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1
Q

Hypokalaemia causing drugs

A

Bendroflumethazide (thiazides) and loop

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2
Q

Hyperkalaemia causing drugs

A

ACEin, potassium sparing diuretics, tacrolimus, heparin

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3
Q

Max Iv potassium rate

A

10mmol/hr

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4
Q

Antiemetic options

A

cyclizine 50mg 8-hrly IV/IM/oral

Metoclopramide 10mg 8hrly IV/IM (heart failure)

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5
Q

Metoclopramide ci

A

parkinsons, young women (dyskinesia, acute dystonia)

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6
Q

Paracetamol max/day

A

4g/day (8x500mg) Co-codamol.

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7
Q

Steroid side effects

A

Stomach ulcers, thin skin, edema, right and left heart failure, osteoporosis, infection (inc candida), diabetes, cushings syndrome

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8
Q

NSAIDS/ibuprofen side effects

A 
No urine
systolic dysfunction- Heart failure
asthma
Indigestion
dyscrasia
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9
Q

pre operative drug changes

A 
I LACK OP 
INsulin
Lithium
anticoag/plt
COCP/HRT 
K-sparing diuretics
oral hypoglycaemics
peridonopril (+ other acein)
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10
Q

when to stop COCP for surgery

A

4 weeks before

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11
Q

when to stop litihium for surgery

A

day before

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12
Q

ACEin/K sparing stop for surgery

A

day of surgery

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13
Q

anticoag when stop for surgery

A

warfarin 5 days before

anti platelets day before

heparin day before

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14
Q

insulin when stop for surgery

A

variable

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15
Q

cough as se- what is the medication?

A

ace in

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16
Q

indigestion causes

A

steroids, nsaids

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17
Q

constipation causes

A

cocodamol, codeine

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18
Q

methotrexate cautions

A

give weekly, no trimethoprim or co-trimoxazole- folate antagonists. Give folic acid alongside to reduce BM toxicity.

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19
Q

peripheral oedema cause

A

CCB e.g. amlodipine

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20
Q

post stroke caution

A

no heparin 2 months e.g. enoxaparin

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21
Q

CCB caution

A

not with beta blockers- bradycardia

e.g. verampil

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22
Q

asthma cautions

A

beta blockers, nsaids, aspirin (can use with caution)

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23
Q

COCP ci

A

migraine with aura

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24
Q

insulin route

A

S/c unless sliding scale IV actrapid and novarapid

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25
Q

agranulocytosis which drug

A

clozapine. immediately cease and refer to haem

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26
Q

Neutrophilia which drug

A

steroids

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27
Q

Neutropenia which drug

A

chemo or radiotherapy. clozapine, carbimazole. carbamazepine.

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28
Q

thrombocytopaenia which drug

A

penicilliamine (RF) reduced production

Heparin increased destruction

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29
Q

SIADH- low na which drug cause

A

carbamezepine, antipscyh

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30
Q

intrinsic renal failure which drug

A

gentamicin, vancomycin, tetracycline, (ACEin), NSAIDS, contrast, lithium

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31
Q

TSH ranges with levothyroxine

A

<0.5 decrease dose
0.5-5 nill action
>5 increase dose

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32
Q

cholestasis drugs

A

flucloxacillin, coamoxiclav, nitrofuratoin, steroids, sulphonylreas

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33
Q

hepatitis drugs

A

paracetamol od, statins, rifampicin.

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34
Q

digoxin tox sx

A

Confusion, nausea, visual halos and arrhythmias

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35
Q

lithium tox sx

A

Early: tremor
Intermediate: tiredness
Late: arrhythmias, seizures, coma, renal failure and diabetes insipidus

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36
Q

phenytoin tox sx

A

Gum hypertrophy, ataxia, nystagmus, peripheral neuropathy and teratogenicity

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37
Q

Gentamicin/vancomycin se

A

Ototoxicity and nephrotoxicity

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38
Q

Gentamicin monitoring

A

IE: peak- 3-5
trough <1

Everything else: 5-10 peak
<2 trough
peak adjust dose, trough adjust interval

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39
Q

gentamicin dose

A

5-7mg/kg OD

renal failure or IE: 1mg/kg 12 hourly- divided daily dosing.

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40
Q

Warfarin INR too high

A

<6 reduce dose
6-8 omit 2 days then reduce
>8 (and no bleeding) omit warfarin and give 1-5mg oral vit k
if minor bleed with INR >5 give 1-2mg vit k phytomenadione IV NOT ORAL!

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41
Q

neutropenic sepsis tx

A

IV piperacillin with tazobactam and gentamicin

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42
Q

UTI in preg mx

A

no trimethoprin- folate antagonist

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43
Q

Addisons caution

A

Increase hydrocortisone with infection or illness

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44
Q

HF acute mx

A

40mg IV furosemide

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45
Q

AF caution

A

can use diltazem but worsens fluid retention as CCB

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46
Q

Neuropathic pain

A

amitriptylline TCA. i.e. 10mg nightly

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47
Q

STEMI MX

A 
ABC. O2 if sats <94%
Aspirin 300mg oral 
Morphine 10mg IV with metoclopramide 10mg IV
GTN spray
Primary PCI
Atenolol 5mg Oral
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48
Q

NSTEMI mx

A

ABC. O2 if sats <94%
Aspirin 300mg oral
Morphine 10mg IV with metoclopramide 10mg IV
GTN spray
Clopidogrel 300mg, enoxaprin 1mg//kg bD SC
Atenolol 5mg Oral

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49
Q

LVF mx acute

A 
ABC and o2
Sit patient up
Morphoine 5-10mg IV with metoclopramide 10mg IV
GTN spary
Furosemide 40-80mg IV
CPAP
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50
Q

Unstable arrthymia mx

A

Synchronised DC shock (3 attempts)

amiodarone 300mg IV 10-20 min and repeat shock then amiodarone 900mg over 24 hours.

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51
Q

Anaphylaxis mx

A 
ABC, o2
Remove cause 
Adrenaline 500mcg of 1:1000 IM
Chlorphenamine 10mg IV
Hydrocortisone 200mg IV
Astham tx with wheeze
amend drug allergys box on chart
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52
Q

Acute asthma mx

A

ABC
100% o2 via non-rebreather
salbutamol 5mg neb (20-30 mins repeat with oxygen driven)
Hydrocortisone 100mg IV (6hrly) or pred 40-50mg oral
Magnesium sulphate 1.2-2g over 20 mins
Ipratropiium 500 mcg neb]
Theophylline.

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53
Q

Pneumonia tx

A 
ABC
High flow o2
antibioitics: amoxicillin or co-amoxiclav, 
paracetamol
IV fluids
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54
Q

Pulmonary Embolism tx

A

High flow O2, morphine 5-10mg IV with metoclopramide 10mg IV

Rivaroxaban- Initially 15 mg twice daily for 21 days, then maintenance 20 mg once daily

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55
Q

GI bleeding mx

A 
ABC with o2 non breather
2 large bore cannulae
catheter with strict fluid monitoring
cross match 6 units
correct clotting abn
endoscopy 
stop nsaids, aspirin, warfarin, heparin
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56
Q

Bacterial meningitis mx

A

ABC, high flow o2, iv fluids, dexamethasone iv unless immmunocompr. LP with CT head
2g cefotaxime QDS/cephtriaxone (2-4g) min 10 days (if over 50 add amoxicillin)

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57
Q

epileptic seizure mx

A

ABC, recovery position with o2

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58
Q

Status epilepticus mx

A 
ABC, recovery position with o2
Lorazepam 2-4mg IV or diazepam/midazolam buccal 10mg
repeat diazepam after 2 mins
inform anaesthetist
phenytoin
intubate then propofol.
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59
Q

Stroke mx

A

ABC CT head to exclude haemmorage
if <80 and <4.5 hrs ago thrombolysis
aspirin 300mg oral
transfer to stroke

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60
Q

Hyperglycaemia mx

A

ABC,
IV fluid 1L stat then 1L over 1 hour then 2, 4, 8.
Fixed dose insulin. 1 unit/mL; with 0.9% saline infuse at a fixed rate of 0.1 units/kg/hour.
Monitor Bm, K, pH and ketones.

CONTINUE WITH LONG ACTING

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61
Q

AKI tx

A 
ABC
cannula and catheter with strict fluid monitoring
IV fluid 500ml stat then 1L 4 hrly. 
Monitor U&E and fluid balance
treat cuase.

Stop allopuriol, acein, arbs, nsaids, metformin, acculumating drugs.

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62
Q

Acute poisoning mx

A

ABC
Cannulae catheter strict fluid balance
supportive IV fluids and analgesia
Correct electrolyte abn
Reduce absorption if <1hr: gastric lavage (unless caustic), whole bowel irrigation (iron/lithium), charcoal (dose dependent)
N-acetyl cysteine if paracetamol at 4 hours above line on normogram
Naloxone )opiates in slow breathing or low GCS
Flumazenil benzo

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63
Q

Lamotrigine se

A

Rash, rarely Stevens–Johnson syndrome

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64
Q

Carbamazepine se

A

Rash, dysarthria, ataxia, nystagmus, ⇓Na, neutropenic sepsis

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65
Q

Phenytoin se

A

Ataxia, peripheral neuropathy, gum hyperplasia, hepatotoxicity

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66
Q

Sodium Valporate se

A

Tremor, teratogenicity, tubby (weight gain

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67
Q

COPD tx

A

smoking cessation, inhaled therapy

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68
Q

Alzheimers tx

A

Acetylcholinesterease inhibitors. Donezepil, rivastigmine, galantamine.
NMDA antagonist- memantine

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69
Q

Crohns mx

A

Induce remission with pred 30mg daily oral
Severe: hydrocortisone 100mg 6hrly IV.
Rectal hydrocortisone if rectal disease.
Maintaining remission with azathioprine or 6-mercaptopurine. (check TPMT)

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70
Q

Rheumatoid arthritis mx

A

methotrexate with DMARD (sulfasalazine or hydroxychloroquine)
Flare: Im methlypred 80mg
Short term nsaids ibuprofen with lansoprazole.
if failure to respond to two DMARDS- infliximab.

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71
Q

Fever mx

A

Tx cause. 4g paracetamol

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72
Q

Constipation mx

A

Stool softener: Docusate sodium. Good for impactino
Bulking agents: isphagula husk (CI in impaction and colonic atony) takes days to work
Stimulant laxatives: senns, bisacodyl (not in acute abdo), exacerbate cramps
osmotic: lactulose/phosphate enema: exacerbate bloating.

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73
Q

HTN when to treat

A

Treat if >150/95 or >135/85 with existing or high risk of vascular disease, hypertensve organ damage.

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74
Q

HTN target BP

A

<80yrs <140/85 in clinic and <135/85 for ambulatory or home.
if over 80 then add 10.

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75
Q

HTN Treatment

A

Under 55/t2dm: Acein or ARB
then add CCB or thiazide
then add the other out of CCB and thiazide

> 55 or black: CCB
then add ACei or ARB or thiazide
then CCB + thiazide + acein or arb

refer if uncontrolled on max dose of 4 drugs.

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76
Q

Heart failure mx

A

Acein-lisinopril 2.5m g daily plus beta blocker e.g. bisoprolol 1.25mg daily.
if mild: add arb
if moderate/black: add hydralazine 25mg 8hrly and isosorbide mononitrate 20mg 8 hrly
mod-sev: spironolactone 25mg daily.

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77
Q

CHADVASC

A 
congetive heart failure (or LHF)
Hypertension
Age >75 2 points
DM
Stroke or TIA (2 points)
Vascular disease (peripheral or IHD)
Age 65-74
Sex (female)

0= aspirin 75mg daily
1 aspirin or warfarin with INR 2.5 target
Score >2 warfarin with inr target 2.5

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78
Q

DM mx

A

education, dietary and exercise advice.
CV risk mx: aspirin 75mg daily if any significant risk or over 50 with t2dm
simvastatin 20-40mg daily if any significant rf or over 40 in t2dm
Annual rv: ACR (diabetic nephropathy), >3mg/mmol- ace in
blood glucose lowering therapy.

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79
Q

Glucose lowering therapy

A

if Hba1c >48: metformin 500mg with breakfast oral. if low or normal weight or high creatinine use sulphonylurea instead gliclazide 40mg with breakfast oral.
then increase dose to max tolerated
then add sulphonylurea (gliclazide)
if already gliclazide add gliptin (dpp4 inhibitor e.g. sitagliptin
if still over 48 add insulin.

80
Q

Skin infection mx

A

flucloxacillin 500mg 6 houly for 7 days.

81
Q

domperidone caution

A

safe for use in parkisons as does not cross bbb

82
Q

Parkinsons meds to avoid

A

metoclopramide, haloperiodol.

83
Q

HTN in pregnancy caution

A

avoid ramipril as teratogenic. Use labetalol

84
Q

HTN in pregnancy tx

A

Labetolol 100 mg BD, dose to be increased at intervals of 14 days; usual dose 200 mg BD, increased if necessary up to 800 mg daily in 2 divided doses, to be taken with food, higher doses to be given in 3–4 divided doses; maximum 2.4 g per day.

85
Q

Tamoxifen cautions

A

Increases endometrial cancer risk, increases warfarin efficacy high INR, increases VTE risk.

86
Q

Metformin Caution

A

causes lactic acidosis

87
Q

Gliclazide se

A

risk of hypoglycaemia. sulphonylurea. taken in morning.

88
Q

Methotrexate monitoring

A

have full blood count and renal and liver function tests repeated every 1–2 weeks until therapy stabilised, thereafter patients should be monitored every 2–3 months.
be advised to report all symptoms and signs suggestive of infection, especially sore throat

89
Q

Warfarin cautions

A

significant bleeding risk, alcohol enzyme inhibition. chronic excess enzyme induction.

90
Q

Warfarin colours

A

White 0.5mg
Brown 1mg
Blue 3mg
Pink 5mg

91
Q

Target INR

A

2.5- af, dvt, pe

recurrent vte or mechanical valve- 3.5

92
Q

Warfarin monitoring

A

initially weekly then monthly INR

93
Q

ACEin caution

A

dehydration, D&V. AKI risk. do not prescribe with NSAIDs. do not use in aortic stenosis.

94
Q

ACEin monitoring

A

check renal function and potassium 1-2 weeks after initiation. and after each dose change.

95
Q

Steroids co-prescribe

A

bisphosphonate (e.g. alendronic acid). Ranitidine or PPI (omeprazole) if at risk. DOnt stop suddenly. Monitor for HTN and DM.

96
Q

Citalopram

A

Photosensitivity, increased suicidality, dry mouth.

97
Q

Serotonin syndrome

A

agitation, temperatures, hallucinations.

98
Q

Alendronic acid

A

Weekly. not with calcium salts or food. swallowed with full glass of water and remain upright for 30 mins afterwards.

99
Q

1%

A

1g in 100ml or 10mg in 1ml

100
Q

ACEin

A

give in evening to avoid postural hypotension.

101
Q

GTN

A

glyceryl trinitrate. 2 sprays sublingual

102
Q

Vancomycin

A

Renal dysfuncton changes the dosage. Measure renal function before treatmetn

103
Q

Statins

A

Should check liver function as is metabolised by the liver. increases myopathy risk check ALT/AST before. CI if >3x normal range. Check at 3 and 12 months.
Check CK is patient at increased risk of myopathy.

104
Q

Phenytoin

A

Reference range (40-80micromols/L) measured at trough. COnsider seizure control also.

105
Q

Lithium

A

Sample 12 hours after last dose. 0.4-0.8mmol/L. Tox at >1.5mmol/L
Routine serum lithium conc weekly after initiation and after each dose change until stable. then 3 monthly after.
Low sodium increases lithium toxicity so dietary changes.

106
Q

Methotrexate

A

Must monitor FBC once stabilised every 2-3months.
Can do xray chest as baseline.
Dont start with abn liver function
renally excreted.

107
Q

Olanzapine

A

Check fasting blood glucose at baseline, at 4-6 months then yearly.

108
Q

Psych

A

ECG if CVS history.

109
Q

OCP

A

check BP prior to prescribing.

110
Q

amiodarone monitoring

A 
T3/4 and TSh must be checked. 
Baseline chest xray. 
Can cause abn LFTs. 
Renal function not applicable. 
Caution in hypokalaemia due to increased arrythmia risk.
111
Q

Carbimazole

A

Check neutrophil count if sore throat- agranulocytosis. FBC.
Associated with hepatic disorders.

112
Q

Digoxin monitoring

A

renally excreted so monitor digoxin levels in renal impairment. Also measure if tox suspected, non-compliance or inadequate effect.

Monitor renal function and electrolytes. Hypokalaemia increases risk of tox.

113
Q

Sodium valproate monitoring

A

Monitor liver function before therapy and during first 6 months (especially in patients most at risk)

Measure full blood count and ensure no undue potential for bleeding before starting and before surgery.
No need to measure plasma conc.

114
Q

Sodium valproate cautions

A

Can cause pancreatitis.
Consider vit d supplementation if pt at risk of osteoporosis.
Change dose based on monitoring in renal impairment.

115
Q

Clozapine monitoring

A

Monitor FBC. weekly for 18 weeks. then fortnightly up to 1 year. then monthly. Monitor for 4 weeks after discontinuation also. Stop permanantly if leukocytes <3000/mm3, or neutrophils <1500/mm3.

Blood conc measured in certain situations.

Observe during initiation (hypotension and convulsions)

Lipids and weight at baseline, at frequent intervals in first 3 months, then 3monthly for 1st year. then yearly. (other psychotics is just baseline, frequently in 1st 3 months then, yearly.

fasting blood glucose tested at baseline, after one months’ treatment, then every 4–6 months.

Patient, prescriber, and supplying pharmacist must be registered with the appropriate Patient Monitoring Service.

116
Q

Anti-psychotics monitoring

A

Lipids and weight at baseline, frequently in 1st 3 months then, yearly.

Fasting blood glucose at baseline, 4-6 months and then yearly.

monitor prolactin at the start of therapy, at 6 months, and then yearly.

Patients with schizophrenia should have physical health monitoring (including cardiovascular disease risk assessment) at least once per year.

117
Q

c.diff

A

broad-spec esp cephalosporins or ciprofloxacin.

118
Q

ACEin Side effects

A

hypotension, electrolyte abn (hyperkalaemia), AKI, dry cough. hyponatraemia.

119
Q

Beta blocker side effects

A

Hypotension, bradycardia, wheeze in asthmatics, worsens acute heart failure (helps chronic). Cold extremities. Fatigue.

120
Q

CCB side effects

A

hypotension, bradycardia, peripheral oedema, flushing

121
Q

Diuretic side effects

A

hypotension, electrolyte abn, AKI, subclass dependent effects.

122
Q

Heparin side effects

A

Haemorrhage (esp in renal failure or <50kg), heparin-induced thrombocytopaenia.

123
Q

Warfarin side effects

A

Haemorrhage, pro-coagulant in first few days (co-prescribe heparin until INR >2)

124
Q

Aspirin side effects

A

Haemorrhage, peptic ulcers and gastritis, tinnitus in large doses.

125
Q

Digoxin side effects

A

N&V, blurred vision, confusion, drowsiness, xanthopsia (yellow green vision). Low K augments effect. high levels limit effect.

126
Q

Amiodarone side effects

A

pulmonary fibrosis, thyroid disease (hypo and hyper), skin greying, corneal deposits.

127
Q

Lithium side effects

A

early- tremor
Intermediate- fatigue
Late- arrythmias, seizures, coma, renal failure, diabetes insipidus.

128
Q

Haloperidol side effects

A

dyskinesias (acute dystonic reactions), drowsiness.

129
Q

Fludrocortisone side effects

A

hypertension, sodium and water retention

130
Q

Statin side effects

A

Myalgia, abdominal pain, increased ALT/AST (mild), rhabdomyolysis (mildly raised CK).

131
Q

Drugs with narrow therapeutic index

A

warfarin, digoxin, phenytoin

132
Q

Drugs that need careful titration of dose to effect

A

Antihypertensives, antidiabetic

133
Q

Low GCS/acidosis

A

metformin

134
Q

Enzyme inducers

A 
PC BRAS: 
Phenytoin
Carbamazepine
Barbituates
Rifampicin
Alcohol chronic
Sulphonylureas
135
Q

Enzyme inhibitors

A 
ketoconazole, ciprofloxacin, erythromycin, grapefruit juice. 
AODEVICES: 
Allopurinol
Omeprazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin
Ethanol (acute)
Sulphonamides.
136
Q

Interactions with alcohol

A

GI bleeding- NSAIDS
Lactic acidosis- metformin
Increased anticoagulation: warfarin (acute alcohol- enzyme inhibition)
Reduced anticoagulation: warfarin (chronic alcohol- enzyme induction).
Hypertensive crisis: Monoamine oxidase inhibitors
Sweating, flushing, N&V: metronidazole and disulfiram.
Sedation: barbituates, opiods and benzodiazepines.

137
Q

Augmentin

A

Co-amoxiclav

138
Q

hypoglycaemia management

A

If conscious- sugar rich snack 10-20g glucose.
Glucagon 1mg IM/SC/IV - if unconscious or unsafe swallow and no IV access.

IV glucose 20% 100ml = 20g of glucose or glucose 10% 100ml = 10g of glucose
give 10-20g. 15-20 mins

139
Q

Bendroflumethaizide

A

increases gout

140
Q

Give potassium max rate

A

20mmol/hour

141
Q

Hyperkalaemia

A 
DREAD
Drugs
Renal failure
Endocrine (addisons)
Artefact (repeat bloods)
DKA (blood sugar)
142
Q

Hyperkalaemia treatment

A

10ml 10% IV calcium gluconate and 10 Units actrapid insulin with 100ml 20% IV dextrose and nebulised salbutamol.

143
Q

Anaphlaxis

A

15L/min Oxygen via non-rebreather mask
500 micrograms (0.5mg) of 1:1000 adrenaline IM.
10mg Chlorphenamine IV
200mg Hydrocortisone IV stat

144
Q

T2DM with renal impairment

A 
Not metformin if GFR <30. 
Give gliclazide (sulphonylurea).
145
Q

Metoclopramide

A

10mg IV prokinetic antiemetic

cannot use in bowel obstruction or first few days post abdo surgery.

146
Q

Clarithromycin

A

Avoid statins CYP3a4 inhibitor increase tox and se.

147
Q

Statins

A

Take at night, avoid grapefruit, not in liver disease, avoid clarithromycin, myositis stop medication.

148
Q

Angio-oedema

A

ACEin, months later due to accumulation of bradykinin

149
Q

Sick day rules

A

2x normal dose. During sepsis.

150
Q

dyspepsia

A

magnesium carbonate 10ml oral

151
Q

Dalteparin dose

A

5000 units S/c OD - prophylactic dose

152
Q

Enoxaparin dose

A

40mg/4000 units s/c od - prophylactic dose

153
Q

Paracetamol dose

A

500mg 4 hourly oral. WITH INDICATION and FREQUENCY. on as required chart.

154
Q

IV abx r/v

A

3 days as often can be stepped down to oral

155
Q

when to give laxatives

A

before bed. oral nightly

156
Q

Monitoring of chest infection

A

O2 sats or ABG- more accurate and specific. Otherwise RR.

157
Q

Tacrolimus monitoring

A

trough level before morning or evening dose. 6-10ng/ml post transplant

158
Q

Vancomycin monitoring

A

trough 10-15mg/l. renally excreted.

159
Q

Steroids

A

Hypokalaemia

160
Q

Bumetanide

A

Hypokalaemia

161
Q

Elderly

A

> 65yrs

162
Q

Chloramphenicol

A

increases phenytoin level

163
Q

Mild UC

A

<6 stools a day and no other symptoms

Oral 30mg prednisolone OD

164
Q

Severe UC

A

> 6 stools a day and systemically unwell.

Hydrocortisone 100mg IV 6 hourly.

165
Q

Hyperkalaemia with ECG changes

A

10ml 10% calcium gluconate IV repeated every 15 mins until ECG normalises (max 50ml).

166
Q

Digoxin loading dose

A

500mcg IV. Maintenance is 62.5-125 mcg daily.

167
Q

pruritis

A

codeine se

168
Q

Spironolactone

A

hyperkalaemia, diuretic, aldosterone antagonist. potassium retention, gynaecomastia.

169
Q

Converting phenytoin

A

normal dose x 0.92 = new dose with capsules or whatever it is

170
Q

1st line medical management for GAD

A

Sertraline or paroxetine

171
Q

DVT

A

Rivaroxaban, apixaban

172
Q

IV phenytoin

A

ECG as cardiac arrythmias

173
Q

SSRI cx

A

rash- side effect indicattive of potential serious systemic reaction

takes 6 weeks

174
Q

Patients <50kg

A

dose-adjustmentt e.g. enoxaparin. also lower dose paracetamol to avoid hepatotoxicity

175
Q

Confusion

A

Morphine, metoclopramide, anticholinergics, antipsychotics, antidepressants, anticonvulsants, histamine H2 receptor antagonists, digoxin, beta blockers, corticosteroids, NSAIDS, abx.

176
Q

Alcohol withdrawl

A

vitamin b substances with ascorbic acid (pabrinex Iv high potency 2 pairs 10ml by iv infusion over 30 mins 8 hourly.

177
Q

DKA

A

soluble insulin 50 units in sodium chloride 0.9% 50ml by iv infusion at a rate of 0.1units/kg/hr.

178
Q

Folic acid

A

low risk 400mcg before conception and up to week 12 of pregnancy.
high risk i.e. family history of neural tube defects. 5mg daily. until week 12 of pregnancy.

179
Q

Adrenaline

A

IM 0.5ml of 1 in 1000 = 500mcg.

180
Q

HRT

A

can increase BP, stop if >160/95. sodium and fluid retention.

181
Q

Statins and liver function

A

3x upper limit with transaminases discontinue.

182
Q

phytomenadione vit k 2mg po

A

if inr >1.5 on the day before surgery, use phytomenadione vit k 1-5mg PO using iv preparation.

183
Q

Statins

A

looking for a >40% reduction in non-HDL cholesterol.

184
Q

Digoxin

A

bradycardia

185
Q

for second episode of c.diff

A

oral vancomycin

186
Q

COCP

A

monitor bp

187
Q

opioids in renal impairment

A

not renal excreted so can use in renal impairment

188
Q

Hyponaturaemia

A

thiazides ssri siadh spirinolactone

189
Q

Breakthrough pain

A

keep same drug, dose is 1/6 of 24 hour dose,

190
Q

INR surgery day

A

if <1.5 give oral vit k 1-5mg phytomenadione

191
Q

Rivaroxaban

A

give with food

192
Q

evening hyperglycaemia

A

increase morning insulin by 10%

193
Q

Tardive dyskinesthia

A

stop drug and give terbutaline

194
Q

Dystonia (olyguric crisis or extra-pyramidal)

A

procyclidine

195
Q

Peripheral vascular disease

A

dont give beta adrenoceptor blockesr e.g. atenolol

196
Q

CK >5 times upper limit discontinue

A

If resolve then restart at lower level

PSA (4 decks)

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