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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
Q

example of anitpsychotics cause weight gain / lipid rise / diabetes

A

onlazapine = atypical

26
Q

what to do if get ankle swelling on CCB?

A

stop CCB - not related to dose!

27
Q

what drugs increase the risk of tendon rupture eg: achilles?

what increases the risk on that medication?

A

ciprofloxacin eg: quinolones

increased risk if on steroids

28
Q

ADR of quinolones eg: cipro

A

reduces seizure threshold

prolongs QT

tendon rutpure

29
Q

what diabetic drug increases risk of eugylcaemic DKA?

A

SGLT2

30
Q

what medication should you stop before surgery? 7

A

ACEi
ARB
Diuretics eg: furosemide / butemanide / thiazide/ spironolactone
Anticoagulants + Antiplatelets
HRT + COCP
Lithium
nsaids

31
Q

medications to continue in surgery examples? 9

A

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
Q

what 3 diabetic medication should you stop day of surgery?

A

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
Q

mx of dyspepsia

A

PPI

34
Q

important information to provide for metformin?

A

signs and sx of lactic acidosis eg: SOB, muscle crmapls, abdo pain, hypothermia

35
Q

important info to provide for sulfonlureas

A

s&S of hypoglycaemia
higher risk in elderly or renal impairment

36
Q

important info for SGLT2

A

look out for s&s of euglycaemic DKA even if BM is normal

37
Q

important info to give patients for DOACS?

A

RAPID fall in drug levels if miss dose (short half lief)

38
Q

important information for clozapine

A

risk of agranulocytosis

38
Q

diabetic sick day rules with insulin

A

take insulin / increase even if not eating too much otherwise risk of DKA

BLOOD glucose increases when unwell

39
Q

important information for sodium valproate

A

teratogenic + needs contraception

40
Q

which has a higher risk of breast cancer combined or oestrogen only HRT?

A

combined

41
Q

important infor for nicotine replacement therapy

A

BG monitoring

42
Q

INR > 1.5 on the day of before surgery what should be given?

A

oral Vitamin 5

NB: LMWH only required if history of AF related stroke or TIA

43
Q

what % rise in creatinine is expected when starting acei?

management?

A

<20%

no further inx or change in ppx

44
Q

what % should you increase long acting insulin if blood glucose is not contorlled?

A

10%

45
Q

what drug is contradincated in severe peripheral vascular disease?

A

beta blockers = peripheral vasoconstriction and worsen ischaemia in PVD

NB: ACEi also cautioned in severe PVD eg: cirtical ischaemia

46
Q

2 drugs that can exacerbate biventricula heart failrue

A

steroid
diltiazem / verampil

47
Q

side effects of bisphosophonates

A

loose stools
dyspepsia

48
Q

how long can it take antidepressants take to work?

A

up to 6 weeks

49
Q

ADR of GLP1 analogues - common!

A

vomitting

50
Q

if miss lithium dose what do you do?

A

measure lithium concentration and adjust lithium dose accordingly

51
Q

normal lithium level

A

0.4-1

52
Q

contraception most effective with enzyme inducers>

A

IUD
depo injection

53
Q

when is monitoring taken for digxoin?

A

6 hours post dose

54
Q

what worsens digoxin toxicity

A

hypoK

55
Q

mx of digoxin toxicity

A

correct hypoK (reverse tick sign on ecg)

digoxin level

56
Q

abdo pain and on carbimazole?

A

pancreatitis

57
Q

drugs that cause agranulocytosis 3

A

clozapine
carbimazole
phenytoin

58
Q

raised CK due to statin managmenet?

A

hold statin
- reduce lower dose / restart/ another statin

59
Q

if gentsmicin level falls on the line what do you do?

A

increaes interval

60
Q

alternative for ppi if low sodium

A

famotidine

PSA (5 decks)

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