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Year 3 Exams > OSCE medications > Flashcards

OSCE medications Flashcards

1
Q

Warfarin: how does it work?

A
  • Thins the blood to treat or prevent blood clots
  • It does this by blocking vitamin K – the vitamin used by the body to make proteins that cause the blood to clot
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2
Q

Warfarin: how to take it

A
  • Once daily tablet (usually in the evening)
  • Usually prescribed for 3 months for a DVT, 6 months for a PE, and lifelong for AF
  • Dose changes take 2-3 days to take effect
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3
Q

Warfarin: contraindications

A
  • pregnancy
  • active bleeding
  • risk of falls
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4
Q

Warfarin: monitoring

A
  • Started at 5mg each evening
  • INR on days 3,4 and 5 – warfarin dosing charts tell you how to adjust the dose
  • Then regular INR checks by anticoagulation clinic – regularity determined by INR stability (patient will be given anticoagulation book)
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5
Q

Warfarin: Side effects

A
  • bleeding
  • diarrhoea and nausea
  • many interactions: alcohol, NSAIDs
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6
Q

DOAC: how does it work?

A
  • Thins the blood to treat or prevent blood clots
  • Many proteins are involved in blood clot formation – this medication blocks one of these proteins from working
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7
Q

DOAC: how to take

A
  • tablet once daily
  • Take with full glass of water whilst sitting upright
  • Usually prescribed for 3 months for a DVT, 6 months for a PE, and lifelong for AF
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8
Q

DOAC: contraindication

A
  • Significant renal impairment
  • Significant risk of major bleeding
  • Active bleeding
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9
Q

DOAC monitoring

A

NONE- this is a great benefit

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10
Q

DOAC: side effects

A
  • Bleeding
  • GI problems
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11
Q

Levothyroxine: How they work

A
  • A synthetic version of thyroxine, the hormone produced by your thyroid gland
  • It is given to bring your thyroid activity back up to normal
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12
Q

Levothyroxine: how you take it

A
  • once daily before breakfast
  • long term medication
  • can take 4-6 weeks to take effect
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13
Q

levothyroxine: contraindication

A

none

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14
Q

levothyroxine: monitoring

A
  • TSH test every 2-3 months until stable
  • When TSH level stable, check annually
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15
Q

levothyroxine : side effects

A
  • rare when normal amount of hormone
  • hyperthyroid symptoms
  • hypothyroid symptoms
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16
Q

Statin: How it works

A
  • Statins stop the liver making cholesterol
  • High cholesterol causes problems with your arteries, which increases your risk of heart disease, stroke, and kidney disease
  • It is important to also address other cardiovascular risk factors…
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17
Q

statins: how its taken

A
  • once every evening
  • taken long term
  • decreases risk over many years
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18
Q

statins: contraindications

A

pregnancy

macrolides

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19
Q

statins: monitoring

A

– Review in 4 weeks, then every 6-12 months (with lipid profile as required) → dose may be titrated up if target not met
– LFTs before starting, at 3 months and at 12 months (statins cause altered LFTs)

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20
Q

statins: side effects

A
  • myalgia
  • headache
  • itching
  • nausea, diarrhoea
  • rhabdomyolysis
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21
Q

statins: interactions

A

grapefruit juice

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22
Q

statins: if patient reports myalgia

A

consider Rhabdomyolysis

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23
Q

metformin: how it works

A
  • Increases your response to insulin so your cells take up more glucose from your blood
  • Also reduces the amount of glucose produced by the liver
24
Q

metformin: how its taken

A

– Once, twice or three-times daily tablet with meals
– Taken long term

25
Q

metformin: contraindications

A
  • Significant renal impairment
  • Ketoacidosis
  • Low BMI
26
Q

metformin: monitoring

A
  • U and Es
  • HbA1c every 3-6 months until stable
27
Q

Metformin: side effects

A
  • Nausea, diarrhoea, abdominal pain, weight loss
  • Lactic acidosis – metformin must not be taken on the day of or for 2 days after having general anaesthetic or X-ray contrast media
28
Q

iron tablets: how they work

A

Replace your body’s store of iron, a mineral required to make red blood cells

29
Q

iron tablets: how they are taken

A
  • 1-3 times daily tablet or syrup (depending on brand)
  • Works best if taken without food, but most take with meals as iron can irritate the stomach
  • Takes 3-4 weeks for Hb to normalise, then further 3 months to replenish iron stores
30
Q

iron tablet: contraindication

A

none

31
Q

iron tablets: monitoring

A

Haemoglobin in 3-4 weeks to assess response

32
Q

Iron tablets: side effects

A
  • GI irritation (nausea, sickness, diarrhoea/constipation, abdominal pain)
  • Black/green stools
  • Metallic taste
33
Q

SSRI: how it works

A
  • Antidepressants alter the balance of some of the chemicals in the brain (neurotransmitters)
  • SSRI antidepressants affect a neurotransmitter called serotonin
  • Imbalance of this and other neurotransmitters is thought to play a part in causing depression and other conditions
34
Q

SSRI: how they are taken

A

– Once daily tablet
– May be gradually stopped 6 months after feeling better
– Effects in 4-8 weeks

35
Q

SSRI: contraindication

A

– Suicidal risk
– Mania

36
Q

SSRI: monitoring

A

none

37
Q

SSRI: side effects

A
  • GI
  • appetite and weight change
  • headaches
  • drowsiness
  • anxiety for 2 weeks
  • withdrawal
  • may increase risk of suicide in younger patients
38
Q

methotrexate: How it works

A

– It is a ‘disease-modifying agent’ which both reduces inflammation and suppresses the immune system
– Early use improves outcome and symptoms

39
Q

methotrexate: how its taken

A
  • Once weekly tablet with a folic acid tablet on another day
  • Same day each week
  • Dose built up slowly
  • Taken long-term if effective
  • Takes 3-12 weeks to work
40
Q

methotrexate: contraindication

A
  • Pregnancy (including male partner)
  • Breast-feeding
  • Hepatic impairment
  • Active infection
  • Immunodeficiency
41
Q

methotrexate: monitoring

A
  • FBC, LFTs, U&EsBefore starting
  • Then, every 2 weeks until therapy stabilised
  • Then, every 2-3 months
  • Patient should be given monitoring book
42
Q

methotrexate: side effects

A
  • GI disturbance
  • alopecia
  • headaches
  • myelosuppression
    • infections
43
Q

levodopa: how it works

A
  • Levodopa is a replacement for some of the dopamine which your brain in no longer able to produce
  • This will help to reduce your symptoms, particularly your rigidity and slow movements
  • Given with carbidopa (inhibits peripheral levodopa degeneration)
44
Q

levodopa: how its taken

A
  • 3-4 times daily tablet with food (reduces nausea)
  • Taken as long as it works effectively – after 5 years most suffer ‘on-off’/‘wearing off’ phenomena (switch between mobility and immobility that occurs before the next dose is due after prolonged levodopa use) and dyskinesias
  • Fast-acting
45
Q

levodopa: contrainidcations

A

glaucoma

46
Q

levodopa: monitoring

A

none

47
Q

levodopa: side effects

A
  • psychosis
  • nausea and vomiting
  • postural hypotension
  • on- off phenomena
48
Q

insulin: how it works

A
  • Insulin allows the cells of your body to take up glucose from the blood and use it for energy
  • This means insulin reduces the blood glucose level
  • In people with diabetes, insulin may be needed because the body cannot produce it or use it effectively
49
Q

insulin: how its taken

A
  • Injected using injection pen at a 90˚ angle
  • Usually injected to different sites around the lower abdomen and upper outer thighs/buttocks
50
Q

insulin: contraindication

A

none

51
Q

insulin: monitoring

A
  • Capillary glucose monitoring is done before each meal and before bed
  • It should also be checked if there are any symptoms of a high/low blood sugar (explain)
52
Q

insulin: side effects

A
  • weight gain
  • sharps injuries
  • hypoglycaemia
  • lipodystrophy
53
Q

bisphosphonate: how they work

A
  • Prevents bone from being broken down and helps to rebuild new bone
  • Remember lifestyle factors can also help with this, such as exercise, not smoking (we can help), and eating a well-balanced diet
54
Q

bisphosphonates: how they are taken

A
  • Once daily or once weekly tablet
  • Swallow tablet with full glass of water
  • Take at least 30 minutes before food or anything other than water
  • Be upright for 30 minutes after swallowing
  • Taken long term
  • Monitoring required
  • Regular dental check-ups (risk of osteonecrosis of jaw)
55
Q

bisphosphonates: contraindication

A
  • Pregnancy
  • Dysphagia/abnormalities of oesophagus
  • Recent peptic ulcer
  • Significant renal impairment
  • Unable to sit upright for 30 minutes
56
Q

bisphosphonates: side effects

A
  • Headache
  • Heartburn
  • GI (diarrhoea/constipation, abdominal pain)
  • Seek urgent medical advice if symptoms of =
    • Osteonecrosis of the jaw,
    • Dysphagia/odynophagia,
    • Upper GI bleeding/black stools

Year 3 Exams (25 decks)

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