PSA Flashcards
What drugs commonly cause Diarrhoea?
CAMP DRAM
C - Colchicine A - ABX M - Metformin P - PPI's D - Digoxin R - Ranitidine A - ACE-inhibitors M - Metoclopramide
What drugs commonly prolong the QT interval?
QT MASQ
Antipsychotics SSRI's Macrolides (e.g. Erythromycin) Antifungals Methadone Quinine
What drugs can induce seizures?
CMON T SEIZ
Opioids Metronidazole Clozapine Theophylline Nicotine replacement medications
Drugs that can exacerbate heart failure?
Pioglitazone - Causes fluid retention
Verapamil - Negatively inotropic
NSAIDs/Glucocorticoids - Cause fluid retention
Class I antiarrhythmics - Flecainide
What blood glucose to aim for in hospital?
5-10 mol/L
What should you do if the Peak dose of gentamicin is too high?
The next dose must be decreased
What should you do if the Trough dose of gentamicin is too high?
Interval between doses must be increased
What 3 things should you do in a patient on warfarin with a major bleed?
Give Dried Prothrombin Complex
Give Vitamin K 5mg IV
Stop warfarin
What antibiotic should you avoid drinking alcohol while taking?
Metronidazole
What should you give in methotrexate toxicity?
Folinic Acid
What weight should you use a reduce paracetamol dose of 15mg/kg for?
<50kg
How long before should you stop a PPI and ABX before H.Pylori testing?
PPI 2 weeks
ABX 4 weeks
What drugs cause urinary retention?
MAGBAT
M - Morphine A - Antipsychotics G - General anaesthesia B - Benzodiazepines A - Antidepressants T - Tricyclic antidepressants
What is the maximum dose of citalopram elderly can take?
20mg OD
What drugs exacerbate psoriasis?
BAAN
B - Beta Blockers
A - ACE-inhibitors
A - Anti-malarials
N - NSAIDs
What is the transfusion threshold of Hb to give blood in normal patients and then those with ACS?
70 g/L unless ACS then is 80 g/L
What blood test do you measure before starting Azathioprine?
TPMT
The enzyme thiopurine methyltransferase (TPMT) metabolises thiopurine drugs (azathioprine, mercaptopurine, tioguanine); the risk of myelosuppression is increased in patients with reduced activity of the enzyme, particularly for the few individuals in whom TPMT activity is undetectable.
What crucial piece of advice should you give patients starting on Methotrexate?
Patients and their carers should be warned to report immediately the onset of any feature of blood disorders (e.g. sore throat, bruising, and mouth ulcers)
At what level of raised LFT would you consider stopping statin therapy?
Can accept LFTs 3X upper normal limit, if above consider having a “statin holiday” and then restarting at a lower dose
What two blood test should be checked every 6 months for patients taking amiodarone?
TFTs and LFTs
When giving ferrous sulphate to correct iron-deficiency anaemia how long should the patient take iron for after their Hb has normalised?
Continue for 3 months after Hb normalises to replenish stores
A vegan patient is found to have a macrocytic anaemia, deficient in B12 but not folate. What would you originally prescribe?
Hydroxocobalamin (B12) 1mg 3 x week for the first 2 weeks
Then 1mg every 2-3 months (maintenance)
What drug may mask the signs and symptoms of hypoglycaemia?
Beat Hugh up
Beta-Blockers
A young 15 year old patient is suffering from frequent migraines. They have tried both paracetamol and ibuprofen which have had no effect. What could you prescribe for this patient?
Sumatriptan 10mg Intranasally
From NICE Guidelines
If simple analgesia is ineffective consider a nasal triptan.
Oral triptans are not licensed for use in people under the age of 18 years.
What medication should be prescribed for patients that have had a subarachnoid haemorrhage as vasospasm prophylaxis?
NIMODIPINE 60mg every 4 hours
What is the maximum rate you can give potassium IV?
K can not be given at more than 10mmol/hr
What is the main electrolyte deficiency that can precipitate digoxin toxicity?
Hypokalaemia
Digoxin normally binds to the ATPase pump on the same site at potassium. In hypokalaemia there is less competition so digoxin binds more easily to the pump and increases its inhibitor effect
Drugs that precipitate encephalopathy fall under 3 categories, what are they?
- Sedatives (Antihistamines, Benzos, Opioids)
- K+ lowering effects (Loop & thiazide diuretics, insulin, steroids)
- Constipating effects (Opioids, verapamil, anti-psychotics)
What medication should you give to an alcoholic who hasn’t had a drink in a few times that is sweating, shaking and feels sick?
Chlordiazepoxide
Patient is in alcohol withdrawal
Patients taking regular opioids for chronic pain. How do you calculate how much they should take for breakthrough pain?
1/10 - 1/6 of their regular 24hr dose
What side effects does Dapagliflozin have?
UTI
MOA is to inhibit reabsorption of glucose in the kidney
What diabetic medication other than insulin is the main cause for hypoglycaemia?
Sulfonylureas (e.g. Gliclazide)
A young women is trying to have a baby but would like some treatment for heavy painful periods she is having. What could you prescribe?
Mefenamic acid (NSAID) is useful in treating both menorrhagia and dysmenorrhoea
An old hag is started can’t keep her wee in and is diagnosed with urge incontinence. Conservative management has failed and she is started on Oxybutynin. What SE should you tell the patient she might experience?
Oxybutynin is an Antimuscarinic: Dry mouth Dizziness Constipation Headache
An 11 year old boys presents to the emergency department drowsy, wheezing, with widespread urticaria after eating some peanuts. What medication should you immediately prescribe.
Adrenaline 300 micrograms (i.e. 0.3ml of 1:1000)
How long should you stop COCP and HRT before surgery?
4 weeks
How long should you stop aspirin before surgery?
7 days
How long should you stop ACE-inhibitors before surgery?
24 hours
A patient has gone into cardiac arrest, he has been shocked 3 times with no success. No medication has been given yet, what two should you give?
Adrenaline 1mg IV (1 in 10,000) every 3-5 minutes in cardiac arrest
Amiodarone 300mg after 3 shocks
What criteria is there to give women continuous combined HRT?
Women >54 Years old
Women <50yrs should have no periods for 2 years
Women >50yrs should have no periods for 1 year
Menopausal women with a uterus do you give oestrogen + progesterone or just oestrogen?
Both
Unopposed oestrogen is a major risk factor for endometrial cancer so need to give with progesterone
How long after stopping methotrexate should patients carry on using effective contraception?
3 months
