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Phase 4 (finals) > PSA > Flashcards

PSA Flashcards

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1
Q

Drugs that exacerbate psoriasis

A

beta blockers
lithium
antimalarials (chloroquine and hydroxychloroquine)
NSAIDs
ACE inhibitors
infliximab

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2
Q

Levothyroxine initial starting dose for those with cardiac disease, severe hypothyroidism or patients over 50 years

A

25mcg od with dose slowly titrated

(other patients should be started on a dose of 50-100mcg od)

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3
Q

When should TFTs be taken following a change in thyroxine dose

A

After 8-12 weeks

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4
Q

Therapeutic goal TSH value

A

0.5-2.5 mU/l

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5
Q

Levothyroxine dose increase for women with established hypothyroidism who become pregnant

A

At least 25-50 micrograms

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6
Q

4 side effects of thyroxine therapy

A

hyperthyroidism: due to over treatment
reduced bone mineral density
worsening of angina
atrial fibrillation

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7
Q

Thyroxine interactions

A

iron
calcium carbonate

(give 4 hours apart)

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8
Q

signs of hypoglycaemia

A

sweating, anxiety, blurred vision, confusion, aggression

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9
Q

drug that reduces hypoglycaemic awareness

A

Beta blockers

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10
Q

antibiotics C/I in pregnancy

A

tetracyclines
aminoglycosides
sulphonamides and trimethoprim
quinolones

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11
Q

drugs C/I in pregnancy

A

ACE inhibitors, angiotensin II receptor antagonists
statins
warfarin
sulfonylureas
retinoids (including topical)
cytotoxic agents
some antibiotics (see card)

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12
Q

BNF advice on how to take oral bisphosphonates

A

swallowed whole with plenty of water while sitting or standing
to be taken on an empty stomach at least 30 minutes before breakfast (or another oral medicine)
patient should stand or sit upright for at least 30 minutes after taking tablet’.

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13
Q

1st line therapy for chronic heart failure

A

ACE-inhibitor
Beta-blocker e.g. Bisoprolol, carvedilol, nebivolol

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14
Q

2nd line therapy for chronic heart failure

A

Aldosterone antagonist e.g. spironolactone and eplerenone

(Monitor potassium)

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15
Q

UKMEC3

A

more than 35 years old and smoking less than 15 cigarettes/day
BMI > 35 kg/m^2*
family history of thromboembolic disease in first degree relatives < 45 years
controlled hypertension
immobility e.g. wheel chair use
carrier of known gene mutations associated with breast cancer (e.g. BRCA1/BRCA2)
current gallbladder disease

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16
Q

UKMEC 4

A

more than 35 years old and smoking more than 15 cigarettes/day
migraine with aura
history of thromboembolic disease or thrombogenic mutation
history of stroke or ischaemic heart disease
breast feeding < 6 weeks post-partum
uncontrolled hypertension
diabetes diagnosed > 20 years
current breast cancer
major surgery with prolonged immobilisation
positive antiphospholipid antibodies (e.g. in SLE)

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17
Q

Medications contraindicated in heart failure

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 has a negative inotropic and proarrhythmic effect)

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18
Q

Croup treatment

A

single dose of oral dexamethasone (0.15mg/kg) to all children regardless of severity

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19
Q

2 adverse affects of gentamicin

A

Ototoxicity
Nephrotoxicity

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20
Q

Gentamicin C/I condition

A

Myasthenia gravis

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21
Q

Gentamicin dosing

A

both peak (1 hour after administration) and trough levels (just before the next dose) are measured

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

Infective endocarditis: peak 3-5mg/litre, trough < 1mg/litre

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22
Q

Management of SVT

A

1st: vagal manoeuvres
2nd: IV adenosine
rapid IV bolus of 6mg → if unsuccessful give 12 mg → if unsuccessful give further 18 mg

contraindicated in asthmatics - verapamil is a preferable option

23
Q

2 types of loop diuretics

A

Furosemide
bumetanide

24
Q

Angina prevention management

A

Beta blocker e.g. ATENOLOL 100 MG PO OD

Asthma: calcium channel blocker e.g. verapamil or diltiazem

25
Q

2 medications prescribed weekly

A

Bisphosphonates
Methotrexate

26
Q

Important adverse affect of carbimazole

A

agranulocytosis

(check FBC with sore throat)

27
Q

drugs allowed during breastfeeding

A

antibiotics: penicillins, cephalosporins, trimethoprim
endocrine: glucocorticoids (avoid high doses), levothyroxine*
epilepsy: sodium valproate, carbamazepine
asthma: salbutamol, theophyllines
psychiatric drugs: tricyclic antidepressants, antipsychotics**
hypertension: beta-blockers, hydralazine
anticoagulants: warfarin, heparin
digoxin

28
Q

drugs C/I during breastfeeding

A

antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides
psychiatric drugs: lithium, benzodiazepines
aspirin
carbimazole
methotrexate
sulfonylureas
cytotoxic drugs
amiodarone

29
Q

% O2 before ABG availability

A

28% Venturi mask at 4 L/min

30
Q

O2 saturation targets

A

Acutely ill patient: 94-98%
Risk of hypercapnia/before ABG: 88-92%

31
Q

Carbimazole vs Carbmazepine

A

carbimazole = antithyroid
carbmazepine = antiepileptic

32
Q

Chlorphenamine vs Chlorpromazine

A

Chlorphenamine = antihistamine
Chlorpromazine = antipsychotic

33
Q

Meds usually taken at night

A

Statins
Amitriptyline

34
Q

3 drugs to use with caution in asthma

A

NSAIDs
Beta blockers
Adenosine

35
Q

Situations where oxygen therapy should not be used routinely if there is no evidence of hypoxia

A

myocardial infarction and acute coronary syndromes
stroke
obstetric emergencies
anxiety-related hyperventilation

36
Q

oxygen for critically ill patients e.g. anaphylactic shock

A

reservoir mask at 15 l/min

37
Q

The following drugs should be used with caution in patients with ischaemic heart disease

A

NSAIDs
oestrogens: e.g. combined oral contraceptive pill, hormone replacement therapy
varenicline

38
Q

Drug inducers of the P450 system include
(INR will decrease)

A

antiepileptics: phenytoin, carbamazepine
barbiturates: phenobarbitone
rifampicin
St John’s Wort
chronic alcohol intake
griseofulvin
smoking (affects CYP1A2, reason why smokers require more aminophylline)

39
Q

Drugs which decrease serum potassium

A

Thiazide diuretics
Loop diuretics
Acetazolamide

40
Q

Drugs which increase serum potassium

A

ACE inhibitors
Angiotensin-2 receptor blockers
Spironolactone

41
Q

Oral morphine dose for breakthrough pain

A

1/6 of total oral morphine dose

look out for BD/TDS/QDS total dose before finding 1/6

42
Q

What should verapamil never be prescribed with?

A

Beta blockers

due to risk of heart block

43
Q

Analgesics common drug doses

A

Paracetamol 1g qds
Ibuprofen 200-400mg tds
Codeine 30-60mg qds
Co-codamol 8/500
Co-codamol 30/500 2 tabs qd

44
Q

Antiemetics common drug doses

A

Cyclizine 50mg tds
Metoclopramide 10mg tds

45
Q

Antibiotics common drug doses

A

Amoxicillin 500mg tds
Clarithromycin 500mg bd

46
Q

PPI common drug doses

A

Lansoprazole 15-30mg od
Omeprazole 20-40mg od

47
Q

CVD common drug doses

A

Aspirin 75-300mg od
Clopidogrel 75-300mg od
Simvastatin 10-80mg on
Atenolol 25-100mg od
Ramipril 1.25-10mg od
Bendroflumethiazide* 2.5mg od
Furosemide 20mg od - 80mg bd**
Amlodipine 5-10mg od

48
Q

Levothyroxine drug dose range

A

25-200mcg od

49
Q

Metformin drug dose range

A

500mg od - 1g bd

50
Q

Asthma patients who are at increased risk of NSAID sensitivity

A

Nasal polyps and middle aged

51
Q

Lithium therapeutic drug monitoring

A

range = 0.4 - 1.0 mmol/l
take 12 hrs post-dose

52
Q

Ciclosporin therapeutic drug monitoring

A

trough levels immediately before dose

53
Q

Digoxin therapeutic drug monitoring

A

at least 6 hrs post-dose

54
Q

When do steroids need to be gradually withdrawn

A

received more than 40mg prednisolone daily for more than one week
received more than 3 weeks treatment
recently received repeated courses

Phase 4 (finals) (19 decks)

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