Other Flashcards
Electrolyte cause of Li toxicity
hypoNa
1st line for unconscious hypoglycaemia in the hospital
20% glucose 100ml IV over 15mins
DKA management (2 components)
1l NaCl 0.9% over 1hr, 1U/kg/hr actrapid
DKA management - when to add K
if K<5.5 after 1l fluids
How many grams of glucose to treat hypoglycaemia?
20g
HRT with periods
cyclical “Elleste-duet”
HRT without periods
continuous “Elleste-duet”
HRT without uterus
“Elleste-solo”
HRT patch
“Elleste-sequi”
Management for local neuropathic pain, tablets contraindicated
Lidocaine patch
2 drug classes taken in the morning
Steroids, diuretics
2 drug classes taken at night
Statins, sedatives
3 drug classes taken weekly
Methotrexate/folate, patches, some bisphosphonates
2 drug classes causing hypoglycaemia
Insulin, sulfonylureas (-ide)
Drug class causing euglycaemic ketoacidosis
SGLT2 inhibitors (-glifozin)
Steroid dose when unwell
x2
5 drug classes to stop during illness
Metformin, SGLT2 inhibitors (-gliflozin), sulfonylureas (-ide), GLP-1 analogues, statins
Sulfonylurea -suffix
-ide
SGLT2 inhibitor -suffix
-glifloxin
When to stop DOACs pre-surgery
48hrs
When to stop clopidogrel pre-surgery
7 days
When to stop warfarin pre-surgery
5 days
What to bridge warfarin with, when to do this, and when to stop pre-surgery
LMWH, high risk of clots (e.g. previous), 24hrs
8 drugs prescribed in mcg
Levothyroxine, digoxin, tamsulosin, naloxone, fludrocortisone, GTN spray, inhalers, ipratropium nebs
COCP brand name
Microgynon 30
POP brand name
Cerazette
Short-acting insulin example
Novorapid
2 long-acting insulin examples and how they are taken
Levemir BD, Lantus OD
Pain relief if eGFR<50
Oxycodone
2 pain relief options if eGFR<10
Fentanyl, buprenorphine
8 drug classes to stop pre-operatively
anticoagulants/platelets, NSAIDs, HRT, contraception,ACEi, ARB, diuretics, Li if major
Metformin perioperative rules
Continue if OD/BD, stop lunchtime dose if TDS or >1meal missed, stop if risk of lactic acidosis
Which antidiabetic drugs to stop perioperatively and when specifically?
Sulfonylureas - stop morning dose, SGLT2 inhibitors - stop on day of surgery
How to prevent adrenal crisis perioperatively/when unwell - prescription
IV hydrocortisone (pred dose x2, conversion to hydrocortisone using treatment summary)
Insulin perioperative rules
reduce dose of OD long-acting insulin to 80% day before surgery, stop all other insulins on day of surgery until eating/drinking
2 indications for variable rate insulin infusion during surgery
Poor diabetes control, fasting for >1 meal
Quinolones -suffix
-floxacin
3 ototoxic drugs
Vancomycin, gentamicin, loop diuretics
Most important warning for patients taking metformin
Signs of lactic acidosis
Most important warning for patients taking sulfonylureas (-ide)
Signs of hypoglycaemia
Most important warning for patients taking SGLT2 inhibitors (-gliflozin)
Signs of DKA and euglycaemic ketoacidosis
Which drug class do patients develop a RAPID tolerance to?
Nitrates
Most important warning for patients taking quinolones (-floxacin)
Tendonitis signs
HbA1c monitoring frequency
3 months
What does progesterone in HRT protect against?
Endometrial cancer
How to find whether a pregnancy requires 5mg vs 400mcg folic acid?
“neural tube defects”
POP missed pill time
12hrs if Cerazette, 3hrs if any others
COCP missed pill time
24hrs
Electrolyte imbalance causing digoxin toxicity
Hypokalaemia
3 drugs causing agranulocytosis
Carbimazole, clozapine, phenytoin
2 risks of carbimazole
Agranulocytosis, pancreatitis
2 blood results needing statins to be stopped
LFTs 3x upper limit, CK 5x upper limit on 2 occasions 7 days apart
Amiodarone monitoring post-treatment
TSH, T3, T4
Is Parkinsonism a risk of 1st or 2nd generation antipsychotics?
1st
Is hyperprolactinaemia a risk of 1st or 2nd generation antipsychotics?
1st
Are metabolic side effects a risk of 1st or 2nd generation antipsychotics?
2nd
Maximum increase in insulin dose
10%
When to stop aspirin pre-surgery?
7 days
When to stop ACEi pre-surgery?
On the day
5 antimuscarinic side effects
Dry mouth, blurred vision, confusion, retention, constipation
2 choices of steroid for asthma exacerbation
PO prednisolone, IV hydrocortisone
3 antithrombin agents
LMWH, unfractionated heparin, fondaparinux
Anxiety management when self-help/psychoeducation has failed
CBT + consider SSRI
120 hours in days
5 days
72 hours in days
3 days
COCP name
Microgynon
HRT name
Elleste
Which anti-hypertensives should be stopped in the peri-operative period?
ACEi, ARBs, diuretics
Which anti-hypertensives should not be stopped in the peri-operative period?
B blockers, CCB
How long is treatment dose aspirin usually continued for?
2 weeks
When is metformin contraindicated?
eGFR<30
Metformin vs sulfonylurea vs SGLT2 inhibitor complication
Lactic acidosis vs hypoglycaemia vs euglycaemic ketoacidosis/DKA
Immediate reflux relief
Magnesium carbonate
Mild allergic reaction management
Oral chlorphenamine
Measurement for resolution of DKA
Serum ketones
Pain relief for neuropathic pain
amitriptyline, gabapentin, pregabalin
Pain relief for muscle spasms/cramp
Baclofen
Which 2 drug classes cause bronchospasm?
NSAIDs, B blockers
ACEi vs B blocker side effect
Dry cough vs bronchospasm (sob)
Type II diabetes 1st line management
Diet and exercise
FFP indication
Deranged clotting
2 options for AF management
Rate control, rhythm control with echo/anticoagulation if >48hrs symptoms
ACEi electrolyte imbalance
Hyperkalaemia
When should methotrexate be stopped?
Active infection
3 CCB examples
Amlodipine, diltiazem, verapamil
Next step in hypertension management if not optimised with ACEi/ARB and CCB?
Thiazide diuretic
Thiazide diuretic example
Indapamide
What is contraindicated with verapamil/diltiazem?
ACEi
What is contraindicated with B blockers?
NSAIDs
Headache vs migraine acute management
Paracetamol vs triptan
Phenytoin toxicity management
Lower dose, stop if drug-induced, swap if seizures not well-controlled
Alcohol effect on diabetes
Hypoglycaemia
When to assess SSRI efficacy?
4 weeks
CCB contraindication for AF rate control
HF
B blocker contraindication for AF rate control
Asthma
High glucose => insulin adjustment
Increase previous dose
Low glucose => insulin adjustment
Decrease previous dose