PSA Flashcards
what class of drug is gliclazide?
sulfonylurea
if trough levels of gentamicin are raised what action needs to be taken?
increase interval between doses
if the peak concentration of gentamicin is high then how should the dose be altered?
reduce the dose
what should be monitored during gentamicin treatment ?
auditory and vestibular function (and renal function)
in a multiple daily dose gentamicin regimen (that is not for endocarditis) what should the peak and trough concentrations be?
peak 5-10
trough less than 2
what time of day are statins taken?
at night
what time of day is amitriptyline taken?
at night
what class of drug is gentamicin?
aminoglycoside
How does gentamicin work?
impairs ability of bacteria to produce proteins
is gentamicin safe in pregnancy
no- may cause otoxicity in fetus
What neuromuscular condition is gentamicin contraindicated in?
myasthenia gravis- may impair neuromuscular transmission
How are aminoglycosides such as gentamicin excreted?
renally
A patient with normal renal function is started on gentamicin, when should we measure their gentamicin concentrations?
After 3 or 4 doses of a multiple daily dose regimen or after a dose change
when do you need to take a blood sample to get a peak gentamicin level?
1 hour after administration
when do you need to take a blood sample to get a trough gentamicin level?
just before the next dose
what should be assessed before starting treatment with an aminoglycoside like gentamicin?
renal function
what is the difference between a NSTEMI and unstable angina?
presence of myocardial necrosis
What may an ECG look like in an NSTEMI?
ST-segment depression, T wave inversion, may be normal!
A patient has chest pain at rest with a normal ECG- how might we differentiate between NSTEMI and unstable angina?
serum troponin
what should be offered in terms of pain relief for a patient with suspected ACS?
glyceryl trinitrate and IV morphine
what is the loading dose of aspirin in ACS?
300mg
what dose of aspirin should most people be on indefinitely following an ACS?
75mg
what common combinations are given as dual antiplatelet therapy following an ACS for up to 12 months?
aspirin plus another antiplatelet such as clopidogrel, ticagrelor or prasugrel
what is the hallmark of a near fatal episode of acute asthma?
raised PaC02
In all cases of acute asthma, what steroid should be given orally?
prednisolone
a peak flow of 33-50% of best or predicted but no other symptoms would put a patient into which severity category of acute asthma?
severe
when treating Helicobacter pylori, what does the triple treatment regimen consist of?
A PPI and two antibacterials e.g omeprazole plus amoxicillin and clarithromysin
what is the first line choice for prophylaxis in close contacts of a person with meningococcal disease?
ciprofloxacin
what is the first line choice for prophylaxis in close contacts of a person with haemophilus influenzae type b (Hib)?
rifampicin
where in the BNF would you find a treatment summary for antibiotic prophylaxis?
‘Antibacterials, use for prophylaxis’
what is the principal side effect of cephalosporins?
hypersensitivity in patients with penicillin allergy
what type of antibiotic is cefotaxime ?
third generation cephalosporin
what type of antibiotic is erythromysin?
macrolide
when is erythromycin contraindicated?
Inn patients with Hx of ventricular arrythmia, electrolyte disturbances or Hx of QT prolongation
what type of antibiotic is doxycycline?
tetracycline
what is penicillin G?
benzylpenicillin sodium
what is the route for benzylpenicillin sodium?
injection (inactivated by gastric acid)
What is penicillin V?
phenoxymethylpenicillin
what does co-amoxiclav consist of?
amoxicillin plus clavulanic acid
what is clavulanic acid?
betalactamase inhibitor
What is piperacillin always combined with?
tazobactam
What treatment might you offer to a patient with localised non-bullous impetigo who is systemically well and not at risk of complications?
hydrogen peroxide 1% cream
what is oral first line in impetigo?
flucloxacillin
what is first line antibiotic for treatment of bites?
co-amoxiclav
what type of antibiotic is ciprofloxacin?
quinolone
why should quinolones generally be avoided in children?
children are at a higher risk of tendon rupture and tendinitis (adults are also at risk of this)
what do quinolones double the risk of a patient developing within 60 days of administration?
aortic aneurysm and dissection
which class of antibiotic can cause suicidal thoughts and psychosis?
quinolones
how may ciprofloxacin affect someone with a history of seizures?
increase seizure risk
what class of antibiotic is levofloxacin?
quinolone
why shouldn’t doxycycline be used in breastfeeding women?
can effect development of the infants teeth
how does rifampicin affect the P450 system?
rifampicin is a P450 inducer and thus decreases warfarin and thus will decrease INR`
what unit is often used to prescribe topical drugs such as creams?
FTU
how can we remember the enzyme inducers?
PC BRAS
phenytoin
carbamazepine
barbiturates
rifampicin
alcohol (chronic)
sulphonylureas
How can we remember the enzyme inhibitors?
AODEVICES
Allopurinol
Omeprazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin
Ethanol (acute)
Sulphonamides
what is the general sick day rule of someone taking steroids long term?
double dose when ill
What medications should be stopped 4 weeks before surgery?
COCP and HRT
What psychiatric drug should be stopped the day before surgery?
lithium
why should metformin be stopped before surgery?
risk of lactic acidosis
why should ACE inhibitors be discontinued before surgery?
can cause severe hypotension
why should potassium sparing diuretics be withheld the day of surgery?
risk of hyperkalaemia
give an example of a potassium sparing diuretic ?
spironolactone
what medications can cause severe hyperkalaemia if taken in conjunction with a potassium sparing diuretic such as spironolactone ?
ARBs and ACEis
what do angiotensin II receptor blocker names usually end in ?
‘sartan’
what antibiotic is first line for tonsilitis in penicillin allergic patients?
Clarithromycin
what should be given in suspected temporal arteritis?
prednisolone
what can be prescribed for allergic conjunctivitis?
sodium cromoglicate
how does lithium affect psoriasis ?
lithium exacerbates psoriasis
what drug class is indapamide?
thiazide-like diuretic
how does indapamide reduce BP?
reduces sodium reabsorption in the kidney and increases urine output
How does bendoflumethiazide work?
reduces sodium reabsorption in the kidney and increases urine output
what type of diuretic is furosemide?
loop diuretic
what type of diuretic is bumetanide?
loop diuretic
what type of diuretic is often used in pulmonary oedema due to left ventricular failure?
loop diuretics e.g furosemide
what type of drug is loratadine?
antihistamine
what type of drug is fexofenadine ?
antihistamine
