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FINAL YEAR > PSA > Flashcards

PSA Flashcards

1
Q

Rapid tranquilisation

A

IM lorazepam 2mg IV

or

IM haloperidol with IM promethazine

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2
Q

hypokalaemia treatment

A

treat the cause
oral or IV replacement

oral: SandoK 40-120mmol/day
IV: large vein man 20 mmol/hr

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3
Q

C. Diff treatment

A

1st: metronidazole

2nd/subseq.: vancomycin

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4
Q

arrhythmia stroke prevention

A

warfarin

non valvular: apixaban, dabigatran, edoxaban, rivaroxaban

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5
Q

hypoglycaemia treatment

A

conscious and able to swallow: 15-20g quick acting carb snack

conscious, uncooperative: glucose gel

unconscious: IV glucose

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6
Q

max IV K+

A

10 mmol/hour

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7
Q

adult fluid challenge

A

0.9% NaCl or Hartmann’s
no additives
infused over 10 mins

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8
Q

child fluid challenge

A

20 ml/kg
0.9% NaCl or Hartmanns
no additives

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9
Q

drugs eliminated by kidneys

A

CVS: atenolol, digoxin

neuro: opioids, gabapentin, lithium
infection: penicillins, aminogylcosides
other: LMWH, allopurinol, metformin

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10
Q

nephrotoxic drugs

A

NSAIDs
aminoglycosides
radiographic contrast
trimethoprim

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11
Q

hepatotoxic drugs

A

paracetamol
methotrexate
phenytoin
co-amoxiclav

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12
Q

drugs precipitating encephalopathy

A

sedative effects: opioids, bentos, TCAs
hypokalaemic effects: diuretics
constipating effects: antimuscarinics

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13
Q

drugs prescribed in micrograms

A

digoxin
levothyroxine
tamsulosin
inhaled bronchodilators

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14
Q

drugs prescribed in units

A

insulin

heparins

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15
Q

drugs prescribed weekly

A

bisphosphonates

methotrexate

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16
Q

drugs to stop before surgery

A

COCP and HRT: 4 weeks
lithium: day before
K+ sp. diuretics and ACEi: day of
oral hypoglycaemics: variable

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17
Q

obscure interactions

A

methotrexate and trimethoprim

SSRIs and antiplatelets/NSAIDs

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18
Q

serotonin syndrome signs

A 
confusion
agitation
hyperthermia
hyperreflexia
clonus
hypertonia
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19
Q

serotonin syndorme treament

A

withdraw serotonergic drugs
cooling and supportive care
benzodiazepines and required

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20
Q

drugs causing diarrhoea

A 
antacids
metoclopramide
PPIs
ranitidine
digoxin
metformin (usually transient)
ACEi
antibiotics
SSRIs
colchicine
gliclazide
mesalazine
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21
Q

drugs causing confusion

A

morphine sulphate
anticholinergics
antidepressants
anticonvulsants

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22
Q

drugs causing HYPOKALAEMIA

A 
loop diuretics
thiazide diuretics
insulin
acetazolamide
theophylline
prednisolone
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23
Q

drugs causing HYPERKALAEMIA

A 
heparins
ACEi
tacrolimus
aldosterone antagonists
K+ sparing diuretics
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24
Q

drugs causing urinary retention

A 
morphine sulphate
anticholinergics
general anaesthetics
alpha-adrenoceptor agonists
benzodiazepines
NSAIDs
CCBs
antihistamines
alcohol
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25
Q

drugs that prolong the QTc interval

A 
antipsychotics
macrolide abx
anti fungal drugs
anti arrhythmic drugs
quinine
methadone
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26
Q

drugs that cause HYPONATRAEMIA

A 
loop diuretics
thiazide diuretics
carbamazepine
desmopressin
oxytocin
SSRIs
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27
Q

drugs that cause HYPERNATRAEMIA

A

lots of saline
mannitol
lithium

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28
Q

drugs that cause constipation

A

antimuscarinics: hyoscine, oxybutynin, tolterodine, TCAs, antipsychotics
cations: iron salts, calcium salts, aluminium salts (antacids)

CCBs: verapamil

OPIOIDS

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29
Q

drugs that cause seizures

A

analgesics: opioids, LA, diclofenac, indomethacin, aspirin

Abx: isoniazid, mefloquine, metronidazole, betalactams

antidepressants: bupropion, tricyclics
antipsychotics: especially clozapine
bronchodilators: theophylline, aminophylline

nicotine replacement: bupropion, varenicline

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30
Q

acute asthma management

A

O - oxygen driven nebs
S - salbutamol 2.5-5mg neb
P - Prednisolone 50mg oral (or hydrocortisone if can’t have pred)
I - ipratropium bromide 500mcg neb
T - theophylline
M - magnesium sulphate 2g IV over 20 mins
E - escalate care (intubation and ventilation)

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31
Q

monitoring in acute asthma

A

pulse oximetry
ABG on admission and repeat as necessary
peak flow on initial assessment, before and after bronchodilator

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32
Q

pulmonary oedema management

A

IV furosemide 40-80mg bolus followed by infusion at 5-20 mg/hr if needed

IV GTN for patients with concomitant myocardial ischaemia, severe hypertension or regurgitant aortic or mitral disease

REVIEW MEDICATION: stop CCB and NSAIDs where possible

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33
Q

MI acute management

A

if STEMI on ECH and PCI available within 120 minutes: primary PCI
(if no: fibrinolysis transfer to primary PCI centre)

M - morphine 5-10 mg in 10ml slow IV
O - oxygen only if sats <94%
N - sublingual GTN 2 puffs if not hypotensive
A - aspirin 300mg PO loading lose then 75mg OD
T - ticagrelor 180mg PO loading dose and then 90mg BD

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34
Q

MI long term management

A

modify risk factors:

  • smoking cessation
  • treat co-morbidities –> DM, HTN, hyperlipidaemia
  • cardiac rehab for graded exercise
  • mental health awareness

optimise cardioprotective medications:

  • anticoagulation: fondaparinux 2.5mg SC OF 3 days post primary PCI
  • Beta-blockers: bisoprolol 2.5mg OD
  • ACEi: ramipril 1.25mg
  • statin: atorvastatin 80mg
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35
Q

acute COPD exacerbation management

A

O - oxygen 24-28% via venturi mask
S - salbutamol 2.5-5mg neb (AIR DRIVEN)
P - prednisolone PO 40mg daily for 7-14 days
I - ipratropium bromide 500mcg neb
T - theophylline
A - antibiotics: doxycycline PO 200mg STAT then 100mcg OD 5-7 days

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36
Q

COPD long term management

A

1st line: SABA or SAMA

if determined as likely to respond to steroids: LABA and ICS

if not: add a LABA and LAMA

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37
Q

GI bleed management

A

ABCDE approach

platelet transfusion if actively bleeding and plt <50

FFP if actively bleeding and PT or APT >1.5

prothrombin complex to those actively bleeding on warfarin

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38
Q

managing variceal bleeding

A

ABCDE
senior help early
TERLIPRESSIN 2mg IV followed by 1 or 2 mg every 4-6 hours

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39
Q

prophylaxis of variceal bleeding

A

propranolol: reduced rebreeding and mortality

endoscopic variceal band ligation (EVL)

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40
Q

ulcerative colitis management

A

MILD ATTACK:

  • mesalazine 5-ASA
  • given PR for distal, PO for more extensive

MODERATE ATTACK:

  • induce remission with oral prednisolone 40mg/d for 1 weeks then taper by 5mg/week over 7 weeks
  • maintain on 5-ASA

SEVERE ATTACK:

  • if unwell and >6 motions/day, admit for: IV fluids, IV steroids, rectal steroids, VTE prophylaxis
  • if not improving on day 3: rescue therapy with cyclosporin or infliximab
  • involve surgery early in shared care
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41
Q

crohns management - inducing remission

A
  • 1st presentation or single flare in 12 months: glucocorticosteroids (prednisolone, methylprednisolone, IV hydrocortisone
  • consider BUDESONIDE in those with more distal disease or can’t tolerate conventional glucocorticoids
  • consider adding AZATHIOPRINE or MERCAPTOPURINE to induce remission if: 2 or more flares in 12 months, steroid dose can’t be tapered
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42
Q

Crohn’s management - maintaining remission

A
  • offer azathioprine or mercaptopurine as mono therapy to maintain remission
  • consider methotrexate to maintain remission only in people who: needed methotrexate to induce remission or did not tolerate azathioprine or mercaptopurine
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43
Q

DKA management

A

ABCDE
Fluids: 1L 0.9% saline over 1h
Insulin: infusion at 0.1 unit/kg/hr (add 50 units of HSI to 50ml 0.9% NaCl)
Monitoring: check glucose and ketones hourly. check VBG at 2/4/8/12/24 hours
Catheter: if not passed urine by 1h. consider NG tube if vomiting or drowsy
Avoid hypoglycaemia: when glucose <14 start 10% glucose at 125ml/h to run alongside saline
K+ replacement: don’t add to first bag. thereafter add according to VBG result ( >5.5=nil, 2.5-5.5=40mmol, <3.5=seek ITU help)

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44
Q

UTI in pregnancy

A

Nitro 50mg QDS immediate release tablets for 7 days

avoid nitro in 3rd trimester
avoid trimeth in 1st trimester

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45
Q

shingles management

A

start within 72 hours of rash: ACICLOVIR 800mg PO 5 times a day for 7 days

immunocompromised: acyclovir 10mg/kg IV 8hrly 5 days

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46
Q

CAP management

A

CURB 0-1: doxycyline 200mg PO STAT then 100mg OD

CURB 2-5: benpen 1.2g IV 4 hourly + doxycycline 200mg PO STAT then 100mg OD

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47
Q

PE management

A

offer choice of LMWH or FONDAPARINUX

offer warfarin to patients with confirmed PE within 24 hours of diagnosis and continue for 3 months

offer warfarin beyond 3 months to patients with an unprovoked PE

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48
Q

delirium tremens

A

S+S: agitation, confusion, paranoia, visual and auditory hallucinations

ORAL LORAZEPAM 1st line treatment

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49
Q

wernicke’s encephalopathy

A

S+S: confusion, apathy, ocular palsies, nystagmus, ataxia

high risk patients: malnourished, decompensated liver disease

Mx: IV pabrinex in 50-100ml NaCl or dextrose 5% IV infusion over 30 minutes

prophylactic oral thiamine should also be given to harmful or dependent drinkers if they are in acute withdrawal, ro before and during assisted alcohol withdrawal

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50
Q

AF management

A

<48 hours: IV flecainide 1-2mg/kg over 10 mins

if HF or cut eischaemia: amiodarone 300mg bolus via large bore cannula

> 48 hours or uncertain: sort rate control beta-blocker or rate limiting CCB

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51
Q

T2DM hyperglycaemia management

A

1st line: metformin

if uncontrolled (HbA1c >58) add:

  • DPP4 inhibitor
  • sulphonylurea
  • SGLT-2 inhibitors
  • pioglitazone
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52
Q

T2DM cardiovascular risk management

A

control BP - ACEi first line

primary prevention: atorvastatin 20mg daily if 10 year CV risk is >10%

secondary prevention: atorvastatin 80mg daily, anti platelets

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53
Q

acne vulgaris management

A
  1. single topical: topical retinoids, benzoyl peroxide
  2. topical combination: topical abx, benzoyl peroxide, topical retinoid
  3. oral abc: tetracyclines (DOXYCYCLINE, in pregnancy use erythromycin)
  4. oral isotretinoin - SPECIALIST
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54
Q

isotretinoin side effects

A 
teratogenicity
dry skin/eyes/lips
raised triglycerides
hair thinning
nose bleeding
intracranial hypertension
suicidal ideation
photosensitivity
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55
Q

pt advice about anticoagulation

A 
risks of accidental ingestion
monitoring 
alcohol and good
interacting drugs - esp NSAIDs
tell dentist/doctors
dabigatran capsules must be kept whole
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56
Q

pt advice about strong steroids

A 
risks of accidental ingestion
dependence and withdrawal
symptoms/signs of toxicity
MR tablets must be swallowed whole
pregnancy and breastfeeding
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57
Q

pt advice about asthma

A 
avoiding or managing triggers
preventer vs reliever
importance of using preventer
signs of poor control
asthma action plans
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58
Q

sick day rules in diabetes

A

keep taking insulin (adjust doses as needed)
keep well hydrated
keep eating
keep testing sugars
check for ketones
get help is can’t eat/drink anything, vomiting and ketones

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59
Q

pt advice about antiepileptics

A

alcohol, sleep, driving, safety

side effects: dizzy, tired, decreased concentration, SJS, agranulocytosis (CBZ)

interactions: enzyme effects, drugs that lower seizure threshold

brand switching
pregnancy and breastfeeding

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60
Q

significant SE of allopurinol

A

DERMATOLOGICAL:
severe cutaneous adverse reaction (SCAR)
DRESS
SJS

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61
Q

ciclosporin side effects

A 
nephrotoxicity
hepatotoxicity
fluid retention
hypertension
hyperkalaemia
hypertrickosis
gingival hyperplasia
tremor
impaired glucose tolerance
hyperlipidaemia
increased susceptibility to severe infection
62
Q

adverse effects fo heparins

A

bleeding
thrombocytopenia
osteoporosis
hyperkalaemia

63
Q

heparin induced thrombocytopenia (HIT)

A

immune mediated
usually develops 5-10 days into treatment
prothrombotic condition
>50% reduction in platelets, thrombosis and skin allergy

treatment: alternative anticoagulants such as lepirudin and danaparoid

64
Q

macrolide examples

A

erythromycin, clarithromycin, azithromycin

65
Q

adverse effects of macrolides

A

GI upset
cholestatic jaundice
P450 inhibitors

66
Q

adverse effects of metformin

A

GI upset: nausea, anorexia, diarrhoea
reduced B12 absorption
lactic acidosis

67
Q

metformin contraindications

A

CKD
tissue hypoxia eg MI, sepsis, AKI, severe dehydration
iodine containing X-ray contrast media
alcohol abuse (relative CI)

68
Q

tamoxifen adverse effects

A 
menstrual disturbance
hot flushes
VTE
endometrial cancer
osteoporosis
69
Q

quinolone examples

A

ciprofloxacin

levofloxacin

70
Q

quinolone adverse effects

A 
lower seizure threshold
tendon damage (risk increased if also taking steroids)
cartilage damage (avoid in children)
lengthens QT interval
71
Q

drugs that CAN be given in breastfeeding

A 
ABX: penicillin, cephalosporins, trimethoprim
Endo: glucocorticoids, levothyroxine
Epilepsy: sodium valproate, carbamazepine
asthma: salbutamol, theophylline
psych: TCAs
HTN: BB, hydralazine
anticoagulant:warfarin, heparin
digoxin
72
Q

drugs to AVOID in breastfeeding

A 
ABX: cipro, tetracyclines, chloramphenicol, sulphonamides
psych: lithium, benzos, clozapine
aspirin
carbimazole
methotrexate
sulfonylureas
cytotoxic drugs
amiodarone
isotretinoin
73
Q

psoriasis exacerbating factors

A

trauma
alcohol
drugs: BB, antimalarials, NSAIDs, ACEi, infliximab
withdrawal of systemic steroids

74
Q

volume required equation

A

(dose req / stock dose) x stock volume

75
Q

rate (ml/hr) equation

A

(rate (mg/hr) / stock dose mg) x stock volume ml

76
Q

P450 inducers

A

decrease the effects of warfarin

PC BRAS
Phenytoin
Carbamazepine
Barbituates
Rifampicin
Alcohol (chronic)
Sulphonylureas
77
Q

P450 inhibitors

A

increase the effects of warfarin

ODEVICES
Omeprazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Cimetidine and Ciprofloxacin
Ethanol (acutely)
Sulphonamides
78
Q

major bleeding on warfarin management

A

dried prothrombin complex
phytomenadione (vit K) 5mg IV

and withhold warfarin

79
Q

minor bleeding on warfarin management

A

phytomenadione (vit K) 1-3mg IB

withhold warfarin

80
Q

INR >8 on warfarin management

A

phytomenadione (vit K) 1-5mg oral

withhold warfarin

81
Q

INR 5-8 on warfarin management

A

withhold warfarin only

82
Q

drugs that cause impaired glucose tolerance

A 
thiazides / furosemide 
steroids
tacrolimus / ciclosporin
interferon alpha
nicotinic acid
antipsychotics
83
Q

drugs that cause urinary retention

A 
morphine sulphate
anticholinergics
general anaesthesia
alpha adrenoceptor agonists
benzos
NSAIDs
CCBs
antihistamines
alcohol
84
Q

drugs that cause lung fibrosis

A 
amiodarone
cytotoxic agents: busulphan, bleomycin
anti rheumatoid drugs: methotrexate, sulfasalazine
nitrofurantoin
bromocriptine / cabergoline / pergolide
85
Q

TB drug side effects

A

RIFANPICIN: P450 inducer, hepatits, orange secretions, flu like symptoms

ISONIAZID: P450 inhibitor, peripheral neuropathy, hepatitis, agranulocytosis

PYRAZINAMIDE: hyperuricaemia (gout), arthralgia, myalgia, hepatitis

ETHAMBUTOL: optic neuritis

86
Q

drug levels routinely measured

A

ahminoglycosides (gentamicin, amikacin)
vancomycin
tacrolimus and ciclosporin
lithium

87
Q

statins safety monitoring

A

liver enzymes at baseline, 3m and 12m
can accept LFTs 3x upper normal
check TFTs before starting

88
Q

methotrexate safety monitoring

A

before: FBC, LFT, U+E - then 1-2 weekly and then 2-3 monthly

avoid in pregnancy

CI in severe renal impairment

can cause hepatotoxicity

89
Q

amiodarone safety monitoring

A

TFTs before and 6 monthly
LFTs before and 6 monthly
K+ before
CXR before

IV use: ECG monitoring and resus available

90
Q

low platelets causes

A

reduced production: infection, pencillamine, myelodysplasia, myelofibrosis, myeloma

increased destruction: heparin, hypersplenism, DIC, ITP, H|US, TTP

91
Q

high platelets causes

A

reactive: bleeding, tissue damage (infection, inflammation, malignancy), post-splenectomy
primary: myeloproliferative disorders

92
Q

high neutrophils causes

A

bacterial infection
tissue damage
steroids

93
Q

low neutrophils causes

A

viral infection
chemo or radio therapy
clozapine
carbimazole

94
Q

high lymphocyte causes

A

viral infection
lymphoma
CLL

95
Q

SIADH

A

large amount of ADH secreted into the body even when there is a decrease in plasma osmolality, causes an increase in aquaporin channels

more water reabsorbed back into the blood and sodium becomes more diluted

urine therefore more concentrated and high urine osmolality (>100)

96
Q

causes of SIADH

A 
'SIADH'
small cell lung tumours
infection
abscess
drugs: carbamazepine, antipsychotics
head injury
97
Q

hyperkalaemia causes

A 
drugs: K+ sp diuretics, ACEi, spironolactone
renal fialure
Addisons disease
artefact (clotted sample)
DKA
rhabdomyolysis
massive blood transfusion
98
Q

hypokalaemia causes

A

drugs: loop and thiazide diuretics
inadequate intake/intestinal loss (D+V)
renal tubular acidosis
endocrine: cushings and conns

99
Q

loop diuretics

A

eg furosemide, bumetanide

ascending LoH

SE: hyponatraemia, hypokalaemia, hearing loss, tinnitus

100
Q

thiazide diuretics

A

eg bendroflumethiazide, indapamide

cotransporter of DCT

SE: hyponatraemia, hypokalaemia, impotence, worsens gout

101
Q

K+ sparing diuretics

A

eg amiloride, triamterene

DCT

not given with K+ supplements of ACEi or ARBs

102
Q

aldosterone antagonists

A

eg spironolacotone, epleronone

DCT

SE: hyperkalaemia, gynaecomastia, liver impairment, jaundice, SJS

103
Q

elective hip VTE prophylaxis

A

LMWH 10 days then aspirin (75 or 150) 18 days

OR

LMWH 28 days combined with strockings

104
Q

elective knee VTE prophylaxis

A

aspirin 75 or 150mg 14 days

or

LMWH 14 days with stocking

105
Q

fragility fractures of pelvis/hip/proximal femur VTE prophylaxis

A

LMWH or fondaparinux

106
Q

HRT contraindications

A 
oestrogen dependent cancer
past PE
undiagnosed PV bleeding
abnormal LFTs
pregnancy
breastfeeding
107
Q

HRT side effects

A 
fluid retention
bloating
breast tenderness
nausea
headaches
leg cramps
dyspepsia
mood swings
depression
acne
backache
108
Q

benefits of HRT

A

reduction of vasomotor symptoms
improvement in GU symptoms
osteoporotic fractures reduced
reduced risk of colorectal cancer (around 1/3)

109
Q

risks of HRT

A

breast cancer risk increased by around 2.3% per year (returns to normal after 5 years off) - highest risk on combined

unopposed oestrogen increase risk of endometrial cancer

more than doubles VTE risk - most likely in first year and increases with age

110
Q

TCA (amitriptyline) toxicity presentation

A 
altered consciousness
tachycardia
dilated pupils
dry mouth
hot dry skin
urinary retention

long PR/QRS/QTc
heart block
changes to ST and T wave

111
Q

management of TCA OD

A

activated charcoal within 1h reduces absorption

IV Lorazepam for convulsions

sodium bicarbonate if QRS >120 ms (3 small squares)

112
Q

digoxin toxicity features

A 
generally unwell
lethargy
N+V
anorexia
confusion
yellow green vision
arrhythmia: AV block, bradycardia
113
Q

precipitating factors of digoxin toxicity

A 
HYPOKALAEMIA
increasing age
renal fialure
myocardial ischaemia
hypomagnesaemia, hypercalcaemia, hypernatraemia
acidosis
hypoalbuminaemia
hypothermia
hypothyroidism

drugs: amiodarone, quinidine, verapamil, diltiazem, spironolactone, ciclosporin

114
Q

lithium toxicity precipitating factors

A

dehydration
renal fialure
drugs: diuretics, ACEi, ARBs, NSAIDs, metronidazole

115
Q

features of lithium toxicity

A 
D+V
ataxia
dysarthria
muscle twitching
tremor
seizure
acute confusion
116
Q

management of lithium toxicity

A

mild-mod: volume resus with NaCl

severe: haemodialysis

117
Q

features of opioid overdose

A 
drowsiness
confusion
hallucinations
myoclonic jerks
respiratory depression (RR<8)
118
Q

opioid overdose management

A

stop the opioid and obs monitoring
ABCDE

NALOXONE IV 100-200mcg every 2-3 mins until rousable and rest drive returns

expect to see improvement after 3-4 doses

119
Q

CO poisoning features

A 
headache
nausea
irritable 
dizziness
respiratory failure
confusion
120
Q

management of CO poisoning

A

measure carboxyhaemoglobin and ABG

give OXYGEN at max conc ± IPPV

treat metabolic acidosis with O2, AVOID sodium bicarb

anticipate cerebral oedema - if necessary give mannitol 1g/kg

discuss hyperbaric oxygen therapy if:

  • unconscious at any time since exposure
  • carboxyhaemoglobin >20%
  • any neuro/psych symptoms
  • CVS complications
  • pregnancy
121
Q

paracetamol OD management

A

WITHIN 4 HRS:

  • <1hr activated charcoal if >150mg/kg ingested
  • NAC if above treatment line

4-8 HOURS:

  • measure plasma conc at presentation
  • use graph to decide on NAC

8-15 HOURS:

  • urgent blood conc
  • start NAC immediately if >150 mg/kg ingested
  • stop NAC if level below treatment line

15-24 HOURS OR STAGGERED:

  • urgent blood measurement
  • start NAC immediately
122
Q

aspirin over dose S+S

A

hyperventilation
respiratory alkalosis then metabolic acidosis
tinnitus (level >400)

123
Q

aspirin over dose management

A

ABCDE

activated charcoal if <1hour

consider gastric lavage in adults within 1hr of potentially life threatening over dose providing can protect airway

urinary alkalinisation: IV sodium bicarbonate

haemodialysis: renal failure, CHF, hypoxia, coma, convulsions, CNS effects not resolved by correction of acidosis, persistently high salicylate levels unresponsive to urinary alkalinisation

124
Q

insulin SEs

A

hypoglycaemia
weight gain
lipodystrophy

125
Q

metformin SE

A

GI upset

lactic acidosis

126
Q

sulphonylureas/gliclazide SEs

A

hypoglycaemia
GI upset
weight gain
hyponatraemia

127
Q

thiazolidinediones SEs

A 
weight gain
anaemia
small increase in bladder cancer
increased fractures in women
fluid retention
128
Q

DPP4 inhibitors (gliptins) SEs

A

generally well tolerated

increased risk of pancreatitis

129
Q

SGLT2 inhibitors (glifozins) SEs

A

UTI

weight loss

130
Q

GLP1 agonists (-tides) SEs

A

N+V
pancreatitis
weight loss

131
Q

examples of rapid acting insulins

A

insulin aspart = NovoRapid

insulin lispro = Humalog

132
Q

examples of short acting insulins

A

Actrapid

Humulin S

133
Q

examples of intermediate acting insulins

A

isophane insulin

134
Q

examples of long acting insulins

A 
insulin determine (Levemir): OD or BD
insulin glargine (Lantus): OD
135
Q

palliative care analgesia for bone metastases

A

bisphosphonates

136
Q

palliative care analgesia for neuropathic pain

A

pregabalin or gabapentin

137
Q

breakthrough pain dosages

A

1/10 to 1/6 of the regular 24 hour dose

repeated every 2-4 hours as required

review pain management if rescue analgesia is needed 2x daily or more

138
Q

palliative care pain relief for patients who can’t tolerate morphine

A

oxycodone

139
Q

opioids oral vs parenteral (SC/IM/IV)

A

parenteral about half the oral dose

140
Q

palliative care: anorexia management

A

prednisolone

dexamethasone

141
Q

palliative care: bowel colic and resp secretions management

A

hyoscine hydrobromide or glycopyrronium bromide

generally given every 4hours SC

142
Q

palliative care: constipation management

A

regular laxatives: faecal softener with a peristaltic stimulant or lactulose solution with a Senna preparation should be used

143
Q

palliative care: convulsions management

A

prophylactic treatment with phenytoin or carbamazepine

144
Q

palliative care: dry mouth management

A

artificial saliva, sucking ice

dry mouth due to candidiasis: nystatin

145
Q

palliative care: dyspnoea management

A

orla morphine

146
Q

palliative care: N+V management

A

metoclopramide: associated with gastritis, gastric states, functional bowel obtruction
haloperidol: most metabolic causes (eg hypercalcaemia, renal failure)
cyclizine: mechanical bowel obstruction, raised ICP, motion sickness

147
Q

levodopa (PD) SEs

A

motor fluctuations

dyskinesias

148
Q

dopamine agonists (PD) SEs

A

sedation

impulse control disorder

149
Q

MAO-B inhibitor (PD) SEs

A

generally well tolerated

150
Q

COMT inhibitor (PD) SEs

A

diarrhoea

151
Q

anticholinergic medication (PD) SEs

A

confusion
dry eyes and mouth
constipation
urinary retention

152
Q

amantadine (PD) SEs

A

diarrhoea

confusion

FINAL YEAR (2 decks)

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