Passmedicine notes Flashcards
1
Q
Normal range for serum lithium
A
0.4-1.0 mmol/litre
2
Q
Level at which lithium becomes toxic
A
> 1.5 mmol/L
3
Q
What are the causes of lithium toxicity
A
As it is excreted by the kidneys anything that effects the kidneys:
- dehydration
- renal failure
- diuretics
- ACE inhibitors
- NSAIDs
- metronidazole
4
Q
Sx of lithium toxicity
A
- coarse tremor (a fine tremor is seen in therapeutic levels)
- hyperreflexia
- acute confusion
- seizure
- coma
5
Q
Monitoring during lithium therapy
A
Serum lithium
- Monitor closely for first few days
- After that every 3-6 months
U+Es
- Baseline
- 6 months
- Annually after that
TFT
- Baseline
- 6 months
- Annually
Parathyriod
- Baseline
- Annually
Wgt
- Baseline
- Annually
6
Q
What drugs should you perscribe with caution in asthma
A
NSAIDs
beta-blockers
adenosine
7
Q
drugs that increase serum potassium
A
- ACE inhibitors
- Angiotensin-2 receptor blockers
- Spironolactone
- Potassium sparing diuretics (amiloride, triamterene)
- Potassium supplements (Sando-K, Slow-K)
8
Q
drugs that decrease serum potassium
A
- Thiazide diuretics
- Loop diuretics
- Acetazolamide
9
Q
drugs to avoid in renal failure
A
- antibiotics: tetracycline, nitrofurantoin
- NSAIDs
- lithium
- metformin
10
Q
drugs accumulate in that CKD patients
A
- most antibiotics including penicillins, cephalosporins, vancomycin, gentamicin, streptomycin
- digoxin, atenolol
- methotrexate
- sulphonylureas
- furosemide
- opioids
11
Q
Drugs that are usually safe in CKD
A
antibiotics: erythromycin, rifampicin
diazepam
warfarin
12
Q
Indications for Acetylcysteine treatment
A
Immediate indications
- Single dose of over 150mg/kg
- Staggered overdose
Non immediate indications
- Plasma concentration above the line!! not below
