Passmed year 5 Flashcards
what is hypoactive delirium
what causes it
a subtype of delirium characterised by withdrawal and sleepiness
dehydration and organ failure
what psych drugs asscoiated with increased VTE risk
antipyschotic such as clozapine and aripiprazole
side effects of beta blockers (5)
bronchospasm
cold peripheries
fatigue dizzy and lightheaded
sleep disturbances, including nightmares
erectile dysfunction
what type of memory loss do benzos cause
anterograde amnesia - future
how does aripiprazole protect against gynaecomastia
reduces prolactin level
partial agonist D2 receptors
main sx of discontinuation sydrome of SSRI
Gi problems
How often do you monitor SSRI bloods in over and uner 25 yr old
1 week if under 25
2 weeks if over 25year old
what psychotherapy is good for EUPD
dialectical behaviour therapy DBT
What drugs can predispose to digoxin toxicity and hwo
indapamide - thiazide as cause low potassium - Low potassium levels increase the binding of digoxin to its receptor (the sodium-potassium ATPase), enhancing its effect and increasing the risk of toxicity
A 72-year-old man has been recently diagnosed with active tuberculosis by respiratory specialists and has been commenced on the initial phase of antibiotic treatment. He has a background of chronic kidney disease stage 4 and atrial fibrillation for which he takes warfarin. An INR taken 3 days after commencing treatment comes back at 8.2.
What antibiotic is most likely to be responsible for this finding?
Isoniazid inhibits the cytochrome p450 system. This inhibition reduces the metabolism of warfarin causing a prolongation of its effects which subsequently increases the INR.
carboxyhaemoglobin is it raised in smokers
Smokers may normally have carboxyhaemoglobin levels of up to 10%
what does nuchal rigidity mean
Nuchal rigidity refers to neck stiffness caused by bacterial meningitis and other serious medical conditions.
mechanism of aspirin
Inhibits the enzyme cyclooxygenase (COX), which blocks the production of thromboxane and prostaglandins that cause inflammation, swelling, pain, and fever.
mechanism of clopidogrel
Inhibits the binding of adenosine diphosphate (ADP) to the platelet P2Y12 receptor, which blocks platelet activation and aggregation.
what other drug is like warfarin affected by p450 system
ciclosporin
how might an inducer affect ciclosporin levels
St John’s Wort is an inducer of the P450 system and can decrease ciclosporin levels, leading to transplant rejection
common side effect of sidenafil
headaches
what anticoag/antiplatelet can cause a promthrombotic state
LMWH - Heparin induced thrombocytopenia is a prothrombotic state
why cant you use warfarin alone for prophylactic tx
Warfarin is prothrombotic in the first few days of treatment. Due to this, patients starting on warfarin should be covered with heparin until their international normalised ratio (INR) is within an acceptable range.
under what eGFR can you use LMWH till - what can you use instead
A LMWH such as dalteparin may be used when eGFR <15ml/min but not at treatment dose. Instead, a reduced dose of LMWH or UFH should be used.
pneumonic to remember organophosphate poisoning
DUMBELS’:
D: defaecation & diaphoresis.
U: urinary incontinence.
M: miosis (pupil constriction).
B: bradycardia
E: emesis.
L: lacrimation.
S: salivation.
Isoniazid 2 se
hepatitis, agranulocytosis
Pyrazinamide 4 se
hepatitis, arthralgia, myalgia, gout
Clarithromycin
GI upset
Cholestatic jaundice - used for various mycoplasma infections e.g. mycoplasma pneumoniae
Rifampicin se
hepatitis, orange bodily secretions
how do you treat miroprolactinoma
dopamine agonist
when do you measure heparin
No routine monitoring needed, but in special situations check anti-Factor Xa levels
35%
side effect of mg salts oral
diarrhoea
Digoxin toxicity is more likely to occur in the presence of hypokalaemia. why
This is because digoxin and potassium compete for binding sites on the Na+/K+ ATPase pump, which is inhibited by digoxin as part of its mechanism of action. When potassium levels are low, there is less competition for these binding sites, allowing more digoxin to bind and exert its effects, thus increasing the risk of toxicity.
monitoring of unfractionated heparin is required hwo do you montiro this
Unlike low molecular weight heparins that do not require monitoring unfractionated heparin does require monitoring, this is done by measuring the APTT.
4 side effects of heparin
bleeding
thrombocytopenia - see below
osteoporosis and an increased risk of fractures
hyperkalaemia - this is thought to be caused by inhibition of aldosterone secretion
long term thiamine if
alcoholic
platelets raised
in clumped states
such as infection ball in discitis so reducing platelets is a good sign
