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PSA > Prescription review > Flashcards

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
Q

When should lithium be stopped before surgery?

A

Day before

26
Q

Is metformin stopped before surgery?

A
  • Yes
  • Patients are ‘nil by mouth’ -> lactic acidosis if metformin is continued
27
Q

How are steroids altered around surgery?

A
  • 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
Q

Which drugs should always be continued during surgery?

A
  • BB
  • CCB
29
Q

What drugs can cause hyponatraemia?

A
  • Thiazides
  • SSRIs e.g. citalopram
  • TCAs - amitriptyline
  • Carbamazepine
  • Opioids
  • PPIs
30
Q

What drugs cause hypernatraemia?

A
  • Lithium
31
Q

When should anticoagulants be stopped around surgery?

A

1 week before

32
Q

Which drugs are usually prescribed in mcg?

A

F F LAND

  • Folic acid
  • Fludrocortisone
  • Levothyroxine
  • Atropine
  • Naloxone
  • Digoxin
33
Q

Which drugs are usually prescribed in g?

A
  • Paracetamol
  • Lithium
  • calcium carbonate
  • NAC
34
Q

Which drugs should be prescribed for the morning?

A
  • Diuretics
  • Steroids
35
Q

Which drugs should be prescribed for nighttime?

A
  • Statins
  • Night sedation
36
Q

Which medications should be prescribed for weekly?

A
  • Bisphosphonates
  • Methotrexate
  • Folic acid
  • Patches
37
Q

What drugs cause hyperglycaemia?

A
  • Steroids
  • Antipsychotics
  • Thiazides
  • BB
  • Tacrolimus
38
Q

What drugs cause constipation?

A
  • Opiods
  • Iron
  • CCB
  • Anticholinergics
  • Some diuretics
  • Some antiemetics
  • Some anti epileptics
  • Antacids that contain calcium
39
Q

What groups of drugs have anticholinergic effects?

A
  • Antidepressants
  • Antihistamines
  • Incontinence meds
  • Antipsychotics
40
Q

What drugs can cause diarrhoea?

A
  • ABX
  • PPIs
  • Colchicine
  • Metformin
41
Q

What drugs can cause urinary incontinence?

A
  • Alpha blockers
  • Diuretics
  • Anticholinesterase inhibitors
  • Clozapine
42
Q

What drugs can cause urinary retention?

A
  • Opiods
  • Anticholinergics
43
Q

What drugs can cause falls?

A
  • Benzos
  • Antidepressants
  • Antipsychotics
  • Antihypertensives
  • Antiepileptics
  • Opioids
  • PD drugs
44
Q

What drugs cause osteoporosis?

A
  • Steroids
  • PPIs
45
Q

What drugs cause HTN?

A
  • Oral contraceptives
  • Steroids
  • NSAIDs
46
Q

What drugs cause high cholesterol?

A
  • Steroids
  • Thiazides
47
Q

What drugs should be stopped if intercurrent illness?

A
  • Metformin
  • Statins
  • -gliflozins
48
Q

What drugs can worsen PD?

A
  • Antipsychotics
  • Antiemetics
  • Antidepressants
49
Q

What drugs can worsen MG?

A
  • Abx
  • BB
  • LA
  • Sedating drugs
50
Q

What drugs can worsen psoriasis?

A
  • BB
  • Li
  • Some abx
51
Q

What drugs can worsen HF?

A
  • NSAIDs
  • CCB
  • Pioglitazone
52
Q

What drugs cause pancreatitis?

A
  • Steriods
  • DDP4-In
  • GLP-1 analogue
  • Mesalazine > sulphasalazine
53
Q

Which drugs should you stop in AKI?

A

‘Stop the DAMN drugs’
- Diuretics
- ACEIn/ARB
- Metformin
- NSAIDs

PSA (9 decks)

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