Prescribing Flashcards
What is verapamil?
a CCB used for angina, hypertension and arrythmia
What is amlodipine?
a CCB used for angina or hypertension
Which CCB can be used in cardiac failure?
amlodipine will not reduce cardiac output like other CCB but it is not a treatment for cardiac failure
Should verapamil or diltiazem be used with a beta blocker?
never, as both reduce heart rate
What is indapamide?
a thiazide diuretic used for hypertension
What are the cautions with thiazide diuretics?
hypokalaemia
exacerbate gout
dont use in pregnancy
When are thiazide diuretics used?
to relieve oedema due to chronic heart failure and, in lower doses, to reduce blood pressure
When are loop diuretics used?
used in pulmonary oedema due to left ventricular failure and in patients with chronic heart failure.
What is the MOA of thiazide diuretics?
moderately potent
inhibit the sodium-chloride transporter in the distal convoluted tubule
decrease sodium reabsorption and therefore decreased fluid reabsorption
What effect do loop and thiazide diuretics have on potassium?
inc amount of sodium in distal tubule stimulates aldosterone-sensitive sodium pump to lose more potassium in the urine
What is the MOA of loop diuretics?
inhibit the sodium-potassium-chloride cotransporter in the thick ascending limb of loop of henle
transporter normally reabsorbs 25% sodium
Give an example of a potassium sparing diuretic
spironolactone
What are the important side effects of statins?
myopathy and deranged LFTs
What is the MOA of statins?
competitively inhibit 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase, an enzyme involved in cholesterol synthesis, especially in the liver.
What is the MOA of tolterodine?
competitive antagonist of AcH at postganglionic muscarinic receptors
What is ranitidine?
a H2 receptor antagonist used for dyspepsia and reflux
What is warfarin?
vit K antagonist
how is morphine excreted?
90% in urine
Can morphine or codeine be used in renal impairment?
avoid or reduce as can accumulate
Which analgesics can be used in renal impairment?
paracetamol
oxycodone
fentanyl
- tramadol ok but needs checked
What is the first line antimotility agent in ibs?
loperamide
SE of PPI
osteoporotic fractures
inc risk C diff
low sodium and magnesium
What is metformin?
a biguanide that works by reducing glucose absorption, liver glucose stores and helps cells use glucose
When should there be caution with metformin?
renal impairment acute illness (stop if D+V or surgery)
