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Medicine > PSA > Flashcards

PSA Flashcards

1
Q

Adren Doses:
Anaphylaxis
Non-Shock

A

Adren: (Anaphylaxis):

  • < 6mo: IM 0.1-0.15mg (1:1000)
  • 6mo – 6yo: IM 0.15mg (1:1000)
  • 6-12yo: IM 0.3mg (1:1000)
  • Adult: IM 0.5mg (1:1000)

Adren: (Non-Shockable Rhythm: PEA/Asystole):
- IV 1mg (1:10,000)

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2
Q

HC (Anaphylaxis, Asthma)
Chlorpheniramine
Atropine

A

HC: 200mg (Anaphylaxis), 100mg (Asthma)
Chlorpheniramine: 10mg
Atropine: 0.5mg (Post-MI BradyC)

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3
Q

Hyperkalaemia Doses

A

Ca2+ Gluconate: 10ml (10%)

Insulin/Dextrose Infusion: (Hyperkalaemia): 10 Units Actrapid + 50ml Dextrose (50%)

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4
Q

Hypoglycaemia Doses

A
  • Conscious, Orientated: 15-20g Fast-acting Carbohydrate
  • Conscious, Disorientated: 1.5-2 tubes of Glucogel
  • Unconscious: IM Glucagon 1mg
  • Prolonged/Persistent: IV 20% Glucose 100ml (over 15mins)
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5
Q

Morphine Doses

Naloxone Doses

A

Morphine: (MI): IV 10mg (w/ IV Metacloperamide 10mg)
Naloxone: IV 0.4mg

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6
Q

Drugs prescribed in Micrograms

Drugs taken weekly

A

Digoxin
Levothyroxine

Methotrexate (Non-oncological)
Alendronate

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7
Q

Indications for Fluid Resus + Mx

A
  • Syst BP < 100
  • HR > 90
  • RR > 20
  • CRT > 2s
  • NEWS > 5

IV 0.9% NaCl 500ml over 15min

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8
Q

Routine Maintenance Fluid:
H2O
K+/Na+/Cl-
Glu

A

25-30ml/Kg/day H2O
1mmol/Kg/day K+/Na+/Cl-
100g/day Glu

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9
Q 
ADR of:
Amlodipine
Beta-blockers
ACEi
Amiodarone
A

Amlodipine: Periph Oedema

Beta-blockers: Changes in BP, BradyC, ED

ACEi: Dry Cough, Changes in BP

Amiodarone: BradyC, Pulmon Fibrosis, Thyroid Dysfunction

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10
Q 
ADR of:
Ferrous Supplements
Warfarin/Aspirin/NSAIDs
Statins
Metformin
A

Ferrous Supplements: Constipation

Warfarin/Aspirin/NSAIDs: Bleeding, Gastritis

Statins: Gastritis, Myopathy

Metformin: Lactic Acidosis

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11
Q 
ADR of:
Benzos/TCA’s/Gabapentin
Prednisolone
Phenytoin
Clozapine
Alendronate
A

Benzos/TCA’s/Gabapentin: Drowsiness, Falls

(TCA’s: Blurred vision, Dry mouth/Xerostomia)

Prednisolone: Changes in BP

Phenytoin: Skin Reactions

Clozapine: Agranulocytosis

Alendronate: Gastritis

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12
Q 
CVS Drug Montioring:
Statins
ACEi
Amiodarone
Furosemide
Anti-coags
A 
Statins (LFTs)
ACEi (U+E)
Amiodarone (TFT, LFT, Serum K+)
Furosemide (Weight)
Anti-coags (Pt reports of bruising)
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13
Q

Rheum Drug Monitoring:
Methotrexate
Azathioprine
Cyclosporin

A

Methotrexate (FBC, LFT, U+Es)
Azathioprine (TMPT/FBC, LFT)
Cyclosporin (Reg U+Es)

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14
Q

Neuro Drug Monitoring:
Lithium
Na+ Valproate

A

Lithium (Li, TFT, U+E)

Na+ Valproate (LFT)

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15
Q

Endo Drug Monitoring:
Glitazones
OCP

A

Glitazones (LFT)

OCP (BP)

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16
Q

Drugs Contraindicated in Pregnancy - 7

A 
ACEi/ARB’s
Antibiotics
Cytotoxic Agents (Azathioprine, Cyclophosphamide, Methotrexate)
Statins
Sulfonylureas (Glicazide)
Retinoids (Incl topical) 
Warfarin
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17
Q

Drugs Contraindicated in Asthma:

A

NSAIDs
Beta-blockers
Adenosine

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18
Q

Drugs Contraindicated in AKI:

A 
ACEi/ARBs, Antihypertensives, NSAIDs
Contrast
Opiates (Codeine, Morphine)
Penicillins, Aminoglycosides (Gentamicin), Sulphonamides
Immunosupp (Tacrolimus, Cyclosporin)
Allopurinol
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19
Q

Drugs Contraindicated in HF:

A

Glitazones
CCB (Amlodipine safe), Class I + II Antiarrythmics (Flecainide, Bisoprolol), Alpha-blockers
NSAIDs
Glucocorticoids (Pred, Dexamethasone, HC)

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20
Q

Drugs Causing Hyperkalaemia:

A 
K+ sparing (ACEi/ARBs, Spironolactone)
NSAIDs
Beta-blockers
Heparin
Yasmin contraception
Trimethoprim
Immunosupp (Tacrolimus, Cyclosporin)
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21
Q

Drugs Causing Hypokalaemia:

A 
Loop/Thiazides Diuretics
Insulin
Beta-Agonists, Theophyllines
Laxatives
Topiramate
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22
Q

Drugs Causing Hypernatraemia:

A

Lithium

Vit A/D

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23
Q

Drugs Causing Hyponatraemia:

A 
SSRi
TCAs
Anti-psychotics
AEDs (Carbamazepine)
ChemoTx
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24
Q

(CYP450 Inhib): (Raised INR):

A 
A: Allopurinol
O: Omeprazole
D: Disulphiram
E: Erythromycin
V: Valproate
I: Isoniazid
C: Ciprofloxacin 
E: Ethanol
S: Sulphonamides
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25
Q

(CYP450 Induc): (Lowered INR):

A 
P: Phenytoin
C: Carbamazepine
B: Barbiturates
R: Rifampicin
A: Alcohol (Chronic Excess)
S: Sulphonlyureas
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26
Q

Pre-Op Med to Stop

A 
Anti-Coag’s, Anti-platelets, NSAIDs
ACEi/ARBs, Diuretics
Lithium, MAOi
PO DM
HRT/OCP (4wks before)
ST Drugs (Vitamins)
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27
Q

Pre-Op Med to Cont

A 
Beta-blockers + other CVS drugs
AEDs
Steroids + other Immunosupp
Asthma Inhalers
PPi/H2-Antag
Thyroid Med
Anti-D, Anxiolytics, Anti-psychotics, Anti-PD
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28
Q

Serotonergic SE’s

A 
Restlessness/Agitation
Headaches
N+V
Sexual Dysfunction
Weight changes
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29
Q

Muscarinic SE’s:

A

Dry Mouth
Hot, dry, flushed skin
Urinary Retention

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30
Q

Histaminic SE’s:

A

Sedation

N+V

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31
Q

Miscellaneous Insulin Rules

A

Never Omit during Illness
If Resistant: Raise by ~ 10%
Rise in AM dose => Drop in PM BM

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32
Q

When to take Rivoroxaban

A

w/ Food

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33
Q

Alendronate Instructions

A

Before breakfast (Empty stomach)
Sat up during and after for 30mins
w/ plenty of Water
Avoid eating Food for 2hrs after + Avoid taking w/ Ca2+ Supplements (=> Reduced Absorption)

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34
Q

Beta-blocker Contras

A

w/ CCB

PVD

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35
Q

When to take Statins/Amitriptyline

A

At night before bed

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36
Q

Digoxin Monitoring

A

Measure Serum Digoxin levels 6 hourly

Monitor U+Es

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37
Q

Statin Discontinuation

A

If Serum Transaminases > 3 x Baseline

If Sx resolve: Restart at lower dose

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38
Q

CCB +

A

CCB + Pred => Worsening of HF

CCB + Naproxen => Oedema

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39
Q

SSRi Warnings, Interactions + Monitoring

A

Reduced mood in first month
+ DOAC => Bleeding
+ Tramadol => Serotonin Synd
(No routine Monitoring)

40
Q

Alendronate Interactions

A

+ Pred => Dyspepsia

+ PPi => Diarrh

41
Q

Opioid Toxicity/AKI Mx

A

Switch Morphine for Oxycodone (Semi-opioid)

42
Q

Post-Op N+V Mx

A

IV Cyclizine

43
Q

Diarrh Mx + Instructions

A

Loperamide taken as 4mg + 2mg after each loose stool (max 16mg/day)

44
Q

GTN Rules

A

Repeat after 5 mins

If no benefit after 2: Call Ambulance

45
Q

Maj Bleeding Mx

A

IV Phytomenadione (Vit K) + Prothrombin Complex

46
Q

Anti-Coag Warning + Monitoring

A

Avoid IM Injections
Recheck INR after 48hrs
(Heparin requires 6 hourly APTT)

47
Q

Carbimazole Indication + SE

A 
Graves D (HyperTh)
Neutropenia, Agranulocytosis
48
Q

Hypoglycaemia Tx

A

IV 20% Glucose 100ml (15mins)

49
Q

ATTB Tx SE

A

R+I: Accelerated metabolism of OCP
R+I+P: Hepatotoxicity
I: Periph Neuropathy (Pyridoxine)
E: Retrobulbar Neuritis

50
Q

Co-Amox SE

A

Jaundice

51
Q

Nitrofurantoin Contras

A 
eGFR < 45
3rd Trimester (Neonatal Haemolysis)
(Avoid Trimethoprim in 1st Trimester)
52
Q

Contras:
Aspirin/Heparin/Warfarin
NSAIDs

A

Aspirin/Heparin/Warfarin: Bleeding, Stroke

NSAIDs: AKI, HF, Asthma, Indigestion, Bleeding D

53
Q

Contras/SE:
Anti-HT
(Beta-blockers, CCB)
(Diuretics)

A

Anti-HT: HypoT
Beta-blockers, CCB (Verapamil/Diltazem): BradyC
Diuretics: Electrolyte disturbance, Renal Fail
(Beta-blockers: Asthma, Acute HF)
(Amlodipine: Periph Oedema)
(ACEi: Dry Cough, Hyperkalaemia)
(Loop: Gout, Hypokalaemia)

54
Q

Comm cause of Dyskinesia/PD Sx

A

Metocloperamide, Haloperidol (crosses BBB)

55
Q

Antiemetic

A

Cyclizine

56
Q

Fluid Prescribing (Maintenance)

A

Adults: 3L (1 Salty + 2 Sweet)
Elderly: 2L
(K+: 40mmol/day)

57
Q

Step-up Pain Mx

A

No Pain: No Reg, Paracetamol PRN (1g QDS)
Mild Pain: Paracetamol Reg, Codeine PRN (30mg QDS)
Severe Pain: Co-codamol Reg, Morphine PRN (10mg QDS)

58
Q

Insulin Route

A 
All SC
Except SA (Novorapid, Actrapid)
59
Q

AF Types Mx

A

Slow AF: Rhythm Control (Amiodarone, Beta-blocker, DC - If < 48hrs)
Fast AF: Rate Control (Beta-blocker - Contra: Asthma, CCB - Contra: Fluid retention, Digoxin)

60
Q

1st Line Hypnotic (Insomnia)

A

Zopiclone

61
Q

Grams in 1% sol

A

1g in 100ml

10mg in 1ml

62
Q

PE 1st Line Tx

A

SC Dalteparin

63
Q

Mild Pain in ACS

A

SL GTN

64
Q

1st Line Tx for lowering Hyperkalaemia

A

IV Actrapid 10 Units in 100ml of Dextrose 20% over 30mins

65
Q

1st line Diabetic control

A

If Overweight: Metformin

If Underweight/Cr > 150: Gliclazide

66
Q

Statin monitoring

A

ALT (Baseline, 3 months, 12 months)

If Myopathy Risk Factors: CK

67
Q

Lithium Monitoring

A

Serum conc should be measured 12hrs after last dose
Lithium levels can be affected by Dietary Sodium Intake
Lithium levels should be checked weekly at start and after each dose change then 3 monthly

68
Q

Methotrexate monitoring

A 
Baseline LFT monitoring
FBC monitoring (Once stable every 2-3 months) - Drop in WBC/RBC/Plt => Stop Methotrexate
69
Q

Amiodarone monitoring

A

Baseline CXR
TFTs, LFTs
(Caution in Pt’s w/ Hypokalaemia)

70
Q

Carbimazole monitoring

A

FBC (esp Neutrophil Count)

71
Q

Gentamicin monitoring

A

For a multiple daily dosing regimen: Pre and Post dose levels should be monitored
Renally excreted => Renal monitoring

72
Q

Digoxin monitoring

A 
Serum Cr (Renally excreted)
Serum digoxin levels only needed if: Toxicity, Non-compliance, Inadequate Effect
73
Q

Na+ Valproate monitoring

A

Serum LFTs

+/- => Pancreatitis: Amylase/Lipase

74
Q

Clozapine monitoring

A

FBC Weekly for 18wks

75
Q

Drugs with narrow Therapeutic window

A

Warfarin
Digoxin
Phenytoin

76
Q

Common ADR of:
Beta-agonists
Beta-blockers

A

Beta-agonists: TachyC/HyperT, Heat Intolerance, Tremor

Beta-blockers: BradyC/HypoT, Cold Intolerance, Fatigue

77
Q

Warfarin Interactions

A

Erythromycin, Clarithromycin (CYP450 Inhib) => Raised INR

78
Q

Aspirin in AKI/Surg

Co-codamol in AKI

A

Aspirin can continue (Should be stopped in Surg)

Co-codamol cannot

79
Q

Drugs interacting w/ Lithium

A

Lithium affected by NSAIDs/Diuretics/ACEi

If Diuretic needed: Furosemide safest

80
Q

Dose adjustment Rules

A

Amend doses by least amount

81
Q

Fluid guidelines

A

2 Salty + 1 Sweet
If High Na+: Give Dextrose, If Low Na+: Give NaCl
Never give KCl > 20mmmol/hr

82
Q

DM control w/ CKD

A

Sulphonylureas safer than Metformin

83
Q

Vent Mx:
T1RF
T2RF

A

T1RF: CPAP
T2RF: BPAP

84
Q

HypoT after Fluid Bolus given Mx

A

IV Colloid (Gelofusine)

85
Q

Statin interaction w/ Clarithromycin

A

Stop Statin

86
Q

Sign of Pneumonia Resolution

A

SpO2

RR

87
Q

SSRi Monitoring

A

Suicide Assessment

88
Q

Tacrolimus Monitoring

A

Pre-dose levels

89
Q

ABx Prescribing

A

Requires Indication + Duration (R/v day)

90
Q

Prescribing Timings

A

If given nightly (Statin, Senna)

91
Q

Pain Mx

A

If constant: Regular Meds, If Variable: PRN

Start Mild + Titrate up

92
Q

Cyclizine SE’s

Acetylcholinesterase Inhib SE’s

A

Cyclizine: Antimuscarinic (Anti-SLUDGE)
AChi: Cholinergic Crisis (SLUDGE)

93
Q

Mild Allergy Mx

A

PO Chlorpheniramine

94
Q

Raised INR w/ Bleeding

A

IV Vit K (Slow Infusion)

95
Q

HF (w/ Asthma)

A

ACEi (taken at night)

Medicine (13 decks)

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