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PSA shite > Prescription review > Flashcards

Prescription review Flashcards

1
Q

What drugs should you STOP if there’s an AKI

A

Lithium

NSAIDs

ACEi

Meformin

ABXs-> tetracyclines & nitro

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2
Q

what drugs should you adjust dose if there’s an AKI

A

Methotrexate

Digoxin

B-blockers

Furosemide

ABXs

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3
Q

What do you have to do with these drugs in an AKI:

Warfarin

Diazepam

Eyrthromycin

Rifampicin

A

Nothing

Leave them alone eh

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4
Q

what ABXs are suicidal in renal failure

A

tetracyloines (e.g. doxycycilne)

nitro

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5
Q

too much of these can cause what SEs…

  1. K-sparring diuretics
  2. thiazide diurectics
  3. loop diuretics
A

ALL cause dehydration

  1. HYPERkalemia

2 & 3 HYPOkalameia

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6
Q

What drugs do these commonly interact with:

  1. ACEi
  2. Wafarin
A
  1. NSAIDs
  2. statins
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7
Q

What do all these drugs have in common:

CCBs

Salbutmol (SABAs)

NSAIDs

Gent & vanc (aminoglycosides)

A

All common causes of SEs

So fucking guess them

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8
Q

if you get some weired SEs, what drug is most likely the culprit

A

The one most recently started lol

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9
Q

What part of the BNF do you look at for mangement of ADRs & poisoning shite

A

Poisonings & emergency treatment

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10
Q

On aspirin or NSAIDs

Has asthma

Gets nasal polyps

What triad is this

A

SAMTERs

Hence why you try not use NSAIDs in asthma, only can’t be used in like 10% so vast majority are sound

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11
Q

What drugs can worsen asthma & COPD?

(so fucking stop/avoid them eh)

A

NSAIDs

B-blockers

Adenosine

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12
Q

What drugs can cause urine retention?

(so fucking stop/avoid them eh)

A

TCAs & Anticholinergics

Opioids

NSAIDs

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13
Q

What drugs can bugger glucose control

A

Thiazides

Steroids

Anti-psychoics

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14
Q

What drugs can casue pulomnary fibrosis

A

Methotrexate

Amiodarone

Sulfazalzine

Nitro

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15
Q
A
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16
Q

what are the causes of an AKI

  1. Pre-renal
  2. Intrsinic
  3. Post-renal
A

1.

Dehydation

Hypovolemia

Renal artery stenosis

2.

Drugs (ACEi & NSAIDs)

Renal tubular acidosis

Ischemia

Infectoin & inflammation

3.

Tumours

Strictures

Stones

BPH & prostate ca

3.

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17
Q

Causes of jaundice

  1. pre-hepatic ​
  2. hepatic
  3. post-hepatic
A

1.

Haemolysis

Gilberts

2.

Hepatitis

Cancer

Cirrhosis

3.

Stones

Tumours

PBC & PSC

Drugs (ABXs, steroids)

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18
Q

what drugs cause drug-induced cholestasis

A

Steoirds

Antibiotics

Fluclox

Co-amox

Nitro

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19
Q
A
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20
Q

if you get bradycardia as a result of digoxin, what should you do

A

Fucking stop it

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21
Q

for prescription review questions, what are like the main things to check?

A

Allergies (peniclliin & Abxs)

Contraindications (asthma, parkinsons, peptic ulver)

SEs

Too much paracetamol

Wrong dose (too much/not enough)

Wrong frequency

Wrong route

Wrong time of day

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22
Q

when should you NEVER prescibe diuretics

A

at night time

or esle they’ll piss the fucking bed

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23
Q

if a pt complains of indigestion, what drugs shoudl you stop like

A

NSAIDS

Steroids

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24
Q

What SEs are these most likely to cause

  1. aspirin & NSAID
  2. ACEi , NSAID, vanc & gent
  3. diuretics
  4. Pioglitazone
  5. Metformin, aspirin
  6. Morphine sulphate
  7. morphine & metoclopramide
  8. drowsiness
  9. bradycardia
A
  1. haematemesis
  2. AKI
  3. dehydration
  4. hypoglycemia
  5. fucked liver
  6. constipation & urine retention
  7. confusion (in old bugger)
  8. TCAs & opioids
  9. B-blockers, CCBs, Digoxin & Donepazil
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25
Q

Donepazil is obvs a drug used to treat Alzheimers, what is a potential SE

A

Bradycardia

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26
Q

what drugs should you withlold if eGFR takes a plumit

A

ACEi

ARBs

Diuretics

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27
Q

If a patient is showing signs of sepsis, what drug in particlar whould you be worried about

You should stop it eh

A

Methotrexate

cause of the risk of neutropenic sepsis

28
Q

a pt gets worseing heart failure symptoms

what drugs could be responsible

A

Steroids

NSAIDs

CCBs (verapapil)

29
Q

why might you see an contraceptive pill on a bloke’s prescripton chart

A

he got his and his’ wifes meds mixed up lol

Not really progressive is it

30
Q

what is important to check regarding drugs for blood clot prophylaxis

A

Right dose?

Treatment vs prophylactic

31
Q

is ‘1mg of paracetamol’ ever right?

A

Fuck no

Only ever prescribed as 1g or 500mg

32
Q

if someone has like chronic pain and TENS is an option, what should you just do

A

Pick it

33
Q

if a patient is completely fine and got no sympomts, but their bloods are fucking off the rails, what should you do

A

Send for another blood test lol

clearly they’re sound

34
Q

what drugs increases the risk of lithium toxicity?

A

ACEi & diurectics

they both decrease lithium excretion

35
Q

What drugs should you stop if any of the following occur:

heamoptysis

acute ischemic stroke

GI bleeding

bleeding of any sort really

A

Drugs that increase fucking bleeding

Warfarin

Aspirin

Heparin

36
Q

When should you stop taking steroids?

A

If there’s any -> STEROIDS

Stomach ulces

Thin skin

oEdema

Right heart failrue

Osteoporosis

Infection

Diabetes

Syndrome (Cushings)

Only if the steroid is the cause, otherwise if a pt is sick you double the fuckign dose

37
Q

When should you stop taking NSAIDS

A

If there’s any -> NSAID

No urine

Systolic dysfunction (heart failure)

Asthma

Indigestion

Dyscarisa (fucked blood)

38
Q

what drug might be fatal in an old geezer who’s hypotensize

A

B-blocker

39
Q

what is the most common prescription error

A

Omission on admission

Forgetting to add the drug on the clerking sheet lol

40
Q

what are considered as the ‘high risk’ drugs that you should always guess when in doubt

A

NSAIDs

Steroids

Anti-coags

Anti-pscyhotics

Insulin

41
Q

what is always essential to check

very fuckign basic

but q might try and catch you out

A

the pt’s fucking name

42
Q

If a pt has a low HR and is on both CCB and B-blocker, what should you do

A

Just stop the one

if you stop both they’ll get like rebound tachycardia

43
Q

what ABxs should be avoided in penicllin allergies

A

Amox & co-amox

Flucloxaccin

Pippercilin & tazobactam (Tazocin)

44
Q

is ciprofloxacin safe to use in a penicllin allergy?

A

It absolutley is

45
Q

why are P450 enzyme inducers/inhibitors important

A

Cause most drugs are metabolised by this enzyme in the liver

influences if the drug is gonna be more/less active

very important for the likes of warfarin

46
Q

what affect fo enzyme INDUCERS have on other drugs

A

the inducer increases the acttivity of P450 enzyme

so the metabolism of the inducer is increased

causing the Metabolsim of other drugs to decrease

so other drug shave a DECREASED effect

47
Q

What affect do enzyme INHIBITORS have on other drugs

(e.g. warfarin)

A

the inhibitor decreases the acttivity of P450 enzyme

so the metabolism of the inhibitor is decreases

metabolism of other drugs is increased

so other drug shave an INCREASED effect

48
Q

What are the enzyme INDUCERS

A

PC BRAS

Phenytoin

Carbamazapine

Barbituates

Rifampicin

Alcohol

Sulphonylureas

49
Q

What are the enzyme INHIBITORS

A

AO DEVICES

Allopurinol & Amiodarone

Omeprazole

Disulfarum

Erthyromycin

Valporate

Isoniazid

Ciprofloxacin

Ethanol

Sulphonamides & Sertaline

50
Q

Are sulphonamides enzyme inducers or inhibitors

also give examples

A

Inhibitors

Trimethoprim

Sulfazalazine

51
Q

Is grapefruit juice an enxyme inducer or inhibitor?

A

Inhibitor

52
Q

what part of the BNF might you find shite like hyperkalaemia

A

“Electrolyte Imbalance”

53
Q

Are barbituates enzyme inducers or inhibitors?

also, what type of drug are they?

A

Inducers

Seadatives

54
Q

Warfarin & P450 enzyme

  1. what should you do to the warfarin dose if an enzyme INDUCER is precribed alongside
  2. what should you do to the warfarin dose if an enzyme INHIBITOR is precribed alongside
A

1. INCREASE DOSE

So theres an increased metabolism of the inducer

which decreases metabolism of warfarin

so warfarin has less effect

dose needs to go up

2. DECREASE DOSE

So theres a decreassed metabolism of the inhibtior

which increases metabolism of warfarin

so warfarin has more of an effect

dose needs to go down

INHIBITORS = INHIBIT the dose of warfarin

55
Q

if the q is about contraception & HRT, and they are on a progesterone only and wanna change, what shoudl you give

A

A COMBINED one

Just put down levonorgestrel and that’ll be you

56
Q

you’re wanting to prescribe an ABx for a UTI

They have an eGFR of <45

What drug can’t you use

A

Nitro

Nitro fucks the kidneys eh

57
Q

for Qs that ask which is the serious drug error, what do you always look for

A

wrong units, dose, route…

contraindications

interactions

allergies

58
Q

what analgesic can cause sertotonin syndrome if used alongside SSRIs like citalopram

A

Tramadol

59
Q

what drugs are usually prescribed weekly, so if you see an OD next to them then it’s clearly wrong

A

methorexate

biophosphonates

60
Q

what sorta age and sex of a pt will deffo influence a drug if it’s part of the question

A

young females

might be on a teratogenic eh

61
Q

are SSRIs safe to use in the ealry stages of pregnancy

A

absolutely not

62
Q

if you have poor renal function, should you stop allopurinol

A

fuck yes

63
Q

whats more likely to fuck up your liver, metformin or methotrexate

A

Methotrexate

64
Q

what type of anti-hypertensive can’t be described if there’s ischemic ulcers

A

b-blockers

65
Q

if somone is on two loop diurectics or one loop and one thiazide, what shoudl you do

A

stop one eh

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