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PSA > Planning Management > Flashcards

Planning Management Flashcards

1
Q

Best pain killer for nerve pain

A

Tricyclic antidepressants - amitriptyline
10mg nightly (can go up to 25mg)

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2
Q

treatment algorithm for STEMI

A

ABC and O2 via 15l non-rebreathe mask (unless COPD) -> Hx, o/e, Inv, Diagnosed STEMI -> Aspirin 300mg oral -> Morphine 5-10mg IV with metoclopramide 10mg IV -> GTN spray/tablet -> Primary PCI (preferred) or thrombolysis -> B-blocker (e.g. atenolol 5mg oral) unless asthma/LVF -> transfer to CCU

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3
Q

Treatment algorithm for NSTEMI

A

ABC and O2 via 15l non-rebreathe mask (unless COPD) -> Hx, o/e, Inv, Diagnosed NSTEMI -> Aspirin 300mg oral -> Morphine 5-10mg IV with metoclopramide 10mg IV -> GTN spray/tablet -> clopidogrel 300mg oral and LMWH (enoxaparin 1mg/kg bd SC) -> B-blocker (e.g. atenolol 5mg oral) unless asthma/LVF -> transfer to CCU

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4
Q

Acute Left ventricular failure (LVF)

A

ABC and O2 via 15l non-rebreathe mask (unless COPD) -> Hx, o/e, Inv, Diagnosed LVF +/- cause -> Sit patient up -> Morphine 5-10mg IV with metoclopramide 10mg IV -> GTN spray/tablet -> Furosemide 40-80mg IV -> if inadequate response, isosorbide denigrate infusion +/- CPAP -> transfer to CCU

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5
Q

Signs and Treatment of unstable tachycardia (>125 bpm)

A

Shock, syncope, myocardial ischaemia, heart failure
Synchronised DC shock up to 3 attempts
if that doesn’t work, amiodarone 300mg IV over 10-20minutes and repeat shock, followed by amiodarone 900mg over 24hrs

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6
Q

diagnosis and Treatment of stable irregular narrow complex tachycardia (>125bpm)?

A

Probably atrial fibrillation
control rate with B-blockers or diltiazem
Consider digoxin or amiodarone if evidence of heart failure

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7
Q

Diagnosis and treatment of Regular rhythm, narrow complex tachycardia

A

(re-entry, paroxysmal) SVT
Vagal manœuvres
adenosine 6mg rapid iv bolus, If unsuccessful give 12mg, if unsuccessful again give further 12mg
continuously monitor ECG
if sinus rhythm restored record 12 lead ECG, give adenosine again if recurs and consider prophylactic anti-arrhythmic
If sinus rhythm not restored seek expert help

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8
Q

Possible diagnosis and treatment if narrow complex, regular tachycardia, no response to vagal manoeuvres and adenosine

A

Seek expert help
Possible atrial flutter, control rate with B-blocker

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9
Q

Possible diagnosis and management of irregular, broad complex tachycardia

A

seek help
Possible:
- AF with BBB, control rate with BB or diltiazem, consider digoxin or amiodarone if evidence of heart failure
- Pre-excited AF - consider amiodarone
- Polymorphic VT (e.g. torsade de pointes - give mg 2g over 10min)

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10
Q

Diagnosis and management of Regular broad complex tachycardia

A

VT - amiodarone 300mg IV over 20-60min then 900mg over 24hr
If previously confirmed SVT with BBB, give adenosine as for regular narrow complex tachycardia (6mg rapid bolus, then 12mg if unsuccessful, and further 12mg if unsuccessful again)

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11
Q

Anaphylaxis treatment algorithm

A

ABC and O2 (15l non rebreather, unless COPD) -> Hx, o/e, inv, and diagnose anaphylaxis -> Remove the cause ASAP (e.g. blood transfusion, stop) -> adrenaline 500 microgram of 1:1000 IM -> Chlorphenamine 10mg IV -> hydrocortisone 200mg IV -> asthma tx if wheeze -> amend drug chart allergies box

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12
Q

Acute exacerbation of asthma algorithm

A

ABC -> Hx, oe, ine, diagnosis acute asthma -> 100% O2 via non-rebreather mask -> Salbutamol 5mg neb -> Steroids: Hydrocortisone 100mg IV (if sever/life threatening) or prednisolone 40-50mg oral (if moderate) -> Ipotropium 500 micrograms neb -> theophylline (only if life threatening)

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13
Q

Acute exacerbation of COPD algorithm

A

ABC -> Hx, oe, ine, diagnosis exacerbation of COPD -> O2: if not peri arrest then 28% O2 non rebreather, review after 30min with and ABG -> Salbutamol 5mg neb -> Steroids: Hydrocortisone 100mg IV (if sever/life threatening) or prednisolone 40-50mg oral (if moderate) -> Ipotropium 500 micrograms neb -> theophylline (only if life threatening) -> antibiotic if infective cause (e.g. amoxicillin 500 mg 3 times a day for 5 days . can be increased to 1g 3x a day if severe)

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14
Q

Treatment of secondary pneumothorax

A

Secondary (patient has lung disease) then always needs treating - chest drain if >2cm/patient sob/>50 years old. otherwise aspirate

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15
Q

treatment of tension pneumothorax

A

tracheal deviation +/− shock
emergency aspiration required, but will need chest drain quickly.

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16
Q

Treatment of primary pneumothorax

A

if <2 cm rim and not SOB then discharge with outpatient follow-up in 4 weeks
if >2 cm rim on CXR or feels SOB then aspirate and if unsuccessful aspirate again, and if still unsuccessful then chest drain

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17
Q

How to assess severity of pneumonia

A

CURB65 to assess severity of community-acquired pneumonia and hence treatment: Confusion (abbreviated mental test score (AMTS) ≤ 8/10), Urea >7.5mmol/L, Respiratory rate >30/min, Blood pressure (systolic) <90 mmHg and age ≥65 years
For the patient with none or one of these then home treatment is possible; with two or more of these then hospital treatment with oral or IV antibiotics according to policy and severity is required; and with more than three of these then consider ITU admission.

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18
Q

Pneumonia treatment algorithm

A

ABC ->
Hx, o/e, inv. ∆ pneumonia ->
High-flow oxygen ->
Antibiotics (e.g. amoxicillin or co-amoxiclav) ->
Paracetamol ->
If low BP: or raised HR IV fluids as normal

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19
Q

PE treatment algorithm

A

ABC
Hx, o/e, inv. ∆ PE
High-flow oxygen
Morphine 5–10 mg IV, metoclopramide 10 mg IV
LMWH e.g. tinzaparin:175 units/kg SC daily
If low BP: IV gelofusine-> noradrenaline-> thrombolysis

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20
Q

GI bleeding treatment algorithm

A

ABC and 02 (15 L by non-rebreather mask unless COPD)
Hx, o/e, inv. ∆ acute GI bleed
Cannulae (x 2 large bore)
Catheter (and strict fluid monitoring)
Crystalloid/ colloid (in general crystalloid if normal/high BP and colloid (e.g. gelofusine) if BP low. once cross matched give blood)
Cross-match 6 units blood
Correct clotting abnormalities (If PT/aPTT > 1.5x normal range give fresh frozen plasma 9UNLESS due to warfarin, give prothrombin complex. if platelets <50 and bleeding give platelet transfusion)
Camera (Endoscopy)
Stop culprit drugs (NSAIDs, aspirin, warfarin, heparin)
Call the surgeons if severe

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21
Q

treatment of meningitis in the community

A

1.2g IM benzlpenicillin and immediate transfer to hospital

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22
Q

Treatment algorithm of bacterial meningitis in the hospital

A

ABC
Hx, o/e, inv. ∆ meningitis
High-flow oxygen
IV fluid
Dexamethasone IV unless severely immunocompromised
LP (+/– CT head)
2 g cefotaxime IV (give pre-LP if having CT head or prolonged LP
Consider ITU

NOTE: CT of head not always required before LP, as scanning can delay LP and therefore antibiotics

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23
Q

Treatment algorithm for seizures

A

Any seizure:
ABC (may need artificial airway)
Hx, o/e, inv. ∆ seizure
Put patient in recovery position with oxygen
Check for provoking factors (plasma glucose, electrolytes, drugs, sepsis)

If >5 mins
Lorazepam 2–4 mg IV or diazepam (IV) or midazolam (buccal) both 10 mg
If still fitting
after 2 min repeat diazepam
Inform anaesthetist
Phenytoin infusion
Intubate then propofol

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24
Q

Treatment algorithm management of an ischaemic stroke

A

ABC
Hx, o/e, inv. (include blood glucose and CT head to exclude haemorrhage), ∆ ischaemic stroke
If aged <80 years and onset <4.5 hours ago consider thrombolysis
Aspirin 300 mg oral
Transfer to stroke unit

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25
name the conditions hyperglycaemia can cause
T1DM - DKA T2DM - Hyperosmolar nonketotic (HONK) coma
26
How do you diagnose DKA
Diabetic Check glucose - hyperglycaemia Urine/blood ketone levels raised ABG - acidosis (low ph) and maybe raised K
27
Diagnosing HONK (hyperosmolar nonketotic) coma
Hyperglycaemia - usually >35mmol/L Osmolality over 340 mol/L (2x Na + 2x K + urea + glucose non ketotic - no ketones in blood or urine
28
Management of hypoglycaemia (<3mmol/L)
If patient able to eat give sugar rich snack if unable to eat (drowsy/vomiting) give IV glucose via a cannula, e.g. 100 mL 20% glucose (traditionally 50 mL 50% glucose IV but can cause extravasation). If unable to eat and no cannula give IM glucagon 1 mg
29
Management algorithm of hyperglycaemia
ABC Hx, o/e, inv. ∆ DKA/HONK coma IV fluid: 1 L stat then 1 L over 1 hour, then 2 hours, then 4 hours, then 8 hours (half this for HONK) Sliding scale insulin Hunt for trigger (infection, MI, missed insulin) Monitor BM, K and pH
30
Treatment algorithm for AKI
ABC Hx, o/e, inv. ∆ acute renal failure Cannula and catheter, strict fluid monitoring IV fluid: 500 ml stat. then 1 L 4 hourly Hunt for cause (pre renal: dehydration. Intrinsic: ischaemia, nephrotoxic antibiotics: gentamicin, vancomycin, tetracyclines), radiological contrast, injury (rhabdomyalisis), gout, inflammation, cholesterol. Post renal: stone, tumour, fibrosis, prostate cancer, aneurysm, lymphadenopathy) and complications (fluid overload, hyperkalaemia, acidosis) Moniter U&E, and fluid balance
31
treatment algorithm of poisoning
ABC Hx, o/e, inv. ∆ acute poisoning Cannula and catheter, strict fluid balance Supportive measures (IV fluids and analgesia if appropriate) Correct electrolyte distrubance Reduce absorption (within 1 hour: gastric lavage, bowel irrigation if lithium/iron, charcoal) Increase elimination (IV fluids plus N-acetyle cysteine if paracetamol level at 4+ hrs is over the treatment nomogram, Naloxone in opiates if low RR or GCS, Flumazenil if benzodiazepines Psychiatric management
32
When to treat hypertension (on ambulatory monitoring)
if BP >150/95 mmHG or >135/85 mmHg if any of the following are also present: Existing or high risk of vascular disease (ischaemic heart disease (IHD), stroke and peripheral vascular disease). Hypertensive organ damage (intracerebral bleed, chronic kidney disease, left ventricular hypertrophy and retinopathy).
33
Target BP on hypertension treatment
In patients aged less than 80 years, aim for <140/85 mmHg (for measurements taken at a clinic) and <135/85 mmHg (for ambulatory or home measurements). In patients aged over 80 add 10 mmHg to the systolic values
34
management of chronic heart failure
- ACE-inhibitor (e.g. lisinopril 2.5 mg daily) plus beta-blocker (e.g. bisoprolol 1.25 mg daily). - If inadequate increase doses as tolerated. If still inadequate then add according to the severity: - Mild–moderate: add angiotensin receptor blocker (e.g. candesartan 4 mg daily). -Moderate–severe (African–Caribbean patients): add hydralazine 25 mg 8-hourly and isosorbide mononitrate 20 mg 8-hourly. -Moderate–severe (other patients): add spironolactone 25 mg daily
35
Treatment algorithm for hypertension
Step 1: Aged under 55 - ACEi or ARB Aged over 55 or black/caribean family origin - CCB Step 2: ACEi/ARB + CCB Step 3: Add Thiazide-like diuretic (Indepamide, chlortalidone, xipamide, and metolazone) Step 4: Resistant hypertension Consider further diuretic (low dose spironalactone if K <4.5, higher dose thiazide like diuretic, BB or ARB. consider seeking expert advice
36
How to decide if stroke prevention needed for patient with AF, and how to treat
Prevent stroke: CHAD2DS2-VASc score Congestive heart failure (or left heart failure alone) Hypertension Age >75 (contributing 2 points) Diabetes mellitus Stroke or TIA before (contributing 2 points) Vascular disease (e.g. peripheral arterial disease or IHD) Age 65–74 Sex (female). score of 0 - 75mg aspirin daily score of 1 - use aspirin or warfarin (aim INR 2.5) Score 2 or more - warfarin ( aiming for INR 2.5 Control rate or rhythm: BB/CCB NOTE: adverse features then utilise algorithm for tachycardia
37
When would someone require rhythm control treatment in AF, and how would they be treated
Who? – if young/symptomatic AF/first episode of AF/AF due to treated precipitant (e.g. sepsis or electrolyte disturbance). How? – cardioversion: electrical or pharmacological (amiodarone 5 mg/kg IV over 20–120 mins). The patient will require anticoagulation if more than 48 hours since onset
38
When would someone require rhythm control treatment in AF, and how would they be treated
Who?: everyone else with heart rate >90 b.p.m (NOT: young/symptomatic AF/first episode of AF/AF due to treated precipitant (e.g. sepsis or electrolyte disturbance) ) How?: start with (depending on the contraindications) either (1) beta-blocker, e.g. propranolol 10 mg 6-hourly or (2) rate-limiting calcium-channel blocker, e.g. diltiazem 120 mg daily. Verapamil can be used instead but avoid with beta- blockers due to the complication of profound bradycardia. 􏰀 Then add digoxin if needed (or use first line if beta-blockers and calcium-channels are contraindicated). Load then start 62.5–125 micrograms daily
39
Treatment of stable angina
GTN spray as recquired Secondary prevention: consider aspirin, statin, ACEi Antianginal drug - BB or CCB if still experiencing stable angina then increase BB or CCB dose If still experiencing stable angina add second anti-anginal therapy. If not contraindicated add the other option (i.e. beta- blocker or calcium-channel blocker). Otherwise add (1) long- acting nitrate, e.g. isosorbide mononitrate, or (2) potassium channel activator, e.g. nicorandil. If uncontrolled on two anti-anginal drugs refer for urgent revascularization therapy (percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG)). Even if controlled with medical management, patients should be referred routinely for consideration of revascularization
40
Contraindications for BB
Asthma, hypotension, bradycardia, acute heart failure
41
Contraindications for CCB
Peripheral Oedema, hypotension, bradycardia
42
What is described by the term ACS (Acute coronary syndrome)
Unstable agina, STEMI, NSTEMI
43
Presentation that links to stable angina rather than ACS
no sweating or vomiting (likely MI if this is present), occurs on exertion/emotion and resolves after 15 mins, GTN spray resolves pain
44
Investigations used to determine stable angina or ACS, and their results
ECG, troponin and 12hr troponin to provide confirmation ● If troponin raised = STEMI/NSTEMI ⇒ look at ECG to determine which: ❏ If ST elevated ⇒ STEMI ❏ If ST depressed or normal ⇒ NSTEMI. Note that ST depression in anterior leads (V1–4) may be anterior ischaemia (i.e. stable/unstable angina) or posterior infarction: add leads V7–9 posteriorly to confirm ST elevation for the latter. ● If first troponin not raised then use ECG: ❏ If normal/ST depression then stable angina if typical onset (see the nature of onset described above); otherwise unstable angina, but need to exclude NSTEMI with 12 h troponin. ❏ If ST elevation then STEMI and troponin will be raised even if having to await 12 h troponin
45
Contraindications for BB
Asthma, hypotension, bradycardia, acute heart failure
46
Contraindications for CCB
Peripheral Oedema, hypotension, bradycardia
47
treatment algorithm for asthma
Step 1: Mild Intermittent Asthma inhaled short acting B2-agonist as required (e.g. salbutamol) Step 2: regular preventer therapy Add inhaled steroid 200-800 (usually 400) Micrograms/day (μg) Step 3: Initial add on therapy - Add inhaled long-acting B2-agonist (LABA, e.g. salmeterol or formoterol fumarate) - Assess control of asthma
47
treatment algorithm for asthma
Step 1: Mild Intermittent Asthma inhaled short acting B2-agonist as required (e.g. salbutamol) Step 2: regular preventer therapy Add inhaled steroid 200-800 (usually 400) Micrograms/day (μg) (e.g. beclometasone, salmeterol) Step 3: Initial add on therapy - Add inhaled long-acting B2-agonist (LABA, e.g. salmeterol or formoterol fumarate) - Assess control of asthma - Good response to LABA, continue LABA - Benefit from LABA but still inadequate, continue LABA and increase inhaled steroid to 800 micrograms/day - No response to LABA, stop LABA, increase inhaled steroid to 800 micrograms/day. if control still inadequate, trial leukotriene receptor antagonist (e.g montelukast) or SR theophylline Step 4: resistant poor control increase inhaled steroid to 2000 micrograms/day add 4th drug - leukotriene receptor antagonist (e.g montelukast) or SR theophylline, B2-agonsist tablet Step 5: Daily steroid tablet (lowest dose possible) continue 2000 microgram/day inhaled steroid refer for specialist care
48
COPD treatment algorithm
Smoking cessation advice (smoking cessation clinic referral, nicotine replacement therapy, bupropion orvarenicline. Inhaled therapy: 1. Breathlessness and exercise limitation: SABA (salbutamol and terbutaline) or SAMA (ipratropium bromide) as required. 2. Exacerbations/persistent breathlessness: can continue SABA as required. - if FEV1>50%: LABA OR LAMA, stop SAMA - if FEV1<50%: LABA + ICS combo inhaler / LABA+LAMA if ICA declined or not tolerated OR LAMA, stop SAMA 3. Persistent exacerbations or breathlessness if on LABA: add ICS, or consider LABA + LAMA is ICS declined/not tolerated. if persists then LABA + ICS + LAMA if on LAMA: LAMA + LABA + ICS if on LABA + ICS: LAMA + LABA +ICS
49
Treatment Parkinson's disease
Co-benlodopa or careldopa (ie levodopa combined with peripheral dopa decarboxylase inhibitor (benserazide or caridoa respectively)) UNLESS question states patient with mild Parkinson's who is particularly worried about the finite period of benefit from levodopa, then dopamine agonist (e.g ripinirole) or MAO-inhibitor (e.g. rasagiline may be more appropriate)
50
Epilepsy definition
2 or more seizures NOTE: first seizures are not normally treatment with anti-epileptic drugs
51
Treatment of generalised tonic-clonic seizures
Sodium valporate
52
Treatment of Absence seizures
Sodium valproate or ethosuximide
53
Treatment of myoclonic seizures
Sodium valporate
54
Treatment of Tonic Seizures
Sodium Valporate
55
Treatment of Focal Seizures
Carbamezipine or lamotrigine
56
Common side effects of Lamotrigine
Rash, rarely stevens-johnson syndrome
57
Common side effects of Carbamezipine
Rash, Dysarthria (difficult/unclear speech), ataxia (balance, coordination, slurred speech), nystagmus, hyponatraemia
58
Common side effects of Phenytoin
Ataxia (balance, coordination, slurred speech), peripheral neuropathy, gum hyperplasia, hepatotoxicity
59
Common side effects of sodium valporate
Tremor, teratogenicity, weight gain
60
Treatment of Alzheimers
Mild/moderate - acetylcholinesterase (AChE) inhibitors - donepezil, rivastigmine, galantamine moderate/severe - NDMA antagonist (memantine) NOTE: treatment can only be started by specialist dr
61
Treatment of Chrons
Induce remission: mild - prednisolone oral severe - hydrocortisone IV and supportive (IV fluid, NBM, antibiotics) NOTE: if rectal disease, rectal hydrocortisone Maintaining remission: Azathioprine NOTE: metabolic derivatives of azathioprine are metabolised in turn by the enzyme TPMT. 10% of the population have low levels of TPMT. therefore levels must be checked before commencing therapy. if low, consider methotrexate instead
62
Side effects of azathiprine
Bone marrow and liver toxicity (exacerbated if low TPMT enzyme levels)
63
Treatment of rheumatoid arthritis
combination of methotrexate + one other DMARD (usually sulfasalizine or hydroxychloroquine) ASAP During fare: - Short term glucocorticoids (e.g. IM methylprednisolone 80mg - Short term NSAIDs with gastro protection (e.g. ibuprofen 400mg 8hrly and lansoprazole) - reinstate DMARDs if dose previously reduced If not responding to 2 DMARDs, TNF alpha inhibitor (e.g. infliximab)
64
Treatment of fever
Beyond treating the underlying cause (usually infection) prescribe paracetamol as an antipyretic (i.e. same dose as for analgesia, maximum 4 g in 24 h).
65
Treatment of Diarrhoea
The commonest cause of diarrhoea is gastrointestinal infection (particularly norovirus and Clostridium difficile gastroenteritis). The quick removal of such infectious agents (via diarrhoea) should not be intentionally inhibited by drugs. However, chronic diarrhoea (that has been proven to be non-infectious with negative stool cultures and microscopy) may be treated with loperamide 2 mg oral up to 3-hourly or codeine 30 mg oral up to 6-hourly (which will also provide relief of pain).
66
Treatment of Insomnia
For the purposes of the exam, if you do give a hypnotic, start with zopiclone 7.5 mg oral nightly in adults (and 3.75 mg nightly in the elderly). NOTE: Many patients will complain of poor sleep in hospital: it is an unfamiliar, noisy and often an unpleasant environment. They may be on drugs that prevent sleep (for example corticosteroids which should be given in the morning to prevent this), and they may nap during the day. These aspects should be dealt with where possible before reaching for a hypnotic, despite requests from nurses. Patients not used to such drugs, particularly the elderly, may become very drowsy and their risk of falling if visiting the toilet, for example, is high.
67
Types of laxatives
Stool softener, bulking agent, stimulant, osmotic
68
Example of Stool softening laxative and when to use
Docusate sodium (this is a stimulant at higher doses) Arachis oil (rectal) Good for faecal impaction
69
Example of Bulking agent laxative and notes for use
Isphagula husk Can take days to develop effect
70
Examples of stimulant laxative
Senna Bosacodyl
71
Examples of osmotic laxatives
Lactulose phosphate enema Macrogol
72
Contraindications to stool softening laxatives
Evidence of obstruction Arachis oil - nut allergy
73
Contraindications to Bulking agents
Evidence of obstruction Faecal impaction Colonic atony
74
Contraindications to stimulant laxatives
Evidence of obstruction Bisacodyl: acute abdomen (Pain, fever, blood stool, D&V etc) May exacerbate abide cramps
75
Contraindications to Osmotic laxatives
Evidence of obstruction Phosphate enema - acute abdomen May exacerbate bloating
76
Signs of sympathomimetic overuse and what can cause this
Tremor, raised HR B-Agonist (salbutamol) overuse
77
Common antibiotic used for GI infections
Metronidazole
78
Common antibiotic used for skin infections
Flucloxacillin
79
Common Antibiotic used for bone infections
Clindamycin NOTE: associated with serious colitis so reserved for bone infections
80
What to give if resistant to furosemide
bumetanide
81
Drugs known to give anti-msucarinic side effects (e.g. Constipation, dry mouth despite drinking, tachycardia, blurred vision)
Cyclizine Amitriptyline Atropine
82
When do you use, and Side effect of Carbimazole
Hyperthyroidism Side effects: Neutropenia and agranulocytosis (signs include Sore throat, mouth sores, fever, weakness, bone pain)
83
Things to note when asked a question about dementia
Alzheimers - donepezil or memanitine Vascular - not a lot of guidance for treatment, so even if asked to treat cognitive impairment, treat the vascular side, ie hypertension and prevention meds
84
Drugs that can exacerbate parkinsons
Haloperidol Metoclopramide Prochlorperazine (Compazine) Promethazine
85
Common trick when treating pain in ACS
normally morphine, but may say in Q allergic to opioid, then correct answer is GTN spray
86
Treatment for anginal chest pain (medication, dose, route)
GTN spray (glycerol trinitrate) Dose: 2 sprays Route: Sublingual
87
Treatment of hyperkalaemia
Short acting insulin - e.g. actrarapid or novarapid 5-10 units with
88
Common times to use metoclopramide
Postoperative nausea/motion sickness/ chemo Bowel obstruction
89
Common uses for cyclizine
pregnancy, pretty much any time not in heart failure/MI
90
What to prescribe for immediate antacid relief if allergic to alginic acid (gaviscon)
Magnesium carbonate
91
Types of laxative, examples and how they work
Bulk forming - Ispaghula husk and methylcellulose (retain fluid, encourage bwels to push out stools) Osmotic - lactulose, macrogol (soften) Stimulant - Senna, Bisacodyl (speed up movement of bowels) Softener - arches oil, decussate sodium (increase fluid content)
92
what can be recorded to see if antibiotics are working in treatment of pneumonia
RR

PSA (9 decks)

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