PSA Flashcards
Cut off for metformin use for eGFR and creatinine
eGFR <30 and a creatinine of >150 μmol/L
when should methotrexate not be started
owing to the risk of liver cirrhosis, treatment with methotrexate should not be started if liver function tests are abnormal.
how many drops in 1 ml
20
what is important to check and record before commencing olanzapine?
fasting blood glucose, as antipsychotics can cause diabetes
amiodarone - what to check before and during rx
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.
blood test for sodium valproate
LFTs
Clozapine monitoring
FULL BLOOD COUNT MUST BE CHECKED WEEKLY FOR THE FIRST 18 WEEKS
1st thing to do in anaphylaxis
secure airway
for drug errors, check what
dose - amount and units, route, frequency
Each tablet of co-codamol contains how much paracetamol
500mg
drowsiness/resp depression - stop what?
Co-codamol, codeine, diazepam
do you stop thiazides before surgery
yes
anuria means what and so what should be stopped
renal failure, so stop nsaids
Lithium excretion is signifcantly reduced by
ACE-inhibitors
Lithium excretion is signifcantly reduced by
ACE-inhibitors, diuretics, NSAIDs
max rate that potassium should be given
should never be given at more than 10mmol/hour
worst pill to miss on cocp
the first one
if IV paracetamol given whats the limit
4g or 3g if <50kg
how to get inr management on bnf
type oral anticoagulants
Communicating information - how to look in bnf
patient and carer advice section
carbamazepine - electrolyte disturbance
hyponatremia
for adrenaline 1 in 1000 and 1 in 10000 means ?
for adrenaline 1 in 1000 means 1 mg/ml, 1 in 10000 means 1mg/10ml
how to increase phenytoin dose
should increase the dose by the minimum increment possible
if change in electrolyte, but patient is well and no drugs given, what to do
repeat biochemistry tests
codeine causes
constipation
what is tens
Transcutaneous electrical nerve stimulation for back pain if nothing else is safe
steroid prescription when ill?
During episodes of sepsis,
steroid prescriptions are doubled to meet physiological demand
can you stay on methotrexate during sepsis
no
rx of HAP
pip-taz
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
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
if mild allergic reaction, what do you give
no anaphylaxis so no adrenaline or IV hyrdrocort
give oral chlorphenamine
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%
what time do you avoid thiazides
evening, as then they will want to pee when sleeping
drugs that worsen asthma
BB and NSAIDS
eg of colloid and when are they used
gelofusine
given when low BP
1st line rx in T2DM
Diet and exercise
when is flecainide CI
HTN and heart disease
INR - when is it considered a major bleed
if low BP
what to avoid in myasthenia gravis
Anti-muscarinics
Review dates for oral and IV abx
oral = 5 days IV = 3 days
GAD rx 1st line
sertraline
DVT rx immeditely
Dalteparin - usually 15000 units
what time are benzos given
at night
how to check theophyline toxicity
serum theophylline levels
oedema rx
furosemide IV
when not to give nitro and egfr cut off
45
Dalteparin prophylaxis dose
5000 units daily at 10000 units/ml
Heparins SE
hyperkalaemia
Tacrollimus SE
hyperkalaemia
when to give vit K before surgery
INR >1.5
ACEi monitoring
exercise tolerance
Cut off to increase statin dose
less than 40% decrease in HDL
how much to raise insulin
10%
better to increase those than add new prescription
taking topiramate - change contraception if ?
taking progesterone only pill- desogestrel
glucose maintenance - answer?
glucose 5%/potassium chloride 0.3% solution (has 40 mmol)
if patch drug, what do you write in dose
1 patch
ishcaemic ulcers - what drug CI
beta blockers
HF - avoid what drug
CCB
unconscious and at hosp cos of hypogly - rx?
15g glucose IV 20% solution
statin - increase CK - what do you do
stop it and wait till CK normalises –> start statin at lower dose
statin and glucose hx - 1st ix to monitor
hba1c
acute bleed - do you stop aspirin
no, as platelets last for 10 days
loose stools - drug causes
steroids
PPI
bradycardia - drug causes
digoxin
beta blockers
candida and preg - rx
clotrimazole pessary 7 days
C.diff rx - 1st and 2nd time
metronidazole
vancomycin if 2nd time
old and post herpetic neuralgia
paracetamol
loperamide - when to take
after each loose stool
antidepressants - what to say to patients
takes 6 weeks to get benefits
how to monitor apixaban
tell pts to report bleeding
In an adverse drug reaction - do you increase/decrease/stop the drug
stop the drug
if asthma attack and on inhaled saba. what do you do
nebs saba
statin 1ry and 2ry prev dose
20mg and 80mg
dvt rx
apixaban or rivaroxaban
anaemia - stop what drug
aspirin
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
if taking paracetamol and cocodamol and its para xs - which to stop
para, cos better to keep stronger painkiller
if nsaid is topical - does it affect asthma
no
short course of pred - SE
candia - as not long enough to cause weight gain or osteoporosis
cancer is a provoking factor for anticoagulation
6 months
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
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
for palliative pain relief do you try to use same or different drugs for regular and breakthrough pain management
same
what anaemia needed for 2ww colorectal referral
iron deficiency
ethambutol SE
gout
hyponatremia caused by
diuretics
