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PSA > other bits: prescribing elderly/ paeds/ ADR / Medical emergencies > Flashcards

other bits: prescribing elderly/ paeds/ ADR / Medical emergencies Flashcards

1
Q

2 stimulant laxatives

C/IX?

A

bisacodyl
senna

=> bowel obstruction

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2
Q

2 osmotic laxatives

C/IX

A

macrogol
lactulose

=> bloating / dehydrated

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3
Q

1 Softener laxative

A

docusate

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4
Q

laxative for opioid induced constipation?

A

osmotic + stimulant eg: macrogol + senna

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5
Q

analgesia for T2DM neuropathic pain eg: pins and needles?

A

gabapentin

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6
Q

analgesia for shingles?

A

PARACETAMOL

then neuropathic pain relief

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7
Q

what to be cautious of when prescribing paracetamol in elderly?

A

dose reduction if < 50kg
eg: 500mg QDS

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8
Q

post operative pain ladder

A
  1. paracetamol
  2. codeine / dihydrocoedine
  3. regular / PRN MST( modified release)
  4. regular PRN immediate release MST oral
  5. transdermal patch eg: fentanly
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9
Q

normal bisoprolol drug range

A

1.25mg -> 20mg

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10
Q

normal drug range for metformin

A

starting dose 500mg

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11
Q

normal drug range for statin

A

10mg -80mg

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12
Q

drugs to stop with abnormal LFTs?

A

nsaids
rifampicin
steroids

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13
Q

enzyme inducers

A

PC BARS

Phenytoin
carbamezapine
barbituates
alcohol - chronic
rifampicin
sulfonyurea

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14
Q

enzyme inhibitors

A

AO DEVICES

allopurinol / amiodarone
ompeprazol
disulfiram
erythromycin
valproate
isoniazide
ciprofloxacin
ethanol - acute
SSRI

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15
Q

which parkinsons medication can be given thoruhg NG tube crushed?

A

immediate release ROPINIROLE

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16
Q

electrolyte disturbance to consider for cause of confusion

A

hypoNa -> check diuretics!

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17
Q

if the pre dose (trough) concentration of gentamicin is high you change the…..

if the post dose (peak) concentration is high the ….

A

interval between doses must be increaed eg: 8 hour ->12 hours

the dose must be increased

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18
Q

interactions with MTX
3

A

nsaids => low platelet count

trimethoprim -> bone marrow suppression

PPI -> increase level of mTX (inhibtor of p450)

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19
Q

common drugs that cause ototoxicty

A

gentamicin
vancomycin
fuorsemide IV rapid
bumetanide

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20
Q

4Cs abx causing c.diff

other cause 1?

A

cephalosporins eg: ceftriaxone/ cefalaxin

clindamycin

co-amoxiclav

ciprofloxacin

PPI

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21
Q

antidote for opioid toxicity

A

IM Naloxone 400mcg every 2-3 mins

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22
Q

mx of neuroepileptic malignant syndrome

A

bromocriptine
dantrolene

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23
Q

symptoms of neuroepileptic malignnat syndrome

A

diffuse rigidity
reduced reflexes
normal pupils
comes on gradually

= assoicated with antipsychotics

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24
Q

where to find the side effects of antiphyschotics

A

psychoses

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25
example of anitpsychotics cause weight gain / lipid rise / diabetes
onlazapine = atypical
26
what to do if get ankle swelling on CCB?
stop CCB - not related to dose!
27
what drugs increase the risk of tendon rupture eg: achilles? what increases the risk on that medication?
ciprofloxacin eg: quinolones increased risk if on steroids
28
ADR of quinolones eg: cipro
reduces seizure threshold prolongs QT tendon rutpure
29
what diabetic drug increases risk of eugylcaemic DKA?
SGLT2
30
what medication should you stop before surgery? 7
ACEi ARB Diuretics eg: furosemide / butemanide / thiazide/ spironolactone Anticoagulants + Antiplatelets HRT + COCP Lithium nsaids
31
medications to continue in surgery examples? 9
thyroid medication epilepsy medication PD medication cardiac or anti HTN (except ACE/ARB/ Diuretics) eg: CCB inhalers PPIs antidepressants streoids immunosupressants/ cancer drugs anxiety medication eg: benzo
32
what 3 diabetic medication should you stop day of surgery?
Metformin - OD / BD = continue - TDS = stop lunchtime dose Sulfonyurea eg: glicazide (hypoG)] = omit the morning dose SGLT2 inhibtors = omit on the day All other medication take as normal on day of the surgery. + day before
33
mx of dyspepsia
PPI
34
important information to provide for metformin?
signs and sx of lactic acidosis eg: SOB, muscle crmapls, abdo pain, hypothermia
35
important info to provide for sulfonlureas
s&S of hypoglycaemia higher risk in elderly or renal impairment
36
important info for SGLT2
look out for s&s of euglycaemic DKA even if BM is normal
37
important info to give patients for DOACS?
RAPID fall in drug levels if miss dose (short half lief)
38
important information for clozapine
risk of agranulocytosis
38
diabetic sick day rules with insulin
take insulin / increase even if not eating too much otherwise risk of DKA BLOOD glucose increases when unwell
39
important information for sodium valproate
teratogenic + needs contraception
40
which has a higher risk of breast cancer combined or oestrogen only HRT?
combined
41
important infor for nicotine replacement therapy
BG monitoring
42
INR > 1.5 on the day of before surgery what should be given?
oral Vitamin 5 NB: LMWH only required if history of AF related stroke or TIA
43
what % rise in creatinine is expected when starting acei? management?
<20% no further inx or change in ppx
44
what % should you increase long acting insulin if blood glucose is not contorlled?
10%
45
what drug is contradincated in severe peripheral vascular disease?
beta blockers = peripheral vasoconstriction and worsen ischaemia in PVD NB: ACEi also cautioned in severe PVD eg: cirtical ischaemia
46
2 drugs that can exacerbate biventricula heart failrue
steroid diltiazem / verampil
47
side effects of bisphosophonates
loose stools dyspepsia
48
how long can it take antidepressants take to work?
up to 6 weeks
49
ADR of GLP1 analogues - common!
vomitting
50
if miss lithium dose what do you do?
measure lithium concentration and adjust lithium dose accordingly
51
normal lithium level
0.4-1
52
contraception most effective with enzyme inducers>
IUD depo injection
53
when is monitoring taken for digxoin?
6 hours post dose
54
what worsens digoxin toxicity
hypoK
55
mx of digoxin toxicity
correct hypoK (reverse tick sign on ecg) digoxin level
56
abdo pain and on carbimazole?
pancreatitis
57
drugs that cause agranulocytosis 3
clozapine carbimazole phenytoin
58
raised CK due to statin managmenet?
hold statin - reduce lower dose / restart/ another statin
59
if gentsmicin level falls on the line what do you do?
increaes interval
60
alternative for ppi if low sodium
famotidine

PSA (5 decks)

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