Prescribing section Flashcards
What is an enzyme inducer
Increase CYP450 activity
faster metabolism
decreased therapeutic effect
Give examples of enzyme inducers
PC BRAS
Phenytoin
Carbamazepine
Barbituates
Rifampicin
Alcohol - chronic excess
Sulphonyureas
St Johns wart
Smoking
Topiramate
What is an enzyme inhibitor
Decreases activity of enzyme
decreased metabolism
remains active for longer
Give examples of enzyme inhibitors
AO DEVICES
Allopurinol / Amiodarone
Omeprazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin
Ethanol - Acute
Sulphonamides
Grapefruit juice
SSRI/SNRI
What medications should be stopped prior to surgery
I LACK OP
Insulin
Lithium - day before
Anticoagulants/platelets
COCP / HRT - 4 weeks before
K+ sparing diuretics
Oral hypoglycaemics
Perindropil - And other ACEi
What can carbamazepine cause
Hyponatraemia
when should steroid be prescribed
Morning - prevent sleep
when should brand names of drugs be used
Insulin
Anti-epilleptics
What shoudl be prescribed for a patient in DKA
Fluids - 1L 0.9% NaCl over 1 hour
Stat if hypotensive
Insulin - Fixed rate
0.1units/kg/hr
How does trimethorpim affect renal function
Falsely causes rise in Creatnine –> AKI
What is gentamicin prescribing based on
Ideal body weight
What is a risk of prescribing quinolones
tendon damage
Name an adverse effect of co-amoxiclav
Increased risk of cholestasis
Name 2 adverse reactions assosciated with ciclosporin
gungival hypetrophy
nephrotoxicity
Name 2 adverse reactions associated with tacrolimus
Cardiomyopathy
peripheral neuropathy
DM
Pancytopenia
Name 2 adverse reactions assosciated with Mycophenelate
GI upset
Myelosuppresion
Name adverse effects of steroids
CORTIOSTEROID
Cushings syndrome
Osteoperosis
Retardation of growth
Thin skin / easy bruising
Immunosupression
Cataracts
Oedema
Stomach ulcers
Teratogenic
Emotional - psychosis
Rise in BP
Obesity
Increased hair growth
DM
Striae
Name anticholinergic side effects
Cant shit, cant spit, cant see, cant pee
Blurred vision
cosntipation
dry mouth
urinary retention
Name anti-muscarinic side effects
confusion
dialted pupil
loss of accommodation
dry mouth
tachycardia
What drugs should be stopped in an AKI
DAMN
Diuretics
ACEi
Metformin
NSAIDs
Describe the management of hypoglycaemia
Conscious - oral glucose
Unconscious
- IM glucagon
Unresponsive to IM or prolonged hypo
10% IV glucose infusion
Name 2 thin emolients
E45
Aveeno
Diprobase cream
Oilatum
Name 2 thick emolients
Diprobase ointment
Hydromol ointment
Cetraben ointment
Describe the topical steroid ladder
Hydrocortisone
Eumovate
Betnovate
Dermovate
When should prophylactic LMWH not be given to patients
Risk of bleeding
Following acute ischaemic stroke
What is a contraindication to compression stockings
PAD - absent limb pulses
Can lead to critical limb ischaemia
How many boluses can you give prior to escalation
6 - 2000mls
Describe what happens if Methotrexate and NSAIDs are co-prescribed
Low platelet count
Describe what happens if methotrexate and PPIs are co-prescribed
PPI - Enzyme inhibitor
Increased level of methotrexate
Name drugs most likely to cause ototoxicity
Gentamicin
Vancomucin
Furosemide
Butenamide
Name drugs most liekly to cause C.diff
Clindamycin
Co-amox
Cephalosporin
Ciprofloxacin
How often should you change a fentanyl patch
every 3 days
when should an asthmatic patient seek medical help
The usual dose not preventing sx
what are the symptoms of hypoglycaemia
Fast heartbeat.
Shaking.
Sweating.
Nervousness or anxiety.
Irritability or confusion.
Dizziness.
Hunger.
What anti-depressants are licensed in anxiety
Escitalopram
Sertraline
Paroxetine
2nd line
- Duloxetine
- Venlafaxine
What is the max dose of escitalopram in the elderly
10mg
When are steroid prescribed
Morning
When are statins prescribed
At night
What medications cause diarrhoea
Antibiotics
PPI
Laxatives
Antidepressants
What medications cause oral thrush
Abx - Amoxicillin
Inhaled ICS
Immunosuppresant
How does an Addisonian crisis present
Reduced consciousness
Hypotension
Hypoglycaemia
hyponatraemia
hyperkaemia
