Prescribing Flashcards
HRT in a peri-menopausal woman
-ve Hysterectomy => oestrogen and progesterone e.g. Levonorgestrel 7mcg/ estradiol 50mcg 24hr via patch
+ve hysterectomy => estradiol 50mcg 24h transdermal patch
What are the starting doses for statins?
Atorvastatin - 20mg Primary, 80 mg Secondary
Simvastatin - 40mg, increase to 80mg if severe
Treatment for hypoglycaemia in a confused/drowsy pt
15g glucose IV i.e. 75 ml 20% glucose IV
A patient is admitted 7 hours after an acute stroke, and appears slightly dehydrated but is haemodynamically stable. Write a prescription for an IV fluid that is most appropriate for this patient
1L 0.9% Saline + 0.3% KCl.
Glucose containing fluids can exacerbate cerebral injury
What is the first line treatment of a DVT/ PE
DOAC. Rivaroxaban or Apixaban. If Cx (antiphospholipid syndrome) then LMWH
How do you treat AF that has been present for >48h?
If AF has been present for >48h, anticoagulate with DOAC/ LMWH for at least 3W (and 4W after) before DC
cardioversion.
What drug do you prescribe in a patient with hypertension and BPH?
Prazosin
What do you prescribe for BPH
Doxazosin
How do you treat hypoglycaemia with impaired consciousness?
20g Glucose IV => 100ml 20% Dextrose IV OR 200ml 10%
Alt. IM/SC glucagon
What are target HbA1c levels for
a) patients on metformin
b) patients on metformin + gliclazide?
a) 48mmol/mol - consider intensifying Tx if HbA1C >58
b) 53 mmol/mol
What is the average maintenance fluids and K+ required in an adult?
3L IV maintenance fluids per day
i. e. 8 hourly bags of 1L with 40-60mmol day
i. e. 20mmol in each 1L bag.
What is the dosage of adrenaline used in cardiac arrest?
IV 1mg of 1:10000 adrenaline.
What is 1st line Tx of T2 diabetes in patients with renal impairment?
If eGFR >45, metformin is first line.
If eGFR <30, 1st line is sulfonylurea e.g. gliclazide - note increased risk of hypoglycaemia.
What is the 1st line fluid to prescribe in hypovolemic shock following initial bolus of 0.9% NaCl?
For hypovolaemic shock, burns and cardiopulmonary bypass, prescribe a colloid bolus to maintain intravascular pressure e.g. fluid challenge of 500ml gelofusine (gelatin) IV over 30 min.
Patient taking ramipril for hypertension presents to GP with a cough. What will you do with this prescription?
Start on trial of angiotensin receptor blocker. eg candasartan losartan
What is the correct dosage of enoxaparin to prescribe in VTE prophylaxis?
20mg in low risk, 40mg in high risk
What is the 1st line treatment for hospital acquired bneumonia?
Co-amox 500/125 mg three times a day orally or 1.2 g three times a day IV5 for 5 days in total then review
Tazocin if severe. 4.5mg TDS
What is an appropriate dose of Senna to prescribe for constipation?
7.5 mg - 15mg
What do you check before starting a patient on ramipril?
U&Es and Renal function
