PSA learning points Flashcards
What is the treatment for pulmonary oedema
Furosemide IV 20-50ml daily
How is hypoglycaemia treated?
Oral intake: Sugar/buccal glucose
IV access: IV glucose 10-20g (1st line 20% 50-100ml OR alternative 10% 100-200ml)
No IV access: IM glucagon
How does dalteparin impact K+ levels?
Can raise them through inhibition of aldosterone
When do you stop antiplatelets before surgery?
7 days before
How do steroids impact glucose levels?
Can increase blood glucose
How does citalopram impact sodium levels?
Reduces sodium through SIADH
How can you generally decide if nitrofurantoin or trimethoprim is contraindicated for UTI?
Nitro: eGFR <45
Trimethoprim: 1st trimester, methotrexate
What is first line management for alcohol withdrawal?
Benzodiazepines
What INR requires bridging therapy prior to surgery?
<1.5
When should rivaroxaban be taken?
With food
How much can creatinine rise when commencing an ACEI?
up to 20%
Above that is concerning
How do you manage a steroid induced rise in glucose when on insulin therapy?
Increase insulin by 10%
What drugs cause acute dystonic reactions?
What management treats it?
Psychiatric drugs (psychotics and depressants)
Procyclidine hydrochloride
If someone hypos at night on biphasic insulin what should you do?
Increase their morning dose
What do you advise regarding COCP pills if
No sex, 1 pill missed
No sex, 2 pills missed
Unprotected sex
1 pill: Take missed and that day’s pill
2 pills: Take today’s and barrier for 7 days
Week 4,1: Emergency
Week 2: 7 days contraception
Week 3: Continue taking pills through omission week
What are the cutoff times for the following POP pills
Traditional
Levonogestrel
3 hours
12 hours
Regarding cutoff times for POPs, what do you do if….
Under time
Over time
Under: Take as normal
Over time:
- Take missed pill ASAP
- Take next pill as usual
- Continue with rest of pack
- Use condoms for 48 hours
For emergency contraception, when can you use…
Levonogesterel
Ullipristal acetate (EllaOne)
Intrauterine devices
3 days
5 days for the other two
What cautions are require for EllaOne use?
Asthmatics
Breastfeeders
What drug interacts with atorvostatin to cause myopathy
Fibrates
Clindamycin
What should cross your mind if a patient on levothyroxine has a high TSH?
Check adherence
What should you check for before commencing an antiemetic?
Parkinson’s history
QT interval
How should insulin therapy be adapted if in DKA?
Swap fast actors for sliding scale
Continue long actors
What drugs can cause serotonin syndrome?
SSRIs
Tramadol
What drug is a go to for strong analgesia in renal impairment?
Oxycodone
What eGFR cautions use of metformin?
under 30
When would you taper rather than stop steroids?
> =40mg daily for 7 days
=3 weeks treatment
Recent repeated courses
What advice is given for bisphosphonates
Take weekly
Take with food and stay upright for 30 mins after admin
If an individual is sub transfusion level anaemic what do you do?
oral iron for normal Hb
Continue 3 months post-normal
What are the causes of
HYPOkalaemia
HYPERkalaemia
HYPO: DIRE (Drugs, Intestinal, RTA, Endocrine)
HYPER: DREAD (Drugs, Renal failure, Endocrine, Artefact, DKA)
What are the causes of SIADH?
SCLC
Infections
Abscesses
Drugs
Head injury
What is the max rate of potassium/hr
<20mmol/hr
What to do with anticoagulation if…
Large bleed
Small bleed
No bleed, INR 5-8
No bleed, INR >=8
Large bleed: 5-10mg IV vitamin K
Small bleed: 1-3mg IV vitamin K
No bleed, INR 5-8: withold
No bleed, INR >=8: Vit k 1-5mg Oral
Which diabetic drugs cause…
Hypos
Weight gain
Weight loss
No change
Fluids, Fractures, fibrosis and Fucked liver
Hypos: Sulfonylurea, GLP-1s
Weight gain: Thiazolinediones
Weight loss: GLP-1, SGLT-2
No change: Metformin, DPP4Is
Fluids, Fractures, fibrosis and Fucked liver: Thiazolinediones
