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

Which drugs should be stopped before surgery?

A

I LACK OP

Insulin
Lithium
Anticoagulants/antiplatelets
COCP/HRT
K-sparing diuretics
Oral hypoglycaemics
Perindopril and other ACE-inhibitors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which drugs should be increased in surgery?

A

Steroids - think sick day rules

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

What are the common enzyme inducers?

A

PC BRAS - these decrease drug concentration

Phenytoin, Carbamazepine
Barbiturates
Rifampicin
Alcohol (chronic excess)
Sulphonylureas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the common enzyme inhibitors?

A

AODEVICES - these increase drug concentration

Allopurinol
Omeprazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin
Ethanol (acute)
Sulphonamides
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the side effects of steroids?

A

STEROIDS

Stomach ulcers
Thin skin
Edema
Right and left heart failure
Osteoporosis
Infection
Diabetes
cushings Syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the CIs for NSAIDS?

A

NSAID

No urine (renal/AKI)
Systolic dysfunction
Asthma
Indigestion
Dyscrasia (clotting)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the two options of antiemetics?

A
  1. Cyclizine

2. Metoclopramide

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

What are the indications and contraindications for metoclopramide as an antiemetic?

A

Indications - nausea in heart failure

CI - parkinsons disease, young women (it is a dopamine antagonist and carries a risk of dyskinesia in this age group)

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

What fluids should be given in hypernatremic/hypoglycaemic patients?

A

5% dextrose

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

What fluids should be given in a patient with ascites?

A

Human-albumin solution (HAS) - this maintains osmotic pressure

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

What fluids should be given if shocked with sBP <90?

A

Gelofusine (colloid) - maintains BP due to high osmotic content

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

What fluids should be given in a patient shocked from bleeding?

A

Blood transfusion but colloid first if no blood available

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

Before giving replacement fluids what should be assessed and how do you respond to this?

A

HR, BP, urine output

If tachycardic/hypotensive - give 500ml bolus stat immediately then reassess
If oliguric only - give 1L over 2-4h then reassess

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

What volume of replacement fluids are given in heart failure?

A

250ml

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

What is the max REPLACEMENT fluid prescription in one day?

A

2L

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

What is the max MAINTENANCE fluid prescription in one day?

A

3L in adults (8hrly bags)

2L in elderly (12hrly bags)

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

With a normal potassium level, how much kCl do patients require a day?

A

1mmol/kg/day

do not give at more than 10mmol/hour

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

When giving fluids, what must you check?

A
  • U&E
  • Ensure not fluid overloaded
  • Ensure bladder not palpable (indicates obstruction)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Recent ischaemic stroke - heparin or no heparin?

A

NO HEPARIN - this should be for 2 months!

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

What do most patients receive in hospital as thromboprophylaxis?

A

Dalteparin 5000 units daily SC

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

Which diuretics cause hypokalemia?

A

Loop and thiazide diuretics

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

Name some side effects of ACE inhibitors?

A
  • Dry cough
  • Hyperkalemia
  • Dizziness
  • Headache
  • Weakness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Why should methotrexate and trimethoprim never be given together?

A

Both folate antagonists - risk of pancytopenia, neutropenic sepsis, bone marrow toxicity

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

Septic patient - methotrexate?

A

Stop methotrexate until you are sure whether it is neutropenic sepsis - IF IN DOUBT WITHOLD

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

TRUE OR FALSE - all diuretics can cause hyponatremia?

A

True - they can also cause hypernatremia if they contribute to dehydration.

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

TRUE OR FALSE - peripheral oedema is a side effect of calcium channel blockers?

A

True - think drug induced if recently started on amlodipine or verapamil

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

Why should verapamil and beta blockers not be prescribed together?

A

Risk of bradycardia and hypotension

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

Why is metoclopramide contraindicated in patients with PD?

A

Dopamine antagonist - crosses the BBB to act on central dopamine receptors in

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

What drugs cause hyperkalemia?

A
  • ACE inhibitors
  • Potassium sparing diuretics
  • Spironolactone
  • Angiotensin receptor blockers (losartan)
  • Tacrolimus
  • Dalteparin and all heparins!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Why should ibuprofen be stopped in AKI?

A

Inhibits prostaglandin synthesis - reduces renal artery diameter - reduces kidney perfusion and function

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

Why should ACE inhibitors be stopped in AKI?

A

Reduce angiotensin-II production - decrease in glomerular filtration when blood flood is reduced

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

Why should NSAIDS be avoided in asthma?

A

NSAIDs can cause bronchoconstriction in asthmatics and should be avoided unless strictly necessary

NB - if you have to use one use aspirin

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

If a patient on methotrexate has sepsis what action should be taken?

A
  • Withhold methotrexate until neutropenic sepsis can be exclude
    IF IN DOUBT WITHHOLD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Which electrolyte abnormalities can furosemide cause?

A
  • Hyponatremia

- Hypokalaemia

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

What drug class is contraindicated in asthmatics?

A

Beta-blockers - can trigger exacerbation of asthma

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

How should gentamicin be monitored?

A

Take blood sample 1 hour after administration (peak dose) and just before the next dose (trough)

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

What is the therapeutic range of lithium?

A

0.4-1.0 (toxicity is >1.5)

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

Which drugs worsen seizure control in patients with epilepsy?

A
  • alcohol, cocaine, amphetamines
  • ciprofloxacin, levofloxacin
  • aminophylline, theophylline
  • bupropion
  • methylphenidate (used in ADHD)
  • mefenamic acid

Also bear in mind drugs that interact with P450

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

How long after an acute stroke should enoxaparin be restarted?

A

2 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

How is insulin administered?

A

All insulin is S/C except for sliding scales using short-acting insulin (eg. act rapid, novorapid) which are given by IV infusion

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

What causes microcytic anaemia?

A

Iron deficiency
Thalassaemia
Sideroblastic anaemia

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

What causes normocytic anaemia?

A

Chronic disease
Acute blood loss
Haemolytic anaemia
Chronic renal failure

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

What causes macrocytic anaemia?

A 
B12/folate deficiency
Excess alcohol
Liver disease
Hyothyroidism
Myeloproliferative, myelodysplastic, multiple myeloma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are the causes of hyponatreamia?

A

HYPOVOLAEMIC - fluid loss, addison’s, diuretics
EUVOLAEMIC - SIADH, hypothyroidism
HYPERVOLAEMIC - heart/renal/liver/thyroid/nutritional failure

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

What are the causes of hypernatremia?

A

Dehydration
Drips
Drugs (sodium tablets)
Diabetes insipidus

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

What are the causes of hypokalaemia?

A 
DIRE
Drugs (loop, thiazide diuretics)
Inadequate intake or intestinal loss (D&amp;V)
Renal tubular acidosis
Endocrine (Cushings/Conns)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What are the causes of hyperkalaemia?

A 
DREAD
Drugs (spironolactone, ARBs eg losartan, ace inhibitors)
Renal failure
Endocrine (Addisons)
Artefact
DKA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Which drugs can cause neutropenia?

A

Carbimazole

Clozapine

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

Which drugs may cause thrombocytopenia (low platelets)?

A

Penicillamine (used in RA treatment)

Heparin

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

Raised urea
Normal creatinine
Not dehydrated
Low haemoglobin

Diagnosis?

A

Upper GI bleed

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

What can raised urea indicate?

A

Upper GI bleed

AKI

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

Which antibiotics are nephrotoxic and can precipitate AKI?

A

Gentamicin
Vancomycin
Tetracycline (eg doxycycline)

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

What causes a raised ALKPHOS?

A 
Any fracture
Liver damage
K (kancer)
Pagets disease of bone and pregnancy
Hyperparathyroidism
Osteomalacia
Surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Which drugs cause cholestasis and subsequent high bilirubin and high ALP?

A 
Flucloxacillin
Coamoxiclav
Nitrofurantoin
Steroids
Sulphonylureas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What ECG changes can digoxin cause?

A

Depressed ST segment

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

Which drugs have a borrow therapeutic index and therefore require monitoring?

A 
Digoxin
Theophylline
Lithium
Phenytoin
Gentamicin
Vancomycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What are the signs of digoxin toxicity?

A

Confusion, nausea, visual halos, arrhythmias

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

What are the signs of lithium toxicity?

A

Early: tremor
Intermediate: tiredness
Late: arrhythmias, seizures, coma, renal failure, diabetes inspires

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

What are the signs of phenytoin toxicity?

A

Gum hypertrophy, ataxia, nystagmus, peripheral neuropathy, teratogenicity

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

What are the signs of gentamicin toxicity?

A

Ototoxicity, nephrotoxicity

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

What are the signs of vancomycin toxicity?

A

Ototoxicity, nephrotoxicity

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

How should gentamicin be monitored?

A

Monitor 1 hour after dose (peak) and just before next dose (trough)

If peak too high (>10), reduce dose
If trough too high (>1), increase dose interval

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

What dose of gentamicin do patients usually receive?

A 
Most patients - 5-7mg/kg od
Renal failure (severe)/endocarditis - divided daily dosing (1mg/kg) either 12 hourly or 8 hourly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

How are nomograms used in gentamicin monitoring?

A

Used to determine whether level is too high

  1. Plot blood conc on y axis
  2. Plot time between starting last infusion and taking blood on x axis

If resultant point falls within 24h continue at same dose
If point falls in 36h area, change to 36hourly dosing
If point falls in 48h area, change to 48hourly dosing
If point falls above 48h area, repeat gentamicin level and only re-dose when conc <1mg/L

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

What happens in paracetamol OD?

A
  1. Depletion of glutathione stores (antioxidant that metabolises paracetamol)
  2. Accumulation of toxic metabolite NAPQI
  3. Acute liver damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What is the target INR for patients on warfarin?

A
  1. 5

3. 5 if metallic valves, recurrent VTE

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

How should a major bleed be managed in pt on warfarin?

A
  • Stop warfarin
  • Give 5-10mg IV vit K
  • Give beriplex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Management of minor bleed, INR >8?

A
  • Stop warfarin
  • Give 1-3mg IV vit K
  • Repeat if necessary
  • Restart warfarin when INR<5
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Management of no bleed, INR>8?

A
  • Stop warfarin
  • Give 1-5mg ORAL vit K
  • Repeat if necessary
  • Restart warfarin when INR<5
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Management of no bleed, INR 5-8?

A
  • Stop warfarin for 2 days

- Reduce dose

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

Management of no bleed, INR<6?

A
  • Reduce warfarin dose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Why should ibuprofen be stopped in AKI?

A

Inhibits prostaglandins, this reduces blood flow to the kidney

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

What antibiotic combo is usually given for neutropenic sepsis?

A

IV Tazocin + IV Gentatmicin

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

What are the sick day rules for patients with Addisons Disease?

A

Increase steroids to provide adequate cortisol for the stress response

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

TRUE OR FALSE - Whilst on salbutamol neb you should stop the inhaled salbutamol

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

How should furosemide be administered in an acute setting?

A

Intravenously

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

What drug is indicated for hypertension in over 55 or afro caribbean patients?

A

CCB - amlodipine

contraindicated in HF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What additional med should all patients on opiates be prescribed?

A

Laxative

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

When increasing an opioid dose, how much should you increase the dose?

A

30-50% (NEVER MORE)

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

What meds are used to treat metastatic bone pain?

A

Strong opioids, bisphosphonates, denosumab

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

How do you convert oral morphine to subcutaneous morphine?

A

Divide by 2

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

Which prophylactic antibiotic is given to contacts of meningitic patients?

A

ORAL Ciprofloxacin/Rifampicin

Prophylaxis needs to be offered to household and close contacts of patients affected with meningococcal meningitis. Prophylaxis should also be offered to people who been exposed to respiratory secretion, regardless of the closeness of contact.

People who have been exposed to a patient with confirmed bacterial meningitis should be given prophylactic antibiotics if they have close contact within the 7 days before onset

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

How is anaphylaxis managed?

A
  1. IM Adrenaline
  2. High flow Oxygen and IV fluids
  3. IV Chlorphenamine (antihistamine)
  4. IV Hydrocortisone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Why should beta blockers never be prescribe with verapamil?

A

Risk of life threatening bradycardia

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

In which instances is gradual withdrawal of steroids required?

A
  1. Received more than 40mg prednisolone daily for more than one week
  2. Received more than 3 weeks treatment
  3. Recently received repeated courses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

In paracetamol OD, when should NAC be given?

A
  1. There is a staggered overdose* or there is doubt over the time of paracetamol ingestion, regardless of the plasma paracetamol concentration; or
  2. The plasma paracetamol concentration is on or above a single treatment line joining points of 100 mg/L at 4 hours and 15 mg/L at 15 hours, regardless of risk factors of hepatotoxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Can patients have ACE is in pregnancy?

A

NO - teratogenic

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

Describe the WHO pain ladder

A

Step 1 Non-opioid analgesics
paracetamol
non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin

Step 2 Mild opioid analgesics
codeine
dihydrocodeine

Step 3 Strong opioid analgesics
morphine

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

What laxative is recommended for opiate induced constipation?

A

Lactulose (osmotic laxative)
Docusate (stool softener)

Opiates inhibit gastric emptying and draw fluid in, leaving you with hard stools - therefore osmotics/stool softeners

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

Which 2 medications are usually prescribed weekly?

A

Bisphosphonates

Methotrexate

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

Which 2 medications are usually taken at night?

A

Statins

Amitriptylline

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

Which medication reduces hypoglycaemic awareness?

A

Beta blockers

This is because they reduce the beta affect of adrenaline so you dont get the typical adrenaline mediated symptoms eg. tremor, palpitations

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

Which ACE inhibitors are advised in pregnancy?

A

Labetolol or methyldopa

ramipril is teratogenic in pregnancy

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

What must be communicated to patients started on tamoxifen?

A

Tamoxifen increases the risk of VTE

It also increases the risk of endometrial cancer

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

When should gliclazide be taken?

A

In the morning with breakfast

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

Acute exacerbation of HF - what drug will quickly improve symptoms?

A

IV furosemide 40mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

What is the most immediate management in a patient with DKA?

A

IV fluid therapy

after, give fixed rate insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Lamotrigine in pregnancy?

A

Slightly teratogenic but one of the safer antiepileptics - can be continued under specialist care but woman should take folic acid supplements

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

How often are blood tests required when starting methotrexate?

A

Weekly until therapy is stabilises

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

What parameters should be monitored with IV infusion of phenytoin?

A

ECG and blood pressure

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

What monitoring is involved when taking statins?

A

Measure LFTs taking statins then repeat within 3 months and at 12 months

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

What is the APTT ratio ?

A

It is the ratio of activated partial thromboplastin time to normal clotting time - it is the primary calculation used to monitor heparin therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

How is STEMI managed?

A
  1. ABC and 15L oxygen via non-rebreather mask
  2. Aspirin 300mg oral
  3. Morphine 5-10mg IV with metoclopramide 10mg IV
  4. GTN spray/tablet
  5. Thrombolysis or PCI
  6. Beta blocker unless contraindicated (LVF/asthma)
  7. Transfer to CCU
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

How is NSTEMI managed?

A
  1. ABC and 15L oxygen via non-rebreather mask
  2. Aspirin 300mg oral
  3. Morphine 5-10mg IV with metoclopramide 10mg IV
  4. GTN spray/tablet
  5. Clopidogrel 100mg oral and LMWH
  6. Beta blocker unless contraindicated
  7. Transfer to CCU
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

How is acute LVF managed?

A
  1. ABC and 15L oxygen via non-rebreather mask
  2. Sit patient up
  3. Morphine 5-10mg IV with metoclopramide 10mg IV
  4. GTN spray/tablet
  5. Furosemide 40-80mg IV
  6. If inadequate response, isosorbide denigrate infusion with CPAP
  7. Transfer CCU
LMNOP
Loop diuretics
Morphine
Nitrates
Oxygen 
Position
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

How is anaphylaxis managed?

A
  1. ABC and 15L oxygen via non-rebreather mask
  2. Remove source of anaphylaxis
  3. Adrenaline 500 micrograms 1:1000 IM
  4. Chlorphenamine 10mg IV
  5. Hydrocortisone 100mg IV
  6. Asthma tx if wheezr
  7. Amend drug chart allergies box
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

How is an acute asthma attack managed?

A
  1. ABC
  2. 100% oxygen via non-rebreather
  3. Salbutamol 5mg NEB
  4. Hydrocortisone 100mg IV (if severe) or prednisolone 40-50mg oral (if moderate)
  5. Ipratropium 500 micrograms NEB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

What drug can be added to the acute asthma attack algorithm if life-threatening?

A

Theophylline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

How is a PE managed?

A
  1. ABC
  2. High flow oxygen
  3. Morphine 5-10mg IV and metoclopramide 10mg IV
  4. LMWH eg tinzaparin 175 units/kg SC daily
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

What can be given if a low BP in a PE?

A

IV gelofusine (colloid )- noradrenaline - thrombolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

When should escalation from salbutamol be considered?

A

Nocturnal cough, tremor or use of salbutamol more than twice weekly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Which drugs have antimuscarinic side effects?

A

Anticholinergics

Atropine, cyclizine, amitriptyline

113
Q

What is the management of mild to moderate AD?

A

Donepezil

114
Q

What is the management of moderate to severe AD?

A

Memantine

115
Q

What is the management of vascular dementia?

A

Target vascular risk factors - aspiring and ACEi/CCB

116
Q

Why is domperidone safe for treating nausea in PD patients?

A

Despite it being a dopamine antagonist, it is not dangerous as it does not cross the BBB

117
Q

How much potassium is usually given alongside saline/dextrose?

A

40mmol (max rate 10mmol/hr)

118
Q

At what rate should maintenance fluids be given?

A

1L over 8-12 hours - about 125mil/hour

119
Q

How do you prescribe blood products (not acutely haemorrhaging)?

A

1 Unit Red Blood Cells to be administered over 3 hours (1-3 hours is acceptable)

ALWAYS PRESCRIBE ONE UNIT AT A TIME

120
Q

What should be prescribed for CAP?

A

Amoxicillin
Clarithromycin (penicillin allergic)
Doxycycline (COPD)

121
Q

Which meds cause dyspepsia?

A

NSAIDs, steroids, aspirin

122
Q

What is the most important initial action for a patient having a tonic-clonic seizure?

A

If less than 5 minutes - put in recovery position

If over 5 minutes - Lorazepam 4mg IV

123
Q

Codeine and driving?

A

Advise patients to take precautions if driving or operating heavy machinery

124
Q

What are the sick day rules for Addisons patients?

A

Double usual steroid dose if unwell - if unable to take oral steroids should use rescue back of IM hydrocortisone instead and seek urgent medical advice

125
Q

What is tornadoes de pointes and what causes it?

A

Polymorphic ventricular tachycardia, caused by long QT interval (usually from electrolyte disturbance)

126
Q

How long does it often take for CRP to change over stating abx?

A

24 hours

127
Q

What are the contraindications for NSAIDS?

A 
No urine
Systolic dysfunction (HF)
Asthma
Indigestion
Dyscrasia (abnormal platelets)
128
Q

What analgesia should be given for moderate pain?

A

Regular - paracetamol 1g 6 hourly

PRN - paracetamol 30mg up to 6 hrly

129
Q

What analgesia should be given for severe pain?

A

Regular - co-codamol 30/500 mg. 2 tablets 6 hourly

PRN - morphine titrate up from 2.5mg to 10mg 6 hourly

130
Q

Describe the pain ladder for neuropathic pain

A 
Paracetamol
Gabapentin
Pregablin
Amitriptylline (used less due to antimuscarninc side effects)
Duloxetine
131
Q

What medication class should not be prescribed with tramadol?

A

SSRIs - as risk of serotonin syndrome

132
Q

Which drugs should be increased before surgery?

A

Corticosteroids

133
Q

What do you do if a patient with renal impairment NEEDS CT with contrast?

A

Give a saline bolus to protect them

134
Q

What is the drug treatment for neutropenic sepsis?

A

IV Tazocin

135
Q

What should you monitor for therapeutic effect of diuretics?

A

Weight

136
Q

T2DM, creatinine>150 - which drug to prescribe?

A

Gliclazide

137
Q

How do you manage hypoglycaemia?

A

Conscious: Oral glucose 10-20g
Unconscious: IM glucagon
Severe/IV access: IV glucose 20%

138
Q

What is the definition of a UC flare and how do you manage it?

A

Over 6 bowel movements and systemically unwell

Mild: oral prednisolone 30mg over 24 hours
Severe: IV hydrocortisone and fast fluids

139
Q

Is warfarin safe in pregnancy?

A

Yes but not breastfeeding

140
Q

Why should warfarin be given with LMWH at first?

A

In the first few days warfarin is pro coagulant

141
Q

How long before surgery should the COCP be stopped?

A

4-6 weeks

142
Q

What fluids are given for REPLACEMENT if HYPOVOLAEMIC?

A

0.9% saline, 500ml over 15 minutes

143
Q

What fluids are given for REPLACEMENT if HYPOGLYCAEMIC?

A

5% glucose, 500ml over 15 minutes

144
Q

What should you check before prescribing fluids?

A
  • bladder not distended/palpable
  • no raised JVP
  • no peripheral oedema
145
Q

How are electrolytes added to MAINTENANCE fluids?

A

1mmol/kg

146
Q

What fluids are prescribed for MAINTENANCE?

A

1 salty 2 sweet

1L 0.9% NaCl + 20mmol K over 8 hours
1L 5% dextrose + 20mmol K over 8 hours
1L 5% dextrose + 20mmol K over 8 hours

147
Q

What fluids are prescribed for RESUSCITATION?

A

500ml fluid bolus STAT <15min

250ml renal/cardiac failure/frail

REASSESS AND REPEAT UP TO 2000ml

148
Q

Which laxatives are given in hepatic encephalopathy?

A

Lactulose

149
Q

When should stimulant laxatives (eg. senna) not be prescribed?

A

Bowel obstruction

150
Q

How is hyperkalemia treated?

A
  • IV calcium gluconate 10ml 10%??? check
  • 10 units actrapid
  • 100ml of 20% IV dextrose
  • Nebulised salbutamol
151
Q

PALLIATIVE CARE: What do you give for secretions?

A

Hyoscine butylbromide 60mg/24h

152
Q

PALLIATIVE CARE: What do you give for nausea?

A

Cyclizine 150mg/24h

153
Q

PALLIATIVE CARE: What do you give for pain?

A

Morphine 10mg/24h if new

154
Q

PALLIATIVE CARE: What do you give for agitation?

A

Midazolam 10-20mg/24h

155
Q

What is the difference between spironolactone and furosemide in HF management?

A

Spironolactone improves PROGNOSIS

Furosemide improves SYMPTOM

156
Q

What is the 1st line management for AF going on for over 48 hours?

A

CCB (diltiazem, verapamil) or beta blockers
THINK VERA AND DILL, OLD LADIES

(If fast AF and beta blockers not allowed - use digoxin)

157
Q

What is the 1st line management for AF going on for less than 48 hours?

A 
Pharma cardioversion (amiodarone, flecanide) or DC cardioversion
THINK AMY AND FLEC, COOL YOUNG DRUMMERS
158
Q

What investigation should be done before pharma cardioversion?

A

CXR - interstitial lung disease

159
Q

When is cardioversion contraindicated?

A

Structural heart disease

160
Q

What is the risk of cardioversion?

A

THROMBOEMBOLISM (this is why you only do it if less than 48 hours)

161
Q

How is the therapeutic effect of ACEis monitored?

A

Exercise tolerance

162
Q

Monitoring for vancomycin?

A

Renal function

163
Q

Monitoring for lithium?

A

Weekly lithium levels til stable then every 3 months

TFTs

164
Q

Monitoring for statins?

A

ALT must be <105

Stop if marked rise in CK

165
Q

Monitoring for phenytoin?

A

Phenytoin levels

If IV do ECG

166
Q

Monitoring for ACE inhibitors?

A

Renal function 1-2 weeks after initiation

167
Q

Monitoring for methotrexate?

A

LFT/renal 1-2 weeks at first then every 3 months

AVOID IN HEPATIC/RENAL DYSFUNCTION

168
Q

Monitoring for olanzapine?

A

Fasting blood glucose

169
Q

Monitoring for clozapine?

A

FBC weekly for 18 weeks

170
Q

ECG monitoring for antipsychotics?

A

Only if existing cardiovascular disease - looking for long QT

171
Q

Monitoring for amiodarone?

A

CXR

172
Q

Monitoring for gentamicin?

A

Gentamicin levels
High trough - increase drug interval to clear drug
High peak - reduce dose

173
Q

Monitoring for digoxin?

A

Measure creatinine

174
Q

Monitoring for valproate?

A

ALT

175
Q

Monitoring for carbimazole?

A

FBC - agranulocytosis

176
Q

Monitoring for tacrolimus?

A

Trough level (this is an immunosuppressive drug given in organ transplant)

177
Q

Monitoring for cyclosporin?

A

Renal function

178
Q

In a bleed, if patient very hypotensive what do you give first?

A

FLUIDS stat then bloods

179
Q

After 2/3 units of blood transfusion what do you give?

A

FFP - this is to prevent DIC

nb - normally dont give blood until Hb about 70

180
Q

What drug is given in:

a) wernickes encephalopathy?
b) prevention of withdrawal?
c) prevention of relapse?

A

a) pabrinex (vitamin replacement)
b) chlordiazepoxide
c) acamprosate

181
Q

What is 5mg prednisolone in hydrocortisone?

A

20mg

182
Q

How should you manage a GI bleed?

A
  1. ABC and oxygen
  2. Insert 2 large bore cannula and catheter
  3. Give crystalloid/colloid
  4. Cross match 6 units of blood
  5. Correct clotting abnormalities
  6. Camera (endoscopy)
  7. Stop culprit drugs (NSAIDS, aspirin, warfarin, heparin)
  8. Call surgeons in severe
183
Q

In a GI bleed when do you give a crystalloid and when a colloid?

A

Normal/high BP - crystalloid eg. saline

Low BP - colloid eg. gelofusine

184
Q

How should you manage bacterial meningitis?

A
  1. ABC
  2. High flow oxygen
  3. IV fluids
  4. IV dexamethasone (blunts immune response)
  5. LP and maybe CT head
  6. 2g cefotaxime IV (about 20 min after dexamethasone)
185
Q

How should you manage a seizure?

A
  1. ABC
  2. Recovery position with oxygen
    IF 5 MINS - STATUS EPILEPTICUS
  3. 2-4mg lorazepam IV or 10mg buccal midazolam
  4. Repeat lorazepam
  5. Inform anaesthatist
  6. Phenytoin infusion
  7. Intubate then propofol

(check NICE guidelines!)

186
Q

How should you manage an ischaemic stroke?

A
  1. ABC
  2. CT head
  3. If aged >80yrs and onset <4.5hours ago consider thrombolysis
  4. Aspirin 300mg oral

If haemorrhage stroke discuss with neurosurgery, do not give aspirin or thrombolysis

187
Q

How do you diagnose hyperglycaemic hyper osmotic nonketotic (HONK) coma?

A
  • Hyperglycaemia (BM >35mmol/L)
  • Hyperosmotic (osmolality >340mmol/L)
  • Non ketonic (no ketones present)
188
Q

How do you diagnose DKA?

A
  • Diabetic (BM often >11)
  • Ketones (blood ketone >3)
  • Bicarb <15 or pH <7.3
189
Q

How do you manage DKA/HONK?

A
  1. ABC
  2. IV fluids (1L stat then 1L over 1 hour then 2 hours then 4 hours then 8 hours) - half this if HONK
  3. Sliding scale insulin
  4. Look for cause
  5. Monitor BM, K and pH
190
Q

How do you manage AKI?

A
  1. ABC
  2. Cannula/catheter with strict fluid monitoring
  3. IV fluid: 500ml stat then 1L 4 hourly
  4. Look for cause and complications (fluid overload, hyperkalemia, acidosis)
  5. Monitor U&E and fluid balance
191
Q

How do you manage acute poisoning?

A
  1. ABC
  2. Cannula/catheter with strict fluid monitoring
  3. Supportive measures (IV fluids and analgesia if appropriate)
  4. Correct electrolyte disturbance
  5. Reduce absorption (eg gastric lavage, irrigation, charcoal)
  6. Increase elimination (eg naloxone, NAC, flumanezil)
  7. Psych management
192
Q

What are the antidotes for:

a) opiate overdose?
b) paracetamol overdose?
c) benzo overdose?

A

a) naloxone - if low RR or low GCS
b) NAC - use treatment nomogram
c) flumazenil

193
Q

Describe the NICE treatment of hypertension

A

Step 1 - ACE inhibitor/ARB or CCB (if aged >55 or black)
Step 2 - Add whichever one hadn’t been used
Step 3 - Add thiazide-like diuretic (eg bendroflumethiazide)
Step 4 - Add further diuretic, alpha blocker or beta blocker

194
Q

At which step of the hypertension treatment algorithm are you said to be treatment resistant?

A

Step 4

195
Q

When do you treat HTN?

A

BP >150/95 or

BP >135/85 + vascular disease/hypertensive organ damage

196
Q

What BP do you aim for in patients with HTN?

A

135/85 (home reading)

145/95 if over 80yrs old

197
Q

How is chronic heart failure managed?

A
  1. ACEi + B-blocker
  2. Increase doses if inadequate
  3. Add ARB
  4. Add hydralazine or isosorbide mononitrate (afro caribbean)
  5. Add spironolactone (others)
198
Q

What score is used to calculate risk of stroke in AF?

A

CHA2Ds2-VASc score

If 0 - consider aspirin 75mg daily
If 1 - use aspirin or warfarin (aim INR 2.5)
If 2 - use warfarin

199
Q

How is stable angina managed?

A

ANTI-ANGINAL DRUG - beta blocker or CCB (try both separately before adding nitrate, isosorbide mononitrate or nicorandil)
SYMPTOM RELIEF - GTN
SECONDARY PREVENTION - aspirin, statin

200
Q

How is asthma managed?

A
  1. SABA
  2. Add ICS
  3. Add LABA, consider LTRA or theophylline
  4. Increase ICS to 2000, add fourth drug (as above or beta agonist)
  5. Add oral steroid
201
Q

How is diabetes managed?

A
  1. Metformin 500mg oral or Gliclazide 40m (if underweight or creatinine >150)
  2. Increase drug dose to max tolerated
  3. Add sulphonylurea if on metformin or glisten if on gliclazide
  4. Add insulin
202
Q

What is 1st line for PD?

A

Cobeneldopa or cocareldopa

consider ropinirole or rasagiline if very mild

203
Q

Which drug is 1st line for generalised tonic clonic seizures?

A

Sodium valproate

204
Q

Which drug is 1st line for absence seizures?

A

Sodium valproate or ethosuximide

205
Q

Which drug is 1st line for myoclonic seizures?

A

Sodium valproate

206
Q

Which drug is 1st line for tonic seizures?

A

Sodium valproate

207
Q

Which drug is 1st line for focal seizures?

A

Carbamazepine or lamotrigine

208
Q

Which drug is 1st line for alzheimers?

A

Mild - AChE inhibitor eg. donepezil, rivastigmine, galantamine

Severe - NMDA antagonist eg. memantine

209
Q

What drug is used in Crohns for:

a) flares?
b) inducing remission?

A

a) Prednisolone oral or hydrocortisone IV

b) Azathioprine

210
Q

What drug is used in RA for:

a) flares?
b) inducing remission?

A

a) methyprednisolone, ibuprofen

b) methotrexate, DMARDs

211
Q

In RA, when would you add TNFa inhibitors to management?

A

Failure to respond to 2 DMARDS

212
Q

Which laxative is best for faecal impaction?

A

Docusate - stool softener (if in doubt prescribe this??)

213
Q

After initiation of ace inhibitors, when should renal function and U&E be checked?

A

1-2 weeks after initiation

TELL PATIENT PRECAUTIONS MUST BE TAKEN IN PATIENTS WHO ARE UNWELL AS RISK OF AKI

214
Q

What are the symptoms of an AKI?

A 
Too little urine leaving the body.
Swelling in legs, ankles, and around the eyes.
Fatigue or tiredness.
Shortness of breath.
Confusion.
Nausea.
Seizures or coma in severe cases.
Chest pain or pressure.
215
Q

When should patients on steroids be prescribed a bisphosphonate?

A

If they are expected to be taking steroids for over 3 months

216
Q

What are the sick day rules for insulin?

A

Increase total daily insulin - this is because blood glucose increases when unwell

(nb - may need to decrease if patient not eating anything)

217
Q

What information should be communicated to patients on bisphosphonatewd?

A

The tablet needs to be swallowed with a full glass of water and the patient should remain upright for 30 mins after

218
Q

What parameter should be checked before starting patients on statins?

A

ALT/AST - if raised 3x normal then statins are contraindications

219
Q

What is the normal reference range for lithium?

A

0.4-1

toxicity usually seen above 1.5

220
Q

For a multiple daily dose regimen, what should the peak serum concentration of gentamicin be when treating endocarditis?

A

3-5mg/L

221
Q

For how many weeks does FBC need to be checked after starting a patient on clozapine?

A

18 weeks

222
Q

What ADRs are associated with aspirin?

A

Haemorrhage, peptic ulcers, tinnitus

223
Q

What ADRs are associated with digoxin?

A

Nausea, D&V, blurred vision, confusion, drowsiness, xanthopsia and halo vision

224
Q

What ADRs are associated with amiodarone?

A

Pulmonary fibrosis, thyroid disease, skin greying, corneal deposits

225
Q

What ADRs are associated with statins?

A

Myalgia, abdo pain, increased ALT/AST, rhabdomyolysis

226
Q

Name some drugs with narrow therapeutic index

A

Digoxin, warfarin, phenytoin

227
Q

Name some drugs that require careful titration of dose

A

Antihypertensives, antidiabetic drugs (as over treatment can lead to clinically significant consequences)

228
Q

What is the potential effect of metformin and alcohol interacting?

A

Lactic acidosis

229
Q

What is the potential interaction of alcohol and MAOIs?

A

Hypertensive crisis

230
Q

What is the potential interaction of alcohol and barbs/benzos/opiates?

A

Sedation

231
Q

Name 4 examples of NSAIDS

A

Ibuprofen
Naproxen
Diclofenac
HIGH DOSE aspirin (low dose is NOT an NSAID)

232
Q

Why should NSAIDS and ACE inhibitors not be prescribed together?

A

ACE inhibitors relax vessels leaving the kidney
NSAIDS inhibit prostaglandins, which means that they constrict afferent renal vessels (vessels supplying the kidney).

BOTH OF THESE DRUGS REDUCE GFR AND REDUCE RENAL PERFUSION

233
Q

What class of drug is amiloride?

A

Potassium-sparing diuretic

234
Q

Why is lactic acidosis a risk with metformin?

A
  1. Metformin inhibits hepatic gluconeogenesis
  2. This process would usually mop up lactate
  3. Without new sugar production, lactate can build up in the liver
235
Q

Why is hypoglycaemia a risk with sulphonylureas eg. gliclazide?

A
  1. Sulphonylureas modify calcium levels in beta cells
  2. This calcium shift changes the cell membrane potential
  3. This makes insulin granules bind more readily to the membrane and exocytose
  4. As they act directly on insulin therefore there is a higher risk of hypo
236
Q

Name 2 rapid-acting insulins

A

Insulin lispro - Humalog

Insulin aspart - Novarapid

237
Q

Name an intermediate-acting insulin

A

Isophane insulin - Humulin

238
Q

Name 2 long-acting insulins

A

Insulin detemir - Levemir

Insulin glargine - Lantus

239
Q

Name 2 short-acting insulins

A

Actrapid

Humulin S

240
Q

What is the loading dose of aminophylline?

A

5mg/kg - remember this is often given as an infusion of 25mg/ml over 20 minutes???? check!

241
Q

What is the difference between LMWH and unfractionated heparin?

A

Unfractionated - binds to antithrombin to stop clots growing, used in heart attacks and unstable angina, higher risk of heparin-induced thrombocytopenia, requires monitoring

LMWH - longer and more predictable, self-administered with no monitoring required, used in obstetrics eg. enoxaparin, dalteparin, tinzaparin

242
Q

What is a suitable antibiotic choice for acne that has not responded to topical abx?

A

Tetracycline PO

243
Q

TRUE OR FALSE - allopurinol can be continued in an AKI

A

FALSE - Allopurinol can accumulate in renal dysfunction and the BNF advises a max daily dose of 100 mg (or less if more severe renal injury) until renal function improves.

244
Q

If eGFR is below 44, what antibiotic should be used in UTI?

A

Trimethoprim (avoid nitrofurantoin if possible!)

245
Q

What antibiotic can cause cholestatic jaundice?

A

Co-amoxiclav - develops during or shortly after treatment

246
Q

When increasing or decreasing levothyroxine, how big should the increments/decrements be?

A

25-50micrograms

247
Q

Can you stop antiepileptics abruptly?

A

NO unless patient is toxic and in hospital environment where emergency seizure treatment may be instigated

248
Q

Which anti epileptic causes SIADH?

A

Carbamazepine

249
Q

Below which eGFR should metformin not be prescribed?

A

30

250
Q

What is TENS?

A

Transcutaenous electrical nerve stimulation - this is a non-pharmacological treatment for pain

251
Q

What is drip and suck?

A

The process of giving concomitant IV fluids to prevent dehydration whilst NBM, whilst using a nasogastric tube - often used in smalll bowel obstruction to relieve nausea

252
Q

How much oxygen should be given to a C02 retainer ?

A

24% oxygen via a venturi mask

253
Q

What parameter should be looked at for efficacy when reviewing a patient on antibiotics for pneumonia?

A

Respiratory rate - creps/consolidation take days/weeks to resolve

254
Q

Which parameter should be monitored for resolution of DKA?

A

Serum ketones

255
Q

TRUE OR FALSE - peak levels required in both gentamicin and vancomycin monitoring

A

FALSE - only gentamicin monitoring

256
Q

What drug should be given in a milder allergic reaction?

A

Oral chlorphenamine

257
Q

What are the 1st line drugs in palliative care?

A

Agitation: Midazolam
Secretions: Hyoscine butylbromide
Pain: Morphine (immediate + modified release)
Nausea: Cyclizine, metoclopramide

258
Q

Which drugs increase the QT interval?

A

Cardiac drugs, macrolides, quinolones, antifungals, antipsychotics, antidepressants, domperidone, methadone

(NB - not all of each class, check in BNF)

259
Q

Which drugs should you avoid prescribing with digoxin?

A

Anything that causes hypokalaemia (diuretics, lithium) as increased hisk of toxicity

260
Q

What are the sick day rules for:

a) metformin
b) ACEis/NSAIDS
c) steroids

A

a) stop - risk of lactic acidosis
b) stop only if dehydration, vomiting etc
c) increase

261
Q

Why should you not prescribe tramadol and codeine together?

A

Can cause confusion!

262
Q

What analgesia do post op patients usuallyy get?

A

Regular codeine and post op morphine

263
Q

What is the 1st line drug treatment for SVT?

A

Adenosine 6mg IV STAT (contraindicated in asthma, give verapamil)

NB - 1st line non drug treatment is the vasalva manoeuvre

264
Q

Which drugs are contraindicated in heart failure?

A

Pioglitazone
Verapamil
NSAIDS (use with caution)
Class 1 antiarrhytmatics eg. flecanide

265
Q

Why should anticoagulated patients not receive IM injections?

A

Risk of developing haematoma at injection site

266
Q

What parameter should be measured to assess beneficial affect of UTI treatment?

A

Resolution of acute symptoms over 72 hours - catheter dipsticks are nearly always positive and dipstick urinalysis is unlikely to be helpful in judging whether infection has resoled

267
Q

How should you manage a patient with myopathy and 5x normal CK, due to statin therapy?

A
  1. Discontinue treatment

2. Restart at lower level if symptoms resolve and CK levels reduce to normal

268
Q

What is the management for Wernickes encephalopathy?

A

Pabrinex

269
Q

What is the management for alcohol withdrawal?

A

Chloridazepoxide

270
Q

What is the management for alcohol addiction/to prevent relapse?

A

Acamprosate

271
Q

What are the symptoms of anticholinergic excess?

A

MAD, RED, DRY, BLIND - from amitriptyline, paroxetine, antimuscarinics, antipsychotics

272
Q

What are the symptoms of serotonin syndrome?

A

MAD, RED, WET, DILATED PUPILS - from SSRIs, SNRIs, TCAs, lithium , metoclopramide, opioids

273
Q

Which antibiotic is first line in a patient with C diff colitis?

A

Metronidazole

274
Q

What advice should be given to patients taking bisphosphonates?

A
  • Tablets should be taken 30 min before breakfast weekly whilst sitting or standing, and swallowed with water
  • Patients should see their dentist before treatment and have regular check ups throughout (risk of osteonecrosis of the jaw)
  • Patients should stop treatment and seek medical attention if heartburn or dysphagia develops
275
Q

What measure can reduce the risk of contrast-induced nephropathy?

A

IV 0.9% NaCl

276
Q

What is a good opiate choice for patients with advanced cancer and comorbid CKD?

A

Fentanyl

Morphine is really excreted therefore is not a great choice for someone with CKD

277
Q

Which drugs should be used with caution in patients with IHD?

A
  • NSAIDS
  • Oestrogen containing meds (eg. COCP)
  • Varenicline (used in smoking addiction)
278
Q

What 2 drugs are first line for improving prognosis in chronic heart failure?

A
  • ACE inhibitors
  • Beta blockers

Start one drug at a time

PSA (1 decks)

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