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Kim's Drug List > PSA > Flashcards

PSA Flashcards

1
Q

Enzyme inducers

A

[Decrease drug] PCBRATS

  • Phenytoin
  • Carbamazepine
  • Barbituates
  • Rifampicin
  • Alcohol chronic
  • Toprimate
  • Sulphonylureas (stimulates pancreatic insulin secretion)

COCP affected by these

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2
Q

Enzyme inhibitors

A

[Increase drug] AODEVICES

  • Allopurinol
  • Omeprazole
  • Disulfiram (adjunct in alcohol dependence treatment)
  • Erythromycin
  • Valproate
  • Isoniazid
  • Ciprofloxacin
  • Ethanol acute
  • Sulphonamides (abs)/ Sertraline
  • Grapefruit & Ketoconazole
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3
Q

Medication to stop before surgery

A

I LACK OP

  • Insulin: continue long acting at lower dose. Stop short acting until E&D. Variable rate needed in theatre
  • Lithium: Day before
  • Anticoagulants/ Antiplatelets
  • COCP/HRT: 4 weeks before
  • K sparing/ ACEi: Day of
  • Oral hypoglycaemic
  • Perindopril
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4
Q

a) Metformin SE in context of surgery
b) When is metformin contraindicated?

A

a) Lactic acidosis particularly in renal failure
b) Significant renal impairment or acutely unwell

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5
Q

SGLT 2 inhibitors SE in context of surgery

A

DKA

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6
Q

Drugs/Conditions causing hyperkalemia

A
  • ACEi
  • Potassium sparing
  • Deltaparin

DREAD

  • Drugs
  • Renal failure
  • Endocrine (Addison’s)
  • Artefact (clot)
  • DKA
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7
Q

Drugs/ Conditions causing HYPOkaleamia

A
  • Thiazides
  • Loop diuretics

DIRE

  • Drugs
  • Inadequate intake
  • RTA
  • Endocrine (Cushing’s/ Conn’s- hyperaldosternism on principle cells causing K+ out and Na+ in
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8
Q

Drug class causing gynaecomastia

A

Potassium sparing

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9
Q

Drug class causing gout

A

Thiazide diuretics

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10
Q

What antiemetic should you avoid in PD and young women

A

Metoclopramide due to dyskinesia

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11
Q

What DMARD should be withheld in active infection

A

Methotrexate

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12
Q

Drugs causing low neutrophils

A

Clozapine & Carbimazole

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13
Q

Digoxin toxicity

A

Confusion, Nausea, Visual halos, Arrythmia

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14
Q

Lithium toxicity

A

Early: Tremor

Intermediate: Tiredness

Late: Arrhythmia (T wave inversion/ flatten), Seizure, Coma, Renal failure, DI

Precipitated by: Dehydration; Renal failure; Diuretics (especially thiazides), ACE inhibitors/angiotensin II receptor blockers, NSAIDs and metronidazole.

Measure levels 12hrs after dose

Monitor:

Before: BMI, U&E, FBC

Every 6m: BMI, U&E & eGF (Renal function), Thyroid

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15
Q

Phenytoin toxicity

A
  • Gum hypertrophy
  • Ataxia
  • Nystagmus
  • Peripheral neuropathy
  • Teratrogenicity
  • Hepatotoxicity

Monitoring trough levels just before dose if: dose change, toxicity, non-adherence

In epilepsy: Fluroquinolones worsen it

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16
Q

Gentamicin and Vancomycin toxicity

A

Ototoxicity & Nephrotoxicity

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17
Q

INR deranged what do you do?

A

Major bleed: Stop warfarin, Give Bit K 5-10mg IV, Give PT

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18
Q

Common side effects of Lamotrigine

A
  • Rash
  • (SJS)
19
Q

Common side effects of Carbamazepine

A
  • Rash
  • Dysarthria
  • Ataxia
  • Nystagmus
  • Low sodium
20
Q

Sodium valproate SE

A

Tremor

Teratogenic

Weight gain

21
Q

Levetiracetam

A

Fatigue

Mood disorder

Agitation

22
Q

What is 1%

A

1g in 100mL or 10mg in 1mL

23
Q

What is the monitoring for statins

A
  • Before: Lipids including triglycerides, TSH, U&E, LFT, CK in patients who have muscle pain, HbA1c for DM
  • During: LFT 3m &12m for signs of hepatotoxicity, HbA1c 3m

Monitoring requirement is usually about LFT you need this!

24
Q

What must you check before prescribing vancomycin?

A

CK levels, clearance reduced in renal failure

25
SE of Heparin
Haemorrhage & HIT
26
Side effect of statins
Myalgia, Rhabdomyolysis
27
SE of Amiodarone
ILD (pulmonary fibrosis), Thyroid disease, Skin greying, Corneal deposits
28
Causes of low sodium
* Fluid loss * Diuretics (all) * Addison's * SSRI * SIADH * Carbamazepine → SIADH * Renal * Heart failure * Sulfonylureas
29
Drugs contraindicated in asthmatics
NSAIDS, Beta blockers
30
Drugs affected by CYP
* Statins * Warfarin * COCP
31
Methotrexate monitoring requirements
FBC, U&E, LFT ever 1-2w until stabilised then 2-3m. Monitor for signs of infection
32
Asthmatic patient in AF what do you give?
CCB with rate control eg: Diltiazem/ Verapamil Do NOT give: NSAIDs, Beta Blocker or Adenosine
33
Hyperkalaemia, First drug to lower potassium
10 units of a short-acting insulin (e.g. ACTRAPID) alongside dextrose (e.g. 50 ml 50% or 100 ml 20%) over 30 minutes. Plasma potassium should be checked 30 minutes following the infusion via a venous blood gas and formal U&Es checked 1-2 hours later.
34
What would stop you using metformin first line
* Under/normal weight patient * Creatinine of \>150 mmol/L
35
Drugs that commonly cause urinary retention
Opioids Anticholinergics Anaesthetics Alpha 1 agonist BDZ NSAID CCB Antihistamines
36
Gentamicin dosing
Major determinant is the concentration POST dose * if the trough (pre-dose) level is high the interval between the doses should be increased * if the peak (post-dose) level is high the dose should be decreased
37
Medicine contraindicated in HF
* thiazolidinediones * pioglitazone is contraindicated as it causes fluid retention * verapamil * negative inotropic effect * NSAIDs/glucocorticoids * should be used with caution as they cause fluid retention * low-dose aspirin is an exception - many patients will have coexistent cardiovascular disease and the benefits of taking aspirin easily outweigh the risks * class I antiarrhythmics * flecainide (negative inotropic and proarrhythmic effect)
38
Drugs usually prescribed weekly
Methotrexate Alendronic acid
39
When do you need to do gradual withdrawal of corticosteroids?
* \>40mg/day for 1 week * \>3w of treatment * Recently received repeated courses
40
Potentiated warfarin
* Liver disease * CYP450 enzyme inhibitors * Cranberry juice * NSAIDs
41
Avoid in breastfeeding
42
What may worsen seizure control in epilepsy?
* Alcohol, Cocaine, Amphetamines * Ciprofloxacin, Levo * Aminophylline, Theo * Bupropion * Methylphenidate * Mefanamic acid
42
ACE inhibitors
* Small rise in creatinine \<20% expected and ok, do not need to change prescription

Kim's Drug List (9 decks)

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