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Year 6 > Pass the PSA > Flashcards

Pass the PSA Flashcards

1
Q

Name drugs that are enzyme inducers

A

PC BRAS

Phenytoin
Carbamazepine

Barbiturates
Rifampicin
Alcohol (chronic excess)
Sulphonylureas

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2
Q

Name drugs that are enzyme inhibitors

A

AO DEVICES

Allopurinol
Omeprazole

Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin
Ethanol (acute intoxication)
Sulphonamides

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3
Q

Which drugs should be stopped before surgery?

A

I LACK OP

Insulin
Lithium
Anticoagulants/antiplatelets
COCP/HRT
K-sparing diuretics
Oral hypoglycaemics
Perindopril and other ACEi

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4
Q

Side effects of steroids

A

STEROIDS

Stomach ulcers
Thin skin
oEdema
Right and left heart failure
Osteoporosis
Infection (including candida)
Diabetes (commonly causes hyperglycaemia and uncommonly progresses to Diabetes)
Syndrome (Cushing’s)

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5
Q

Side effects of NSAIDs

A

NSAID

No urine (renal failure)
Systolic d/f (i.e. heart failure)
Asthma
Indigestion
Dyscrasia (clotting abnormality)

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6
Q

How much maintenance fluid in volume?

A

adults: 3L/24h

elderly: 2L/24h

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7
Q

In which patient groups should metoclopramide be avoided?

A

pts with PD (risk of exacerbating symptoms)

young women (due to risk of dyskinesia, esp. acute dystonia)

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8
Q

What do you usually give as replacement fluid?

A

500 mls 0.9% saline (250 mld if pt has a hx of heart failure)

unless:
- pt hypernatraemic or hypoglycaemic, then give 5% dextrose
- pt has ascites, then give human albumin solution (HAS) instead, NaCl can make the ascites worse
- pt is shocked from bleeding, then give blood, if no blood is available then give crystalloid

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9
Q

How much fluid in an oliguric patient?

A

1L over 2-4h, then reassess

make sure the patient is not urinary obstructed

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10
Q

What maintenance fluids should be given to provide adequate electrolytes?

A

over 24h: 2 salty 1 sweet

2L 0.9% NaCl
1L 5% dextrose

supplement K+ based on U&Es, pts require about 40mmol KCl per day, so add 20 mmol to two bags total).

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11
Q

How slowly does KCl have to be given?

A

Should NOT be given faster than 10 mmol/h

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12
Q

typical antiemetic

A

cyclizine 50mg 8hrly IM/IV/oral

-> not in HF because causes fluid retention -> give metoclopramide then

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13
Q

What is the maximum dose of paracetamol in people under 50kg? /24h

A

500 mg 6hrly

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14
Q

What type of antiemetic is cyclizine?

A

anti-histamine

therefore safe in PD

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15
Q

How do ACEi cause cough?

A

accumulation of bradykinin via reduced degradation by ACE

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16
Q

How do ACEi cause hyperkalaemia?

A

decreased aldosterone production leading to decreased K+ excretion.

remember: kind of like in Addison’s

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17
Q

Causes of a raised ALP?

A

alkphos

Any fracture
Liver damage (posthepatic)
K for Kancer
Paget’s disease of bone and Pregnancy
Hyperparathyroidism
Osteomalacia
Surgery

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18
Q

Valsartan - type of medication

A

Angiotensin II receptor antagonists

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19
Q

Celecoxib drug class

A

NSAID

(Can be used in OA)

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20
Q

Do you need to stop amlodipine (istin) in AKI?

A

no

it is a CCB and has no effects on electrolytes or renal function

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21
Q

how does ibuprofen cause AKI?

A

decreases renal BF by inhibiting prostaglandins which normally dilate BVs flowing into the kidneys, especially if the patient has RAS.

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22
Q

what medication is Tritace?

A

it is an ACE-i

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23
Q

what is the INR target for AF?

A

2-3

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24
Q

what do INR values mean? What is bleedy and what is clotty?

A

the higher the more bleedy

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25
Q

INR is too high - what action do you take dependent on the value? (If there is no bleeding vs bleeding)

A

No bleeding:
- 5-8: omit warfarin for 2 days then reudce dose
- >8: omit warfarin and give 1-5mg PO Vit K

Bleeding:
- 5-8: omit warfarin and give 1-5mg IV vit K
- >8: omit warfarin and give 1-5mg Vit K IV

If there is a major bleed, omit warfarin, give 5-10mg Vit K IV and give prothrombin ocmplex

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26
Q

what dose of Vit K should you give in a patient with to high INR? what route?

A

1-5mg PO

27
Q

What is the commonest antibiotic regimen for neutropenic sepsis?

also, what route?

A

piperacillin
tazobactam
gentamicin

-> IV (po abx are never sufficient for neutropenic sepsis)

28
Q

What OTC medication can lower the effectiveness of trimethoprim?

A

folate

29
Q

What is the mainstay of treatment in acute heart failure?

A

Furosemide (in acute settings give IV)

30
Q

What medication is the brand name Lanoxin?

A

digoxin

31
Q

What features indicate that DC cardioversion is required in an acute setting?

A

Adverse features e.g.
- chest pain
- HF
- low BP
- Syncope

32
Q

Which antibiotics can you prescribe for whooping cough?

A

azithromycin
clarithromycin
erythromycin
co-trimoxazole

33
Q

what would you prescribe first line in an 8 month old weighing 8 kilos with whooping cough?

A

Azithromycin 80 mg PO OD

34
Q

What drugs are given in Graves disease?

A

propranolol to ease sx

anti-thyroid drugs (under specialist advice )
- carbimazole (usually 1st line)
- propylthiouracil

radioiodine treatment is another option

34
Q

How long are anti-thyroid drugs usually given for?

A

12-18 months

35
Q

How are triptans prescribed?

A

Dose 50 or 100 mg

oral

ONCE ONLY (not PRN)

36
Q

What medication taken with SSRIs have a high risk of serotonin syndrome?

A

triptans

37
Q

What is the first line treatment in GORD in babies?

A

1-2 week trial of alginate therapy (gaviscon infant, alginic acid, alginate)

38
Q

How often should children with T1DM on long acting insulin measure their blood glucose levels?

A

at least 5 times a day

39
Q

What is the antidote to opioid overdose?

A

naloxone

40
Q

which antihypertensive drugs are known to cause leg swelling?

A

calcium channel blockers (peripheral oedema, particularly leg swelling)

bisoprolol causes leg swelling very rarely

41
Q

What medication class is gliclazide?

A

sulfonylurea

42
Q

common SE of sulfonylureas (2)

A
  • hypoglycaemic episodes (more common with long-acting preparations such as chlorpropamide)
  • weight gain
43
Q

What drug class is gliclazide? What are important SE to consider?

A

sulfonylurea

can cause weight gain and drops in blood sugar levels

44
Q

Name different penicillin antibiotics

A

phenoxymethylpenicillin
benzylpenicillin
flucloxacillin
amoxicillin
ampicillin
co-amoxiclav (Augmentin)
co-fluampicil (Magnapen)
piperacillin with tazobactam (Tazocin)
ticarcillin with clavulanic acid (Timentin)

45
Q

Can you give Tazosin in penicillin allergy?

A

no

it is piperacillin with tazobactam

46
Q

Which 2 of the following medications most likely caused dry mouth and double vision?

A. omeprazole
B. cyclizine
C. amitriptyline
D. Ibuprofen
E. enoxaparin

A

B and C

Cyclizine is a sedating antihistamine which is mainly used as an antiemetic, it is known to have anti-muscarinic SE.

Amitriptyline is a TCA. Can be used for neuropathic pain too. Known to have antimuscarinic SE.

47
Q

Carbimazole rare SE

A

drug induced neutropenia

go to GP if sore throat etc.!

48
Q

What type of medication is domperidone?

A

dopamine antagonist

anti-emetic

49
Q

Can you use domperidone in patients with Parkinson’s disease?

A

Yes

it is a DA antagonist

however, it does not cross the BBB and therefore can be used in PD.

50
Q

in a patient with chronic hyperkalaemia is it better to use a CCB or ACEi?

A

CCB is safer

51
Q

What are the indications for unfractionated heparin?

A

?in pts at high risk of bleeding complications because of the short activity and reversibility

?check this

52
Q

What is the concern in prescribing a COCP in a patient with epilepsy taking carbamazepine?

A

carbamazepine is an enzyme inducer and could reduce the effectiveness of the COCP

53
Q

Which drugs are contraindicated in patients with Asthma?

A

adenosine
beta blockers
NSAIDs

54
Q

Which psychiatric medication is known to exacerbate psoriasis?

A

Lithium

55
Q

Which factors (incl. meds) exacerbate psoriasis?

A
  • trauma
  • alcohol
  • drugs: beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab
  • withdrawal of systemic steroids
  • Streptococcal infection may trigger guttate psoriasis.
56
Q

1st line treatment to lower K+ in hyperkalaemia

what is second line?

include doses

A

10 U of actrapid insulin in 100 mL 20% dextrose over 30 minutes

(Salbutamol 2.5-5mg nebulised is second line)

57
Q

What are the best medications for focal epilepsy?

Which one is preferred in pregnancy / pts wanting to conceive?

A

lamotrigine
carbamazepine

lamotrigine is safer in pregnancy

58
Q

How do you change insulin treatment in DKA?

A

stop short acting

continue long acting as normal

start insulin FIXED rate with fluids (not variable rate)

59
Q

1st line pain management in shingles

A

paracetamol

60
Q

How should loperamide be taken?

A

initial dose of 4mg

2mg after each loose stool

do not exceed 16 mg/24h

61
Q

do antidepressants work right away? how long does it take to see effects?

A

It may take up to 6 weeks for the effects of antidepressants to become visible

62
Q

delete

A

delete

Year 6 (37 decks)

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