (metoclopramide and domperidone).
Antidiabetics (insulin, chlorpropamide, and tolbutamine).
Nonsteroidal anti-inflammatory drugs.
MDMA (ecstasy).
What does adjuvant mean in the context of chemotherapy?
In the context of chemotherapy, adjuvant refers to treatment given after the primary therapy (usually surgery) to reduce the risk of cancer recurrence and improve overall outcomes. Adjuvant chemotherapy aims to eliminate any remaining cancer cells that may not be detectable but could potentially cause a relapse.
What is febrile neutropenia?
Febrile neutropenia is a serious condition that occurs when a patient has a fever and a low number of neutrophils in their blood
It can occur in patients on chemotherapy
what is SACT therapy
SACT stands for Systemic Anti-Cancer Therapy, which refers to any treatment used to target and kill cancer cells throughout the body. It is an umbrella term encompassing various systemic treatments delivered to patients with cancer, aiming to shrink tumors, prevent recurrence, or manage advanced disease.
Which anti-sickness medication should not be given in parkinsons disease and what should be given?
Metoclopramide (Maxalon), Prochlorperazine (Stemetil), Phenergan (promethazine), and Haloperidol should be avoided
Consider prescribing low-dose domperidone
what are Granulocyte Colony-Stimulating Factors (G-CSFs):
Examples:
Filgrastim (daily injection for 5–7 days after chemotherapy).
Pegfilgrastim (a single-dose injection given 24–72 hours after chemotherapy).
Pegfilgrastim is often preferred due to its convenience (single injection per cycle).
Mechanism:
Stimulates bone marrow to produce more neutrophils, reducing the risk of severe neutropenia and febrile neutropenia.
Timing:
Administer 24–72 hours after chemotherapy to avoid interfering with the cytotoxic effects on rapidly dividing cells.
What type of drug is Letrozole
Letrozole is an aromatase inhibitor, a type of endocrine therapy used primarily in the treatment of hormone receptor-positive (HR-positive) breast cancer, particularly in postmenopausal women.
Primary Treatment:
For early-stage breast cancer in postmenopausal women, particularly those with ER-positive or HR-positive tumors. It is used adjuvantly (after surgery) to reduce the risk of recurrence.
Secondary (Metastatic) Breast Cancer:
Used in postmenopausal women with metastatic ER-positive breast cancer.
Letrozole is often used when chemotherapy is not indicated, especially in patients who are hormone receptor-positive.
WHat drug would be used in premenopausal women instead of letrozole
Tamoxifen
How can type 2 diabetes affect COPD?
It can make COPD worse. High blood sugar can affect the blood vessels in the lungs. Over time this can damage the blood vessels, leading to worsening of asthma or COPD .
COPD can make it more difficult to do physical activity.
Why is it advisable to take prednisolone as a single dose in the morning?
To prevent disruption of circadian rhythm (1mark)
As repeat evening doses can cause pituitary-adrenal suppression (1mark)
What should be checked if opioids are prescribed in the hospital?
- dose increase does not exceed 50% increase - work out total daily dose and divide by 2 for max dose
- Is Naloxone Prescribed?
- Is the breakthrough dose correct?
- Have they been given laxative and correct one (stimulant)?
- Paracetamol - should be in regular pain meds as its opioid sparing
What is lifestyle advise
- cardioprotective diet à balanced diet, reduce saturated fat and salt
Foods high in saturated fat include:- meat pies
- sausages and fatty cuts of meat
- butter
- ghee – a type of butter often used in Indian cooking
- lard
- cream
- hard cheese
- cakes and biscuits
- foods that contain coconut or palm oil
- Less salt in diet, have to reduce fluid intake 1500-2000ml
less than 6g - 5 a day
- omega 3 - oily fish atleast twice a week.
- pregnancy- limit to one portion of oily fish a week - no more than 2 due to containing pollutants.
Regular exercise Reduced chances of developing high blood pressure - lower cholesterol level
* physical activity
* 150 mins of aerobic exercise a week - can still carry on a convo
* 75 mins of vigorous exercise a week
* strength exercise 2 days a week
* weight management
- smoking cessation
- need to check motivation to quit.
- alcohol consumption - causes high blood pressure which is a risk factor - reduce - no more than 14 units per week
How does quitting smoking benefit COPD and diabetes?
Smoking is one of the main causes of COPD. Quitting smoking is the most effective way to slow down the progression of symptoms.
Chemicals from Smoking can cause inflammation and to blood vessels
