Planning management Flashcards
How do you manage these drug poisonings
(Whats the antidote)
- Opioids
- Benzos
- TCAs
- Warfarin
- B-blockers
- Digoxin
- Naloxone
- Benzos
- IV bicarb
- Vit K
- Atropine
- Digibind (digoxin specific antibody)
Warfatin shite
What do you hvae to do if…
INR is low
INR is high
You’ve just had a major bleed
Low -> increase dose
High -> decrease dose or stop or give Vit K
Just had a major bleed -> stop it & give Vit K +. prothrombin complex
A high INR means you’re more or less likely to bleed
MORE
If it says the pt “hasn’t collected their prescription” and they’re getting like symptoms, what do you do to the dose
Fuck all changes
It’s just cause they’re not taking the drugs
can you kick off methotrexate if you have abnormal LFTs
absolutley not
Paracetamol OD
- When do you NOT give NAC
- When do you give NAC
- When should paracetamol levels be measured
1.
Below treatment line
2.
Not sure when OD happened
Above treatment line
Staggered dose
Not got a blood result yet
3.
4hrs post OD
if pt is sick, what do you always do to the fucking dose of steroid
double it mate
if a pt is now on their 2nd bout of C.diff, what is 1st line
Oral vanc
Clearly metro didn’t work first time lol
For DKAs, what…
- rate of insulin do you give
- do you do to short acting insulin
- do you do to long acting insulin
- fixed rate
- stop it
- continue
if someone isn’t on any analgeisa, regardless of the type of pain, what is the 1st thing to give
para
For surgey, what drugs should you…
- continue
- increase dose
- stop
- anti-hypertensives (B-blockers & CCBs)
- steroids
- I LACK OP
I LACK OP
Insulin
Lithium
Anti-coagulants
COCP & HRT
K-sparring diuretics
Oral hypoglycemixs
Perindopil + ACEi
For the drugs in the I LACK OP meumonic, which ones should you stop…
- 4 weeks before
- day before
- on the day
- COCP & HRT
- lithium
- K-sparring diuretcics & ACEi
For the drugs in the I LACK OP meumonic, what should you do the drugs…
Insulin -> sliding scale & houlry BGs
Lithium -> day before
Anti-coags -> depends lol
COCP & HRT -> 4 weeks before
K-sparring diuretics -> on the day
Oral hypoglycemics -> sliding scale
Perinopril (ACEis) -> on the day
what is like the main sign that somebody is unwell for anything
tachycardia
bmp >125
what is the 1st line anti-emetic to pretty much always use
what type of SEs can you get
Cyclizine
SEs
Constipation
Dry mouth
If someone has an exacerbation of asthma, what shoudl you do to their inhaler
STOP it
Start NEBULISED salbuatmol
How do you manage these common symptoms
- fever
- insomnia
- diarrhoea
- constipatoin
- paracetamol
- zopiclone
- loperamide + codeinie props
- senna, lactulose, docsuate, isphagula husk
Constipation management
- stool softoners
- bulking
- stimulants
- osmotic
- docusate
- isphagula husk
- senna
- lactulose
constipation management
- which one to use fori mpactoin
- one can’t be used if nut allergy
- deffo don’t use for impaction
- can cause cramps
- can cause bloating
- when enema is needed
1 & 2. docusate
- isphagula husk (obvs don;t wanna bulk it up)
- senna
- lactulose
- if acute abdomen
What should you give man with an alcohol dependency who presents with…
- shivers, sweating & hallucaitnons
- abdo pain
- chlorodiazpoxide
- pabrinex
what do ya give to a young diabetic bloke who is…
- tierd, lethargic & anxious
- unconsciouss
- soluble insulin
- IV glucose
what do you give for a middle-aged man with newly diagnosed hypertension
OBVIOUSLY ACEi
what do you do to a yound lass who just got knocked up and is on the cOCP
Stop the cOCP
start folic acid
what do ya give for an acute gout attack
colchicine
what do you give a lady with CAP who is…
- preggers
- not preggers
- clarithromycin
- doxycyline
what cardio drugs should you avoid in preggers
ACEi
ARBs
statins
00286882
83-26-19
if someone is mad unwell, but has been taken oral meds with no issue, what route should you use
obviosuly fucking oral mate
what antibiotic do both warfarin and statins interact with
clarithoromycin
If you get a cough when on an ACEi, what drug shoudl you change to
ARB
if on too much analgeisa and yuo might not need to use it, what can ou change it to
Modified release morphine
if a lass struggles to remember to take her constraception, what can you change it to
Depo-provera innjection
patients of which condition are least compliant
asthma
heroin is another name for
diamorophine
Whats the 1st line for any skin infection
Fluclox
If PA -> clarith/erythro/doxy
for pain relief in an MI, but you’re allergic to fucking morphine for somereason, what do you give?
GTN
why is dextrose used in the manageemtn of hyperkalemia
as insulin is also used, which will obvs lower BG
focal seizures are treated with what
what can cause them
carbmazpine
can be caused by tumours
if some presents with chest pain, but it doesn’t respod ot GTN, what is it unlikely to be?
STEMI or NSTEMI
for severe hypos, what % of glucose do you give
10% lad
Never give more cause it will cause some pure shite eh
best analgesia for tension-type headaches
paracetamol
if ‘self-care’ measures is an option, what do you do
fucking pick it u cunt
what do you use to treat meningitis in kids
Benzylpenicilin
600mg IM
How much folic acid shoudl you give preggers ladies
At low risk -> 400mcg
At high risk -> 5mg (only until 12 weeks)
FH of any congenital shite puts you at high risk
if you’ve got a penicillin allergy, can you have flucox
nah bro you can’t eh
what diabetic medication can’t be used if the pt is mad fat
Pioglitazone
Also can’t be used for HF eh
in kids, what ABXs are used for the following rashes
- blacnhing
- non-blanching
- phenocxymethyl -> scarlet fever
- benzyl -> meningitis
Scalert fever -> sorte throat before hand eh
Meningitis -> probs some GI issue
if you’ve got shite kidneys, what pain relief should you change to
oxycodone mate
