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PSA > PSA 1 > Flashcards

PSA 1 Flashcards

1
Q

Every drug prescription must be?

A

Legible

Unambiguous

Approved name

IN CAPITALS

Without abbreviations

SIgned

‘If used as required’ -

i) indication
ii) max frequency

Duration of treatment

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2
Q

What system most commonly metabolizes drugs in the body?

A

P450 enzyme system

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3
Q

What is an Inducer? What effect will it have on the drug?

A

It will increase P450 enzyme activity

Therefore there is reduced effect of the drug

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4
Q

What is an inhibitor? What effect will it have on the drug?

A

It will decrease P450 enzyme activity

Increased level and effect of drugs

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5
Q

What are examples of inducers?

A

PC BRAS

Phenytoin
Carbamezepine
Barbiturates
Rifampicin
Alcohol
Sulphonylureas
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6
Q

What are examples of inhibitors?

A

AODEVICES

Allopurinol
Omeprazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Cirprofloxacin
Ethanol
Sulphonamides
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7
Q

What drugs do you stop before surgery?

A

I LACK OP

Insulin

Lithium

Anticoag/antiplatelets

COCP/HRT (4 weeks before)

K-sparing diuretics

Oral Hypoglycaemics

Perindopril and other ACE-i

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8
Q

What steps for safe prescribing?

A

PReSCRIBER

Patient details
Reaction
Sign 
Contradictions
Route
IV fluids
Blood clot prophylaxis
antiEmetic
Relief
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9
Q

What do co-amoxiclav and tazocin both contain?

A

Penicillin

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10
Q

What contra-indications should we be aware of?

A

If bleeding risk - NO aspirin, heparin and warfarin

If steroids - remember side effects - ulcers, thin skin, oedema, right and left HF, osteoporosis, infection, diabetes

If NSAIDs - Renal issues, Asthma, Indigestion, Clotting abnorm

Antihypertensives - hypotension, brady with b-blocker, ACE and diuretics with electrolyte discturbance

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11
Q

When should 0.9% saline not be given as replacement fluid?

A
  1. Hypernatraemic or Hypoglycaemic (give 5% dextrose)
  2. Ascites - give human-albumin solution
  3. Shocked - give colloid
  4. Bleeding - blood transfusion
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12
Q

What amount of fluids should be given as maintenence?

A

3L IV per 24 hrs

2L for elderly

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13
Q

What’s will provide an adequate amount of electrolytes?

A

1L 0.9% saline

2L of 5% dextrose

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14
Q

What is standard blood clot prophylaxis?

A

LMWH - dalteparin 5000 units daily s/c

Compression stockings

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15
Q

What is standard choice of antiemetic?

A

Cyclizine expect if in cardiac cases

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16
Q

What can be prescribed regularly as pain relief?

A

Mild pain - rparacetamol 1 g - 6 hourly

Severe pain - co-codamil - 30/500. 2 tablets 6 hourly

17
Q

What can be prescribed as required for pain relief?

A

no pain - paracetamol

mild pain - codeine 30mg up to 6 hourly oral

severe pain - morphine sulphate 10 mg up to 6 hourly oral

18
Q

What can prescribed for neuropathic pain?

A

Amytriptyline

Pregabalin

Duloxetine

19
Q

Calcium channel blockers commonly cause what side effect?

A

Peripheral oedema

20
Q

What analgesic should not be prescribed in Asthmatics?

A

NSAIDs

21
Q

When prescribed co-codamol what must you be wary off?

A

It contains paracetamol

Caution if there is also normal paracetamol prescription

22
Q

What drugs can cause low neutrophils?

A

Clozapine

Carbimazole

23
Q

What drugs can cause low platelets?

A

penicillamine

heparin

24
Q

What can a raised urea indicate?

A

AKI

Upper GI hemmorhage

Raised urea w/ normal creatinine in patient who isn’t dehydrated should prompt a look at Hb

25
Q

How would you alter the dose of levothyroxine based on TSH range?

A

<0.5 - decrease dose

0.5-5 - nil action - same dose

> 5 - increase dose

26
Q

Why is it important to check inspired oxygen concentration?

A

As it would give a better picture with regards to the PaO2

E.g. - 13kPa on 100% oxygen would mean someone is grossly hypoxic

27
Q

What are some commonly encountered drugs which cause toxicity?

A

Digoxin - confusion, nausea, visual halos, arrythmias

Lithium - tremor, tiredness, arrythmias, seizures, coma

Phenytoin - gum hypertrophy, ataxia, nystagmus

Gentamicin - ototoxicity, nephrotoxicity

Vancomycin - ototoxicity, nephrotoxicity

28
Q

What is normal range for gentamicin? When would this not be the case?

A

5-10 mg/L, <2 trough before next dose

In infective endocarditis, 3-5 mg/L, <1 trough

29
Q

What to do in case of Gent toxicity?

A

Strop drug

IV fluids

Antidotre

30
Q

What bleeding value does warfarin effecr?

A

Prolongs PT which INR is derived

31
Q

What is target INR for most patients on warfarin? What if there is recurrent thromboembolism, or metal replacement heart valves?

A
  1. 5

3. 5

32
Q

How to counter warfarin?

A

Stop

5-10mg IV vit K

Give PT complex (beriplex)

33
Q

What is management of Warfarin for specific INRs?

A

<6 - reduce dose

6-8 - omit for 2 days then reduce dose

> 8 - omit and give 1-5mg oral Vit K

if INR > 5 with minor bleed = give IV vit K 1-3mg

34
Q

What are some treatments for constipation?

A

Faecal Impaction - Docusate sodium

Bulking agent - isphagula husk

Stimulant - Senna, Bisacodyl

Osmotic - Lactulose, Phosphate enema

35
Q

What is the first line antibiotic in skin infections?

A

Fluclox 500mg 6 hourly for 7 days

36
Q

When treating a raised D-dimer/pulmonary embolism wth anti-coag, what do oyu have to remember?

A

Difference between propholactic dose and treatment dose

37
Q

What are some folate antagonists?

A

trimethoprim

MTX

PSA (2 decks)

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