Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PSA EXAM > PSA Generic > Flashcards

PSA Generic Flashcards

1
Q

Common Enzyme Inducers

(Mneumonic = PC BRAS)

A

Phenytoin
Carbamazepine
Barbiturates
Rifampicin
Alcohol (Chronic XS)
Sulphonylureas (e.g. Gliclazide, Glipizide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Common Enzyme Inhibitors

(Mneumonic = AODEVICES)

A

Allopurinol
Omeprazole
Disulfiram
Erythromycin
Valporate
Isoniazid
Ciprofloxacin
Ethanol (Acute intoxication)
Sulphonamides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Consequence of an enzyme inducing drug

A

Increased enzyme activity –> Decreased drug concentration

Increased metabolism of drugs means reduced effect (pt may require increased concentration if taking an enzyme inducer to get desired effect)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Consequence of an enzyme inhibiting drug

A

Decreased enzyme activity –> increased drug concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Consequence of an enzyme inhibiting drug

A

Decreased enzyme activity –> increased drug concentration

e.g. patient in warfarin and taking erythromycin - need to be careful with dosing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Common drugs to stop before surgery

(Mneumonic = I LACK OP)

A

Insulin
Lithium
Anticoagulants / Antiplatelets
COCP/HRT
K-Sparing diuretics (e.g. Spironolactone)
Oral Hypoglycaemics
Perindopril and other ACE inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

COCP and HRT: when to stop before surgery

A

4 weeks before surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Lithium: when to stop before surgery

A

Day before

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Potassium sparing diuretics: when to stop before surgery

A

Day of surgery

(hyperkalaemia may develop if renal perfusion is impaired or if there is tissue damage)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ACE Inhibitors: when to stop before surgery

A

Day of surgery

(associated with severe hypotension after induction of anaesthesia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Clopidogrel: when to stop before surgery

A

7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Oral hypoglycaemic drugs and insulin: when to stop before surgery

A

Metformin should be stopped (because it will cause lactic acidosis)

All other oral hypoglycaemics and insulin should be stopped as will cause hypos because NBM

Sliding scales should be started - dose dependent on capillary glucose measurements

long-acting insulin should be given day of surgery at a reduced dose (80%)

intravenous glucose 20 % should be given if blood-glucose drops below 6 mmol/litre, and blood-glucose checked every hour, to prevent a drop below 4 mmol/litre. If blood-glucose drops below 4 mmol/litre, intravenous glucose 20 % should be adjusted and blood-glucose checked every 15 minutes, until blood-glucose is above 6 mmol/litre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Warfarin: when to stop before surgery

A

5 days

INR must be <1.5
May have to reverse the warfarinisation with PO Vitamin K if the INR remains high on the evening before

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

DOACs: When to stop before surgery

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Drugs that may exacerbate heart failure

A
  1. thiazolidinediones - pioglitazone is contraindicated as it causes fluid retention
  2. verapamil - negative inotropic effect
  3. NSAIDs/glucocorticoids - should be used with caution as they cause fluid retention

(low-dose aspirin is an exception - many patients will have coexistent cardiovascular disease and the benefits of taking aspirin easily outweigh the risks)

  1. class I antiarrhythmics - flecainide (negative inotropic and proarrhythmic effect)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How much fluid: just reduced urine output

A

500mL fluid depletion

16
Q

How much fluid: reduced urine output and tachycardia

A

1L fluid depletion

17
Q

How much fluid: reduced urine and tachy and shocked

A

> 2L fluid depletion

18
Q

How much fluid does an adult require / 24 hours

A

3L for adults, 2L for elderly

Adequate electrolytes are provided by 1L 0.9% NaCl and 2L 5% dextrose

19
Q

Adult potassium requirement in fluids

A

Normal potassium level:
- 40mmol KCl per day (so 20mmol KCl in 2 bags)

20
Q

How fast to give maintenance fluids

A

3L per day - 8 hourly bags
2L per day - 12 hourly

21
Q

Signs of fluid overload

A

Increased JVP
Peripheral / pulmonary oedema

22
Q

Metaclopramide contraindications

A

Pt with Parkinson’s (it is a dopamine antagonist)
Young women and elderly - due to risk of dyskinesia

23
Q

Inpatient VTE Prophylaxis

A

Prophylactic LMW heparin e.g. dalteparin 5000 units daily s/c
Compression stockings

24
Q

Who should NOT be prescribed compression stockings

A

Patient with peripheral arterial disease (may cause limb ischaemia)

25
Q

Domperidone vs metoclopramide - which one exacerbates parkinsonism

A

Bother dopamine antagonists
Metoclopramide crosses the BBB whereas domperidone doesnt - domperidone safe to use in parkinsons

26
Q

Drugs that can cause hypokalaemia

A

Diuretics - loop diuretics, thiazide diuretics
Glucocorticoids, Mineralocorticoids

27
Q

Drugs that can cause hyperkalaemia

A

ACE inhibitors - e.g. lisinopril
ARBs
K- sparing diuretics
Trimethoprim
Mannitol

28
Q

Antimuscarinics examples

A

Oxybutynin (urinary freq./urgency)

29
Q

Antimuscarinics side effects

A

CONFUSION in the elderly
PUPILLARY DILATION with LOSS OF ACCOMMODATION
DRY MOUTH
TACHYCARDIA (after transient bradycardia)

30
Q

Drugs with anticholinergic effects

A

Cyclizine

31
Q

Cyclizine in the elderly

A

Reduced dose recommended as has anticholinergic effects - can cause drowsiness and confusion

32
Q

Anticholinergic side effects

A
33
Q

Drugs that should be avoided when on methotrexate

A
  • TRIMETHOPRIM (is also folate antagonist so high risk of bone marrow toxicity –> pancytopenia and neutropenic sepsis)
  • NSAIDs (should be used with caution due to risk of nephrotoxicity)
    N.B. methotrexate should be withheld during active infection
34
Q

Medications that can exacerbate asthma

A

Beta-blockers
NSAIDs
(except aspirin as this rarely worsens asthma)

35
Q

Clozapine worrying side effect

A

Agranulocytosis resulting in neutropenia
!! required immediate cessation of the drug

PSA EXAM (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions