Planning management / ADR Flashcards
management of acute mania / hypomania
antipyschotics eg: onlazapine / haloperidol
management of acute agitation / anxiety?
benzodiazepines
management of pyelonephritis
IV ABX eg: ceftriaxone
mx of anaphylaxis
1:1000 IM 0.5mg adrenaline
how does bronchiolitis present?
<1 year
coryza
wheeze
mild fever!
increased WOB
dry cough
mx of bronchiolitis?
prophylaxis?
- supportive eg: oxygen
- headbox
- nasal canula - IV fluids
palivizumab
presentation of croup?
management?
mild
moderate
severe?
barking cough worse at night, temperature, stridor, resp distress, coryza
Mx:
All severity = one off dose of oral dexamethasone (0.15mglg)
mild = at home
moderate / severe= admit
moderate / severe= nebulised adrenaline / budenoside
drug management of cardiac arrest shockable rhythms
= VF / pulseless VT
- adrenaline 1mg after the 3rd shock then after 5/ 7 th shock
- amiodarone after 3rd shock 300mg IV
drug management of non shockable rhythm PEA / asystole
adrenaline 1mg IV / IO 3rd/5th/7th
drug mx of dvt?
DOAC
mx of emergency hypoglcyaemia
20% glucose 100ml OVER 15 m
mx of DKA?
IV fluids eg:
1L 0.9% NaCl over 1 hour
1L 0.9% NaCl+ KCL over 2 hours -> 2 -> 4 -> 4
fixed rate insulin infusion 0.1units /kg/ hour
once BG < 14 = 10% dextrose infusion
mx of HHS?
1L over 1 hour
mx of hyperK
IV 10% calcium gluconate 10 ml
Insulin / dextrose infusion (10 units actrapid + 25g glucose)
nebulised salbutamol
how to find management of status elipticus?
under epilepsy
mx of status elipticus
buccal midazol / rectal diazepam community
IV 4mg lorazepam
IV 4mg lorazepam (2 doses benzo 10mins apart)
Iv pheynytoin / sodium valproate
RSI eg: propofol / midazol
mx of pneumonia CAP
CURB 1 + pen allergic?
CURB 2
CURB 3
- amoxicillin
PA : doxycline/ clarithromycin - amoxicillin + clarithryomcin oral
- IV co-amoxiclav + clarithromycin
mx of HAP
- oral co-amox
- IV taz
- mrsa = vacno
mx of sickle cell crisis
analgesia eg: opiates
hydration
oxygen
blood transfusion
exchange transfusion
what to type in for alcohol syndromes?
alcohol dependence
mx of alcohol withdrawal
chlordiazepoxide reducing regimen
mx of delirium tremens
benzo eg: lorzepam
mx of wernickes encephalothpyg
pabrinx IV thiamine
where to find management of gynae infections?
genital infections
where to find anti-emetics
under nausea
mx of PMR?
15mg oral prednisolone
mx of BPH?
alpha blocker eg: tamsulosin
5 alpha reductase inhbitors eg: finasteride
drug mx of conjunctivtis
chloramphenicol eye drops 0.5%
fusidic acid
calcium / vitmain D + bisphoonates how to take?
at least 4 hours apart - calcium interferes with absorption of bisohposonates
what are the MHRA/ CHM warnings?
less common but more serious adverse effects to look out for
advice for use of amiodarone?
wear suncream
ADR of loop diuretics? 4
dehydration
renal impairment
hypoK
otoxicity
ADR of NSAIDS? 3
PUD
renal impairment
HTN
ADR of opioids 5
urinary retention
constipation
drowsy
confusion
sedation
2 drugs that interact with warfarin and increase INR?
clarityhromycin
amiodarone
example of drugs that require plasma drug concentration monitoring
lithium
dixogin
gentamicin
vancomycin
phenytoin
when are lithium samples taken?
range?
6 hours post dose
0.4-1
when are gentamicin levels taken?
6-14 hours post dose for once daily regimen
when are vancomycin levels taken?
pre dose (trough) = taken after 3-4 doses
when should digoxin smaples be taken?
how is efficacy determined?
6 hours post dose
HR
example of drugs which renal function will have an influence on the initial or maintenance dosage
DOAC eg: apixaban should be halved if creatinin clearance 15-29
co-amox = dosing interval extended if egfr 10-30
venlafaxine = maintenance dose half if egfr <30
statins and LFT?
what is safe to continue?
if AST/ALT less than x3 upper limit = safe to continue
drugs that affect LFT
amiodarone
MTX
statins
terbinafine
drugs that cause hypoNa 6
- thiazide diuretics / loops diuretics
- TCAs
- SSRi
- antipsychotics eG: haloperidol
- Anti epiletics eg: carbmazeapine
- PPI
drugs that cause hypoK 5
thiazide and loop diruetics
mieralcorticoids eg: fludrocortisone
insulin
beta 2 agonists eg: salbutamol
chronic use of laxatives
drugs that cause hyperK 6
K+ sparing diuretics eg: spiro
ACEi / ARB
NSAIDS
ciclosporin
tacrolimus
trimethorpime
target blood concentration for diabetes
6-10 (4-12 ok)
Mx of high INR: BLEEDING
- major bleeding
- minor bleeding and iNR > 8
- minor bleeding INR 5-8
Bleeding
- stop warfarin - IV vitamin K - PTComplex / FFP
- Stop warafrin - IV vitamin K - repeat INR 24 horus - repeat vitamin K - restart warfarin when INR < 5
- STOP warfarin - IV vitamin K, restart warfarin INR < 5
Mx of high INR: no bleeding
- INR > 8
- INR 5-8
- BLEEDING INR normal
- sto warfarin- oral vitamin K - repeat INR 24 hours - restart warfarin < 5
- withhold 1-2 doses of warfarin and reduced subsequent maintenance dose
- investigate underlying cause
how to control overnight glycaemic control? ie : high BMs in the morning?
increase long acting in prior evening
lithium + ACEi?
interact = increased serum lithium concentration
reduce lithium levels by 1/3 or 1/2