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PSA Flashcards

1
Q

Prescribe the most appropriate drug to rapidly relieve bronchospasm (COPD/asthma).

A

Salbutamol 1 mg/mL OR 2.5 mg/mL nebuliser liquid
Dose = 2.5-5 mg
Route = nebulised/inhaled
Frequency = PRN, up to 4 times daily

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2
Q

Treatment of confirmed DVT/PE

A

Factor Xa inhibitors:
Apixaban 10 mg PO BD
Rivaroxaban 15 mg PO BD

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3
Q

When is LMWH contra-indicated?

A
  • Current or history of heparin-induced thrombocytopaenia
  • Conditions that put the patient at high risk of bleeding complications (acute GI bleed, cerebral haemorrhage, serious coagulation disorders, recent stroke)
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4
Q

What is the treatment dose of LMWH for DVT/PE?

A

1.5 mg/kg every 24 hours until oral anticoagulation established

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5
Q

INITIAL TREATMENT of dehydration (no cardiac failure)

A

Sodium chloride 0.9% + Potassium chloride 0.3%/0.15

500 mL over 4-6 hours or 1 L over 8-12 hours

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6
Q

How quickly should potassium be replaced on the ward?

A

Max 10 mmol/hour

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7
Q

Primary prevention of cardiovascular disease

A

QRisk score >10% = atorvastatin 20 mg OD at night

QRisk score <10% = simvastatin 20 mg OD at night

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8
Q

What is the QRisk3 score?

A

Calculates a person’s risk of developing a heart attack or stroke over the next 10 years

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9
Q

What are the important dose-related adverse effects of statins?

A 
Myalgia (rarely risk of myopathy, myositis, and rhabdomyolysis)
Disturbed liver function
GI disturbance
Sleep disturbance
Headache
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10
Q

How do NSAIDs work?

A

Inhibit COX2 enzyme and production of prostaglandins which protect the gastric mucosa against acid-related erosion and ulceration.

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11
Q

How does ibuprofen effect the kdneys?

A

Ibuprofen inhibits prostaglandin synthesis in the kidney so reduces cortical blood flow and renal function.

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12
Q

What is the significance of renal function and ramipril?

A

Ramipril is an ACE inhibitor which blocks intrarenal production of angiotensin 2. Angiotensin 2 is important for protecting GFR when renal blood flow is reduced.

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13
Q

Why are U&Es checked 1-2 weeks after starting ramipril?

A

If the patient has undiagnosed renal artery stenosis, then the kidney function will be significantly impaired.

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14
Q

Which two drugs (anti-hypertensive and NSAID) and taken together are bad for kidneys?

A

Ramipril and ibuprofen

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15
Q

What kind of drug is bendroflumethiazide and where does it work?

A

Thiazide diuretic - acts on the sodium/chloride-co-transporter in the distal convoluted tubule.
Causes excess sodium and water loss.

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16
Q

What kind of drug is spironolactone and where does it work?

A

Potassium-sparing diuretic - aldosterone agonist which inhibits aldosterone-dependent sodium-potassium-exchange channels in the DCT.

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17
Q

What is atenolol, what is it used for and how would it be prescribed?

A

Cardio-selective beta-blocker
Used to treat hypertension, angina, and arrhythmias

Normal range of dose = 25-50 mg for hypertension and 100 mg for angina

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18
Q

Absolute contra-indications for beta-blockers

A 
History of asthma/bronchospasm
Severe:
Heart failure
Bradycardia
Heart failure
Hypotension
Peripheral arterial disease
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19
Q

What common drugs should be held in renal impairment?

A

Ramipril - reduced effectiveness of renin-angiotensin system means renal blood flow will not be correctly maintained and potassium is not excreted enough
Metformin - contraindicated in significant renal impairment and acutely unwell patients

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20
Q

What kind of drug is pioglitazone and what is one adverse effect?

A

Thiazolidinedione

Higher risk of hypoglycaemia episodes

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21
Q

What drugs can cause urinary retention?

A 
Morphine + other opioid analgesics
Anticholinergics (antipsychotics, detrusor relaxants, antidepressants)
General anaesthetics
Benzodiazepines
NSAIDs
CCBs
Alcohol
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22
Q

What drugs can cause disorientation/confusion?

A 
Metoclopramide
Morphine
Antipsychotics
Antidepressants
Anticonvulsants
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23
Q

Treatment of Wernicke’s encephalopathy?

A

Vitamin B substances with ascorbic acid (Pabrinex IV high potency)
IV infusion over 30 minutes 8-hourly

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24
Q

Management of DKA

A

Soluble short-acting insulin:

50 units in 50 mL 0.9% sodium chloride by IV infusion at a rate of 0.1 units/kg/hour

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25
Q

Treatment of hypertension

A

Age <55 = ACE inhibitor (Ramipril)

Age >55 or Afro-Caribbean of any age = CCB (Amlodipine)

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26
Q

Folic acid in pregnancy

A

Prevention of neural tube defects, taken until week 12 of pregnancy

High risk = e.g. family history of spina bidifa, malnutrition
5 mg OD

Low risk = 400 micrograms OD

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27
Q

What is alendronic acid and how should it be taken?

A

Bisphosphonate
10 mg daily or 70 mg once weekly
Take on empty stomach first thing in the morning, with water
Sit upright for 30 minutes

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28
Q

What are the main adverse events associated with bisphosphonates?

A

Atypical femoral fracture
Osteonecrosis of the jaw - dental appointment before starting
Osteonecrosis of the internal auditory canal

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29
Q

Hormone replacement therapy options

A 
Combined = used in women with a uterus, used to reduce the risk of endometrial carcinoma associated with unopposed oestrogen
Oestrogen-only = used in women without a uterus
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30
Q

What does a % solution mean?

A

grams per 100 mL

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31
Q

What are the adverse events associated with methotrexate?

A

Bone marrow suppression
GI toxicity
Liver toxicity
Pulmonary toxicity

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32
Q

What are the side effects most commonly associated with methotrexate?

A 
Anaemia
Anorexia
Diarrhoea
Fatigue
GI upset
Increased risk of infection
Leucopaenia
Skin reactions
Vomiting
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33
Q

What antibiotic can cause ototoxicity?

A

Gentamicin - aminoglycoside antibiotic that can damage the vestibular nerve

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34
Q

Which antibiotic interacts with drugs metabolised by P450 system?

A

Clarithromycin

E.g. interacts with simvastatin and causes reduced clearance

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35
Q

How does allopurinol work?

A

Reduction of serum urate levels by inhibiting xanthine oxidase

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36
Q

What needs to be monitored in lithium therapy?

A

Renal function - nephrotic syndrome and nephrogenic DI

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37
Q

What can HRT do to blood pressure?

A

Hypertension

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38
Q

What should be done with LFTs when starting statins?

A

Measure before treatment
Repeat at 3 months and 12 months if asymptomatic
Stop therapy if 3x upper limit

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39
Q

Peak and trough concentration of gentamicin

A

Peak concentration = determined by dose
Trough concentration = determined by interval

Note: if the trough is too high - toxicity

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40
Q

Most common enzyme inducers

A

Enzyme inducers will decrease drug concentration.

PC BRAS:

Phenytoin
Carbamazepine

Baribiturates
Rifampicin
Alcohol (chronic excess)
Sulphonylureas

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41
Q

Most common enzyme inhibitors

A

Enzyme inhibitors will increase drug concentration.

AO DEVICES:

Allopurinol
Omeprazole

Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin
Ethanol (acute intoxication)
Sulphonamides
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42
Q

Why should metformin be stopped before surgery?

A

Will cause lactic acidosis

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43
Q

What drugs should be stopped in any patient that is bleeding?

A

Antiplatelets (aspirin)
Anticoagulants (LMWH, Factor Xa inhibitors)
Heparin - e.g. stroke
Consider drug interactions - e.g. erythromycin and warfarin causing a very high INR

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44
Q

What are the side effects of steroids?

A

STEROIDS

Stomach ulcers
Thin skin
oEdema
Right and left heart failure
Osteoporosis
Infection
Diabetes
cushing's Syndrome
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45
Q

Side effects of anti-hypertensives

A
  1. Hypotension
  2. Bradycardia - beta blockers and some CCBs
  3. Elecrolyte imbalances - ACEi and diuretics

Specific:

  • Ramipril = dry cough
  • Beta blockers = wheeze in asthmatics
  • CCBs = peripheral oedema and flushing
  • Diuretics = renal failure, spironolactone = gynaecomastia, thiazide diuretics = gout
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46
Q

What is typically given for VTE prophylaxis for hospital inpatients?

A

Dalteparin 5000 units daily SC + compression stockings

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47
Q

What kind of drug is metoclopramide and when should it be avoided?

A

Dopamine antagonist

Avoid in patients with Parkinson’s and young women due to risk of dyskinesia

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48
Q

What is first-line treatment for neuropathic pain?

A

Amitriptyline 10 mg OD PO at night

Pregabalin 75 mg PO 12 hourly

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49
Q

How do ACE inhibitors affect potassium?

A

Cause hyperkalaemia through reduced aldosterone production and thus reduced potassium excretion in the kidneys

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50
Q

What drugs are notorious for causing confusion (esp in the elderly)?

A

Tramadol
Cyclizine
Diazepam

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51
Q

Why should NSAIDs be used with caution in patients on methotrexate?

A

Increased risk of nephrotoxicity

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52
Q

What drugs should DEFINITELY be avoided in patients taking methotrexate?

A

Other folate antagonists such as trimethoprim

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53
Q

What should be done to methotrexate in patients with active infection?

A

Stop it

Long half-life means it won’t affect control of chronic disease

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54
Q

What do potassium-sparing diuretics and ACE inhibitors do to potassium?

A

Hyperkalaemia

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55
Q

What do loop and thiazide diuretics do to potassium?

A

Hypokalaemia

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56
Q

What is the main side effect of amlodipine and what should be done?

A

Peripheral oedema

Stop the medication

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57
Q

What life-threatening side effect can be caused by clozapine?

A

Agranulocytosis

Stop the drug immediately and refer to a haematologist

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58
Q

Causes of normocytic anaemia

A

Anaemia of chronic disease
Acute blood loss
Haemolysis
Renal failure

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59
Q

Causes of neutropaenia

A

Viral infection
Chemo/radiotherapy
Clozapine
Carbimazole

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60
Q

What does raised urea indicate?

A

AKI or upper GI bleed (digestion of blood)

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61
Q

How do urea and creatinine rise in pre-renal vs post-renal AKI?

A 
Pre-renal = urea > creatinine
Post-renal = creatinine > urea
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62
Q

What are the vitamin K dependent clotting factors?

A

2, 7, 9 and 10

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63
Q

Causes of raised ALP

A 
Fracture
Post-hepatic liver damage
Cancer
Paget's disease
Pregnancy
Hyperparathyroidism
Osteomalacia
Surgery
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64
Q

In which projection does the heart appear larger on a CXR?

A

AP

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65
Q

How to tell if there is adequate inspiration on a CXR?

A

7th anterior rib (down-sloping) transects the diaphragm

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66
Q

Which way does the trachea deviate if there is a collapsed lung?

A

Towards affected side

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67
Q

Which way does the trachea deviate in a tension pneumothorax?

A

Away from the affected side

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68
Q

What would suggest a right upper lobe collapse on a CXR?

A

Widened mediastinum with tracheal deviation

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69
Q

Signs of heart failure on CXR

A 
Alveolar oedema (bat wings)
Kerley B lines 
Cardiomegaly
Diversion of blood to upper lobes (large vessels)
Pleural effusions
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70
Q

Causes of metabolic alkalosis

A

Vomiting
Diuretics
Conn’s syndrome

71
Q

LBBB on ECG

A

W in V1

M in V6

72
Q

RBBB on ECG

A

M in V1

W in V6

73
Q

Small complexes throughout ECG

A

Pericardial effusion

74
Q

ST segment convex and raised in all leads

A

Pericarditis

75
Q

Down-sloping/reverse tickmark ST segment in all leads

A

Digoxin toxicity

76
Q

Where is T wave inversion normal?

A

aVR and lead 1

77
Q

Common examples of drugs which need monitoring

A 
Digoxin
Theophylline
Lithium
Phenytoin
Some antibiotics - gentamicin and vancomycin
78
Q

Signs of lithium toxicity

A 
Early = tremor
Intermediate = tiredness
Late = arrhythmias, seizures, coma, renal failure, diabetes insipidus
79
Q

Paracetamol metabolism

A

Metabolised by the liver

Relies on antioxidant known as glutathione

80
Q

How does paracetamol overdose cause acute liver damage?

A

Limited hepatic stores of glutathione are quickly depleted, leading to accumulation of the toxic metabolite NAPQI which causes acute liver damage

81
Q

How does warfarin work?

A

Inhibits synthesis of vitamin K-dependent clotting factors

Prolongs the PT

82
Q

What to do if there is a major bleed in a patient on warfarin?

A

Stop warfarin
Give 5-10 mg IV vitamin K
Give prothrombin complex

83
Q

Can trimethoprim be given in pregnancy?

A

No

Folate antagonist and so predisposes to neural tube defects

84
Q

What happens if too much digoxin is given?

A

Bradycardia

85
Q

How should you treat fast AF if the patient is asthmatic and/or has peripheral oedema?

A

Digoxin

1st line = beta blockers (not in asthmatics)
2nd line = diltiazem (not if peripheral oedema as will worsen fluid retention)

86
Q

What kind of drug is amitryptiline and what does it get used for?

A

Tricyclic antidepressant

Treatment of neuropathic pain

87
Q

Treatment of STEMI

A 
300 mg aspirin
75 mg ticagrelor/300 mg clopidogrel
Oxygen if sats <94%
GTN spray/tablet
Morphine 5-10 mg IV + cyclizine 50 mg IV
Bisoprolol 2.5 mg oral
Primary PCI preferred
88
Q

Treatment of NSTEMI

A 
300 mg aspirin
75 mg ticagrelor/300 mg clopidogrel
LMWH OR Fondaparinux
Oxygen if sats <94%
GTN spray/tablet
Morphine 5-10 mg IV + cyclizine 50 mg IV
Bisoprolol 2.5 mg oral
89
Q

Drug treatment of anaphylaxis

A

ABCDE approach
500 micrograms of 1:1000 IM
10 mg chlorphenamine IV
200 mg hydrocortisone IV

90
Q

Drug treatment of acute asthma

A 
ABCDE approach
Oxygen
Salbutamol 5 mg nebs
Ipratropium 500 micrograms nebs
100 mg hydrocortisone IV if severe/life-threatening or prednisolone 40-50 mg oral
91
Q

Drug treatment of COPD

A

SAME AS ASTHMA + Antibiotics

ABCDE approach
Oxygen
Salbutamol 5 mg nebs
Ipratropium 500 micrograms nebs
100 mg hydrocortisone IV if severe/life-threatening or prednisolone 40-50 mg oral
92
Q

What is CURB-65?

A 
Confusion
Urea > 7
Resp rate >30
Blood pressure (systolic) <90
Age > 65
93
Q

Treatment of PE

A 
ABCDE
High flow oxygen
Morphine 5-10 mg IV
Cyclizine 50 mg IV
LMWH e.g. tinzaparin
If unstable - IV fluid bolus, contact ITU, consider thrombolysis
94
Q

Seizure management

A

1) Ensure airway is patent
2) Put in recovery position
3) Bedside tests for provoking factors - glucose, electrolytes, drugs, sepsis
If >5 mins then treat with IV lorazepam

95
Q

Features of hyperosmolar hyperglycaemic state

A

Hyperglycaemia - usually > 35 mmol/L
Hyperosmolar - osmolality >340
Non-ketotic

96
Q

First-line treatment of angina

A

GTN spray as required
Secondary prevention
Anti-anginal drugs dependent on contraindications - beta blocker or calcium channel blocker

97
Q

Contraindications of CCBs

A

Hypotension
Bradycardia
Peripheral oedema

98
Q

Chronic asthma management

A 
SABA as required throughout
Low-dose ICS
Add inhaled LABA or combine with MART
Consider adding LTRA (Montelukast) 
Refer to specialist care
99
Q

Treatment of Parkinson’s

A

Co-beneldopa (levodopa + peripheral dopa decarboxylase inhibitor)
UNLESS very mild disease - try dopamine agonist like ropinirole or monoamine oxidase inhibitor (rasagiline)

100
Q

Drugs for generalised tonic-clonic seizures

A

Valproate for males

Lamotrigine for females

101
Q

Drugs for myoclonic seizures

A

Valproate for males

Levetiracetam for females

102
Q

Which anti-epileptic drug causes a rash?

A

Lamotrigine

Can rarely cause Steven-Johnson syndrome

103
Q

What drugs are used to treat Alzheimer’s?

A

Acetylcholinesterase inhibitors

Donepezil, rivastigmine, galantamine

104
Q

Drugs used to maintain remission of Crohn’s

A

Azathioprine

6-mercaptopurine

105
Q

What do you HAVE to check before starting Azathioprine or 6-mercaptopurine?

A

TPMT levels

106
Q

Treatment of Rheumatoid arthritis

A

Methotrexate
+ additional DMARDs
Short-term glucocorticoids = IM methylpred
Short-term NSAIDs with gastric protection
TNF-alpha inhibitors e.g. infliximab

107
Q

Paracetamol antipyretic dose

A

1 g every 6 hours

Max 4 g in 24 hours

108
Q

Stimulant laxatives + contraindication

A

Senna
Bisacodyl

Contraindicated in acute abdomen

109
Q

Osmotic laxatives + contraindication

A

Lactulose
Phosphate enema

Contraindicated in acute abdomen + IBD

110
Q

Treatment of chronic diarrhoea

A

Loperamide 2 mg PO or codeine 30 mg PO

111
Q

Drugs to help patients sleep in the PSA

A

Zopiclone 7.5 mg oral nightly in adults

3.75 mg in elderly

112
Q

What would signify SABA overuse?

A

Tremor

113
Q

Antibiotics for skin infections

A

Flucloxacillin 500 mg QDS for 7 days

114
Q

What kind of unintended side effects can amitriptyline have?

A

Antimuscarinic side effects - dry mouth, dry eyes

115
Q

Why should haloperidol and metoclopramide not be used in patients with Parkinson’s?

A

They are dopamine antagonists and so can precipitate parkinsonian symptoms.

Note: domperidone is safe as it does not cross the BBB.

116
Q

What type of contraceptive pill should be used in a woman with significant VTE risk factors?

A

POP

117
Q

Treatment of hypertension in pregnancy

A

Labetalol 100 mg BD to be titrated, can go up to 200 mg BD

118
Q

Treatment of gout in someone with significant CKD

A

No NSAIDs
Colchicine ok
Depo-Medrone (steroid injection)

119
Q

Which blood pressure drug should NOT be taken during pregnancy?

A

Ramipril - teratogenic

120
Q

Which blood pressure drug should be given during pregnancy?

A

Labetalol

121
Q

Which class of diabetes drugs are associated with hypoglycaemia?

A

Sulphonylureas

122
Q

When should gliclazide be taken?

A

Morning

123
Q

What is the mechanism behind the cough caused by ACE-inhibitors?

A

Release of bradykinin
Dose-dependent
Use ARB instead - Losartan

124
Q

What features are suggestive of serotonin syndrome?

A 
Mild = hypertension, tachycardia, fever
Moderate/severe = fever, agitation, hyperreflexia, tremor, dilated pupils
125
Q

How should bisphosphonates be taken?

A

Swallowed with a full glass of water

Remain upright for 30 mins

126
Q

What does a 1% solution mean?

A

1 g of drug in 100 mL for weight/volume calculations

1 g in 100 g for weight/weight calculations

127
Q

What does adrenaline 1:1000 mean?

A

1 g in 1000 mL

128
Q

Risk factors for development of myopathy with statins

A 
Personal or family history of muscular disorders
Previous history of muscular toxicity
High alcohol intake
Renal impairment
Hypothyroidism
Elderly
129
Q

What should be checked at baseline when starting simvastatin?

A

Creatine kinase

130
Q

Two classic side effects of vancomycin

A

Nephrotoxicity
Ototoxicity

After a week - can cause neutropaenia

131
Q

What level of transaminitis should make you stop the statins?

A

3x upper limit of normal

Check after 3 months of treatment

132
Q

Normal reference range for lithium

A

0.4-0.8 mmol/L

133
Q

When are toxic effects of lithium likely to manifest?

A

Levels >1.5 mmol/L

134
Q

When should blood tests for lithium be done?

A

Weekly after initiation and after dose changes until concentration is stable, then every 3 months thereafter

135
Q

What can increase the risk of lithium toxicity?

A

Sodium depletion/dehydration

136
Q

Methotrexate blood monitoring

A

Weekly but once on stable treatment, every 2-3 months

137
Q

When should methotrexate NOT be started?

A

Abnormal LFTs

138
Q

How is methotrexate excreted?

A

Renally

139
Q

What needs to be checked before a patient starts the contraceptive pill?

A

Blood pressure - can make the patient hypertensive

Weight

140
Q

What should be done at baseline before starting amiodarone and why?

A

Chest xray

Pulmonary toxicity - fibrosis

141
Q

Why do we need to warn people on carbimazole to come to hospital if they get a sore throat?

A

Carbimazole-induced bone marrow suppression/agranulocytosis

Neutrophil count

142
Q

1 hour peak serum concentration of gentamicin multiple daily dose regimen for treatment of endocarditis

A

3-5 mg/L

143
Q

What electrolyte derangement increases risk of digoxin toxicity?

A

Hypokalaemia

144
Q

What organ dysfunction is associated with sodium valproate therapy?

A

Liver

Measure LFTs regularly

145
Q

Clozapine monitoring

A

Weekly FBC for the first 18 weeks

146
Q

Most common drugs with a narrow therapeutic index

A

Warfarin
Digoxin
Phenytoin

147
Q

Digoxin side effects

A 
Nausea & vomiting
Diarrhoea
Blurred vision
Drowsiness/confusion
Xanthopsia (disturbed yellow/green visual perception, "halo")
148
Q

Amiodarone side effects

A

Interstitial lung disease
Thyroid disease - hypo and hyper
Grey skin
Corneal deposits

149
Q

Side effects of steroids

A 
Stomach ulcers
Thin skin
Oedema
Right and left heart failure
Osteoporosis
Infection
Diabetes
Cushing's syndrome
150
Q

Which diabetic drug can cause lactic acidosis?

A

Metformin

151
Q

Which antidepressants can trigger a hypertensive crisis?

A

Monoamine oxidase inhibitors

152
Q

Why is 50% glucose generally avoided?

A

High risk of extravasation injury

153
Q

Which drug classes should NOT be stopped before surgery?

A 
Antiepileptics
Antiparkinsonian drugs
Antipsychotics
Anxiolytics
Bronchodilators
Cardiovascular drugs 
Glaucoma drugs
Immunosuppressants
Drugs of dependance
Thyroid/antithyroid drugs
154
Q

Metformin + surgery - should it be stopped? What should it be replaced with?

A

Yes, stop if there is a chance of the patient missing more than 1 meal or of AKI
Variable rate IV insulin infusion ONLY if metformin dose is >1 daily
Do not recommence metformin until patient is eating/drinking and renal function is normal.

155
Q

Very important information to warn patients of on rivaroxaban

A

Severe or spontaneous bruising - seek medical attention

156
Q

What bloods need to be monitored in patients on rivaroxaban + how often?

A

Depends on patient factors/level of risk

FBC
U&Es
LFTs

Every 6-12 months

157
Q

When should rivaroxaban be taken?

A

With food to maximise absorption

Any time of day

158
Q

Management of hypoglycaemia

A

If conscious + able to swallow - 15-20g of fast-acting carbohydrate

Reduced GCS - 15-20g of 10% or 20% glucose IV over 15 minutes

Emergency/no IV access - IM glucagon

159
Q

Common side effects of furosemide

A 
Dizziness
Electrolyte imbalances
Fatigue
Headache
Muscle spasms
160
Q

What patient factors mean a woman is not suitable for the COCP?

A

Migraines with aura
Age >35 AND smokes > 15 per day
BMI > 35

161
Q

Medical management of anxiety

A

First-line = SSRI (sertraline, paroxetine, escitalopram) or SNRI (duloxetine or venlafaxine)

162
Q

What is the mechanism of ipratropium bromide?

A

Anti-muscarinic

163
Q

When to offer lipid modification therapy?

A

People aged 84 or younger if estimated QRISK score is 10% or more

Offer high intensity statin treatment

164
Q

What is high intensity statin treatment?

A

Atorvastatin 20 mg OD at night

165
Q

Which vaccines should women have in pregnancy?

A

Flu vaccine
Whooping cough/percussis

NO live vaccines

166
Q

What is the process around chicken pox exposure in pregnancy?

A

If exposed - check immunisation status
If immune - no further action
If not immune + within first 10 days = treat with VZIG

167
Q

VTE prophylaxis dose for high risk surgical patients

A

Enoxaparin sodium 40 mg SC OD

Rivaroxaban 10 mg PO OD

168
Q

Diabetes treatment ladder

A

Metformin

Dual therapy - metformin + gliptin, DPP-4 inhibitor, pioglidazone or sulfonylurea

169
Q

What needs to be done after any change in levothyroxine dose?

A

Repeat TFTs in 6-8 weeks

170
Q

PE treatment

A

Rivaroxaban 15 mg PO BD

LMWH if not suitable (bc rivaroxaban is renally excreted)

171
Q

Nitrofurantoin in pregnancy

A

DO NOT GIVE AT TERM - haemolysis of the newborn

172
Q

Trimethoprim in pregnancy

A

DO NOT GIVE
Folate antagonist
Teratogenic

173
Q

UTI in term pregnant lady

A

Cefalexin 500 mg PO BD for 7 days

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