PSA Flashcards
What is the dose of metoclopramide
10mg TDS
What drugs cause low sodium
carbamazepine
sulfonylureas* SSRIs, tricyclics carbamazepine vincristine cyclophosphamide
When are dextrose solutions contraindicated
in stroke due to risk of cerebral odema
How many mmol of Na in a bag of saline?
154
What is the dose of sertraline
50mg OD slowly put up each week to upto 200mg
Facts about tamoxifen
is taken for 5 years and commonly causes hot flushes. risk of VTE - seek help if calf pain
What is the problem with carbimazole?
can cause neutropenic sepsis - marrow suppression therefore check TFTs and FBC
What drugs reduce seizure threshhold?
aminophylline/ theophylline
mefenamic acid
fluoroquinolones
methylphenidate
What three drugs cannot be given in asthmatics?
beta blockers
adenosine
NSAIDs
How do you manage gentamicin dosing?
Dosing due to the significant ototoxic and nephrotoxic potential of gentamicin it is important to monitor plasma concentrations 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
When is gentamicin contraindicated
myasthenia gravis
Dose of furosemide?
20-50mg IV for pulmonary odema
Dose of rivoroxaban
10mg OD for prevention
20mg OD but 15mg BD initially treatment
Apixaban dose?
2.5mg BD
How much glucose do you need to give in hypoglycaemia?
10-20g within 20 minutes
use 20% glucose (50-100ml)
Dose of tetracycline in acne kids?
500mg BD
can use other tetracyclines but should not be used under 12
What topicals can be used for acne
clindamycin
benzoyl peroxide
three drugs that may cause hyperkalaemia?
dalteparin
ramipril
tacrolimus
dose of tacrolimus?
roughly 200mcg/kg divided into two doses therefore average 70kg will be on around 14mg per day = 7mg twice
drugs to withold in AKI
ACEi
Allopurinol - can accumilate when function is poor
NOT aspririn
How many days before surgery should asprin be stopped?
7 days
drugs contributing to confusion?
opiates
benzos
steroids
What is the dose of levothyroxine?
mcg not mg
taken daily not weekly
drugs causing hyponatraemia?
citalopram
bendro
ramipril
When should pain patches be used?
for background pain not breakthrough
often placed on for a number of days.
Contraindications for nitrofurantoin?
GFR less than 45 - use trimethoprim if possible
What is the dose of breakthrough pain meds?
1/6th of the 24 hr dose every 4 hours as required
What is the eqivalent in morphine of a 50mcg p/hr fentanyl patch?
120mg in 24hr
can be found in medicines guidance > palliative care
Alcoholic with delerium trememns? first management?
chlordiazepoxide 20mg PO 6hrly
What is vitamin k also known as?
phytomenedione
1-5mg oral common dose?
used pre surgery elective when INR is greater than o equal to 1.5
What does topirimate do?
induces - reduces efficacy of hormonal contraceptive
What does the BNF say instead of erectile dysfunction?
sexual dysfunction
Which drugs can often cause cholestatic jaundice?
co amoxyclav
sulphonylureas?
Side effect of carbimazole that causes it to require monitoring?
neutropenic sepsis - monitor FBC
What are the indications of perindopril?
HTN
HF
check indication in question if it is asking you how you would monitor for beneficial side efects
side effects of ciclosporin that require monitoring?
LOTS OF THEM
renal dysfunction with U+E is more important than neutropenia with FBC.
What is a safe dosing increase for insulin to ameliorate steroid induced hyperglycaemia?
10%
Side effects of beta blockers?
sleep disturbance
bronchospasm in asthmatics
cold peripheris
fatigue
Side effects of calcium channel blockers?
ankle swelling
flushing
headache
verapamil causes constipation
Side effects of nitrates
tachycardia
hypotension
headache
Side effects of nicorandil
Headache
fflushing
anal ulceration
eye problems with amiodarone
corneal opacities, optic neuritis
What drugs can cause your vision to change colour?
digoxin - green/yellow
sildenafil - blue
What is dosulepin
TCA
side effectsa of amoxicaillin
rash with EBV
side effects of cipro
tendonitis
reduce seizure threshold
side effects of flucloxacillin
cholestasis - a few weeks later
side effects of erythromycin
enzyme inhibitor
vomiting and GI disturbance
prolongs QT
antiplatelets for dental surgery?
dont bother stopping
side effecs of ethambutol
optic neuritis
renal dosing adjustment
side effects of pyrizinamide
hepatic toxicity
GOUT - hyperuricaemia
arthralgia
side effects of isnoniazid
enzyme inhibitor
peripheral neuropathy? b6 reduction
side effects of rifampicin
orange secretions
enzyme inducer
liver toxicity
flu like sx
1st line for neuropathic pain in diabetes peripheral neuropathy?
duloxetine - SNRI
contraindications to bisphosphonates?
renal failure egfr less than 30?
diclofenac contraindications
heart failure
Side effects of sulphonylureas e.g glimepride
hypos
SIADH
appetite and weight gain
cholestasis
Side effects of metformin
lactic acidosis
stomach upset
Side effects of thiazoledindiones
fluid retention
weight gain
fractures
causes of occulogyric crisis
phenothiazines
metoclopramide
haloperidol
monitoring for methotrexate
FBC LFT UE
Monitoring for amiodarone
LFT TFT
Monitoring for leviteracetam?
no monitoring
Which is the most common dose of statin to cause myopathy?
high dose - 80mg simvastatin
What should you do if a patient get myopathic symptoms from statins?
look at their CK - stop if over 5 times upper limit.
less than 5 - monitor and stop if intolerable symptoms
shooting pain in left arm after mastectomy treatment
pregabalin or amytriptilline first line neuropathic
gabapentin is 2nd
Gentamicin common uses?
severe UTI
abdo - gram neg
infective endocard?
mode of action for tamoxifen causing cancer?
acts as an oestogen recepter AGONIST in the endometrium in contrast to effects in the breast
TCA overdose signs
anticholinergic signs are present early on:
(similar to sympathitic) wide pupils, dry mouth, agitation, sinus tachy.
they get QRS widening (seizure risk up) and a long QT predisposing them to arrythmias
also likely to get an acidosis
how do you treat TCA overdose?
Bicarb
How do you treat aspirin overdose
urinary alkalisation with bicarb. - more often just dialyse because it is contraindicated in pulmonary or cerebral odema?
indications for dialysis include pulmonary odema and acidosis
What recepters should you use to have a prokinetic effect?
dopamine antagonist such as metoclopramide~?
What recepters re useful in nasal decongestant?
alpha 1 agonists
histamine 1 vs 2?
1 - antihistamines
2 - - rantitidine
Contraindications to digoxin?
hypokalaemia? makes toxicity likely
second line treatment in beta blocker overdose - unresponsive to atropine?
glucagon
Drugs which can cause malignant hyperthermia?
halothane
suxamethonium
How do you treat malignant hyperthermia
dantrolene - stops calcium release appaz
cautions to pred?
heart failure -causes fluid retention
HRT regimes
consist of a small amount of oestrodiol with norethisterone
can be continuous or cyclical to induce withdrawal bleed
What is trazadone?
anti depressant - inculding side effects of sedation, postural hypos and priapism
What cant you give trimethoprim with?
methotrexate
What do you treat scarlet fever wiyth?
phenoxymethylpenicillin - 10 days
What cant you do with methotrexat?
have babies for 3 months even if you a man
What do you do if they get myopathy from a statin?
half the dose after withdrawing for some timne
What drugs should be stopped before surgery
I LACK OP Insulin Lithium Anticoaglants cocp potassium sparing diuretics oral hypoglycaemics perindopril and acei
side effect of loop diuretics?
gout
Side effects of steroids
STEROIDS stomach ulcers thin skin edema right and left heart failure osteoporosis infections diabetes syndromes - cushings
cautions and contra’s of NSAIDS
NSAID no urine systolic dysfunction asthma Indigestion dyscrasia
What are the contraindications to domperidone?
long qt prolongation and occulogyric cris(less likely as peripherally actiung)
increased levels of dopamine?
Which antiemetics cause occulogyric crisis?
metoclopramide - if on other parksinsons drugs, antipsychotic too and also carbamazipine.
alendronic acid side effects?
stomach upset in all forms, dyspepsia, flatulence, diarhhoea and constipation
atypical femoral fractures with long term use.
causes of ankle odema
CCBs
NSAIDS
Course of treatment for candida in pregnancy?
usually 7 days of clotrimazole pessary 100mg
they cannot take oral fluconazole treatment
In DKA what do you do with their normal insulin?
keep the long acting one going and stop their short acting and start them on a flat rate insulin.
WHAT PAIN MANAGEMENT DSHOULD YOU GIVE OLD PEOPLE WITH SHINGLES?
PARACETAMOL
lOPERAMIDE
USE AFTER EACH LOOSE STOOL 4mg followed by 2 after each. maximum 16 poer day
you have to let patients know if they are gonna need monitoring on msoemthing
eg renal on ciclosporin
monitoring for cocp
high blood pressures
What morphine do you use in renal impariment?
oxycodone as it is hepatically metabolised
Contraindications to most laxatives and stool softeners?
acute abdomen
ileus
cannot give bulking agents such as ispagula husk in impaced individuals
whats the best type of laxative for faecal impaction?
stool softeners such as docusate sodium which also acts as a stimulant at higher doses.
What insulin should be used in hyperkalaemia?
10 units short acting actrapid or novorapid insulin in 100ml 20% glucose over 30 minutes
