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Finals Revision Progress > PSA > Flashcards

PSA Flashcards

1
Q

Drugs causing urinary retention

A
  1. tricyclic antidepressants
  2. anticholinergics
  3. opioids
  4. NSAIDs
  5. BENZOS
  6. Anaesthetics
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2
Q

NSTEMI key difference

A

No PCI, instead :

Clopi 300mg
LMWH 1mg/kg bd SC

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3
Q

Drugs to stop before surgery

A

CALIA OP

COCP/HRT (4wks before)
Anticoagulants/antiplatelets
Lithium (day before)
Insulin
ACEis (day of)
Oral hypoglycaemics 
Potassium sparing diuretics (day of)
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4
Q

Drugs causing HYPERkalaemia

A

“K CHAT”

K sparing diuretics
Ciclosporin
Heparins
ACEis
Tacrolimus
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5
Q

DKA insulin rules?

A

Short-acting SC insulin should be stopped, and long-acting insulin should be continued. Patient requires fixed-rate IV insulin alongside fluid resuscitation.

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6
Q

Drugs that worsen heart failure

A 
Diltiazem
Prenisolone
Thiazolididinoes 
Verapamil
NSAIDs
Class I antiarrythmic
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7
Q

COPD infective exacerbation drugs and doses

A

 30mg prednisolone 7-14 days
 salbutamol 5mg max every 4h
 ipratropium 500 micrograms QDS
 24-18% venturi
Hydrocortisone 200mg or oral pred – 30mg – continue for 7 days
4. Amoxicillin 500mg tds ; clarithromycin or doxycycline
5. IV aminophyline

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8
Q

Causes of low neutrophils

A

Viral infection
Clozapine
Carbimazole
Chemo

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9
Q

Statins

A

Measure LFTs; lipids at baseline

Measure LFTs at baseline, 3 and 12 months

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10
Q

If INR >1.5 on day of surgery?

A

Give phytomenadione

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11
Q

drugs that can precipitate serotonin syndrome?

A

SSRIs

If you combine with opioids, can cause serotonin syndrome

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12
Q

Fondaparinux CIs?

A

Renal impairment

Active bleeding

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13
Q

Tamoxifen risks

A

VTE

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14
Q

Treating AF

A

Beta blocker

if asthmatic, give VERAPAMIL

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15
Q

VTE prophylaxis in needle phobics

A

“RAD”

RIVAROXABAN
APIXIBAN
DABIGATRAN

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16
Q

Drugs to withhold poor renal function/AKI

A

Allopurinol (100mg or less until renal recovers)
ACEis
Statins (caution)
ARBs
Ciclosporin
Abx: Tetracycline, Vancomycin, Gentamicin, Nitrofurantoin

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17
Q

Carbamazepine, when not to give?

A

SIADH

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18
Q

Patients at high risk of VTE who have had to stop warfarin before surgery, what do you give them?

A

Bridging therapy - LMWH

Stop it 24 hours before surgery though

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19
Q

Mx of irregular narrow complex tachycardia

A

Probable AF. Control rate with

  • beta blocker or diltiazem
  • digoxin or amiodarone if contraindications ( asthma or heart failure )
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20
Q

Drugs causing peripheral neuropathy

A
  • amiodarone
  • isoniazid
  • vincristine
  • nitrofurantoin
  • metronidazole

“VAIN Me”

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21
Q

Changing doses of thyroxine in response to TSH?

A

<0.5: decrease dose
0.5-5; do nothing
>5; increase dose

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22
Q

Liver enzyme inducers

A

PC BRAS

Phenytoin
Carbamazepine
Barbiturates
Rifampicin
Alcohol CHRONIC
Sulphonylureas
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23
Q

anti emetics first line?

A

If unknown cause/idiopathic,

CYCLIZINE 50mg 8 hourly IM/IV/oral

however causes fluid retention, so in heart failure,

METOCLOPRAMIDE 10mg 8 hourly IM/IV
(avoid in Parkinson’s, young women -> dystonia)

24
Q

Clarithomycin and wafarin?

A

Increases bleeding

25
Q

Verapamil can’t be combined with which drugs?

A

Beta blockers

26
Q

Breakthrough pain, dosing?

A

1/6th of 24 hour dose every 4 hours as required

27
Q

Patients on warfarin who need emergency surgery

A

If can be delayed 6-12 hours, give phytomeniadone

If not, give dried prothrombin complex in addition

28
Q

Maintenance fluids; which and how much?

A

30ml/kg/24 hr - approx 3L per 24 hours, 2L in elderly

1 salty 2 sweet (0.9% saline and 5% dextrose)

Approx 100mL per hour, so 500ml every 5/6 hours ash

29
Q

Tx for DVT

A

LMWH - Dalteparin

30
Q

Mx of irregular narrow complex tachycardia

A

Probable AF. Control rate with

  • beta blocker or diltiazem
  • digoxin or amiodarone if contraindications ( asthma or heart failure )
31
Q

Co-amoxiclav can cause hepatitis and jaundice

A

-

32
Q

Treating hyperkalaemia

A

Calcium gluconate does NOT lower potassium

give:
Short acting insulin (Actrapid) and glucose
Salbutamol

ALL THE 5’s: e.g. 5 units of ActRapid in 50ml of 50% glucose over 5 mins IV

33
Q

Drugs that are dangerous to combine with alcoho

A 
Methotrexate
Metronidazole
Mao inhibitors
NSAIDs
Warfarin
Opioids/barbs/benzos
34
Q

ACEis contraindications?

A

Pregnancy
Renal Artery Stenosis
Kidney failure
Hx of angiodema

35
Q

Drugs causing HYPOnatraemia

A

Thiazides
ACEis
SSRIs

36
Q

Monitoring and co prescribing on methotrexate

A

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

FBC, U&E and LFTs need to be regularly monitored

37
Q

Commonest drugs with major contraindications

A

Aspirin/heparin/warfarin - Patients bleeding or at risk of bleeding

Steroids - STEROIDS
Stomach ulcers
Thin skin
Edema
Right and left heart failure
Osteoporosis
Infection
Diabetes
Syndrome Cushings
NSAIDS
No urine
Systolic dysfunction
Asthma
Indigestion
Dyscrasia (clotting abnormality)
38
Q

Drugs to increase during surgery

A

Patients on long term corticosteroids (i.e. Addison’s)

39
Q

Electrolyte disturbances caused by
ACEIs
Thiazides

A

ACEIs, K-sparing diuretics: HyperK
Thiazides and Loop diuretics: HypoK
All diuretics - HyperNa

40
Q

Drugs causing pulmonary fibrosis

A

BAMENS

Amiodarone
Methotrexate 
Ergo derivatives = bromocriptine, ergolide, pergolide
Nitrofurantoin 
Sulfasalazine drugs
Busulphan, bleomycin
41
Q

Monitoring before starting azathioprine?

A

thiopurine methyltransferase (TPMT)

42
Q

How fast to give fluids?

A

If tachycardia or hypotensive, give 500ml bolus then reassess HR, urine output, BP for next bag

If oliguric (<30ml/hr) (NOT DUE TO OBSTRUCTION) give 1L over 2-4 hours then reassess

Never prescribe more than 2L for a patient

43
Q

NSTEMI key difference

A

No PCI, instead :

Clopi 300mg
LMWH 1mg/kg bd SC

44
Q

Raised urea?

A

Think dehydration

or if low Hb also, Upper GI bleed

45
Q

Dangerous side effect of heparin?

A

Heparin induced thrombocytopenia

46
Q

Opioids in renal impairment?

A

Morphine will accumulate in the kidney, so better to give Oxycodone

47
Q

Liver enzyme inhibitors

A

AO DEVICES

Allopurinol
Omeprazole
Disulfuram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin
Ethanol (ACUTE)
Sulphonamides
48
Q

Starting out on a statin?

A

Atorvastatin 20mg

49
Q

Acute dystonia

A

Procyclidine 10mg IV

50
Q

Treating hypoglycaemia

A

Glucose 20% is first line IV treatment of hypoglycaemia. If glucose 20 % is not available, glucose 10% is an alternative.

Volumes delivering between 10–20 g of glucose in 20 minutes are optimal, so 20% glucose in 50-100ml over 20 mins

51
Q

Prophylactic enoxaparin is contraindicated following acute stroke!

A

-

52
Q

When to avoid nitrofurantoin

A

if eGFR less than 45

53
Q

Drugs that worsen seizure control

A

Aminophylline
Ciprofloxacin/levofloxacin
Alcohol and drugs
Mefenamic acid

54
Q

Gentamicin levels

A

If trough level high, increase interval

If peak level high, reduce dose

55
Q

What exacerbates psoriasis?

A 
Lithium
Alcohol
Beta blockers
Anti malarial
NSAIDS

Finals Revision Progress (16 decks)

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