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PSA > PSA > Flashcards

PSA Flashcards

1
Q

mnemonic for review

A

P - patient details
Re - reactions/allergies
S - sign
C - contraindications
R - route
I - IV fluids?
B - blood clot proph
E - emetic (anti)
R - relief (pain)

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2
Q

what drugs need to be stopped before surgery and when

A

I LACK OP
insulin - variable
lithium - day before
antiplatelets/coagulants - variable
COCP/HRT - 4 weeks before
K sparing antidiuretics - day of

oral hypoglycaemics
Perindopril + ACEi

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3
Q

name some enzyme inducers = drugs conc decrease

A

PC BRAS
phenytoin
carbamezapine
barbituates
rifampicin
alcohol chronic
sulphonylureas

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4
Q

name some enzyme inhibitors = drug conc increase

A

AO DEVICES
allopurinol
omeprazole
disulfuram
erythromycin
valproate
isoniazid
ciprofloxacin
ethanol
sulphonamides

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5
Q

what 4 groups of drugs are commonly contraindicated and why

A
  1. anticoagulants in active bleeding
  2. steroids
    Stomach ulcers
    Thin skin
    Edema
    Right/left HF
    Osteoporosis
    Infection
    Diabetes
    Syndrome Cushings
    3.NSAIDS
    No urine
    Systolic dysfunction
    Asthma
    Indigestion
    Dyscrasia
  3. antihypertensives
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6
Q

describe the common side effects of antihypertensives

A
  1. bradycardias (BB, CCB)
  2. electrolyte disturbances (ACEi/diuretics)
  3. specific SEs
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7
Q

when should IV normal saline NOT be given

A

hypernatraemic or hypoglycaemic
= give 5% dextrose

ascites = give human albumin sollution

shock from haemorrhage = give blood

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8
Q

what rate should IV potassium be given

A

no more than 10mmol/hour

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9
Q

how much fluids and potassium do adults generally need

A

3L per 24hrs
elderly 2L per 24hrs
40mmol KCl per dayw

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10
Q

what antiemetics to give a nauseated patient

A

cyclizine 50mg 8 hourly (causes fluid retention)
metoclopromide 10mg 8 hrly
ondansetron 4mg 8 hourly

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11
Q

what antiemetics to give a NON nauseated patient

A

cyclizine 50mg 8 hrly
metoclopromide 10mg 8 hrly

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12
Q

who should NOT get metoclopramide

A

pt with parkinsons
young women
= dyskinesia

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13
Q

what analgesic is first line in neuropathic pain

A

amitriptyline or pregabalin

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14
Q

what antihypertensives cause hypERkalaemia + other causes

A

ARBs and ACEi
renal failure
addisons
DKA

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15
Q

what antihypertensives cause hypOkalaemia + other causes

A

thiazide diuretics
loop diuretics
D+V
renal tubular acidosis
conns/cushings

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16
Q

what drugs can cause renal impairment

A

NSAIDs
ACEi
lithium
immunosuppressants

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17
Q

what drugs should you be careful of in the elderly - confusion etc

A

oxybutinin
opioids
cyclizine
benzodiazepines

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18
Q

what drugs need to be stopped in infection

A

methotrexate

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19
Q

causes of normocytic anaemia

A

chronic disease
acute blood loss
haemolytic anaemia
renal failure

20
Q

causes of macrocytic anaemia

A

B12/folate def anaemia
excess alcohol
liver disease

21
Q

causes of low neutrophils

A

viral infection
clozapine
carbimazole

22
Q

causes of SIADH

A

small cell lung tumours
infection
abscess
drugs - carbamezapine and antipsychotics
head injury

23
Q

name 3 nephrotoxic antibiotics

A

gentamycin
vancomycin
tetracyclines

24
Q

what does it indicate if there is a urea rise&raquo_space; creatinine risk

A

pre-renal AKI

25
Q

what does it indicate if there is a urea rise &laquo_space;creatinine rise

A

intrinsic renal AKI
postrenal

26
Q

what does a raised urea but normal creatinine indicate

A

upper GI bleed !!

27
Q

what does a raised bilirubin but normal LFTs suggest

A

prehepatic
= haemolysis

28
Q

what does a raised bilirubin + raised AST/ALT suggest

A

intrahepatic
= hepatitis
= cirrhosis
= malignancies

29
Q

what does a raised bilirubin and raised ALP suggest

A

posthepatic
= stones
= tumours

30
Q

what is the target TSH level

A

0.5 -5

31
Q

things to check when looking at ABG

A

FiO2 - if patient on O2 - 10 from %
PaO2 should be higher
if not pt = hypoxic

32
Q

what drugs have a narrow therapeutic index so need close monitoring

A

digoxin
theophylline
lithium
phenytoin
gentamycin/vancomycin

33
Q

what drugs can affect sleep

A

corticosteroids = give in morning

34
Q

how to prescribe for short term insomnia

A

good sleep hygiene
CBT
hypnotics = lowest dose for shortest time
zopiclone 7.5mg once daily at bedtime (half dose in elderly)

35
Q

what is:
femodette
zoely
katya 30/75
microgynon 30 ED

A

COCP

36
Q

what is climanor

A

progesterone only contraceptive

37
Q

what contraceptives can NOT be used if taking carbamezapine

A

COCP because oral = enzyme inducers will affect it
take sayana press instead = parenteral route

38
Q

management of HTN in pregnancy

A

stop ACEi before pregnancy
labetalol is first line

39
Q

what to be communicated about tamoxifen

A

VTE risk, look out for signs

40
Q

what to communicate about gliclazides

A

take in the morning with breakfast
dont miss meals = risk of hypos

41
Q

what to communicate about methotrexate

A

take once a week
1-2 weekly blood tests for FBC
take folic acid to limit toxicity

42
Q

describe warfarin tablets

A

0.5mg = white
1mg = brown
3mg = blue
5mg = pink

43
Q

what to communicate about ACEi

A

1-2 weeks after starting = U+Es
caution taken when vomiting or diarrhoea = risk of AKI

44
Q

what to communicate about steroids

A

increases risk of hyperglycaemia
increase risk of OP = need bisphosph
increased risk of gastric irritation
never stop suddenly = addisonian crisis
increased risk of HTN

45
Q

what to communicate about SSRIs

A

citalopram = more sensitive to sunlight
caution about suicidal ideation
fever, agitation and hallucinations = seratonin syndrome

46
Q

can alendronic acid and calcium be taken at the same time

A

no
calcium reduces the uptake of bisphosphonates

47
Q

what to communicate about HRT

A

increased risk relates to duration of use
risk returns to non HRT levels after 5 years of stopping

PSA (1 decks)

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