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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
Q

SE of Heparin

A

Haemorrhage & HIT

26
Q

Side effect of statins

A

Myalgia, Rhabdomyolysis

27
Q

SE of Amiodarone

A

ILD (pulmonary fibrosis), Thyroid disease, Skin greying, Corneal deposits

28
Q

Causes of low sodium

A
  • Fluid loss
  • Diuretics (all)
  • Addison’s
  • SSRI
  • SIADH
  • Carbamazepine → SIADH
  • Renal
  • Heart failure
  • Sulfonylureas
29
Q

Drugs contraindicated in asthmatics

A

NSAIDS, Beta blockers

30
Q

Drugs affected by CYP

A
  • Statins
  • Warfarin
  • COCP
31
Q

Methotrexate monitoring requirements

A

FBC, U&E, LFT ever 1-2w until stabilised then 2-3m.

Monitor for signs of infection

32
Q

Asthmatic patient in AF what do you give?

A

CCB with rate control eg: Diltiazem/ Verapamil

Do NOT give: NSAIDs, Beta Blocker or Adenosine

33
Q

Hyperkalaemia, First drug to lower potassium

A

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
Q

What would stop you using metformin first line

A
  • Under/normal weight patient
  • Creatinine of >150 mmol/L
35
Q

Drugs that commonly cause urinary retention

A

Opioids

Anticholinergics

Anaesthetics

Alpha 1 agonist

BDZ

NSAID

CCB

Antihistamines

36
Q

Gentamicin dosing

A

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
Q

Medicine contraindicated in HF

A
  • 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
Q

Drugs usually prescribed weekly

A

Methotrexate

Alendronic acid

39
Q

When do you need to do gradual withdrawal of corticosteroids?

A
  • >40mg/day for 1 week
  • >3w of treatment
  • Recently received repeated courses
40
Q

Potentiated warfarin

A
  • Liver disease
  • CYP450 enzyme inhibitors
  • Cranberry juice
  • NSAIDs
41
Q

Avoid in breastfeeding

A
42
Q

What may worsen seizure control in epilepsy?

A
  • Alcohol, Cocaine, Amphetamines
  • Ciprofloxacin, Levo
  • Aminophylline, Theo
  • Bupropion
  • Methylphenidate
  • Mefanamic acid
42
Q

ACE inhibitors

A
  • Small rise in creatinine <20% expected and ok, do not need to change prescription

Kim's Drug List (9 decks)

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