prescribing: do it yourself

Question 1

what is the treatment dose of dalteparin (LMWH) ?

Answer 1

15000 units S/C once daily

Question 2

what is the treatment dose of enoxaparin? (LMWH?)

Answer 2

120mg or 12000 units S/C once daily

Question 3

what is the treatment dose of tinzaparin (LMWH?)

Answer 3

14000 units s/c once daily

Question 4

what is first line for chronic HF management?

Answer 4

ACEI or beta blocker.

wary in asthma - give ACEI.

Question 5

what time should ACEI be given and why?

Answer 5

in the evening because they can cause postural hypotension.

Question 6

what are you gonna prescribe for pain in an elderly lady who is having an MI?

Answer 6

GTN spray
2 sprays
sublingual

or GTN tablet
0.3-1mg sublingual (pick a dose)

Question 7

what is the first line tx for AF?

Answer 7

first line rate control: beta blocker or rate limiting CCB (diltiazem/verapamil).
- rate control is first line if patient is elderly.

rhythm control: cardio version - *but always do anticoagulation if onset was >48 hours ago

Question 8

what is the first line treatment of hyperkalaemia?

Answer 8

is their glucose high? need short acting insulin, (eg Actrapid or Novorapid with glucose).

INSULIN + DEXTROSE - the insulin will cause intracellular uptake of potassium, dextrose will prevent subsequent hypoglycemia

ie: 10 UNITS IN 100ML OF 20% DEXTROSE IV

Question 9

type 2 diabetes, when do you give metformin and when do you give sulfonylurea?

Answer 9

metformin: if overweight (as it causes appetite supression).
AVOID if creatinine >150.

sulfonylurea: if normal or underweight.
if creatinine >150 you can use this.

Question 10

how do you take a sulfonylurea?

Answer 10

once daily with first meal