Passmed Flashcards
Describe the different types of laxatives
Osmotic laxatives
examples include lactulose, macrogols and rectal phosphates
Stimulant laxatives
examples include senna, docusate, bisacodyl and glycerol
co-danthramer should only be prescribed to palliative patients due to its carcinogenic potential
Bulk-forming laxatives
examples include ispaghula husk and methylcellulose
Summarise sulfonylureas
Common adverse effects: hypoglycaemic episodes and weight gain
Rarer adverse effects: SIADH, hepatotoxicity, peripheral neuropathy
Sulfonylureas should be avoided in breastfeeding and pregnancy.
What drugs can induce SIADH?
sulfonylureas SSRIs, tricyclics carbamazepine vincristine cyclophosphamide
List of drugs that can be given to people breastfeeding
antibiotics: penicillins, cephalosporins, trimethoprim
endocrine: glucocorticoids (avoid high doses), levothyroxine*
epilepsy: sodium valproate, carbamazepine
asthma: salbutamol, theophyllines
psychiatric drugs: tricyclic antidepressants, antipsychotics**
hypertension: beta-blockers, hydralazine
anticoagulants: warfarin, heparin
digoxin
When is a gradual tapering of corticosteroids required?
The BNF suggests gradual withdrawal of systemic corticosteroids if patients have:
received more than 40mg prednisolone daily for more than one week
received more than 3 weeks treatment
recently received repeated courses
When should NAC be commenced immediately?
If over 150mg/kg then start NAC immediately in paracetamol OD
or if is a staggered dose (over 1 hr apart)
Drugs to avoid in breastfeeding?
antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides psychiatric drugs: lithium, benzodiazepines aspirin carbimazole methotrexate sulfonylureas cytotoxic drugs amiodarone
Drugs CI in pregnancy?
Antibiotics tetracyclines aminoglycosides sulphonamides and trimethoprim quinolones: the BNF advises to avoid due to arthropathy in some animal studies
Other drugs ACE inhibitors, angiotensin II receptor antagonists statins warfarin sulfonylureas retinoids (including topical) cytotoxic agents
How much should you increase opioids by when you go up?
When increasing the dose of opioids the next dose should be increased by 30-50%.
How do you convert PO codeine to PO morphine?
divide by ten
How do you convert PO tramadol to morphine
divide by ten
How do you convert from PO morphine to oxycodone
Oxycodone generally causes less sedation, vomiting and pruritis than morphine but more constipation
divide by 1.5-2
Which diabetic drug is bad for HF?
Pioglitazone bad in heart failure
what do 0.1 and 1% mean
1% = 10mg/ml (remember Lidocaine)
0.1% = 1mg/ml (remember isosorbide dinitrate)
