Misc Flashcards
When can activated charcoal be used in repeated doses?
Poisoning from: Carbamazepine Dapsone Phenobarbitol Quinine Theophylline
How to treat aspirin poisoning?
Activated charcoal
What is used to treat opioid poisoning?
Naloxone. It has a shorter half life that many opioids so may need monitoring and repeated doses. Not as effective on buprenorphine poisoning
What is used to treat paracetamol poisoning?
Acetylcysteiene
What is used for SSRI poisoning?
Activated charcoal Supportive measures Benzos for seizures
Benzodiazepine overdose treatment
Activated charcoal Flumazenil
What electrolyte imbalance can LABA and SABA cause?
hypokalaemia
what asthma treatments can cause glaucoma?
tiotropium and ipratropium
what type of ‘aba’ is vilanterol?
ultra long acting beta agonist
what plasma conc of theophylline is needed for satisfactory bronchodilation?
10-20mg/L
when should theophylline levels be measured?
at least 5 days after initiating treatment, and 3 days after any dose adjustment
what happens if baclofen is adruptly withdrawn? how long should withdrawal take?
Should be done over 1-2 weeks.
Risks of abrupt withdrawal include: hyperactive state, spasticity, hyperthermia, psychiatric reactions, convulsions.
how long should rivaroxaban be taken for VTE prophylaxis after hip surgery?
35 days
what beta blockers are cardioselective?
Bisoprolol
Acebutolol
Metoprolol
Atenolol
Nebivolol
what beta blockers are water soluble?
Celiprolol
Atenolol
Nadolol
Sotalol
What should INR be to switch from DOAC to warfarin?
Under 2
What anticoags have risk of epidural haematoma?
NOACS
what is INR target for MI?
2.5
Can warfarin be taken in pregnancy?
NOT in first trimester, but fine in 2nd or 3rd
what are the colours of warfarin tablets?
0.5mg (White), 1mg (Brown), 3mg (Blue), 5mg (Pink)
what is BP target for a diabetic with kidney complications?
<130/80
what is BP target for a type 1 diabetic with no complications?
<135/85
what is warfarin duration for:
- isolated calf DVT
- provoked VTE
- Unprovoked DVT/PE
- AF/prosthetic valve
- isolated calf DVT 6 WEEKS
- provoked VTE 3 MONTHS
- Unprovoked DVT/PE
- AF/prosthetic valve LIFELONG
What statin is given for primary CVD prevention for QRISK over 10%?
Atorvastatin 20mg
What statin is given for secondary CVD prevetion?
Atorvastatin 80mg
after when should dypridamole tablets be discarded?
6 weeks
how long should be left to determine a response to ramipril?
at least 4 weeks
Do LMWH or UH have longer duration of action?
LMWH
What should be done if amiodarone and digoxin need to be given together?
half the dose of digoxin
how long should a patient be on an antipsychotic before being seemed ineffective?
4-6 weeks
what monitoring needs to occur with clozapine?
weekly WBC monitoring for 18 weeks, then fortnightly for up to a year. Then monthly.
Blood lipids and wieght at baseline, at 3 motnhs and yearly
Fasting BGC at baseline, at 4-6 months, yearly
Prolactin conc at baseline, at 6 months, yearly
with which antipsychotics is hyperprolactinemia least likely?
aripiprazole
clozapine
quetiapine
Which gen of antipsychotics have highest and lowest risk of sexual dysfunction?
Highest: - risperidone, haloperidol, olanzapine
Lowest: aripiprazole, quetiapine
Which gen of antipsychotic has highest risk of CVD?
Both generations carry equal risk.
IV admin most high risk.
Highest risk drug is pimozide.
What gen of antipsychotics carry highest risk of hypotension?
2nd gen highest risk (especially clozapine and quetiapine)
what gen of antipsychotic has lowest risk of hyperglycemia/diabetes
LOWEST TOTAL RISK: haloperidol
(2nd gen is higher risk EXCEPT for amisulpride and aripiprazole)
what antipsychotics have the highest incidence of weight gain?
clozapine and olanzapine
which CD drug has both opioid agonist and antagonist properties?
buprenorphine
what SSRI has longest half life?
Fluoxetine
what side effects does domperidone have if used for longer than 7 days?
Arrhythmias
what side effects does metoclopramide have if used for longer than 5 days?
Neurological adverse effects (parkinsonism, neuroleptic malignant syndrome, dystonia)
what should be used to treat nausea in parkinsons?
Cyclizine
Domperidone
Ondansetron
what monitoring is requring in sodium valproate (besides PPP)?
Liver function before therapy and every 6 months.
being high risk of developing type 2 diabetes is defined as a hba1c of?
42-47mmol
how often should a type 2 diabetic stabilised on medication have thier hba1c checked?
every 6 months
what is the optimal self monitoring blood glucose conc for driving?
at least 5mmol
how often should you monitor TSH when somes thyroid level is stabilisded?
Yearly
What are the fat soluble vitamins?
ADEK
What are the common enzyme inhibitors?
(causes INCREASED plasma concentrations)
Sodium valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Alcohol (binging)
Chloramphenicol
Erythromycin
Sulphonamide
Ciprofloxacin
Omeprazole
Metronidazole
What are the common enzyme inducers?
(causes DECREASED plasma concentrations)
Barbituates
St johns wort
Carbamazepine
Rifampicin
Alcohol (chronic)
Phenytoin
Griseofulvin
Phenobarbitol
Sulfonylureas
What drugs does grapefruit juice interact with to cause an increased plasma concentration?
CVS: Amiodarone, Statins, CCBs
CNS: sertraline, quetiapine
Also: tacrolimus, ciclosporin, sildenafil, colchicine
What drugs should be temporarily witheld in AKI?
Diuretics
ACEI/ARB
Metformin
NSAIDs
what can colour urine blue?
triamterene
what can colour urine pink/orange?
phenindione
what colours urine/body secretions:
- red/orange
- orange
- yellow/brown
- red/orange: RIFAMPICIN
- orange: SULFASALAZINE
- yellow/brown: NITROFURANTOIN, SENNA
what anti-epileptic can cause vit D deficiency?
phenytoin
how does smoking and alcohol affect theophylline?
The plasma-theophylline concentration is decreased in smokers, and by alcohol consumption.
what electrolyte imbalance can be caused by theophylline?
hypokalemia
what are signs of theophylline toxicity?
tachycardia, dilated pupils, hyperglycemia, convulsions, arrhythmias
what IV anasthetic can be given to children to provide quick recovery and minimal hangover?
propofol
what inhaled anasthetic has obstetric use?
isoflurane most commonly used, causes muscle relaxation.
nitrous oxide is also used, has analgesic properties too, self administration.
what is the washout period for sertraline?
2 weeks
what is the washout period for fluoxetine?
5 weeks
how long after stopping an MAOI can a patient drink alcohol?
2 weeks after stopping
What monitoring needs to occur with lithium?
renal, cardiac, thyroid function, BMI, serum electrolytes, and a full blood count before treatment initiation.
BMI, serum electrolytes, eGFR, and thyroid function every 6 months
what are signs of litihum toxicity?
hypernatremia
coarse tremor
visual disturbance
muscle weakness
what anti-parkinsons drug group is most likely to cause reckless behaviour?
Most likely with dopamine agonists (pramipexole, ropinirole, rotigotine)(DA’s also increase risk of serotonin syndrome with SSRI’s)
Can also happen with levodopa
what are the MOBI’s that are used in parkinsons?
rasigiline
selegiline (caution in tyramine rich foods, also may increase conc of levodopa)
What would TSH and T4 be in hypothyroidism?
High TSH
Low T4
What would TSH, T4 and T3 show in hyperthyroidism?
Low TSH
High T4 and T3
How long after taking EHC should a woman continue breastfeeding?
ulipristal: 1 weeks
levon: does not matter
what is:
- herpes simplex
- herpes zoster
- varicella zoster
- herpes simplex (oral/genital herpes)
- herpes zoster (shingles)
- varicella zoster (chickenpox)
DONT USE NSAIDS
what is max dose of colchicine per day and per course? when can course be repeated?
500mcg 2-4 times daily
max dose per course is three days
repeat after 3 days
when to stop warfarin before elective surgery?
5 days
what pathogen is responsible for the majority of viral conjunctivitis cases?
adenovirus
