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PSA > Prescribing in conditions > Flashcards

Prescribing in conditions Flashcards

1
Q

which drugs should always be continued during surgery? (3)

A

BB
CCB
corticosteroids

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2
Q

which drugs should be stopped during surgery?

A

Insulin (convert so sliding scale)
Lithium
Anticoagulants/antiplatelets - stop 7 days before
COCP - stop 4 weeks before
K - K+ sparing diuretic + ACE-I (stop on day)

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3
Q

what decolonization therapy is prescribed for MRSA?

A

nasal mupirocin
chlorhexidine body washes
vancomycin
teicoplanin

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4
Q

what kind of bacteria is c.diff?

A

gram +ve

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5
Q

what is prescribed for C.Diff?

A

first line -metronidazole

second line- vancomycin

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6
Q

what is prescribed for infective endocarditis?

A

gentamycin + benzylpenicillin

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7
Q

what is prescribed for menigioccocal disease?

A

cefotaxime
ceftriaxone
IM benzylpenicillin

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8
Q

what is used to assess severity of pneumonia?

A 
Confusion 
Urea > 7
RR > 30 
BP < 90
Age 65
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9
Q

what is prescribed in CAP?

A

low severity- amoxicillin (oral) - if penicillin allergic clarithromycin/erythromycin

moderate- amoxicillin + clarithromycin/erythromycin

severe- co-amoxiclav + erythromycin/clarithromycin

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10
Q

what is prescribed in pylonephritis?

A

co-amoxiclav or ciprofloxacin ORAL or IV

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11
Q

which antibiotic can cause tendon damage?

A

cefotaxime

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12
Q

which antibiotic cannot be used in glandular fever?

A

amoxicillin (any penicillins) - gives rash

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13
Q

what is prescribed in neutropenic sepsis?

A

IV tazocin

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14
Q

what is the prescribing pattern for HTN?

A

step 1:
A: ACE-I or ARB - under 55
C: CCB if over 55 or black

step 2:
A+ C

step 3:
A+C+D (diuretic- thiazide)

step 4:
all + BB + senior review

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15
Q

electrolyte S/E of ACE-I?

A

hyperkalaemia

hyponatraemia

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16
Q

when should ACE-I be avoided?

A

renal disease

PVD

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17
Q

what should be prescribed in acute congestive heart failure?

A

UNLOAD FAST:

Upright 
Nitrate 
Loop diuretic 
Oxygen 
ACE-I
Digoxin

Fluids - reduce
Afterload
Sodium restrict
Test - ABG, K+, ECG etc

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18
Q

what class of drug is losartan and give an electrolyte S/E?

A

ARB

hyperkalaemia

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19
Q

what class of drug is amlodipine and give a S/E?

A

CCB

leg oedema

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20
Q

when should amlodipine be avoided?

A

biventricular heart failure

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21
Q

what is prescribed in hypoglycaemia?

A

if conscious- 20g oral glucose

if unconscious- IV glucose 20% in 100ml

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22
Q

what is prescribed in severe flare of UC?

A

IV hydrocortisone + fluid bolus

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23
Q

what is prescribed in mild flare of UC?

A

oral prednisolone - 30mg over 24hrs

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24
Q

what would you do to warfarin if INR <6 but not in target range?

A

reduce and re-mreasure in 2 days

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25
Q

what would you do to warfarin if INR was 6-8?

A

omit warfarin for 2 days, then reduce the dose

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26
Q

what would you do if INR >8?

A

omit warfarin and give vitamin K (1-5mg)

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27
Q

what is given for blood clot prophylaxis?

A

dalteparin 5000 units (LMWH) sub cut

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28
Q

treatment for PE/DVT?

A

dalteparin 15,000 units

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29
Q

what is given for neuropathic pain?

A

amitryptilline 10mg

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30
Q

S/E of COCP?

A

migraine
stroke
DVT/PE

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31
Q

what can be given as emergency contraception?

A

copper IUD- 5days

levonestrogel pill - 72 hours

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32
Q

what are the 4 different types of laxatives and give an example of each?

A

bulk forming
osmotic - lactulose
stimulant - senna, bisacodyl
stool softening - docusate

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33
Q

when are stimulants contraindicated?

A

obstruction

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34
Q

what is prescribed for hyperkalaemia?

A

calcium gluconate
10 units insulin (actrapid)
10ml of 20 units glucose
neb salbutamol

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35
Q

what is prescribed for secretions in palliative care?

A

hyoscine bromide

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36
Q

what is prescribed for agitation in palliative care?

A

midazolam

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37
Q

what is prescribed for pain in palliative care?

A

morphine 10mg/24hrs

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38
Q

what is prescribed for nausea in palliative care?

A

cyclizine 150mg/24 hours

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39
Q

what is prescribed for stable angina?

A

GTN spray

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40
Q

what is prescribed in a STEMI?

A 
MONAT- 
Morphine 
Oxygen if needed
Nitrates - GTN 
Aspirin 300mg
Ticagrelor 300mg
\+PCI within 2 hours + fondaparinux if no PCI within 2 hours
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41
Q

what is prescribed in an NSTEMI?

A

MONAT + PCI within 24-48hours + fondaparinux if no PCI available

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42
Q

what is the long-term treatment post MI?

A 
CRABS: 
Clopidogrel 
Ramipril 
Aspirin 
BB
Statin
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43
Q

what is prescribed in chronic heart failure?

A

ACE-I (if not tolerated then hydralazine + isosorbide trinitrate)
BB (if congested)
Spironolactone

(ABS)

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44
Q

what is prescribed in AF that has been going on for >48hours?

A

rate control=
verapamil or diltiazem (vera + dilly)
BB

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45
Q

what is prescribed in AF that has been going on for <48 hours?

A

Amiodarone
Flecanide (Amy + Fleck)
or DC conversion
anticoagulate if >48 hours - DOAC or Warfarin

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46
Q

what is prescribed in anaphylaxis?

A

neb salbutamol
500micrograms of 1:1000 IM adrenaline
IV chlorphenamine
200mg IV hydrocortisone

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47
Q

what is prescribed in acute asthma attack?

A

Oxygen

Salbutamol IV 2.5-5mg
Hydrocortisone
Ipratropium bromide
Theophylline + MgSO4 + senior review

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48
Q

what is prescribed in a generalised, absence or myoclonic seizure?

A

sodium valproate

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49
Q

what is prescribed in a focal seizure?

A

carbamazepine or lamotrigine

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50
Q

what must be prescribed with sodium valproate?

A

vitamin D supplements

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51
Q

name some drugs that need to be monitored?

A 
lithium 
phenytoin 
gentamycin 
vancomycin 
methotrexate
amiodarone 
digoxin 
statins 
carbimazole 
ciclosporin 
theophylline 
antipsychotics 
ACE-I
52
Q

what needs to be monitored for phenytoin?

A

ECG

53
Q

monitoring for ACE-I?

A

renal function/K+

54
Q

monitoring for methotrexate?

A

FBC

55
Q

monitoring for digoxin?

A

serum creatinine

56
Q

monitoring for clozapine?

A

FBC

57
Q

monitoring for olanzapine?

A

fasting blood glucose

58
Q

monitoring for COCP?

A

BP

59
Q

monitoring for carbimazole?

A

FBC (agranulocytosis)

60
Q

monitoring for tacrolimus?

A

trough level

61
Q

monitoring for ciclosporin?

A

renal function

62
Q

monitoring for statins?

A

lipid profile + LFT’s

creatinine kinase in those at risk of developing a myopathy

63
Q

when do you transfuse blood in iron deficiency?

A

if severely symptomatic or Hb<70

64
Q

what is prescribed to prevent alcohol withdrawal?

A

chlordizaepoxide + thiamine/pabrinex

65
Q

what is prescribed to assist with addiction to alcohol?

A

acamprosate

66
Q

what is prescribed in dyskinesia/parkinsonism caused by drugs such as antipsychotics?

A

procyclidine

67
Q

what is prescribed in neuroleptic malignant syndrome?

A

dantrolene

bromocriptine

68
Q

what is prescribed in serotonin syndrome?

A

benzodiazepine

cyproheptadine

69
Q

what is prescribed in a oculogyric crisis?

A

procylcidine

70
Q

what is prescribed in hepatic encephalopathy?

A

lactulose

71
Q

is warfarin safe during breast feeding?

A

yes

72
Q

is warfarin safe during pregnancy?

A

no- teratogenic

73
Q

what is prescriebd during fluid resuscitation?

A

500ml NaCL over 15 mins (if renally impaired 250ml)

re-assess and if not responding repeat up to 2000ml

74
Q

what fluids are prescribed during resuscitation of hypoglycamia ?

A

500ml 5% dextrose over 15 mins

75
Q

what are the steps of the WHO pain ladder and give examples of each level?

A

step 1 non-opioid: paracetamol, ibuprofen, aspirin
step 2 weak opioid: codeine, tramadol, co-codamol
step 3 strong opioids: morphine, fentanyl

76
Q

what is prescribed in morphine overdose?

A

naloxone

77
Q

how is breakthrough pain calculated?

A

1/6th of total pain relief given in day

78
Q

what can be given for neuropathic pain?

A

amitryptilline
gabapentin
duloxetine
pregabalin

79
Q

what is prescribed for trigemninal neurlagia?

A

carbamazepine

80
Q

what is given in hypoglycaemia if no IV access?

A

IM glucagon

81
Q

what is prescribed in DKA?

A

fluid - 1000ml NaCL over 1 hour

insulin therapy- 0.1 units/kg/hour - actrapid IV

82
Q

what is measured to ensure response to DKA therapy?

A

ketones

cap glucose

83
Q

what is prescribed in HHS?

A

fluids - 1L 0.9% Nacl
prophylactic heparin
insulin - give later as blood glucose should respond to the fluids first

84
Q

what is prescribed in iron overload/poisoning?

A

desfurroxamine

85
Q

what is prescriebd in benzodiazepine overdose?

A

flumanezil

86
Q

what drugs are prescribed during cardiac arrest?

A 
adrenaline 1mg IV
amiodarone 300mg (after 3rd shock if shockable rhythm)
87
Q

What is the aim for TSH in patients taking levothyroxine?

A

0.4-2.5 mU/L (0.4-5.0)

88
Q

measurements for effectiveness of thyroid treatment?

A

TSH 2-3 months later

resolution of symptoms

89
Q

what kind of fluid is used in replacement of massive parecentesis (>5L)?

A

20% human albumin solution

90
Q

what is given for SVT?

A

IV adenosine

91
Q

what is the recommended fluids to give a patient in DKA?

A

NaCl + Potassium 40mmol -> up to 5.5 K+

92
Q

what should be given as fluid resusitation?

A

500ml NaCL over 15 mins (250ml if frail or renal failure)

re-assess if not responding and repeat up to 2000ml

93
Q

what should be given as fluid maintenance?

A

2 sweet and 1 salty-
1L NaCL 0.9% + 20 mmol KCL over 8hrs
1L 5% dextrose + 20mmol KCL over 8 hrs
1L 5% dextrose + 20 mmol KCL over 8 hours

94
Q

what should be given as post-herpetic pain relief?

A

amitryptilline

95
Q

what should be given as first pain relief in the elderly and why?

A

paracetamol - avoid NSAIDs in the elderly as they are more vulnerable to the effects such as gastrotoxicity

96
Q

what is a well known S/E of ciclosporin?

A

nephrotoxicity

97
Q

what should be used for acute pain relief for severe pain in renal failure?

A

oxycodone rather than morphine !!!!

98
Q

what should be done if there is hyperthryoidism caused by amiodarone?

A

with hold amiodarone until there is control and then can consider restarting with carbamazepine treatment

99
Q

what is prescribed to increase factor VIII levels in von willerbands disease?

A

desmopressin

100
Q

what is prescribed for a patient with c.diff and ileus?

A

metronidazole IV (will not be effective orally if prescribed via tablet form)

101
Q

first line for acute cluster headache?

A

100% O2

102
Q

what must be monitored in children taking steroids (i.e in chronic condition or asthma)?

A

growth chart

103
Q

what is first line for osteoporosis prophylaxis in a patient with GORD?

A

raloxifene !!

alendronic acid -> cannot be prescribed in GORD

104
Q

name some drugs that exacerbate asthma?

A

NSAID’s (mechanism unknown)
BB
ACE-I (due to dry cough)

105
Q

what is the most dangerous reactant to warfarin?

A

SIMVASTATIN - anticoagulant effects are drastically increased

106
Q

what should be given in a patient requiring anticoagulant prophylaxis who is needle phobic?

A

DOAC instead of dalteparin (oral)

107
Q

name some topical corticosteroids?

A

budeosinde
beclamethasone
hydrocortisone

108
Q

name some ICS?

A

budesonide
beclamethasone
hydrocortisone

109
Q

name a LABA?

A

formoterol

110
Q

what is given for tremor in huntingtons disease?

A

haloperidol

111
Q

what is prescribed in HAP (severe)?

A

Piperacillin with tazobactam

112
Q

what is prescribed in HAP with MRSA?

A

ADD to piperacillin and tazobactam:

vancomycin or teicoplanin

113
Q

management of status epilepticus?

A

Diazepam 10−20 mg given rectally, repeated once 15 minutes later if status continues to threaten, or midazolam 10 mg given buccally.

IV lorazepam

IV phenytoin

anaesthetic input

114
Q

drug to lower ICP?

A

mannitol

115
Q

drug management of ischaemic stroke?

A

aletplase within 4.5hours

aspirin

116
Q

first line for gout <72 hours ?

A

colchicine/OTC NSAID’s

117
Q

first line for gout >72 hours/not responding to OTC meds?

A

diclofenac

naproxen

118
Q

management of hypercalcaemia?

A 
fluids NaCl (0.9%) 
bisphopshonates
119
Q

management of SVT?

A

Adenosine

120
Q

management of croup? (barking cough)

A

dexamethasone

121
Q

management of whooping cough? (pertussis)

A

clarithromycin

122
Q

management of acute hypertension?

A

amlodipine

123
Q

management of insomnia?

A

zopiclone

temazepam

124
Q

management of PCP?

A

co-trimoxazole + prednisolone

125
Q

what is one drug you can give as part of treatment of refeeding syndrome?

A

Pabrinex

126
Q

what can be given to relieve nausea post op?

A

odansetron
metoclopramide
Cyclizine

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