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PSA > PSA drugs > Flashcards

PSA drugs Flashcards

1
Q

Electrolyte giving per day?

A

1 salty + 2 sweet / day -1 0.9% saline bag -2 5% dextrose bag

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2
Q

What are the common adverse effects of metronidazole?

A

GI upset (N&V), hypersensitivity, neurological (peripheral, optic neuropathy, seizures, encephalopathy)

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3
Q

Causes of raised urea?

A

kidney damage, GI bleed, big bloody steak

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4
Q

SGLT-2 inhibitors (gliflozins) MOA?

A

inhibits reabsorption of glucose in the kidney

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5
Q

Generally, how much fluids do adults require in 24hrs?

A

adults-3L/day elderly- 2L/day

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6
Q

What are caution when giving gliclazide?

A

reduce dose in hepatic/ renal impairment; ppl at risk of hypoglycaemia (hepatic impairment, elderly, adrenal or pituitary insufficiency, malnutrition)

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7
Q

What are important interactions of insulin?

A

other hypoglycaemics, systemic corticosteroids increases insulin requirements

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8
Q

How is metformin monitored?

A

HbA1c every 3 mths, renal function annually

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9
Q

How much potassium does a person with normal potassium level require per day?

A

40mmol KCI/day -put 20mmol of KCL in two bags *IV potassium should not be given at more than 10 mmolhr

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10
Q

What are the indications of aldosterone?

A

ascites and oedema due to liver cirrhosis, CHF, 1’ hyperaldosteronism

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11
Q

What is the MOA of metronidazole?

A

bactericidal by reducing synthesis of DNA by binding to it and causing widespread damage

ONLY in anaerobic bacteria and protozoa

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12
Q

What important interactions in loop diuretics?

A

medication renally excreted: lithium, digoxin, aminoglycosides [increased risk of ototoxic and nephrotoxic]

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13
Q

Monitoring in phenytoin?

A

plasma concentrations immediately before next dose and then 7 days after

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14
Q

How to prescribe erythromycin?

A

250-500mg/ 6hrly

short shelf life

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15
Q

MOA of phenytoin?

A

decrease excitability of neurones by inhibiting Na+ influx

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16
Q

How much fluid is lost if reduced urine output + tachycardic?

A

1L fluid loss

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17
Q

Drugs that cause cholestasis?

A

fluclox, coamox, nitrofurantoin, steroids, sulphonylureas

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18
Q

Efficacy of loop diuretics?

A

symptoms improvement; long term monitor symptoms, signs and weight (1kg/day lost)

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19
Q

What is MOA of amiodarone?

A

block sodium, calcium and potassium channels and antagonist of a & b adrenergic receptiors=> slow rate, increase resistance to depolorisation (stop spontaneous depolorisation)

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20
Q

What caution should you take when prescribing cephalosporins and carbapenems?

A
  • people ar risk of C. difficile (admitted and elderly)
  • epileptics
  • renal impairment (lower dose)
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21
Q

What caution to take when prescribing macrolides?

A

CI: hypersensitivity

Reduce dose: renal or hepatic impairment

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22
Q

Name the B-blockers and their most common use?

A

bisoprolol: HTN, angina, HF

atenolol

propanolol: migraine prophylaxis, anixety, angina

metroprolol

sotalol: SVT

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23
Q

Replacement fluid what to give shocked fro bleeding?

A

Blood transfusion if not blood give colloid

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24
Q

Warnings in giving b-blockers?

A

DO NOT GIVE in asthmatics and heart block; careful in HF, haemodynamic instability, hepatic failure

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25
Q

What are some possible interactions with ACEi?

A

do not give with potassium elevating drugs (eg. spironolactone) causes severe hypotension; NSAID and ACEi increases risk of nephrotoxicity

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26
Q

What are some caution you have to take when prescribing ACEi?

A

DO NOT GIVE in renal artery stenosis (rely on efferent vasoconstriction for filtration), AKI
careful when: pregnant, breastfeeding, CKD

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27
Q

How do you prescribe cephalosporins?

A
  • rate 6-12hrly
  • route: cephalo: oral, IV, IM, infusion, bolus
    carbapenem: IV, infusion
  • dose: cefo 2g IV/ 6hrly

carba 1-2mg IV 8hrly

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28
Q

What drugs to give for nausea?

A

Cyclizine 50mg 8-hrly IM/IV/oral - SE: fluid retention Metoclopramide 10mg 8-hrly IM/IV/if HF *nauseated- regular antiemetic not nauseated- as required

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29
Q

What are important interactions in macrolides?

A
  • CP450 inhibitors: clarithromycin, erythromycin
  • warfarin, statins
  • QT prolonging meds: amiodarone, antipsychotics, quinine, quinolone, SSRI
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30
Q

What are the important adverse effects of cephalosporins and carbapenems?

A

GI upset, abx associated colitis, hypersensitivity (immediate and delayed reactions)

-neurological toxicity (seizures)

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31
Q

What is the MOA of cephalosporins and carbapenems?

A

bactericidal due to B-lactam ring that inhibits cross-linking of peptidoglycans of cell wall causing swelling, lysis and death

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32
Q

How should you prescribe aminoglycosides?

A

intermittnet IV infusion/ Once daily

  • particularly paying attention to patient age and renal function before prescription
  • renal normal: every 24hrs
  • renal abnormal: 36-48 hrs
  • duration: once-7days
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33
Q

What are the different types of diabetes drugs?

A

6: metformin, sulphonylureas, gliptins, glitazones, SGLUT-2 inhibitor, GLP-1 agonist, thiazolidinediones

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34
Q

What are the uses for macrolides?

A
  • rx of resp, skin, soft tissue infections as an alt. to penicillin when CI (eg. allergy)
  • severe pneumonia as addition to penicillin to cover atypical (legionella, mycoplasma pneumoniae)
  • eradication of helicobacter pylori (conjunction with PPI + metronidazole/ amoxicillin
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35
Q

Replacement fluid how much and how fast in tachycardic or hypotensive patient?

A

500ml bolus -250ml if HF

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36
Q

What are the SE of NSAIDs?

A

No urine (renal failure) systolic dysfunction asthma indigestion dyscrasia (abnormal blood clotting)

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37
Q

What are adverse effects of CBB?

A

vascular: ankle oedema, flushing, headache, palpitations; cardiac: bradycardia, heart block, HF; constipation

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38
Q

What is the MOA of macrolides?

A

bacterialstatic: inhibit protein synthesis via 50s subunit

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39
Q

What is the adverse effects of atropine?

A

tacycardia, dry mouth and constipation, urinary retention, blurred vision, drowsiness, and confusion

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40
Q

What is the adverse effects of GLP-1 agonist?

A

GI(N&V, vomiting, diarrhoea, constipation), pancreatitis, AV block,weightloss

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41
Q

What are the adverse effects of amiodarone?

A

hypotension, pneumonitis, bradycardia, AV block, hepatitis, photosensitivity, grey discoloration, thyroid abnormalities, long time for elimination even after drug is stopped (long half-life)

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42
Q

How much fluid is lost if reduced urine output + tachycardia+ shocked?

A

2L of fluid loss

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43
Q

What are the indication for aminoglycosides?

A

Rx of severe infection, particularly gram -ve aerobes + pseudomonas aeruginosa:

  1. severe sepsis (even in unknown source)
  2. pyelonephritis and complicated UTI
  3. Biliary and other intrabdominal sepsis
  4. Endocarditis
  5. Bacterial skin, eye or external ear infections
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44
Q

What are common adverse effects of chloramphenicol?

A

Topical: stinging, burning, itching

Systemic: (rarely given) bone marrow suppression, aplastic anaemia

  • Grey baby syndrome
  • optic and peripheral neuritis (prolonged use)
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45
Q

When is flecainide CI?

A

post myocardial infarction

structural heart disease: e.g. heart failure

sinus node dysfunction; second-degree or greater AV block

atrial flutter

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46
Q

When to avoid metoclopramide?

A

PD patients- dopamine antagonist Young women due to risk of dyskinesia

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47
Q

How is amiodarone give?

A

can be IV bolus injection via cannulae; best via central line due to risk of phlebitis

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48
Q

What to assess to determine amount and rate of fluids?

A

HR, urine output, BP

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49
Q

PReSCRIBER for pitfalls and traps in PSA

A

Patient details REaction Sign the front of the chart check for Contraindications to each drug check Route for each drug prescribe Intravenous fluids if needed prescribe Blood clot prophylaxis if needed prescribe antiEmetic if needed prescribe pain Relief if needed

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50
Q

Enzyme Inducers

A

PC BRAS: Phenytoin Carbamezapine Barbituate Rifampacin Alcohol (chronic excess) Sulphonylureas

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51
Q

What is the adverse effect of insulin?

A

hypoglycemia; lipohypertrophy in SC site, weight gain

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52
Q

What is the adverse effects of flecainide?

A

negatively inotropic (decreases contraction force)

bradycardia

proarrhythmic

oral paraesthesia

visual disturbances

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53
Q

What is the spectrum of metronidazole?

A

anaerobes and protozoa

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54
Q

What is the MOA of chloramphenicol?

A

bacterial static

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55
Q

What is the treatment regime for H. Pylori?

A

Triple therapy:

  1. PPI+ amoxicillin+ clari/metro
  2. can repeat 1st line second time
  3. PPI+ amoxicillin+ tetra or levofloxacin
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56
Q

How do you monitor efficacy of macrolides?

A

resolution of symptoms: pt report, examination, bloods (CRP, WBC)

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57
Q

What is the adverse effects of SGLT-2 inhibitors?

A

UTI, constipation, hypo, RARE: fournier’s gangrene, weightloss

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58
Q

What is the MOA of aminoglycosides?

A

bind irreversibly to bacterial ribosome (30s subunit) and inhibit protein synthesis

  • oxygen dependent (aerobic)
  • therefore logically streptococci and anaerobic bacteria are resistant
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59
Q

What are the indications of digoxin?

A

AF, Atrial flutter, severe HF

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60
Q

How to prescribe clarithromycin?

A

250-500mg/ 12hrly

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61
Q

Advice to pt with b-blockers?

A

SE: dizziness, impotence; warn HF pt about risk of initial deterioration and safety net, COPD pts safety net

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62
Q

What are adverse effects of b-blockers?

A

GI disturbance, fatigue, cold extremities, headache, impotence, sleep disturbance, nightmares, bradycardia

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63
Q

What are some caution to take when prescribing chloramphenicol?

A

CI: hypersensitivity reactions

bone marrow disorders

third trimester of pregnancy

neonates

breastfeeding

Reduce dose: hepatic impairment

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64
Q

Causes of neutrophilia?

A

bacterial infection, tissue damage (inflammation/infarct/malignancy), steroids

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65
Q

How do you monitor for chloramphenicol?

A

FBC–> watching out for myelosuppression

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66
Q

When to give CCB?

A

HTN, stable angina, SV arrythmias rate control

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67
Q

What are important interactions with amiodarone?

A

Many, most notably increase risk of brady, AV block, HF if given with digoxin, diltiazem and verapamil

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68
Q

How much insulin is given in DKA?

A

Actrapid 50 units in 0.9% sodium chloride 50mL; rate: 6units/hr

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69
Q

Advice when taking ACEi?

A

take it sitting down or first does before bed, dizziness, dry cough, do not take with NSAIDs, need blood test monitoring, possible allergic reactions

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70
Q

What are the adverse effects of aminoglycosides?

A

nephrotoxicity (tubular toxic), ototoxicity (cochlear and vestibular hair cells)

  • nephro can be reversible
  • oto may not be due to late findings
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71
Q

What advice to give pt taking amiodarone?

A
  • explain high risks of adverse effects
  • aware of weightloss, jaundice, SOB, minimise exposure to sunlight, thyroid symptoms
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72
Q

What is the MOA of ACEi?

A

inhibits Ang1 –> 2 conversion; decreases peripheral resistance, dilates efferent arteriole of glomeruli, decrease aldosterone causing hyperkalaemia, promotes water and sodium excretion.

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73
Q

What is the MOA of flecainide?

A

potent sodium channel blocker=> causes QRS complex broadening and PR prolongation

74
Q

How to prescribe azithromycin?

A

230-500mg/daily

75
Q

GLP-1 agonist MOA?

A

incretin mimetic which inhibits glucagon secretion

76
Q

How do you monitor and prevent adverse reaction of aminoglycosides?

A
  • drug level monitoring with plasma drug concentration after 18-24hrs of first dose
  • renal function before and after dose

*however, can be given before results if pt <65 and normal renal function

77
Q
A
78
Q

What are caution when giving digoxin?

A

DO NO GIVE: 2nd degree heart block, intermittent complete heart block, ventricular arrythmias; caution: hypokalemia, hypomagnesaemia, hypercalcaemia

79
Q

MOA of sulfonylureas?

A

stimulate pancreas beta cells to secrete insulin

80
Q

What is the MOA of digoxin?

A

-ve chronotropic (decrease HR), +ve ionotropic (increase contractility)

81
Q

What are the cautions for antimuscarinics?

A

angle closure glaucoma, arrythmias

82
Q

Indications of flecainide?

A

AF, SVT with accessory pathway (WPW)

83
Q

List common macrolides

A

clarithromycin, erythromycin, azithromycin

84
Q

What are important interactions of metronidazole?

A

is a mild CYP450 inhibitor so don’t use with warfarin/ phenytoin;

do not use with CYP450 inducers or lithium

85
Q

What is the spectrum of activity of cephalosporins?

A

broad spectrum abx, type of b-lactam (higher resistance to b-lactamases)

-rx against gram -ve/+ve and pseudomonas

86
Q

Indications of phenytoin?

A

status epilepticus, epilepsy

87
Q

How much fluid is lost if reduced urine output? (oliguric <30mL/hr, anuric 0mL)

A

500mL fluid loss

88
Q

Replacement fluid what to give shocked with systolic BP <90?

A

Gelofusine (colloid) -high osmotic content keeps fluid intravascularly, maintains BP for longer

89
Q

What caution should you take when prescribing aminoglycosides?

A

renal excretion therefore neonates, elderly and renal impairment pt

-do not give to myasthenia gravis pt as can impair neuromuscular transmission

90
Q

How do you monitor efficacy of aminoglycosides?

A

symptoms and signs (eg. pyrexia) and blood inflammatory markers (C-reactive protein)

91
Q

Drugs that cause cholestasis?

A

paracetamol overdose, statins, rifampicin

92
Q

What are the adverse effects of aldosterone?

A

hyperkalemia (muscle weakness, arrhythmias, cardiac arrest), gynaecomastia, liver impairment and jaundice, Steven-Johnson syndrome

93
Q

Replacement fluid what to give pt with ascites?

A

Human-albumin solution (HAS) -albumin maintains oncotic pressure -high sodium content (0.9% saline) will worsen ascites

94
Q

What are caution when giving amiodarone?

A

risk-benefit is justified due to serious SE, avoided in severe hypotension, heart block, thyroid disease

95
Q

Safety of loop diuretics?

A

U&E (renal function, sodium and potassium) for first few weeks

96
Q

How do you monitor amiodarone?

A

short: cardiac monitoring, heart rate and rhythym
long: FBC, LFT, thyroid function, U&E, CXR

97
Q

How do you measure efficacy of ACEi?

A

symptoms improvement–> SOB (HF), BP (HTN)

98
Q

Causes of hypokalamia?

A

DIRE: diuretics, inadequate intake or intestinal loss, renal tubular acidosis, endocrine (Cushings, conn’s)

99
Q

Advice of DM patients for sick days?

A

monitor bloods more frequently, drink lots of water, drink sugary drinks if cannot eat solids, have a phone with you in case of emergency (DKA); DO NOT STOP taking meds even if you aren’t eating much

100
Q

Advice when giving thiazides?

A

take in morning for max effects, impotence, careful with NSAIDs, ask about mobility [cuz will make them pee a lot])

101
Q

Enzyme Inhibitor

A

AODEVICES: Allopurinol Omeprazole Disulfiram Erythromycin Valproate Isoniazid Ciprofloxacin Ethanol (actue intoxication) Sulphoamides

102
Q

Interactions in B-blockers?

A

DO NOT GIVE WITH non-dihyropyridine CCB (verapamil, diltiazem)

103
Q

Glucose management in acute illness?

A

may need to change to insulin while impatient as shorter half-life and easy to adjust dose

104
Q

When do you not prescribe drugs that increase bleeding (aspirin, heparin, warfarin) ?

A

active bleeding, suspected bleeding, risk of bleeding

105
Q

What are the adverse effects of metformin?

A

GI upset (N&V, diarrhoea, anorexia, taste disturbance), lactic acidosis

106
Q

What advice given when giving aldosterone?

A

gynaecomastia, impotence

107
Q

What are interactions of aldosterone?

A

other potassium elevating drugs (ACEi, ARB); potassium supplements

108
Q

Caution when giving CCB?

A

amlodipine, nifedipine: DO NOT GIVE in severe aortic stenosis, unstable angina; verapamil, diltiazem: caution in poor LV function, AVN delay

109
Q

Name CCB?

A

amlodipine, nifedipine, diltiazem, verapamil (rate limiting; cardioselective)

110
Q

Important interactions of digoxin?

A

loop and thiazide diuretics increase toxicity=> hypokalameia; amiodarone, CCB, spironolactone and quinine increase concentration=> toxicity

111
Q

DPP-4 inhibitors (gliptins) MOA?

A

increases incretin levels which inhibit glucagon secretion

112
Q

What should you ask patients who are prescribed aminoglycosides daily?

A

Any changes in hearing, ringing in the ears, dizziness

113
Q

How do you monitor ACEi?

A

blood tests (U&E): 1-2wks initally

114
Q

How is insulin given?

A

SC injection; units

115
Q

What are cation you have to take when prescribing metronidazole?

A

metabolised by CYP450

reduce dose: liver disease

DO NOT take with alcohol as cause disulfiram-like reaction (flushing, headache, nausea, vomiting)

116
Q

What is the MOA of insulin?

A

glucose uptake into cells, stimulate glycogen, lipids and protein synthesis, inhibits gluconeogenesis and ketogenesis; drive K+ into cells temporarily in hyperkalemia while other treatment is started.

117
Q

What are the indication for metronidazole?

A
  • abx associated colitis (c. dif)
  • oral infection or aspiration pneumonia (gram -ve anaerobes)
  • surgical or gynae infections (gram-ve anaerobes)
  • protozoal infections: trichomonas vaginalis, amoeba, giardiasis
118
Q

How much insulin is given rx of hyperkalaemia?

A

given as dextrose/insulin infusion: 50mL of 50% dextrose w/ 10 units of soluble human insulin over 15min

119
Q

What are the common aminoglycosides?

A

gentamicin, amikacin, neomycin

120
Q

What are the common adverse effects of ACEi?

A

dry cough, hypotension (initially), hyperkalaemia, may cause or worsen renal failure, angioedema, anapyhlactoid reactions

121
Q

What are important interactions of aminoglycosides?

A
  • higher risk of ototoxicity if prescribed with loop diuretics or vancomycin
  • higher risk of nephrotoxicity if prescribed with ciclosporin, chemo, cephalosporins, or vancomycin
122
Q

What are the adverse effects of sulphonylureas?

A

GI (diarrhoea, nausea, abdo px), weight gain, hypoglycaemia, hyponatremia; rare hypersensitivty (hepatic toxicity, drug hypersensitivity syndrome, haem [agranulocytosis])

123
Q

What is chloramphenicol used for?

A
  • bacterial conjunctivitis (drops/ointment)
  • otitis externa (drops)
124
Q

What are the MOA of aldosterone?

A

competitive inhibitor of aldosterone receptor in renal distal tubule; ENaC

125
Q

Interactions with phenytoin?

A

warfarin, osterogens and progestogens, CP450 inhibitors (amiodarone, diltiazem and fluconazole; drugs lower seizure threshold (SSRI, TCA, antipsychotics, tramadol)

126
Q

How do you prescribe chloramphenicol?

A

topical use

eye drops: 0.5% 1drop/2hrly–> 3-4 times/day

eye ointment: 1% 3-4 times/daily

continue for 48hrs after healing

otitis externa: 5-10%, 3-4 drops/ 2-3times/day

one week

127
Q

Causes of raised ALP?

A

ALKPHOS: Any fracture, Liver damage (posthepatic), Kancer, Paget’s disease of bone and pregnancy, Hyperparathyroidism, Osteomalacia, Surgery

128
Q

What are the indications of insulin use?

A

DMI, DMII, DKA, HHS, perioperative (sometimes), hyperkalaemia rx with glucose

129
Q

What routes are there for giving macrolides?

A

oral

IV: dilute in large volume

eg. 500mg in 250mL 0.9% NaCI- over 1 hr

DO NOT give as bolus IV or IM (risk of arrythmias)

*but always try to aim to switch to oral ASAP

130
Q

When do you not give compression stocking as VTE prophylaxis?

A

peripheral arterial disease- absent foot pulses as can cause acute limb ischaemia

131
Q

Name thiazide diuretics and their use?

A

bendroflumethiazide, indapamide, chlortalidone; HTN

132
Q

Drugs with narrow therapeutic index?

A

digoxin, theophylline, lithium, phenytoin, gentamicin, vancomycin

133
Q

Adverse effects of loop diuretics?

A

dehydration, hypotension, low electrolyte state [hyponatraemia, hypokalemia, hypocalcemia, hypochloremia, hypomagnaesaema and metabolic acidosis], hearing loss and tinnitus

134
Q

Causes of hypernatremia?

A

dehydration, drips, sodium content tablets, DI

135
Q

What are the different types of insulin?

A

rapid acting (NovoRapid), short acting (Actrapid), intermediate acting (Humulin I), long acting (Lantus, Levemir), biphasic insulin (rapid + intermediate mix) (NovoMix); IV soluble insulin (Actrapid) used

136
Q

CI for antimuscarinics?

A

DO NOT GIVE with TCA

137
Q

What are common adverse effects of macrolides?

A

irritant (oral): nausea, vomiting, abdo px, diarrhoea

IV: thrombophlebitis

  • allergy
  • abx associated colitis
  • deranged LFTs: cholestatic jaundice, prolonged QT interval, ototoxicity
138
Q

What is the adverse effects of digoxin?

A

bradycardia, GI disturbance, rash, dizziness, visual disturbance, toxicity (low therapeutic index) causing arrhythmias

139
Q

Medications you should not give if pt has asthma?

A

B-blockers, NSAIDs, contrast

140
Q

Caution in administering insulin?

A

renal impairment–> reduced clearance, increased risk of hypoglycaemia

141
Q

What are caution in phenytoin?

A

decrease dose in liver disease, low-therapeutic index, caution in pregnancy

142
Q

What are the SE of steroids?

A

STEROIDS: stomach ulcers thin skin oedema right and left heart failure osteoporosis infection (including candida) diabetes (hyperglycaemia–>diabetes) Cushings syndrome

143
Q

Replacement fluid what to give in hypernatremic/hypoglycaemic pt?

A

5% dextrose

144
Q

Prescribing amiodarone as FY1?

A

always consult senior with dose, continuation

145
Q

What are the indications for antimuscarinics CVS and GI (atropine, hyosine butylbromide, glycopyrronium)?

A

symptomatic bradycardia, anterior uveitis, cycloplegia, IBS, copious resp. secretions

146
Q

Adverse effects of phenytoin?

A

PHENYTOIN: P450 interactions, Hirtuism, Enlarged gums, Nystagmus, yellow-brown skin, Teratogenicity, Osteomalacia, Interference with B12 (anemia), Neuropathies: ataxia, vertigo, headache; antiepileptic hypersensitivity syndrome, respiratory depression, CVS collapse

147
Q

Types of diuretics?

A

loop, thiazide, thiazide-like

148
Q

What are adverse effects of pioglitazone?

A

bone fracture, weight increase, increase risk of infection, visual impairment, fluid retention

149
Q

Causes of hyperkalemia?

A

DREAD: potassium sparing diuretics and ACEi, Renal failure, Endocrine (Addison’s), Artefact (very common due to clotted sample), DKA

150
Q

What are important interactions of metformin?

A

other hypodrugs (metformin, DPP-4, thiazolidinediones, insulin, alcohol); b-blockers, efficacy reduced and increased glucose by prednisolone, thiazide, loop diuretics

151
Q

What is the spectrum of activity of aminoglycosides?

A

main action against gram -ve aerobic bacteria

are inactive against streptococci and anaerobes so should be combined with penicillin and metronidazole when unknown organism

152
Q

Some changes in ECG for digoxin?

A

reverse tick: ST depression

-NORMAL

153
Q

What are some caution in prescribing metformin?

A

do not give in AKI, severe tissue hypoxia (MI, sepsis, resp), acute alochol intoxication; caution in renal/hepatic impairment, chronic alcohol use

154
Q

What are adverse effects of thiazides?

A

hyponatraemia, hypokalemia => arrythmias, impotence

155
Q

What is the spectrum of macrolides?

A

broad spectrum: gram+ve/-ve, haem. influenzae

156
Q

What are the uses of ACEi?

A

HTN, CHF, IHD, DM nephropathy, CKD w/proteinuria

157
Q

How do you monitor for efficacy of cephalosporins and carbapenems?

A

-symptoms relief and bloods ( ↓ CRP, WBC)

158
Q
A
159
Q

What is the MOA of atropine?

A

antimuscarinic, anticholinergic: increase heart rate, conduction, reduce muscle tone and peristaltic contraction, reduce secretions

160
Q

What is the MOA of loop diuretics?

A

inhibition of Na+/K+/Cl- co-transporter==> diuretic, K+ loss, Ca2+ loss, dilatation of capacitance veins

161
Q

What caution to take in loop diuretics?

A

DO NOT GIVE in hypovolemia, dehydration; caution in hypokalamia, hyponatremia, gout (due to uric acid accumulation)

162
Q

What are important interactions of CCB?

A

verapamil, diltiazem: do not give with b-blockers=> HF, brady, asystole

163
Q

What is the MOA of thiazolidnediones (pioglitazone)?

A

activate PPAR-gamma receptor in adipocytes to promote adipogenesis and FFA uptake

164
Q

What drugs should you stop before surgery?

A

I LACK OP: Insulin (variable) - sliding scale Lithium (day before) Anticoagulants/antiplatelets (varies) COCP/HRT (4wks before) K-sparing diuretics (day of surgery) Oral hypoglycaemics Perindopril & other ACE inhibitors

165
Q

What important interactions of cephalosporins and carbapenems?

A
  • enhance warfarin effect
  • increase risk of nephrotoxic of aminoglycosides (cephalo)
  • reduce efficacy of valproate (carba)
166
Q

What are important interactions of metformin?

A

stop for 48 hrs before and after contrast imaging; ACEi, NSAIDs, diuretics increase risk of renal impairment when used in combination; prednisolone, thiazide, loop diuretics increase glucose levels, decrease efficacy

167
Q

What are some caution when giving aldosterone?

A

DO NOT GIVE: severe renal impairment, hyperkalemia, Addison’s disease; caution in pregnant or lactating women

168
Q

Name loop diuretics and their use?

A

furosemide, bumetanide; acute pulmonary oedema, CHF, other oedematous states (liver, renal)

169
Q

What are the drugs that cause bradycardia?

A

B-blockers, CCB, digoxin, amiodarone, clonidine, verapamil

170
Q

When do you use amiodarone?

A

tachyarrythmias: AF, atrial flutter, SVT, VT, VF as last line

171
Q

What are the adverse effects of sitagliptin?

A

headache, pancreatitis, constipation, dizziness

172
Q

MOA of thiazides?

A

inhibition of Na+/Cl- co-transporter in distal convoluted tubule; longer term is vasodilation (not completely understood)

173
Q

What caution when giving thiazides?

A

NSAIDs reduce efficacy, do not give with other potassium lowering drug

174
Q

Advise patients taking insulin?

A

lifestyle, hypos, eat sugary then starch

175
Q

Replacement fluid what to give in all patients?

A

0.9% saline (normal saline or crystalloid)

176
Q

What is the spectrum of activity of chloramphenicol?

A

broad activity against gram-ve/+ve, aerobic and anaerobic organisms

-NOT used systemic first line for any infection due to high risk of toxicity

177
Q

Causes of neutropenia?

A

viral infection, chemo or radiotherapy, clozapine, carbimazole

178
Q

Name cephalosporins and carbapenems

A

cefalexin, cefotaxim, meropenem, ertapenem

179
Q

Causes of neutrophilia

A

Bacterial infection, tissue damage (inflmmation/infarct/malignancy)

180
Q
A
181
Q
A

PSA (2 decks)

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