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Prescription review Flashcards

1
Q

What are the side effects/contraindications to steroids?

A

STERIODS:
- Stomach ulcers
- Thin skin
- oEdema
- Right and left HF
- Osteoporosis
- Infection (inc candida)
- Diabetes
- cushing’s Syndrome

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2
Q

What are the safety considerations with NSAIDs?

A

NSAIDS:
- No urine
- Systolic dysfunction
- Asthma
- Indigestion
- Discrasia (clotting abnormality)

remember aspirin is less associated with these risks

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3
Q

Which antihypertensives cause bradycardia?

A
  • BB
  • CCB
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4
Q

Which antihypertensives cause electrolyte disturbance?

A
  • ACE-In
  • Diuretics
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5
Q

What are the individuals side effects of common antihypertensives?

A
  • ACE-In - dry cough
  • BB - wheeze in a asthmatics, worsen acute HF (help chronic)
  • CCB - peripheral oedema
  • Diuretics - renal failure, thiazide = gout, spiro = gynaecomastia
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6
Q

What is a common trap with IV potassium prescribing?

A

Should not be given at more that 10mmol/hour

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7
Q

As a general rule how much IV fluids do adults/elderly require per 24hrs?

A
  • Adults - 3L
  • Elderly 2L
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8
Q

What fluids would provide adequate electrolytes for one day?

A
  • 1L 0.9% NaCl
  • 2L 5% dextrose

(1 salty, 2 sweet)

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9
Q

When should you avoid metaclopramide?

A
  • Pts with PD as is a dopamine antagonist
  • Young women due to risk of dyskinesia
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10
Q

What is a good first line antiemetic? When should it be avoided? What is an alternative?

A
  • Cyclizine 50mg 8 hrly
  • Cardiac cases (can worsen fluid retention)
  • Metoclopramide 10mg 8 hrly
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11
Q

What is the correct Paracetamol prescription?

A

Paracetamol 1g 6 hourly oral

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12
Q

What does co-cocodamol 30/500 mean?

A

30mg codeine and 500mg paracetamol

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13
Q

What is the maximum daily paracetamol dose?

A

4g

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14
Q

What is the max dose of paracetamol in someone <50kg?

A
  • 500mg 6 hourly
  • 2g in 24 hours
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15
Q

What drugs cause hyperkalemia?

A
  • ACE-In
  • K+ sparing diuretics
  • ARBs
  • All heparins
  • Tacrolimus
  • Blood transfusion
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16
Q

What are common causes of hypokalaemia?

A
  • Loop diuretics
  • Thiazide
  • Steroids
  • Salbutamol
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17
Q

What drugs can cause confusion in elderly?

A
  • Antimuscarinics - oxybutinin
  • Anticholinergics - cyclizine
  • Sedatives - diazepam
  • Opioids - tramadol, codeine (co-codamol)
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18
Q

What type of drugs are trimethoprim and methotrexate?

A

Folate antagonists

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19
Q

What do you need to do with heparin thromboprophylaxis around a stroke?

A

Stop during acute periods

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20
Q

What is Half Securon SR?

A

Verapamil

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21
Q

What indicates peripheral oedema is drug induced?

A

Normal ejection fraction

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22
Q

What two antihypertensives are contraindicated together?

A
  • BB
  • Verapamil
23
Q

What drugs should be stopped before surgery?

A

I LACK OP

  • Insulin
  • Lithium
  • Anticoagulants/antiplatelets
  • COCP/HRT
  • K sparing diuretics
  • Oral hypoglycaemics
  • Perindopril and other ACE-In
24
Q

When should COCP/HRT be stopped before surgery?

A

4 weeks before

25
When should lithium be stopped before surgery?
Day before
26
Is metformin stopped before surgery?
- Yes - Patients are 'nil by mouth' -> lactic acidosis if metformin is continued
27
How are steroids altered around surgery?
- Pts on long term steroids often have adrenal atrophy - Can result in profound hypotension if the steroids are discontinued - As with sick day rules where steroid doses are doubled, additionally IV steroids are given at induction of anaesthesia
28
Which drugs should always be continued during surgery?
- BB - CCB
29
What drugs can cause hyponatraemia?
- Thiazides - SSRIs e.g. citalopram - TCAs - amitriptyline - Carbamazepine - Opioids - PPIs
30
What drugs cause hypernatraemia?
- Lithium
31
When should anticoagulants be stopped around surgery?
1 week before
32
Which drugs are usually prescribed in mcg?
F F LAND - Folic acid - Fludrocortisone - Levothyroxine - Atropine - Naloxone - Digoxin
33
Which drugs are usually prescribed in g?
- Paracetamol - Lithium - calcium carbonate - NAC
34
Which drugs should be prescribed for the morning?
- Diuretics - Steroids
35
Which drugs should be prescribed for nighttime?
- Statins - Night sedation
36
Which medications should be prescribed for weekly?
- Bisphosphonates - Methotrexate - Folic acid - Patches
37
What drugs cause hyperglycaemia?
- Steroids - Antipsychotics - Thiazides - BB - Tacrolimus
38
What drugs cause constipation?
- Opiods - Iron - CCB - Anticholinergics - Some diuretics - Some antiemetics - Some anti epileptics - Antacids that contain calcium
39
What groups of drugs have anticholinergic effects?
- Antidepressants - Antihistamines - Incontinence meds - Antipsychotics
40
What drugs can cause diarrhoea?
- ABX - PPIs - Colchicine - Metformin
41
What drugs can cause urinary incontinence?
- Alpha blockers - Diuretics - Anticholinesterase inhibitors - Clozapine
42
What drugs can cause urinary retention?
- Opiods - Anticholinergics
43
What drugs can cause falls?
- Benzos - Antidepressants - Antipsychotics - Antihypertensives - Antiepileptics - Opioids - PD drugs
44
What drugs cause osteoporosis?
- Steroids - PPIs
45
What drugs cause HTN?
- Oral contraceptives - Steroids - NSAIDs
46
What drugs cause high cholesterol?
- Steroids - Thiazides
47
What drugs should be stopped if intercurrent illness?
- Metformin - Statins - -gliflozins
48
What drugs can worsen PD?
- Antipsychotics - Antiemetics - Antidepressants
49
What drugs can worsen MG?
- Abx - BB - LA - Sedating drugs
50
What drugs can worsen psoriasis?
- BB - Li - Some abx
51
What drugs can worsen HF?
- NSAIDs - CCB - Pioglitazone
52
What drugs cause pancreatitis?
- Steriods - DDP4-In - GLP-1 analogue - Mesalazine > sulphasalazine
53
Which drugs should you stop in AKI?
'Stop the DAMN drugs' - Diuretics - ACEIn/ARB - Metformin - NSAIDs

PSA (9 decks)

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