Prescribing Flashcards
1st line antiplatelet therapy for secondary prevention in medically treated ACS
Aspirin - lifelong
P2Y12 inhibitor e.g. ticagrelor (prasugrel, or clopidogrel) - 12 months
2nd line antiplatelet therapy for medically treated ACS
If aspirin contraindicated, lifelong clopidogrel
1st line antiplatelet therapy for secondary prevention following PCI
Aspirin - lifelong
No oral anticoagulant –> prasugrel/ticagrelor - 12 months
oral anticoagulant –> clopidogrel - 12 months
2nd line antiplatelet therapy for secondary prevention following PCI
If aspirin contraindicated, lifelong clopidogrel
1st line antiplatelet therapy for secondary prevention following fibrinolysis for STEMI
Aspirin - lifelong
Ticagrelor - unless high bleeding risk, up to 12 moths
2nd line antiplatelet therapy for secondary prevention following fibrinolysis for STEMI
If high bleeding risk –> clopidogrel for up to 12 months,
Or aspirin alone
Antiplatelet therapy in acute management of TIA
Aspirin 300mg oral loading dose
2nd line: clopidogrel 300mg oral loading dose
Antiplatelet therapy in acute management of STEMI
Aspirin - 300mg oral loading dose
1st line antiplatelet therapy for secondary prevention following TIA/ischaemic stroke
Clopidogrel - 75mg oral, once daily
2nd line antiplatelet therapy for secondary prevention following TIA/ischaemic stroke
If clopidogrel contraindicated/not tolerated –>
Aspirin - 75mg oral, od
+ Dipyramidole MR - 200mg, twice daily
When is clopidogrel used as a single agent anticoagulant?
In peripheral vascular disease, or CVA for secondary prevention
Monitoring for statins
LFTs
-Baseline
-3 months
-12 months
Monitoring for ACE-inhibitors
U+Es
- Prior to treatment
- After increasing dose
- Minimum annually
Monitoring for amioadrone
TFTs, LFTs, U+Es, CXR - prior to treatment
TFTs + LFTs - every 6 months
Monitoring for methotrexate
FBCs
LFTs
U+Es
Before starting treatment
Weekly until therapy stabilised
Then every 2-3 months
Monitoring for azathioprine
FBCs
- Before treatment
- Weekly for first 4 weeks
- Then every 3 months
LFTs
- Before treatment
- Every 3 months
Monitoring for lithium
Lithium levels
- Weekly until stabilised
- Then every 3 months
TFTs + U+Es
- Prior to treatment
- Every 6 months
Monitoring for sodium valproate
LFTs
- Before treatment
- Periodically during first 6 months
FBC - before treatment
Monitoring for glitazones
LFTs
- Before treatment
- ‘regularly’
Antibiotics for throat infections
Phenoxymethylpenicillin - 5-10 days
Clarithromycin or erythromycin (pregnant) if pen allergic
1st line antibiotics for sinusitis
Phenoxymethylpenicillin
Doxycycline or clarithromycin if pen allergic
2nd line antibiotics for sinusitis
Co-amoxiclav - if symptoms worsening despite 2-3 days of antibiotics
If pen allergic –> consult local microbiologist
1st line antibiotics for otitis media
Amoxicillin
Clarithromycin or erythromycin if pen allergic
2nd line antibiotics for otitis media
Co-amoxiclav - if symptoms worsening despite 2-3 days of antibiotics
If pen allergic –> consult local microbiologist
Antibiotics for periapical or periodontal abscess
Phenoxymethylpenicillin, or amoxicillin
Clarithromycin if pen allergic
+ metronidazole if signs of spreading infection
Treat up to 5 days, review at 3 days
Antibiotics for gingivitis
Metronidazole - 3 days
Amoxicillin if metronidazole contraindicated
Beta blockers licensed for use in heart failure
Bisoprolol
Carvedilol
Nebivolol
Reversal agent for apixaban + rivaroxaban
Andexanet alfa