PSA Flashcards
mnemonic for review
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)
what drugs need to be stopped before surgery and when
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
name some enzyme inducers = drugs conc decrease
PC BRAS
phenytoin
carbamezapine
barbituates
rifampicin
alcohol chronic
sulphonylureas
name some enzyme inhibitors = drug conc increase
AO DEVICES
allopurinol
omeprazole
disulfuram
erythromycin
valproate
isoniazid
ciprofloxacin
ethanol
sulphonamides
what 4 groups of drugs are commonly contraindicated and why
- anticoagulants in active bleeding
- steroids
Stomach ulcers
Thin skin
Edema
Right/left HF
Osteoporosis
Infection
Diabetes
Syndrome Cushings
3.NSAIDS
No urine
Systolic dysfunction
Asthma
Indigestion
Dyscrasia - antihypertensives
describe the common side effects of antihypertensives
- bradycardias (BB, CCB)
- electrolyte disturbances (ACEi/diuretics)
- specific SEs
when should IV normal saline NOT be given
hypernatraemic or hypoglycaemic
= give 5% dextrose
ascites = give human albumin sollution
shock from haemorrhage = give blood
what rate should IV potassium be given
no more than 10mmol/hour
how much fluids and potassium do adults generally need
3L per 24hrs
elderly 2L per 24hrs
40mmol KCl per dayw
what antiemetics to give a nauseated patient
cyclizine 50mg 8 hourly (causes fluid retention)
metoclopromide 10mg 8 hrly
ondansetron 4mg 8 hourly
what antiemetics to give a NON nauseated patient
cyclizine 50mg 8 hrly
metoclopromide 10mg 8 hrly
who should NOT get metoclopramide
pt with parkinsons
young women
= dyskinesia
what analgesic is first line in neuropathic pain
amitriptyline or pregabalin
what antihypertensives cause hypERkalaemia + other causes
ARBs and ACEi
renal failure
addisons
DKA
what antihypertensives cause hypOkalaemia + other causes
thiazide diuretics
loop diuretics
D+V
renal tubular acidosis
conns/cushings
what drugs can cause renal impairment
NSAIDs
ACEi
lithium
immunosuppressants
what drugs should you be careful of in the elderly - confusion etc
oxybutinin
opioids
cyclizine
benzodiazepines
what drugs need to be stopped in infection
methotrexate
causes of normocytic anaemia
chronic disease
acute blood loss
haemolytic anaemia
renal failure
causes of macrocytic anaemia
B12/folate def anaemia
excess alcohol
liver disease
causes of low neutrophils
viral infection
clozapine
carbimazole
causes of SIADH
small cell lung tumours
infection
abscess
drugs - carbamezapine and antipsychotics
head injury
name 3 nephrotoxic antibiotics
gentamycin
vancomycin
tetracyclines
what does it indicate if there is a urea rise»_space; creatinine risk
pre-renal AKI
what does it indicate if there is a urea rise «_space;creatinine rise
intrinsic renal AKI
postrenal
what does a raised urea but normal creatinine indicate
upper GI bleed !!
what does a raised bilirubin but normal LFTs suggest
prehepatic
= haemolysis
what does a raised bilirubin + raised AST/ALT suggest
intrahepatic
= hepatitis
= cirrhosis
= malignancies
what does a raised bilirubin and raised ALP suggest
posthepatic
= stones
= tumours
what is the target TSH level
0.5 -5
things to check when looking at ABG
FiO2 - if patient on O2 - 10 from %
PaO2 should be higher
if not pt = hypoxic
what drugs have a narrow therapeutic index so need close monitoring
digoxin
theophylline
lithium
phenytoin
gentamycin/vancomycin
what drugs can affect sleep
corticosteroids = give in morning
how to prescribe for short term insomnia
good sleep hygiene
CBT
hypnotics = lowest dose for shortest time
zopiclone 7.5mg once daily at bedtime (half dose in elderly)
what is:
femodette
zoely
katya 30/75
microgynon 30 ED
COCP
what is climanor
progesterone only contraceptive
what contraceptives can NOT be used if taking carbamezapine
COCP because oral = enzyme inducers will affect it
take sayana press instead = parenteral route
management of HTN in pregnancy
stop ACEi before pregnancy
labetalol is first line
what to be communicated about tamoxifen
VTE risk, look out for signs
what to communicate about gliclazides
take in the morning with breakfast
dont miss meals = risk of hypos
what to communicate about methotrexate
take once a week
1-2 weekly blood tests for FBC
take folic acid to limit toxicity
describe warfarin tablets
0.5mg = white
1mg = brown
3mg = blue
5mg = pink
what to communicate about ACEi
1-2 weeks after starting = U+Es
caution taken when vomiting or diarrhoea = risk of AKI
what to communicate about steroids
increases risk of hyperglycaemia
increase risk of OP = need bisphosph
increased risk of gastric irritation
never stop suddenly = addisonian crisis
increased risk of HTN
what to communicate about SSRIs
citalopram = more sensitive to sunlight
caution about suicidal ideation
fever, agitation and hallucinations = seratonin syndrome
can alendronic acid and calcium be taken at the same time
no
calcium reduces the uptake of bisphosphonates
what to communicate about HRT
increased risk relates to duration of use
risk returns to non HRT levels after 5 years of stopping
