Prescribing Flashcards
What is the mneumoic you use before you think about prescribing something?
Prescriber
Patient deatils
REactions
Side effects
Contraindications
Route
IV fluids?
Blood clot prophylaxis?
Emetics, anti-emetics?
Relief from pain?
If the pt has a histroy of peptic ulcers, what drug shouldn’t you prescribe
NSAIDS ya dick
What Abx is used for epidlottitis?
CefoTAXime
TAX meningits and epiglottitis
whats the difference between SSRI use for depression and anxiety
Anxiety typically has a lower dose
Not for shite like citalopram for some reason eh
Management of incontinence
- for stess
- for urge with myasthenia gravis
- for urge without myasthena gravis
1 & 2 duloxetine
3 oxybutynin
for urge incontinince, you usually give oxybutynin unless there’s a history of…
Myasthenia gravis
If a pt is looking for more pain relief and they’re already on paracetamol & NSAIDs, what do you gice?
Codeine
A pt is constipated, and after sticking your fingers up their bum the stool feels nice and soft
What laxative should you prescribe?
SENNA
SOFT= SENNA
Senna is a stimulant, things like docusate are stool-softenors, so there’s no need to further soften the fucking shite
if the meds are ‘usually taken at bed time’, what should you write on the chart under frequcny
…x nightly
If the case is about a bloke with SOB and they also give you an ECG, what’s the likely problem?
AF
what should you give someone with increasing breathlessness with a history of like asthma/COPD
what will you give to stop the breathlessness
Salbuatmol NEBS
What is always used for clot (DVT or PE) prophylaxis and treatment
UNLESS it’s an acute stroke
Dalteparin SC mate
+
Compression stockings
if a pt has leg ulcers, probs as a result of periphearl arterial disease, can you prescribe a B-blocker?
Absolultey no fucking way
if you’re thinking about an anti-emetic, but the pt has parkinsons or acute dystonia, what one can you absolutley not use
Metoclopramide
you’re wanting to prescribe an ABx for a UTI
They have an eGFR of <45
What drug can’t you use
Nitro
Nitro completley fucks the kidneys
if the pt is vomiting or they ‘can’t take oral fluids’, what route should you use
hard one this bloody hell
IV
SC
IM
pick whichever eh, cheers
what do you prescribe for IBS
Mebeverine
+
Loperamide (for the diarrhoea lol)
Pain prescribing: what do you give for…
- no pain
- mild pain
- moderate pain
- severe pain
- neuropathic
- TENS is an option
- just PRN paracetamol
- regular pacacetamol + PRN codeine/tramadol
- regular cocodamol/codeine + PRN morphine
- regular morphone + PRN morphine
- amitrytyline (at night)
- TENS
For blood clot prophylaxis…
- how long do you need to wait after an acute stroke before you can give Dalteparin
- when can you not give compression stockings
- 2 months
- PAD (‘can’t feel feet pulses’)
If a pt has some neruopathic sounding pain, when do you need to prescribe the amitriptyline
at NIGHTIME
same as steroids eh
Paracetamol shite
- what is the max dose you can give in a day
- what is the usual prescirption
- what do you need to look out for
- 4g
- 1g, 6hrly
- other shite containing para, like co-codamol
what is the max dose of paracetamol you can prescribe in a day
4g
when in doubt about what to prescribe, where do you look in the BNF
TREATMENT SUMMARIES
Resp ABXs
- AECOPD
- CAP
- atypical pneumonia
- Hospital acquired pneumonia
1.
Amox or tetra or clarith
2.
Amox
PA = clartih or doxy
staph A likely = fluclox
3.
Clarith
4.
<5 days = co-amox
>5 days= pipercillin + Tazobactam (Tazocin)
when in doubt, what resp ABX should you guess
Normal -> amox
PA -> clarith or doxy
Urinary tract ABXs
- UTI
- acute pyleonephritis
- acute prostatitis
1.
Normal or low eGFR -> trimeth
Preggers or methotrexate -> nitro
close to term -> amox
2. & 3
Cipro
3 can also use trimeth
what do you give for acute pulmonary oedema?
IV furosemide
For shite like AF, what fo you give in younf & old folk
Young -> amiodarone (rythm control)
Old -> verampail (rate control)
What should you prescribe for…
- chronic HF
- sevre SOB/AECOPD or asthma
- chest pian (angina) relief
- SOB with AF
- hyperkalemia
- tumour induced seizure (focal)
- diabetes
- dyspepsia
- severe pneumonia
- ACEi + B-blocker
- Salbutamol NEBS
- GTN
- veramapil
- Ca gluconate or insulin
- carba or lamotrigine
- metofmrin or glicazide
- magnesuium carbonate
- tazocin
what is magnesium carbonate used to treat
dyspepsia
what do you use to treat hyperkalaemia
protect heart -> IV Ca gluconate
lower K levels -> 10 units of IV Insulin (actrapid)
when do you not use metformin 1st line for diabetets
when liver is fucked
>150 creatinine leevles
signs of lactiv acidosis
do ya prescribe something orally if a poor bugger is vomiting
fuck off
what route do you use if theres already IV access
IV you clown
what bit in the BNF do you fing out about how to prescribe HRT
Sex hormones
what route is best avoided in kids
IV
they might not be best pleased
if you need ro prescribe Vit K, what is the druc called
used in cases of too much warfarin
phytometidine
what is the only route of administratoin for insulin
SC
what drug, used to prevent transplant rejection, is one of the very few drugs that is prescribed by it’s brand name
tacrolismus
steroid treatment for eczema?
topical hydrocortisone
if a pt has an alcohol dependence, can you give oral metronidazole
nope
if bacterial vaginosis, use an intravaginal cream
if it says to prescribe a ‘change’, what does it mean
prescribe one of the drugs they’re already on, but just change the dose
like if steroids and unwell, just increase the dose
what do you put down for ‘route’ when prescribing eye drops
occular
what cause of macrocytic anaemia is common in pt’s with coelaics
b12 defieicny
treate with HYDROXOCOBALAMIN
when in the bnf do you find stuff on fludis & electrolytes
Fluids & electrolytes you fucking idiot
how do you treat chalmydia
azithromycin (only 1 dose needed)-> DEFFO IF PREGNANY
or
Doxyxyxline for like 7 days
what sti has gram -ve diplodocci and obvs get this discharge after sex
gonorrohea
1st line for pain in ankylosing spondylitits
NSAID -> naproxen
scabies is treated with…
permithrin cream
how do you find out like specific VTE prophylaxis for certwin operations
go onto the VTE bit
control F the type of surgery lol
anti-emetic for migraine
prochloperazine
what route should morphine be gien by in acute pain
IV obvs
what might be going on if you’ve got abdo pain, N&V and are on long-term steroids for shite like crohns
you’ve also got like low sodium and high K
What would you use to treat
Addisoninan (adrenal) crisis
give hydrocorisone
where do you look up for about emegerncy contreacpetion
just fucking search emegency contraception
if you’re looking for stuff to describe for STIs, where do you look
Genital system infections
noisy breathing in a palliiative pt is probs due to…
secretions
for a pessary, what do you put down for route
vaginal
what infection often comes after an insect bite
cellulitis
