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PSA Flashcards

1
Q

All diuretics

A 
· Hyponatremia
	• Although when they contribute to dehydration, the sodium can increase too.
· Hypotension
· AKI
· Give in mornings – subsequent diuresis
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2
Q

Thiazide (Bendroflumethiazide)

+ Loop diuretic (Furosemide)

A

· Hypokalaemia

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3
Q

ACEi (Lisinopril)

A

· Hyperkalaemia
· Dry cough
• (accumulation of bradykinin via reduced degradation by ACE)
· Reduces AT-2 production necessary for preserving GFR when the renal blood flow is reduced
· CI in pregnancy (teratogenic) – convert to Labetolol before conception
· Postural hypotension – given in evenings [except Perindopril: in AM]

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4
Q

K+ sparing diuretics (aldosterone antagonists)(Amiloride)

A

· Hyperkalaemia

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5
Q

CCB (Amlodipine)

A 
· Peripheral oedema (ankle swelling)
	• E.g. normal EF/echo i.e. no HF
· Hypotension
· Bradycardia
· Flushing
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6
Q

βblockers

Bisoprolol 10mg daily

A 
· Bronchospasm in asthmatics
· Hypotension
· Bradycardia
· Cold extremities
· Fatigue
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7
Q

SABA (Salbutamol, Terbutaline)

A

· Tremor

· Tachycardia

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8
Q

NSAID (Ibuprofen, Diclofenac, Naproxen)

A

NSAIDs: No urine (renal failure), Systolic dysfunction (HF), Asthma, Indigestion (any cause), Dyscrasia (clotting abnormality)
· Indigestion
o (inhibits PG synthesis needed for gastric mucosal protection from acid – thus @ risk of influencing inflammation + ulceration)
· Renal failure
o (inhibits PG synthesis which reduces renal artery diameter (+ blood flow) and thus reducing kidney perfusion and function)
· Bronchoconstriction – asthmatics

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9
Q

Aspirin

Cardioprotective dose = 75mg daily ACS/stroke dose = 300mg orally

A

· Despite being NSAID, aspirin rarely worsens asthma and is commonly (cautiously) used
· Haemorrhage
· Peptic ulcers + gastritis
· Tinnitus in large doses

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10
Q

Warfarin

A

· Haemorrhage

• Remember Heparin should be prescribed alongside Warfarin (pro-coag effects first) and continued until INR >2

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11
Q

Heparin

A

· Haemorrhage (esp if renal failure or <50kg)

· HIT

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12
Q

Steroids (Prednisolone)

A

· Oral steroids inhibit gastric epithelial renewal thus predisposing to ulceration
STEROIDS: Stomach ulcers, Thin skin, Edema, Right + Left HF, Osteoporosis,
Infection (incl Candida), Diabetes,

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13
Q

Antibiotics (most commonly broad- spectrum e.g.Cephalosporins/Cipro)

A

· Clostridium Difficile colitis

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14
Q

Gentamicin/Vancomycin

A

· Nephrotoxicity, ototoxicity

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15
Q

Trimethoprim

A

· Risk of bone marrow toxicity (pancytopenia/neutropenic sepsis)
• Folate antagonist thus CI if on Methotrexate (another folate antagonist)

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16
Q

Methotrexate

A

· If patient on Methotrexate has sepsis, this medication is withheld pending exclusion of neutropenic sepsis.
· Do not start if abnormal LFTs (risk of liver cirrhosis)
· Fatal blood dyscrasias
· Pulmonary fibrosis

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17
Q

Cyclizine

A

· Sedating antihistamine

· Anti-muscarinic effects

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18
Q

TCA (Amitryptiline)

A

· Also has anti-muscarinic SEs (seeing double, dry mouth)

• Used at lower doses in the tx of neuropathic pain (10mg), higher doses in tx as antidepressant (20mg)

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19
Q

SSRI (Citalopram)

A

· Dry mouth
· Serotonin syndrome (temperatures, agitation, hallucinations)
· Photosensitive

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20
Q

COCP (Microgynon)

A

· CI in migraine with aura as significantly incr risk of stroke

21
Q

Tamoxifen

A

· DVT
· Hot flushes
· Incr risk of endometrial carcinoma
· Increases efficacy of Warfarin and thus incr susceptibility to high INR readings

22
Q

Carbimazole

A

· Drug-induced neutropenia

· –> seek help if signs of infection (e.g. sore throat)

23
Q

Metformin

A

· Risk of lactic acidosis

24
Q

Carbamazepine
(alternative to gabapentin for tx of
neuropathic pain)

A

· Neutropenia

· SIADH

25
Q

Sodium Valproate

A

· Hepatotoxicity
· Pancreatitis
· OP risk?

26
Q

Lithium

A

· Early – tremor
· Intermediate – tiredness
· Late – arrhythmias, seizures, coma, renal failure, DI

27
Q

Haloperidol

A

· Dyskinesias e.g. acute dystonic rxns, drowsiness

28
Q

Clozapine

A

· Agranulocytosis (req intensive FBC monitoring)

29
Q

Statin

A 
· Caution if liver disease
	o CI if active disease/ALT or AST is > 3x the normal range
· If RFs present, @ risk of myopathy
	o Common SE: myalgia
	o Dangerouse SE: rhabdomyolysis
· Abdo pain
30
Q

Amiodarone (anti- arrhythmic)

A

· ILD (pulmonary fibrosis)
· Thyroid disease (both hypo- and hyperthyroidism are reported; it is structurally related to iodine)
· Skin greying
· Corneal deposits

31
Q

Digoxin (anti-arrhythmic)

A 
· HypoK increases risk of toxicity
· N&amp;V
· Diarrhoea
· Blurred vision
· Confusion + drowsiness
· Xanthopsia (disturbed green/yellow visual perception including ‘halo’ vision)
32
Q

Most Antibiotic courses duration

A

5 days

33
Q

Regular mild pain

A

Paracetamol 1g up to 6-hourly oral

34
Q

Regular severe pain

A

Co-codamol 30/500, 2 tablets 6-hourly oral

35
Q

PRN mild pain

A

Codeine 30mg up to 6-hourly oral

36
Q

PRN severe pain

A

Morphine Sulphate (Oral –> SC –> IV)*(1) Oramorph 10mg/5ml up to 6-hourly

(2) SC Morphine sulphate
(3) IV Morphine sulphate

37
Q

PRN no pain

A

Paracetamol 1g up to 6-hourly oral

38
Q

Regular no pain

A

Nil

39
Q

Calculate PRN dose of Morphine sulphate

A

*PRN doses of Morphine Sulphate (e.g. Oramorph) = 1/6 of the total daily dose given up to every 4-6 hrs

40
Q

Generally, which fluid to give

A

GENERAL RULE: Give all patients 0.9% Sodium Chloride

41
Q

Which fluid to give in hypernatraemia

A

give 5% Dextrose

42
Q

Which fluid to give in hypoglycaemia

A

give 5% Dextrose

43
Q

Which fluid to give in ascites

A

give Human-Albumin Solution (HAS)Albumin maintains oncotic pressure, higher Na content in saline worsens ascites

44
Q

Which fluid to give in shock with sBP < 90

A

give Gelofusine (a colloid)Has a high osmotic content so stays intravascularly thus maintain BP for longer

45
Q

Which fluid to give in shock due to bleeding

A

give blood transfusion but a colloid 1st if no blood available

46
Q

Generally, 1st line anti-emetic

A

Cyclizine 50mg 8-hourly

MOA: anti-histamine

Good 1st line tx for almost all cases

C/I: Cardiac failure (can worsen fluid retention)

47
Q

Anti-emetic in heart failure

A

Metoclopramide 10mg 8-hourly

C/I: Parkinson’s disease

48
Q

Anti-emetic in PD

A

Domperidone: safer to use b/c does not cross BBB

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