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1
Q

Cut off for metformin use for eGFR and creatinine

A

eGFR <30 and a creatinine of >150 μmol/L

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2
Q

when should methotrexate not be started

A

owing to the risk of liver cirrhosis, treatment with methotrexate should not be started if liver function tests are abnormal.

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3
Q

how many drops in 1 ml

A

20

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4
Q

what is important to check and record before commencing olanzapine?

A

fasting blood glucose, as antipsychotics can cause diabetes

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5
Q

amiodarone - what to check before and during rx

A

CXR before needed
Thyroid function tests should be performed before treatment and then every 6 months.
Liver function tests required before treatment and then every 6 months.
Serum potassium concentration should be measured before treatment.

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6
Q

blood test for sodium valproate

A

LFTs

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7
Q

Clozapine monitoring

A

FULL BLOOD COUNT MUST BE CHECKED WEEKLY FOR THE FIRST 18 WEEKS

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8
Q

1st thing to do in anaphylaxis

A

secure airway

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9
Q

for drug errors, check what

A

dose - amount and units, route, frequency

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10
Q

Each tablet of co-codamol contains how much paracetamol

A

500mg

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11
Q

drowsiness/resp depression - stop what?

A

Co-codamol, codeine, diazepam

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12
Q

do you stop thiazides before surgery

A

yes

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13
Q

anuria means what and so what should be stopped

A

renal failure, so stop nsaids

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14
Q

Lithium excretion is signifcantly reduced by

A

ACE-inhibitors

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15
Q

Lithium excretion is signifcantly reduced by

A

ACE-inhibitors, diuretics, NSAIDs

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16
Q

max rate that potassium should be given

A

should never be given at more than 10mmol/hour

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17
Q

worst pill to miss on cocp

A

the first one

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18
Q

if IV paracetamol given whats the limit

A

4g or 3g if <50kg

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19
Q

how to get inr management on bnf

A

type oral anticoagulants

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20
Q

Communicating information - how to look in bnf

A

patient and carer advice section

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21
Q

carbamazepine - electrolyte disturbance

A

hyponatremia

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22
Q

for adrenaline 1 in 1000 and 1 in 10000 means ?

A

for adrenaline 1 in 1000 means 1 mg/ml, 1 in 10000 means 1mg/10ml

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23
Q

how to increase phenytoin dose

A

should increase the dose by the minimum increment possible

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24
Q

if change in electrolyte, but patient is well and no drugs given, what to do

A

repeat biochemistry tests

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25
codeine causes
constipation
26
what is tens
Transcutaneous electrical nerve stimulation for back pain if nothing else is safe
27
steroid prescription when ill?
During episodes of sepsis, | steroid prescriptions are doubled to meet physiological demand
28
can you stay on methotrexate during sepsis
no
29
rx of HAP
pip-taz
30
in the majority of cases with IV antibiotics one should review after no more than 3 days as most patients will be able to step down to oral antibiotics
know this
31
when to give pain meds in prn vs regular
prn when you're not in constant pain and it comes and goes regular when constant
32
if mild allergic reaction, what do you give
no anaphylaxis so no adrenaline or IV hyrdrocort give oral chlorphenamine
33
Glucose 50% is not recommended due to the high risk of extravasation injury and because administration is diffcult due to the high viscosity.
use 10 or 20%
34
what time do you avoid thiazides
evening, as then they will want to pee when sleeping
35
drugs that worsen asthma
BB and NSAIDS
36
eg of colloid and when are they used
gelofusine | given when low BP
37
1st line rx in T2DM
Diet and exercise
38
when is flecainide CI
HTN and heart disease
39
INR - when is it considered a major bleed
if low BP
40
what to avoid in myasthenia gravis
Anti-muscarinics
41
Review dates for oral and IV abx
``` oral = 5 days IV = 3 days ```
42
GAD rx 1st line
sertraline
43
DVT rx immeditely
Dalteparin - usually 15000 units
44
what time are benzos given
at night
45
how to check theophyline toxicity
serum theophylline levels
46
oedema rx
furosemide IV
47
when not to give nitro and egfr cut off
45
48
Dalteparin prophylaxis dose
5000 units daily at 10000 units/ml
49
Heparins SE
hyperkalaemia
50
Tacrollimus SE
hyperkalaemia
51
when to give vit K before surgery
INR >1.5
52
ACEi monitoring
exercise tolerance
53
Cut off to increase statin dose
less than 40% decrease in HDL
54
how much to raise insulin
10% better to increase those than add new prescription
55
taking topiramate - change contraception if ?
taking progesterone only pill- desogestrel
56
glucose maintenance - answer?
glucose 5%/potassium chloride 0.3% solution (has 40 mmol)
57
if patch drug, what do you write in dose
1 patch
58
ishcaemic ulcers - what drug CI
beta blockers
59
HF - avoid what drug
CCB
60
unconscious and at hosp cos of hypogly - rx?
15g glucose IV 20% solution
61
statin - increase CK - what do you do
stop it and wait till CK normalises --> start statin at lower dose
62
statin and glucose hx - 1st ix to monitor
hba1c
63
acute bleed - do you stop aspirin
no, as platelets last for 10 days
64
loose stools - drug causes
steroids | PPI
65
bradycardia - drug causes
digoxin | beta blockers
66
candida and preg - rx
clotrimazole pessary 7 days
67
C.diff rx - 1st and 2nd time
metronidazole | vancomycin if 2nd time
68
old and post herpetic neuralgia
paracetamol
69
loperamide - when to take
after each loose stool
70
antidepressants - what to say to patients
takes 6 weeks to get benefits
71
how to monitor apixaban
tell pts to report bleeding
72
In an adverse drug reaction - do you increase/decrease/stop the drug
stop the drug
73
if asthma attack and on inhaled saba. what do you do
nebs saba
74
statin 1ry and 2ry prev dose
20mg and 80mg
75
dvt rx
apixaban or rivaroxaban
76
anaemia - stop what drug
aspirin
77
statin given - LFT rises - whats the cut off and what do you do
more than 3x upper limit = stop | less than 3x upper limit = continue
78
if taking paracetamol and cocodamol and its para xs - which to stop
para, cos better to keep stronger painkiller
79
if nsaid is topical - does it affect asthma
no
80
short course of pred - SE
candia - as not long enough to cause weight gain or osteoporosis
81
cancer is a provoking factor for anticoagulation
6 months
82
``` Drugs to stop in AKI ACE-i, ARBs NSAIDs Metformin Diuretics (consider continuing in fluid overload) Contrast ```
``` Drugs that require dose adjustment in renal failure Lithium Aminoglycosides (e.g. gentamicin) Cephalosporins Heparin (e.g. enoxaparin for VTE prophylaxis) Digoxin Opiates Sulphonylureas ```
83
Prescribing in pregnancy
``` AVOID: ACE-i Warfarin Ciprofloxacin Nitrofurantoin (3rd trimester); Trimethoprim (1st trimester) Tetracyclines; Gentamicin NSAIDs Lithium Sodium valproate; Carbamezepine Methotrexate Topiramate Paroxetine ``` ``` ACCEPTABLE: Labetalol LMWH Paracetamol Sulfasalazine Fluoxetine Corticosteroids Metoclopramide ```
84
for palliative pain relief do you try to use same or different drugs for regular and breakthrough pain management
same
85
what anaemia needed for 2ww colorectal referral
iron deficiency
86
ethambutol SE
gout
87
hyponatremia caused by
diuretics

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