Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PSA > PSA > Flashcards

PSA Flashcards

1
Q

What are the medications exacerbating heart failure?

A
  • thazelidenodiones: pioglitazione
  • Ca 2+ channel blockers verapamil: negative inotropic effect
  • NSAID: should be used with caution as they cause fluid retention
  • glucocorticoids should be used with caution as they cause fluid retention
  • class I arrhythmic, flecainide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Prescribing in patients with asthma and COPD

A

NSAIDs beta-blockers adenosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Psoriasis: exacerbating factors

A

Beta blockers

Lithium

Anti-malarias

Infliximab

Nsaid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Prescribing in patients with epilepsy

A

Prescribing in patients with epilepsy:

*antibiotics: ciprofloxacin, levofloxacin *aminophylline, theophylline

Nicotinc theraphy: *bupropion

ADHD

NSAID*methylphenidate (used in ADHD) *mefenamic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which medications are taken weakly?

A

methotrexate, lithium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Approximately what percentage of patients who are allergic to penicillin are also allergic to cephalosporins?

A

0.5-6.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Types of penicillin

A

*phenoxymethylpenicillin *benzylpenicillin

FACT

*flucloxacillin

*amoxicillin *ampicillin

*co-amoxiclav (Augmentin) *co-fluampicil (Magnapen) *piperacillin with tazobactam (Tazocin) *ticarcillin with clavulanic acid (Timentin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the common side effects of Calcium Channel Blockers?

A

Headache and ankle swelling are common side-effects of calcium channel blockers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

when using lithium, what parameters should be measured before prescrbing lithium ?

A

U&E

thyroid function should be checked every 6 months

FBC

ECG if cardo risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Clostridium difficile infection treatment 1st ine

A

metronnidazole 400 mg TDS 10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

C.Difficile infection first line

A

METRONIDAZOLE 400-500 MG PO TDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

treatment of cellulitis in adults

A

FLUCLOXACILLIN 250 MG PO QDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what’s the therapeutic dose of lithium

A

0.4 - 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What would you prescribe to the patient with angina on the bacground of asthma ?

A

atorvastatin 80 mg Adizem-SR 90mg bd (diltiazem modified-release)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Rapid-acting insulin analogues

A

insulin aspart: NovoRapid insulin lispro: Humalog

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Short-acting insulins

A

soluble insulin examples: Actrapid (human, pyr), Humulin S (human, prb) may be used as the bolus dose in ‘basal-bolus’ regimes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Intermidate-acting insulins

A

isophane insulin many patients use isophane insulin in a premixed formulation with

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Long-acting insulins

A

insulin determir (Levemir): given once or twice daily insulin glargine (Lantus): given once daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the inducers of the P450 system, the warfarin INR will decrease

A

*anti-biotics and anti-funguals: rifampicin *griseofulvin

*barbiturates: phenobarbitone

*anti-eplieptics: carbamazepine, phenytoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Inhibitors of the P450 system include - INR will increase

A

antibiotics: metronidazole, ciprofloxacin, erythromycin isoniazid cimetidine

amiodarone

allopurinol

anti-virals: ritonavir

omeprazole

imidazoles: ketoconazole, fluconazole

SSRIs: fluoxetine, sertraline

sodium valproate

acute alcohol intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Paracetamol dose

A

1g qds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Ibuprofen dose

A

200-400mg tds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Codeine dose

A

30-60mg qds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Co-codamol dose

A

8/500 2 tabs qds 30/500 2 tabs qds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Cyclizine dose

A

50mg tds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Metoclopramide dose

A

10mg tds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Amoxicillin dose

A

500mg tds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Clarithromycin dose

A

500mg bd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Lansoprazole dose

A

15-30mg od

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Omeprazole dose

A

20-40mg od

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Atenolol dose

A

25-100mg od

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Ramipril dose

A

1.25-10mg od

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Bendroflumethiazide* dose

A

2.5mg od

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Furosemide dose

A

20mg od - 80mg bd**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Amlodipine dose

A

5-10mg od

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Levothyroxine dose

A

25-200mcg od

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Metformin dose

A

500mg od - 1g bd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

how to assess how well type I diabetes is controlled?

A
  • Hba1c% -home glucose readings
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is it that you are worried about in patients taking carbamizaole?

A

*Neutropenia and agranulocytosis (sore throat) *Thyroid Function Test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What’s the mechanism of carbimazole?

A

Blocks TPO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Loop diuretics SE

A

Furosemide and bumetanide are loop diuretics that act by inhibiting the Na-K-Cl cotransporter in TAL Adverse effects: hypotension hyponatraemia hypokalaemia hypochloraemic alkalosis ototoxicity hypocalcaemia renal impairment (from dehydration + direct toxic effect) hyperglycaemia (less common than with thiazides) gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

The syndrome of inappropriate ADH secretion (SIADH) is characterised by hyponatraemia secondary to the dilutional effects of excessive water retention:

A
  • sulfonylureas* (glimperide) - SSRIs, tricyclics - carbamazepine - vincristine - cyclophosphamide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what is the starting dose of levothyroxine?

A

Start levothyroxine 25mcg od

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

dose of morphine in MI

A

2.5 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

dose of metoclopramide in MI

A

10 mg IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Prescribing errors: timing of medication

A

statins amitriptyline (to be taken at bedtime)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What volume of oramorph should he take when he experiences breakthrough pain

A

It is recommended that patients take one-sixth of their total oral morphine dose for breakthrough pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

first line treatment in asthma exacerbation

A

*40 mg prednisolone per oral *5 mg nebulised salbutamol *ipratropium bromide 0.5 mg QDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what’s tazocin?

A

piperacillin with tazobactam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What’s the prophylactic dose of heparin post-operatively in high risk patients ?

A

ENOXAPARIN 40 MG S/C OD 12h before and than every 24h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

How many hours post-operatively LMWH should be given?

A

LMWH, started 12 hours after surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what is the correct way to prescribe insulin glangarine?

A

22 UNITS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

lactulose dose constipation

A

15 ml BD PO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Which one of the following is most likely to be responsible for reducing hypoglycaemic awareness?

A

atenolol (beta-blockers)

Beta blockers[edit]

These medicines are designed to blunt the β-effect of adrenalin and related substances. Hence, if hypoglycemia occurs in someone who is using this type of drug, he/she may not experience the typical adrenergic warning symptoms such as tremor and palpitations. Again, the result is hypoglycemic unawareness. As noted above, beta blockers will also prevent adrenalin from stimulating the liver to make glucose, and therefore may make the hypoglycemia more severe and/or more protracted.[11] Of all the hypoglycemia symptoms, sweating is typically not blocked by beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Which one of the following is an antihistamine used in the management of anaphylaxis?

A

Chlorphenamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

The following drugs should be avoided in pregnancy:

A

-ciprofloxacin -tetracycline -chloramphenicol -sulphonamides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

The following drugs should be avoided in pregnancy -psychiatric drugs

A

lithium, benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

The following drugs should be avoided in pregnacy

A

aspirin amiodarone carbimazole cytotoxic drugs methotrexate sulphonylureas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

The following antibiotic drugs can be given to mothers who are breastfeeding:

A

penicillins, cephalosporins, trimethoprim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

The following drugs can be given to mothers who are breastfeeding - endocrine:

A

glucocorticoids (avoid high doses), levothyroxine*

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

The following drugs can be given to mothers who are breastfeeding in epilepsy:

A

sodium valproate, carbamazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

The following drugs can be given to mothers who are breastfeeding in asthma:

A

salbutamol, theophyllines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

The following drugs can be given to mothers who are breastfeeding:

A

tricyclic antidepressants, antipsychotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

The following drugs can be given to mothers who are breastfeeding:

A

hypertension: beta-blockers, hydralazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

The current BNF advice on how to take oral bisphosphonates:

A

Tablets should be 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’.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

weeks post-partum presents for her routine post-natal check. Her urine dipstick today shows evidence of a urinary tract infection and she also complains of some mastitis.

A

A. Ibuprofen is commonly prescribed to breastfeeding women, particularly if mastitis develops B.A short course of trimethoprim is safe to take whilst breastfeeding C.Aspirin should be avoided for pain relief because of the risk of Reye syndrome in the infant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What do you prescribe for uncomplicated UTI?

A

TRIMETHOPRIM 200 MG PO BD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Exacerbations of chronic bronchitis

A

Amoxicillin or tetracycline or clarithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Uncomplicated community-acquired pneumonia

A

Amoxicillin (Doxycycline or clarithromycin in penicillin allergic, add flucloxacillin if staphylococci suspected e.g. In influenza)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Pneumonia possibly caused by atypical pathogens

A

clarithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Hospital-acquired pneumonia

A

co-amoxiclav or cefuroxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

More than 5 days after admission HAP

A

piperacillin with tazobactam OR a broad-spectrum cephalosporin (e.g. ceftazidime) OR a quinolone (e.g. ciprofloxacin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

HAP <5 days

A

co-amoxiclav or cefuroxime

piepracylin > 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Acute pyelonephritis

A

CEFUROXIME

  • Pyelonephritis
  • Adult
  • 250 mg twice daily
  • oral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Acute prostatitis

A

CIPROFLOXACIN

By mouth

Adult

500 mg BD for 28 days.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

‘golden’, crusted skin lesions typically found around the mouth

A
  • Impetigo
  • Topical fusidic acid - local
  • Oral flucloxacillin - extensive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Cellulitis

A

Flucloxacillin

250–500 mg 4 times a day.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Cellulitis pen allergic

A

Clarithromycin or Clindomycin if penicillin-allergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

can be distinguished from cellulitis by its raised advancing edges and sharp borders

A

Erysipelas

Phenoxymethylpenicillin (erythromycin if penicillin-allergic)

Adult

500 mg every QDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Animal or human bite

A

Co-amoxiclav (doxycycline + metronidazole if penicillin-allergic)

250/125 mg TDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Mastitis during breast-feeding

A

Flucloxacillin

250 mg QDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Throat infections

A

Phenoxymethylpenicillin

500 mg QDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Throat infections pen allergic

A

(erythromycin alone if penicillin-allergic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Features

facial pain: typically frontal pressure pain which is worse on bending forward

nasal discharge: usually thick and purulent

nasal obstruction: e.g. ‘mouth breathing’

post-nasal drip: may produce chronic cough

A

sinusitis

Amoxicillin 500 mg TDS

or doxycycline or erythromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Otitis media

A

Amoxicillin 500 mg TDS (erythromycin if penicillin-allergic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Otitis externa

A

chloroamphenicol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Periapical or periodontal abscess

A

Amoxicillin

500 mg TDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

painful bleeding gums with halitosis and punched-out ulcers on the gums

A

Metronidazole

Gingivitis: acute necrotising ulcerative

400 mg every 8 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Gonorrhoea

males: urethral discharge, dysuria

A

500 mg

Intramuscular ceftriaxone + oral azithromycin

1g single dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Chlamydia

A

azithromycin 1g stat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Pelvic inflammatory disease

A

intramuscular ceftriaxone + oral doxycycline + oral metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Syphilis

A

Benzathine benzylpenicillin or doxycycline or erythromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

vaginal discharge: ‘fishy’, offensive

asymptomatic in 50%

A

Bacterial vaginosis

Oral metronidazole or topical clindamycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Watery diarrhea is the cardinal symptom of C. difficile–associated diarrhea (CDAD) with colitis (≥3 loose stools in 24 hours). Elevated WBC count

A

Clostridium difficile

500mg TDS metronidazole Second or subsequent episode of infection: vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

A flu-like prodrome is usually followed by crampy abdominal pains, fever and diarrhoea which may be bloody

A
  • Campylobacter enteritis
  • Clarithromycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

initially systemic upset as above

  • relative bradycardia
  • abdominal pain, distension
  • constipation:
A
  • termed enteric fevers, producing systemic symptoms such as headache, fever, arthralgia
  • Salmonella (non-typhoid)
  • Ciprofloxacin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Shigellosis

A

Ciprofloxacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Minimal glucocorticoid activity, very high mineralocorticoid activity

A

Fludrocortisone

Mineralocorticoid side-effects

fluid retention

hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Glucocorticoid activity, high mineralocorticoid activity

A

Hydrocortisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Predominant glucocorticoid activity, low mineralocorticoid activity

A

Prednisolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Very high glucocorticoid activity, minimal mineralocorticoid activity

A

Dexamethasone

Betmethasone

103
Q

Glucocorticoid side-effects

A

*endocrine: impaired glucose regulation, increased *appetite/weight gain, hirsutism, hyperlipidaemia *Cushing’s syndrome: moon face, buffalo hump, striae *musculoskeletal: osteoporosis, proximal myopathy, *avascular necrosis of the femoral head *immunosuppression: increased susceptibility to severe *infection, reactivation of tuberculosis *psychiatric: insomnia, mania, depression, psychosis *gastrointestinal: peptic ulceration, acute pancreatitis *ophthalmic: glaucoma, cataracts *suppression of growth in children *intracranial hypertension

104
Q

Mineralocorticoid side-effects

A

fluid retention hypertension

105
Q

CAP pnenumonia in penicillin allergic man

A

500 mg BD clarithromycin

106
Q

What’s the aim metformin theraphy?

A

To reduce Hba1c% to less than 6.5

107
Q

Bacterial Menigitis

A

2g IV ceftriaxone

108
Q

barking cough and stridor in children managment

A

Croup=

DEXAMETHASONE

150 micrograms/kg for 1 dose.

109
Q

high blood preassure in 75 year old man

A

1st line amlodipine 5 mg

110
Q

tamoxiofen SE

A

Hot flushes are important to mention as they are so common. Venous thromoboembolism (VTE)

Tamoxifen is a Selective oEstrogen Receptor Modulator (SERM) which acts as an oestrogen receptor antagonist and partial agonist. It is used in the management of oestrogen receptor positive breast cancer

Adverse effects

  • menstrual disturbance: vaginal bleeding, amenorrhoea
  • hot flushes: 3% of patients stop taking tamoxifen due to climateric side-effects
  • VTE
  • endometrial cancer*

Tamoxifen is typically used for 5 years following removal of the tumour.

111
Q

what’s the monitoring of digoxin?

A
  • ECG
  • U&E (hypokalemia)
112
Q

Drugs to avoid in renal failure

A

antibiotics: tetracycline, nitrofurantoin

NSAIDs

lithium

metformin

113
Q

Drugs likely to accumulate in chronic kidney disease - need dose adjustment

A

​FOAMS

Frusemide

Opioids

Atenolol

Methotrexate

114
Q

Nephrotoxicity due to contrast media definitition

A

Contrast media nephrotoxicity may be defined as a 25% increase in creatinine occurring within 3 days of the intravascular administration of contrast media.

115
Q

The BNF recommends different target gentamicin concentrations for patients with infective endocarditis

A

peak 3-5mg/litre, trough < 1mg/litre

116
Q

dose of omeprazole to be taken

A

20 mg OD

117
Q

What are the three options for smoking cessation?

A

veranecline and buprion , nicotine replacement theraphy

118
Q

A 60-year-old lady with metastatic endometrial cancer comes for review. She is currently taking MST (slow release morphine) 75mg bd but is unfortunately troubled with pruritus. You therefore decide to switch her to

A

OxyContin should therefore be 150 / 1.5 = 100mg per day

119
Q

lithium monitoring tests:

A

U&E

TFT

120
Q

Statins monitoring

A

LFTs at baseline, 3 months and 12 months

121
Q

ACE inhibitors

A

U&E

  • U&E prior to treatment
  • U&E after increasing dose
  • U&E at least annually
122
Q

Amiodarone

A

TFT, LFT

TFT, LFT, U&E, CXR prior to treatment
TFT, LFT every 6 months

123
Q

Methotrexate monitoring

A

FBC, LFT, U&E

The Committee on Safety of Medicines recommend ‘FBC and renal and LFTs before starting treatment and repeated weekly until therapy stabilised, thereafter patients should be monitored every 2-3 months’

124
Q

Azathioprine monitoring

A

FBC, LFT

  • FBC, LFT before treatment
  • FBC weekly for the first 4 weeks
  • FBC, LFT every 3 months
125
Q

Lithium monitoring

A

Lithium level, TFT, U&E

  • TFT, U&E prior to treatment
  • Lithium levels weekly until stabilised then every 3 months
  • TFT, U&E every 6 months
126
Q

Sodium valproate monitoring

A
  • LFT
  • LFT, FBC before treatment
  • LFT ‘periodically’ during first 6 month
127
Q

Glitazone monitoring

A

LFT

LFT before treatment
LFT ‘regularly’ during treatment

128
Q

if the trough (pre-dose) level is high of the gentamycin….

A

the interval between the doses should be increased

129
Q

if the peak (post-dose) level of gentamycin is high

A

the dose should be decreased

130
Q

Drugs which decrease serum potassium

A

Thiazide diuretics
Loop diuretics
Acetazolamide

131
Q

Drugs which increase serum potassium

A

ACE inhibitors
Angiotensin-2 receptor blockers
Spironolactone
Potassium sparing diuretics (amiloride, triamterene)
Potassium supplements (Sando-K, Slow-K)

132
Q

emergency contraception

A

levonorgestrel 1.5 mg

133
Q

digoxin monitoring

A
  • Serum digoxin level just before next dose
  • Ventricular rate at rest​
134
Q

Oculogyric crisis managment

A

Procyclidine 5 mg IV

135
Q

medication that will not give monthly withdraval bleeds for HRT

A

Evorel Conti 50 mg and norethiestrone replacement theraphy

136
Q

Which medications are causing confusion?

A

opiates (fentanyl)

benzodiazepines (tamazepam)

trazodone (TCA)

137
Q

Which medications are not allowed in ischemic ulucer disease?

A

beta-blockers

138
Q

Which drugs should be in caution in peripheral vascular disease?

A

ACE inhibitors

139
Q

Which medications predispose to development of vaginal trush?

A

steroids and antibiotics

inhaled steroid not so much

140
Q

What’s the usual dose of omeprazole?

A

10 mg of omeprazole

20 mg if the symptoms persist

141
Q

Insulin prescribing

A
142
Q

Nitrofurantoin dose

A

100 mg BD for 3 days

143
Q

What do you prescribe for scarlet fever?

A

phenoxymethylpenicillin 125 mg orally 6 hourly for 10 days

144
Q

What should you monitor when presribing drugs that can lead to hyperkalemia?

A

K+ sparing diuretics: we need to monitor Potassium

145
Q

What advice should be given to patients taking methotrexate?

A

The advice regarding effective contraception for ment and women as it is highly tetragoneic drug

146
Q

What would you use in the treatment of neuropathic pain?

A

Tricyclic antidepressants

Amitryptyline

147
Q

common side effects of TCAs

A

Think about the anti-cholinergic properties of TCAs:

  • drowsiness
  • dry mouth
  • blurred vision
  • constipation
  • urinary retention
148
Q

Which drugs cause hypokalemia?

A

Diuretics:

Loop (TAL)

Thiazide (DCT)

amiodorone

steroids

149
Q

Which drug should be avoided when taking statins?

A

Gemofibrozil (fibrates)

It is a know cause for toxicity causing myopathy and rhabdomyloysis

150
Q

What is the management of hypoglycemia in unconsious patient (not-insulin dependent)

A

15g glucose IV using 20% solution

151
Q

What is the management of hypoglycemia in insulin-induced hypoglycemia?

A

1 mg glucagon IM

Won’t work in drunks and has short duration of effect (20 min)

Insulin relase might cause rebound hypoglycemia

IM injections are also not ideal for anti-coagulated patietns (brusing).

152
Q

How do you measure the effect of the treatment in the AF?

A

rate control drugs - heart rate would be controlled by measuring the heart rate.

153
Q

What needs to be monitored with amiodorone?

A

checked for hypokalemia (it acts on Na,K channel)

  • TFT, LFT, U&E, CXR prior to treatment
  • TFT, LFT every 6 months
154
Q

If patient is taking setraline and has hepatic impariemtn, what needs to be done?

A

The dose of sertareline would need to be reduced.

155
Q

Long term urinary cathers are usally colonised. The speciment should only be sent for analysis if there is suspiciton of highly infective organism

A
156
Q
A
157
Q

If the statins are suspected to be the cause of myopathy and creatinine kinase is markedly elevated (more than 5 times upper limit of normal) , of if muscular symptoms are severe, statins should be discontinued.

If symptoms resolve and kretine kinase levels return to normal, statins should be re-introduced at lower dose.

A
158
Q

what would you use for treatment of DVT first line

A

enoxaparin 1.5 mg/kg subcutaneous

159
Q

What should be used if patient has kidney impairement and DVT?

A

unfractionated heparin rather than enoxaparin

160
Q

when dalteparin is contradicted?

A
  • heparin induced thrombocytopenia
  • high risk of bleeding complications

(acute gastroduodenal ulucer)

  • cerebral hemorrhage
  • conditions predisposing to bleed.
  • stroke
161
Q

when atorvostatin should be prescribed?

A
  • primary prevention if the cardiovascular risk is 10% or more 20 mg
  • type I diabetic
  • CKD GFR less than <60
  • secondary prevention
162
Q

how is atorvostatin monitored?

A

Non-HDL

163
Q

statins side effects

A

mylagia

disturbed liver function

GI

Sleep disturbance

Hedache tim

164
Q

Which one of the following is a disadvantage of using a proton-pump inhibitor (PPI) long-term?

A

The BNF states that PPI’s are used at the lowest effective dose for the shortest period and the need for long-term treatment should be reviewed periodically.

Long-term use of PPI’s can mask the symptoms of gastric cancer. They can also increase the risk of osteoporosis and fractures -due to malabsorption of calcium and magnesium.

165
Q

A 24-year old female presents to general practice with a few-weeks history of diarrhoea, passage of mucus, lethargy and abdominal discomfort relieved by defaection.

What do you prescribe?

A

Loperamide 61%

166
Q

What’s the mangment of IBS?

A

First-line pharmacological treatment - according to predominant symptom

pain: antispasmodic agents
constipation: laxatives but avoid lactulose
diarrhoea: loperamide is first-line

167
Q

Mechanism of action of amino-salicylte drugs?

A

5-aminosalicyclic acid (5-ASA) is released in the colon and is not absorbed. It acts locally as an anti-inflammatory. The mechanism of action is not fully understood but 5-ASA may inhibit prostaglandin synthesis

168
Q

Mesalasine side effects:

A

mesalazine is still however associated with side-effects such as GI upset, headache, agranulocytosis, pancreatitis*, interstitial nephritis

169
Q

Sulphasalzine side effects:

A

rashes, headache, Heinz body anaemia, megaloblastic anaemia

170
Q

What antibiotics do you prescribe in acute appendicitis?

A

Co-amoxiclav TDS pending no penicillin allergy

171
Q

What’s the most common minimal and maximal doses of amitryptyline?

A

The min - 10 mg

Max - 75 mg

The common use of amitryptyline:

1) Neuropathic pain 10 mg
2) prophylaxis of: migrane and tension hedache

172
Q

What is used as second line treatment of IBS?

A

amitryptyline 10 mg

173
Q

what’s the management of IBS?

A

First-line pharmacological treatment - according to predominant symptom

pain: antispasmodic agents (MEBEVERINE HYDROCHLORIDE)
constipation: laxatives but avoid lactulose
diarrhoea: loperamide is first-line

174
Q

What is maximal dose of beta-blockers?

A

200 mg

175
Q

What’s the maximum dose of bendrofluemthazide?

A

10 mg

176
Q

What’s prazosin?

What’s the maximum dose?

A

alpha 1 selective inhibitor

2 mg

177
Q

What’s the maixmal dose of spironolactone?

A

200 mg

178
Q

What are the common side effects of metform?

A

gastrointestinal upsets are common (nausea, anorexia, diarrhoea), intolerable in 20%

reduced vitamin B12 absorption - rarely a clinical problem

lactic acidosis* with severe liver disease or renal failure

179
Q

What are the contradictions to metformin theraphy?

A

Contraindications**

chronic kidney disease: NICE recommend that the dose should be reviewed if the creatinine is > 130 µmol/l (or eGFR < 45 ml/min) and stopped if the creatinine is > 150 µmol/l (or eGFR < 30 ml/min)

metformin may cause lactic acidosis if taken during a period where there is tissue hypoxia. Examples include a recent myocardial infarction, sepsis, acute kidney injury and severe dehydration

iodine-containing x-ray contrast media: examples include peripheral arterial angiography, coronary angiography, intravenous pyelography (IVP); there is an increasing risk of provoking renal impairment due to contrast nephropathy; metformin should be discontinued on the day of the procedure and for 48 hours thereafter

alcohol abuse is a relative contraindication

180
Q

What are two mechanism of action of aspirin?

A
  • anti-platlet
  • COX-1 and COX-2 inhibitors
181
Q

Why aspirin is causing iron deficency anemia?

A

Because of lack of protective effect of prostaglandin on the gastric mucosa

182
Q

Which anti-diabetic agents can cause hypoglycemia?

A

Pioglitazone (thazelidenodiones) - PPARgamma inhibitors

Sulphonylureas (Glicazide)

183
Q

What are two commonly used alpha blockers?

A

doxazosin

tamusolosin

184
Q

What are the side effects of alpha blockers?

A
  • postural hypotension
  • drowsiness
  • dyspnoea
  • cough
185
Q

What’s ezetimbe?

A

Ezetimibe is a lipid lowering drug which acts on enterocytes to inhibit cholesterol absorption from the small intestine

186
Q

Which drugs are causing urinary retention?

A
  • Opioids
  • anti-cholinergic (anti-depressants, anti-psychotics, detrusor relaxants)
  • general anasthethic
  • alpha adrenergic receptor agonist
  • benzodiazepines
  • NSAIDs
  • Ca channel bloeckers
  • anti-histamines

-

187
Q

Which drugs can cause confusion ?

A

Anti-cholinergic

Ant-depressants

Anti-psychotics

Anti-convulsants

Less common - (histamine receptor antagonists)

188
Q

What sort of insulin should be given in DKA patient?

A

short acting insulin at the rate of 0.1 units/kg/hour.

189
Q

What’s step 4 of the blood preassure monitoring?

A

Then decsion has to be made depning on the K

if the K>4.5 thazide like diurectics (causes hypokalemia)

K<4.5 spironolcatone (causes hyperkalemmia)

190
Q

What’s the folic acid prescribing dose?

A

It depends: high risk pregnant woman - 5 mg

in low-risk woman and no family hisotry of spina bifida

400 mg

191
Q

What’s the mechanism of action alendronic acid?

A

Reduces bone deminaralisation

Works on the osteoclasts, reducing its apoptosis

192
Q

How does glicaside work?

A

Glisacide works by increasing insulin release from the pancreas

193
Q

Learn about HRT and its key facts

A
194
Q

What are methotrexate side effects?

A

mucositis

myelosuppression

pneumonitis

pulmonary fibrosis

liver cirrhosis

195
Q

How biphosphonates should be given?

A

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

196
Q

what advice should be given to pregnant women and men taking methotrexate?

A
  • women should avoid pregnancy for at least 3 months after treatment has stopped
  • the BNF also advises that men using methotrexate need to use effective contraception for at least 3 months after treatment
197
Q

How methotrexate should be monitored?

A

FBC, U&E and LFTs need to be regularly monitored. The Committee on Safety of Medicines recommend ‘FBC and renal and LFTs before starting treatment and repeated weekly until therapy stabilised, thereafter patients should be monitored every 2-3 months’

198
Q

which additional drug should be prescribed with methotrexate?

A

folic acid 5mg once weekly should be co-prescribed, taken more than 24 hours after methotrexate dosefolic

199
Q

what’s the starting dose of methotrexate?

A

the starting dose of methotrexate is 7.5 mg weekly (source: BNF)

200
Q

what’s the strenght of the methotrexate tablet?

A

only one strength of methotrexate tablet should be prescribed (usually 2.5 mg)

201
Q

which drugs should not be prescribed with methotrexate?

A

avoid prescribing trimethoprim or cotrimoxazole concurrently - increases risk of marrow aplasia

202
Q

Gentamycin:

How is it measured?

A

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

203
Q

what should be done if the through dose of gentamycin is high if the trough (pre-dose) level is high

A
  • if the trough (pre-dose) level is high the interval between the doses should be increased
204
Q

If the peak (post-dose) is high the dose should be decreased?

A

if the peak (post-dose) level is high the dose should be decreased

205
Q

What are the macrolidies?

A
  • erythomycin
  • azythromycin
  • clarithromycin
206
Q

how do macrolides work?

A
  • inhibit the action of 23S ribosomal subunit
207
Q

What are the side effects of macrolides?

A

gastrointestinal side-effects are common. Nausea is less common with clarithromycin than erythromycin

cholestatic jaundice: risk may be reduced if erythromycin stearate is used

P450 inhibitor (see below)

208
Q

What’s the common interaction of statins?

A

statins should be stopped whilst taking a course of macrolides. Macrolides inhibit the cytochrome P450 isoenzyme CYP3A4 that metabolises statins. Taking macrolides concurrently with statins significantly increases the risk of myopathy and rhabdomyolysis.

209
Q

Anaphyaxis drugs and disages adult

A
210
Q

How does alluprinol work?

A

reduces serum urate by inhibiting the action of the enzyme xanthine oxidase

211
Q

When shoul alluprinol be started?

A

two weeks after the acute attack has settled

212
Q

What’s the intial dose of alluprinol?

A

nitial dose of 100 mg od, with the dose titrated every few weeks to aim for a serum uric acid of < 300 µmol/l

213
Q

What are two common interactions of alluprinol?

A

Azathrophine

Cyclophoshamide

214
Q

What are the monitoring actions of lithium?

A

lithium blood level should ‘normally’ be checked every 3 months. Levels should be taken 12 hours post-dose

thyroid and renal function should be checked every 6 months

215
Q

What are other adverse features of lithium?

A

renal

thyroid

nephrotic syndrome

nephhrogenic diabetes inispidius

216
Q

What are the side effects of hormone replacement theraphy?

A

Hormone replacement theraphy can cause Na and water retention, thus leading to increased blood preassure

217
Q

Which patients shoudl discontinue the statin theraphy?

A

Patient should discontinue the statin theraphy if they liver enzymes are three times above the range

218
Q

What dose of levothyroxine should be given to:

  • patients above 50
  • cardiac disease
  • severe hypothyroidism
A

the initial starting dose should be 25mcg od with dose slowly titrated.

219
Q

Following the change in thyroxine dose thyroid function tests should be checked every?

A

following a change in thyroxine dose thyroid function tests should be checked after 8-12 weeks

220
Q

What’s the therpaheuitc goal of lithium theraphy?

A

the therapeutic goal is ‘normalisation’ of the thyroid stimulating hormone (TSH) level. As the majority of unaffected people have a TSH value 0.5-2.5 mU/l it is now thought preferable to aim for a TSH in this range

221
Q

What advice should be given to pregnant women taking levothyroxine?

A

women with established hypothyroidism who become pregnant should have their dose increased ‘by at least 25-50 micrograms levothyroxine’* due to the increased demands of pregnancy. The TSH should be monitored carefully, aiming for a low-normal value

222
Q

What’s the main interacton with levothyroxine?

A

iron: absorption of levothyroxine reduced, give at least 2 hours apart

223
Q

Prophylaxis of deep-vein thrombosis, especially in surgical patients—moderate risk

A

20 mg for 1 dose, dose to be given approximately 2 hours before surgery, then 20 mg every 24 hours.

224
Q

PCP treatment

A

co-trimoxazole

225
Q

apiration pneumonia treatement

A

co-amoxiclav

226
Q

Fungi pneumonia

A

amphotercin

227
Q

CMV treatment

A

ganciclovir

228
Q

Important safety information with flucoxacylin

A
  • flucloxacillin should not be used in patients with a history of hepatic dysfunction associated with flucloxacillin
  • flucloxacillin should be used with caution in patients with hepatic impairment
229
Q

Cautions

For all MACROLIDES:

A

electrolyte disturbances (predisposition to QT interval prolongation); may aggravate myasthenia gravis; predisposition to QT interval prolongation

230
Q

Managment of acute and subacute endocardits

A

 Acute severe: Fuclox / vanc + gent IV

 Subacute: Benpen + gent IV

231
Q

Which SE would prompt you to switch from morphine to oxydone?

A
  • Nausea
  • Vomitting
  • Pruritis
232
Q

opioids in palliative care, starting points

A

if no comorbidities use 20-30mg of MR a day with 5mg morphine for breakthrough pain.

For example, 15mg modified-release morphine tablets twice a day with 5mg of oral morphine solution as required (p.r.n.)

233
Q

What should be mentioned to all patients taking taking opioids?

A

patients should be advised that nausea is often transient. If it persists then an antiemetic should be offered

drowsiness is usually transient - if it does not settle then adjustment of the dose should be considered

234
Q

What analgesia should be prescribed to patients with CKD?

A

opioids should be used with caution in patients with chronic kidney disease. Alfentanil, buprenorphine and fentanyl are preferred

235
Q

How would you increase opioid dose?

A

When increasing the dose of opioids the next dose should be increased by 30-50%.

236
Q

conversion of oral codeine to morphine

A

Oral codeine Oral morphine

Divide by 10

237
Q

Oral tramadol conversion to Oral morphine

A

Divide by 10**

238
Q

The current BNF gives the following conversion factors for transdermal perparations to morphine

  • a transdermal fentanyl
  • a transdermal buprenorphine
A

a transdermal fentanyl 12 microgram patch equates to approximately 30 mg oral morphine daily

a transdermal buprenorphine 10 microgram patch equates to approximately 24 mg oral morphine daily.

239
Q

Oral morphine > Subcutaneous morphine

A

Divide by 2

240
Q

Oral morphine > Subcutaneous diamorphine

A

Divide by 3

241
Q

Oral oxycodone > Subcutaneous diamorphine

A

Divide by 1.5

242
Q

Drugs causing a peripheral neuropathy

A

mavin

Metronidazole

amiodorone

Vincrisitine

isoniazid

metronidazole

243
Q

Drugs causing Hypercalcaemia

A

drugs: thiazides, calcium containing antacids

244
Q

What is the first-line insulin regime he should be offered?

A

In newly diagnosed adults with type 1 diabetes, the first-line insulin regime should be a basal–bolus using twice‑daily insulin detemir

245
Q

Leflunomide monitoring

A

FBC/LFT and blood pressure

246
Q

A 43-year-old woman who has rheumatoid arthritis is reviewed in clinic. She has responded poorly to methotrexate and consideration is being given to starting sulfasalazine. An existing allergy to which one of the following drugs may be a contradiction to the prescription?

A

Patients who are allergic to aspirin may also react to sulfasalazine

247
Q

T score is Less than -1.5. what do you do?

A

Offer bone protection

Alendronate

248
Q

Gout with dudoenal ulcer managament

A

Diclofenac and indomethacin are contraindicated because of his duodenal ulcer. Colchicine is a suitable alternative. Allopurinol should not be given in the acute phase, but is good for preventing recurrent attacks.

249
Q

Which one of the following treatments may be beneficial in raynaulds disease?

A

Management

first-line: calcium channel blockers e.g. nifedipine

IV prostacyclin infusions: effects may last several weeks/mont

250
Q

which painkillers are absolutely contradicted in patients on warfarin?

A

NSAIDS due to risk of GI bleed

251
Q

peripheral vascular disease and therefore should be prescribed

A

clopidogrel 75 mg

atorvastatin 80 mg

252
Q
A
253
Q
A

PSA (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions