Passmed PSA Corrections Flashcards
Chronic HF drug management 1st line
ACEi and B-blocker (bisoprolol/carvedilol/nebivolol) as they improve long term prognosis
- one should be started at a time
- neither have any effect on mortality in HF with PRESERVED ejection fraction
Which drugs are clasically taken at night?
statins
amitriptyline
common and rarer adverse effects of sulfonylureas (e.g. gliclazide)
hypoglycaemic episodes
weight gain
hyponatremia 2ndary to SIADH
bone marrow suppression
hepatotoxicity
peripheral neuropathy
contraindications for sulfonylureas
breastfeeding
pregnancy
COCP absolute contraindications
age >35 while smoking >15/day
Why should b-blockers and verapamil never be prescribed together?
due to risk of life threatening bradycardias
initial O2 dose for critically ill patients
reservoir mask at 15l/min normally
28% venturi mask at 4l/min for COPD patients
situations where O2 should not be used routinely if there is no evidence of hypoxia
MI and ACS
stroke
obstetric emergencies
anxiety-related hyperventilation
harmful antibiotics in pregnancy
tetracyclines e.g. doxycycline
aminoglycosides e.g. gentamycin
sulphonamides e.g. sulfasalazine, and trimethoprim
quinolones e.g. ciprofloxacin
drugs to avoid in pregnancy (not abx)
ACE inhibitors, angiotensin II receptor antagonists
statins
warfarin
sulfonylureas
retinoids (inc. topical)
cytotoxic agents
(majority of antiepileptics e.g. valproate, carbamazepine, phenytoin are potentially harmful but may not be stopped as uncontrolled epilepsy is also a risk)
differentiate between carbimazole and carbamazepine
carbimazole = antithyroid
carbamazepine = antiepileptic
differentiate between chlorphenamine, chlorpromazine, chloramphenicol and chlordiazepoxide
chlorphenamine = antihistamine
chlorpromazine = antipsychotic
chloramphenicol = abx used for superficial eye infections/bacterial infection in otitis externa
chlordiazepoxide = benzodiazepine
verapamil SE
HF
constipation
hypotension
bradycardia
flushing
amlodipine/nifedipine/felodipine SE
flushing
headache
ankle swelling
abx contraindicated in breastfeeding
ciproflaxin
tetracyclines e,g, doxycycline
chloramphenicol
sulphonamides e.g. sulfasalazine
psychiatric drugs contraindicated in breastfeeding
lithium
benzodiazepines e.g. diazepam, lorazepam, chlordiazepoxide
other contraindicated drugs in breastfeeding (not abx/psychiatric)
aspirin
carbimazole
methotrexate
sulfonylureas
cytotoxic drugs
amiodarone
abx that CAN be given to breastfeeding mothers
penicillins
cephalosporins, e.g. cephalexin, cefuroxime, ceftriaxone
trimethoprim
endo drugs that CAN be given to breastfeeding women
glucocorticoids (avoid high doses) e.g. prednisolone, dexamethasone, methylprednisolone.
levothyroxine (amount is too small to affect neonatal hypothyroidism screening)
epilepsy drugs that CAN be given to breastfeeding women
sodium valproate
carbamazepine
asthma drugs that CAN be given to breastfeeding women
salbutamol
theophyllines
psychiatric drugs that CAN be given to breastfeeding women
tricyclic antidepressants, e.g. amitriptyline, imipramine, clomipramine, nortriptyline
antipsychotics (BUT NOT CLOZAPINE!)
recommended treatment for exacerbations of COPD
amoxicillin/tetracycline/clarithromycin
recommended treatment for uncomplicated CAP
amoxicillin (doxy or clarithro if pen allergy, add fluclox if staphy suspected e.g. in influenza)
recommended treatment for CAP caused by atypical pathogens
clarithromycin
recommended treatment for lower UTI
trimethoprim/nitrofurantoin (alternatively amoxicillin or cephalosporin)
recommended treatment for acute pyelonephritis
broad spectrum cephalosporin (e.g. cephalexin/cefuroxime) or a quinolone (e.g. ciprofloxacin)
recommended treatment for prostatitis
quinolone or trimethoprim
recommended treatment for impetigo
topical hydrogen peroxide, oral flucloxacillin or erythromycin if widespread
recommended treatment for cellulitis
flucloxacillin (clarithromycin, erythromycin or doxycycline if penicillin-allergic)
recommended treatment for cellulitis (near the eyes or nose)
co-amoxiclav (clarithromycin, + metronidazole if penicillin-allergic)
recommended treatment for animal or human bite
co-amoxiclav (doxycycline + metronidazole if penicillin-allergic)
recommended treatment for mastitis during breastfeeding
flucloxacillin
recommended tx for throat infections
phenoxymethylpenicillin (if pen allergy then erythromycin alone)
recommended tx for sinusitis
phenoxymethylpenicillin
recommended tx for otitis media
amoxicillin ( erythro if pen allergy)
otitis externa tx
flucloxacillin (combined topical abx + corticosteroid usually used for mild/moderate cases)
periapical/periodontal abscess tx
amoxicillin
gingivitis: acute necrotising ulcerative tx
metronidazole
gonorrhoea tx
IM ceftriaxone
chlamydia tx
doxycycline or azithromycin
PID tx
oral fluclox + oral metronidazole OR IM ceftriaxone + oral doxy + oral metro
syphilis tx
benzathine benzylpenicillin or doxy or erythro
bacterial vaginosis tx
oral or topical metronidazole or topical clindamycin
c.diff tx
first episode: oral vancomycin
second/subsequent episode: oral fidaxomicin
campylobacter enteritis tx
clarithromycin
salmonella tx
ciprofloxacin
shigellosis tx
ciprofloxacin
