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PSA > PSA notes > Flashcards

PSA notes Flashcards

1
Q

Hack for searching for one side effect within multiple drugs

A

side effect AND (drug1 OR drug2 OR drug3)

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2
Q

How to find HRT in treatment summaries

A

Search sex hormones

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3
Q

How to find opioid dose equivalent tables

A

Search prescribing in palliative care

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4
Q

How to find glucocorticoid dose equivalence tables

A

Search corticosteroid

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5
Q

How to find information on overdoses?

A

Poisoning section

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6
Q

How to find information on how to manage a high INR

A

oral anticoagulants treatment summary

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7
Q

How to find conversions eg lb to Kg

A

search approximate conversions and units

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8
Q

what does PRESCRIBER stand for

A

to remember what to do when you get a full paper prescription

Patient details
Reactions
Signature
Contraindications
Route
IV fluids if needed
Blood clot prophylaxis if needed
Emetic prophylaxis if needed
Relief of pain if needed

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9
Q

Drugs causing prolonged QT

A

Amiodarone
Chlorpromazine
Citalopram (SSRI)
Clarithromycin
Clomipramine
Domperidone
Erythromycin
Escitalopram
Flecainide
Fluconazole
Haloperidol
Levomepromazine
Lithium
Methadone
Metocloperamide
Ondansetron
Quinine
Risperidone
Sildenafil
Tolterodine
Tricyclic antidepressants

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10
Q

Antibiotics to avoid in renal failure

A

Nitrofurantoin and tetracyclines

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11
Q

Drugs likely to accumulate in renal failure

A

Digoxin
Furosemide
Atenolol
Allopurinol
Opioids
Methotrexate
Metformin
Sulphonylureas

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12
Q

Drugs to avoid in pregnancy

A

Rotton wet dogs smell so stinky
Ramipril
Warfarin
Doxycycline
Sulphonylureas - gliclazide
Statins
Sodium Valproate

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13
Q

Drugs which cause hyperkalaemia

A

Dalteparin sodium
Ramipril
Tacrolimus (oral immunosuppressant)

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14
Q

things to include if prescribing an ‘as required’ medication

A

give an indication and maximum frequency

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15
Q

things to include if prescribing an antibiotic

A

give an indication and a stop or review date

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16
Q

remember to include what when prescribing tacrolimus

A

trade name

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17
Q

can you write a prescription for tazocin?

A

No it needs to be written as piperacillin with tazobactam

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18
Q

when is diclofenac contraindicated

A

peripheral arterial disease, vascular disease, and congestive heart failure due to increased risk of CVD

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19
Q

which drugs may exacerbate heart failure

A

Thiazolidinediones due to fluid retention.
Verapamil.
NSAIDS
Glucocorticoids.
CLASS one antiarrhythmics such flecainide.

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20
Q

Cp450 inducers

A

BS CRAP GPS
Barbiturates
St johns wart / Smoking

Carbamazepine
Rifampicin
Alcohol (chronic)
Phenytoin

Griseofulvin
Phenobarbitones
Sulphonylureas

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21
Q

Cp450 inhibitors

A

SICKFACESS.COM
Sodium valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Alcohol (acute)
Chloramphenicol
Erythromycin/
Clarithromycin
Sulphonamides
SSRIs (sertraline & fluoxetine)
Ciprofloxacin
Omeprazole
Metronidazole

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22
Q

what is 1 Fingertip unit

A

Amount of medication to squeeze a line from tip of adult finger to first crease. This will be enough to treat one side of both hands

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23
Q

If someone is on long term steroids, what do you do at induction of anaesthesia

A

Give IV steroids

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24
Q

Drugs to stop before surgery

A

HIA LACK
Hypoglycemics (oral)
Insulin
Anticoagulants/antiplatelets
Lithium - day before
ACEi - day of
COCP - 4 weeks before
K sparing – day of

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25
Q

Maximum dose of paracetamol

A

4g / day (8 X 500mg tablets)

(2g per day if <50kg)

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26
Q

why should you not give prophylactic heparin in acute ischaemic stroke

A

bleeding risk

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27
Q

Side effects of steroids

A

Stomach ulcers,
Thin skin,
Edema,
Right and left heart failure,
Osteoporosis,
Infection,
Diabetes,
Syndrome of cushings.

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28
Q

Side effects of NSAIDS

A

No urine (renal failure),
Systolic dysfunction (heart failure),
Asthma,
Indigestion,
Dodgy clotting (or Dyscrasia)

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29
Q

ACEi side effects

A

dry cough due to bradykinin accumulation

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30
Q

beta blocker side effects

A

wheeze in asthmatics,
worsening acute HF but help chronic.

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31
Q

CCB side effects

A

Peripheral oedema and flushing

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32
Q

side effects of K+ sparing diuretics

A

gynaecomastia

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33
Q

When to stop NSAIDS in asthma

A

when wheezy

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34
Q

do you still give oral medications including prior to surgery if NBM?

A

yes

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35
Q

when to give 5% dextrose as replacement fluid

A

if Hypernatraemic or hypoglycaemia

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36
Q

when to give human albumin solution (HAS) as replacement fluid

A

If they have ascites

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37
Q

how much fluid to give in bolus if heart failure

A

250ml

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38
Q

what is the maximum speed to give IV potassium?

A

don’t give faster than 10mmol/hour

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39
Q

what volume maintenance fluid should be given?

A

25-30 ml/kg/day (around 3L per day IV for adults and 2L per day for elderly)

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40
Q

when should you NOT prescribe compression stockings or B blockers

A

in PAD due to risk of acute limb ischaemia

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41
Q

when to avoid metoclopramide

A

In Parkinson’s and in young women due to risk of unwanted movements eg acute dystonia.

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41
Q

when to avoid metoclopramide

A

In Parkinson’s and in young women due to risk of unwanted movements eg acute dystonia.

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42
Q

How to change between anti-emetics

A

common antiemetics have the same dose regardless of the route taken.

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43
Q

what anti-emetic should be used in heart failure

A

metocloperamide. Cyclizine causes fluid retention

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44
Q

first line anti-emetic

A

cyclizine as long as no cardiac problems

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45
Q

Maximum dose of ibuprofen

A

400mg 8 hourly

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46
Q

First line for neuropathic pain

A
  • amitriptyline 10mg oral nightly
  • OR pregabalin 75mg oral BD
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47
Q

first line for diabetic neuropathy

A

duloxetine 60mg oral daily

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48
Q

How to manage pain

A

NO PAIN –
PRN paracetamol 1g up to 6 hrly ORAL

MILD PAIN –
Regular paracetamol 1g up to 6 hrly ORAL
PRN Codeine 30mg up to 6 hrly ORAL (OR TRAMADOL)

SEVERE PAIN –
Regular co-codamol 30/500, 2 tablets 6 hrly ORAL
PRN Morphine sulphate (10mg/5ml) 10mg up to 6 hrly ORAL.

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49
Q

what does co-codamol 30/500 mean

A

30mg of codeine and 500mg of paracetamol

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50
Q

what is NEO-NACLEX

A

thiazide diuretic

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51
Q

what is oxybutynin and what are the side effects

A

= antimuscarinic causing confusion in the elderly. Pupil dilation, loss of accommodation, dry mouth and tachycardia.

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52
Q

tramadol in elderly

A

opioid, causes confusion and should be avoided unless completely necessary

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53
Q

cyclizine in elderly

A

can cause drowsiness and confusion. Reduce dose in elderly.

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54
Q

diazepam in elderly

A

use with extreme caution and only for short courses.

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55
Q

why is trimethoprim contraindicated with methotrexate?

A

methotrexate is a folate antagonist and so is trimethoprim which can cause pancytopenia and neutropenic sepsis.

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56
Q

what to avoid prescribing with methotrexate due to nephrotoxic risk

A

ibuprofen and other NSAIDs

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57
Q

what to do with methotrexate in active infection?

A

stop methotrexate. it has a long half-life so shouldn’t affect the control of RA

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58
Q

what to do with methotrexate in active infection?

A

stop methotrexate. it has a long half-life so shouldn’t affect the control of RA

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59
Q

monitoring of methotrexate

A

1-2 weekly FBC, U&E, LFTs until stable, monitored 2-3 months after.

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60
Q

Inpatients with INR >2

A

should not be given prophylactic heparin as it increases the risk of unnecessary bleeding

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61
Q

dose of aspirin

A

75mg cardioprotective. 300mg in ACS

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62
Q

bisoprolol dose

A

10mg/ day

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63
Q

i

A
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64
Q

urea and creatinine in different types of AKI

A

Pre-renal - Urea rises more than creatinine. (Urea X10) > creatinine

Renal - Creatinine rises more than urea
(Urea X10) < creatinine

Post-renal - Creatinine rises more than urea
(Urea X10) < creatinine

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65
Q

isolated raised bilirubin

A

pre hepatic hepatitis due to haemolytic.

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66
Q

drugs which cause cholestasis

A

flucloxacillin, co-amoxiclav, nitrofurantoin, steroids, Sulphonylureas, COCP

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67
Q

drugs requiring monitoring of levels

A

Digoxin – confusion, nausea, visual halos, arrythmias. Check digoxin 8-10days later.
Theophylline
Lithium - tremor, tiredness, arrythmia, seizure, coma, renal failure, insipidus.
Phenytoin – gum hypertrophy, ataxia, nystagmus, peripheral neuropathy, teratogenicity.
Antibiotics – gentamycin and vancomycin – ototoxic and nephrotoxic

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68
Q

if high serum level of a drug what do you do?

A

= decrease dose
Except gentamycin where a high level = reduce frequency by 12hrs.

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69
Q

gentamicin monitoring

A

If high serum level and toxicity = omit for few days.
If plotted point is above the every 48 hour area = repeat gentamicin level and only give another dose when <1mg/L

12 hours after last infusion is started (troph measurement)

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70
Q

when might someone taking gentamicin receive reduced and divided doses

A

renal failure or endocarditis

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71
Q

INR and warfarin

A

INR 5-8
NO BLEEDING = withheld 1-2 doses and reduce subsequent dose
MINOR BLEEDING = stop warfarin, IV VITAMIN K, restart when INR <5.

INR >8
NO BLEEDING = stop warfarin. Oral vitamin K. restart when INR <5.
MINOR BLEEDING = stop warfarin. IV vitamin K. restart when INR <5.

Any major bleeding = stop warfarin. IV vitamin K. Prothrombin complex concentrate / FFP if unavailable

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72
Q

management of neutropenic sepsis

A

= piperacillin with tazobactam and gentamicin IV

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73
Q

electrolytes and carbemazepine

A

hyponatraemia

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74
Q

Digoxin and HR

A

stop digoxin if bradycardic

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75
Q

Salbutamol inhaler during acute attack

A

Withold salbutamol inhaler while using nebulisers

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76
Q

acute HF drug management

A

furosemide 20-50mg IV.

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77
Q

lanoxin

A

trade name for diltiazem

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78
Q

side effects of lamotrigine

A

rash, rarely SJS

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79
Q

side effects of carbamazepine

A

rash, dysarthria, ataxia, nystagmus, hyponatraemia

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80
Q

side effects of phenytoin

A

ataxia, peripheral neuropathy, gum hyperplasia, hepatotoxicity.

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81
Q

side effects of levetiracetam

A

fatigue mood disorders and agitation

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82
Q

flecanide is contraindicated when?

A

structural heart disease

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83
Q

Diabetes – managing cardiovascular risk factors

A

Aspirin 75mg if CV risk factors or >50yo in T2DM
Stating 20mg daily if CV risk factors >40yo in T2DM

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84
Q

Annual review in diabetes –
Albumin creatinine ratio

A

indicates diabetic nephropathy early. ACR >3= ACEi.

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85
Q

alzheimers drug management

A

treatment may only be started by specialist doctors
* there are three licenced drugs: donepezil, rivastigmine and galantamine.
* If moderate/severe dementia, then treat with NMDA antagonist (memantine

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86
Q

Crohns disease management

A

Inducing remission
Mild – 20-40mg pred oral daily
Severe – 100-500mg IV hydrocortisone
Maintaining remission
Azathioprine (check TPMT activity before starting as a deficiency can increase the risks of liver and bone marrow toxicity)

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87
Q

when to start TNF-alpha inhibitors in RA

A

If fail to respond to 2 DMARDS then severely active RA may be managed with TNF-alpha inhibitors like infliximab

88
Q

when to give steroids

A

Steroids can cause insomnia so give in the morning.

89
Q

Carbimazole and carbamazepine can cause

A

neutropenia

90
Q

what to prescribe if Cardiac chest pain and allergic to opiates

A

sublingual GTN 2 puffs. Can do infusion if this doesn’t work.

91
Q

examples of LMWH

A

enoxaparin, tinzaparin or dalteparin.

92
Q

If a contraception is 30/75 it tells you

A

you it is combined straight away without having to check

93
Q

carbamazepine and oral contraception

A

COCP and POP should be avoided if taking carbamazepine (enzyme inducers)

94
Q

Sayana press and depo-provera are

A

injectable contraceptives

95
Q

ramipril and pregnancy

A

Ramipril is teratogenic in the first trimester. Stop before conception and start labetalol

96
Q

tamoxifen and warfarin

A

Tamoxifen increases the efficacy of warfarin = bleeds.

97
Q

Warfarin colour tablets

A

we bite big penises
white (0.5 mg), brown (1 mg), blue (3 mg), and pink (5 mg).

98
Q

warfarin monitoring

A

When first on warfarin weekly blood tests required. Monthly when stable.

99
Q

when to check renal function with ramipril

A

1-2 weeks after starting

100
Q

when to take bisphosphonates with steroids

A

if taking steroids more than 3 months

101
Q

citalopram side effects

A

suicidal and salivate a lot

102
Q

instructions for taking bisphonates

A

swallow with full glass of water and remain upright for 30 min. Taken once weekly. Don’t eat for 2 hours after

103
Q

Breast cancer risk after stopping HRT

A

Although the risk of breast cancer is lower after stopping HRT than it is during current use, the excess risk persists for more than 10 years after stopping compared with women who have never used HRT.

104
Q

calculation questions for weight/volume or weight/weight

A

1%= 10mg/ml 1% = 1g/100g

105
Q

how much oral phenytoin = a 100mg phenytoin capsule

A

92mg

106
Q

when to give ACE inhibitors

A

in evening as they can cause postural hypotension

107
Q

how to prescribe GTN spray

A

write the dose in the drug name GTN spray (400 micrograms/metered dose) and write 2 sprays in the dose

108
Q

For guidance on electrolytes what do you search

A

fluid and electrolytes section on treatment summary

109
Q

what to prescribe hyperkalaemia

A

Short-acting insulin (actrapid) with glucose.
10 units of actrapid in 50 ml of 50% dextrose over 15 min IV

110
Q

when not to prescribe levetiracetam

A

Levetiracetam can worsen low mood so don’t give if depressed!

111
Q

gliclazide and low BMI

A

Gliclazide can be used if underweight.

112
Q

when to check CK on simvastatin

A

should be checked at baseline if at risk of myopathy i.e. a personal or family history of muscular disorders, previous history of muscular toxicity, a high alcohol intake, renal impairment, hypothyroidism, and in the elderly.
If no risk factors then measure serum ALT.

113
Q

before prescribing vancomycin check what?

A

creatine for renal function

114
Q

Vancomycin may cause what after a week of therapy

A

neutropenia

115
Q

– recommended sampling time for lithium

A

is 12 hours after last dose. Weekly serum lithium after initiation and after each dose change until stable then every 3 month.

116
Q

lithium

A

Likely to have toxic symptoms above 1.5 mmol/L.

117
Q

methotrexate if liver function tests are abnormal

A

should not be started

118
Q

monitoring in methotrexate

A

FBC every 2-3 month. In clinically significant drop in WCC or platelets, methotrexate should be stopped.

119
Q

monitoring olanzapine

A

– fasting blood glucose should be measured at baseline, at 4-6 month and then yearly. Baseline ECG is only required if risk factors

120
Q

amiodarone monitoring

A

baseline chest xray prior to amiodarone. T3 TSH and T4 must all be checked. LFT should be checked at baseline and at regular intervals. Caution in hypokalaemia.

121
Q

carbimazole and sore throat

A

Neutropenia so do a FBC

122
Q

sodium valproate monitoring

A

liver function should be measured at baseline as well as at regular intervals.

123
Q

clozapine monitoring

A

FBC weekly for 18weeks, fortnightly for 1 year and monthly after due to agranulocytosis. Registration with a clozapine monitoring service is required for all patients.

124
Q

side effects of ciprofloxacin

A

lowers seizure threshold and causes tendonitis

125
Q

BB and heart failure

A

worsens acute heart failure (but helps chronic heart failure)

126
Q

heparins are a higher risk of bleeding when?

A

in renal failure or <50kg

127
Q

why should heparin be prescribed alongside warfarin at first

A

warfarin has a procoagulant effect initially, as well as taking a few days to become an anticoagulant; thus heparin should be prescribed alongside warfarin and continued until the INR exceeds 2

128
Q

side effects of aspirin

A

Haemorrhage, peptic ulcers and gastritis, tinnitus in large doses

129
Q

side effects of amiodarone

A

Interstitial lung disease (pulmonary fibrosis), thyroid disease (both hypo- and hyperthyroidism are reported; it is structurally related to iodine, hence its name amIODarone), skin greying, corneal deposits.

130
Q

side effects of fludrocortisone

A

Hypertension/sodium and water retention

131
Q

side effects of simvastatin

A

Myalgia∗, abdominal pain, increased ALT/AST (can be mild), rhabdomyolysis (can be just mildly increased creatine kinase though)

132
Q

management of statin induced myalgia

A

exclude rhabdomyolysis (with creatine kinase (CK) level and urine dip). Otherwise, if symptoms unacceptable or CK very high (>2,000): (i) ensure needs statin, then (ii) reduce the dose; then (iii) switch to other statin with lower risk of myalgia (risk of myalgias: simvastatin > atorvastatin > pravastatin > fluvastatin).

133
Q

low GCS and metformin

A

lactic acidosis

134
Q

monoamine oxidase inhibitors can do what to BP

A

cause hypertensive crisis

135
Q

ACEi and NSAIDS ok?

A

should not be co-prescribed due to renal function

136
Q

amiloride drug class

A

potassium sparing diuretic

137
Q

metformin and contrast

A

Discontinue metformin from day of procedure to 48 hours after CT with contrast. Review if eGFR <45 and stop if <30.

138
Q

Antidotes to drugs -

B- blocker =
Lithium =
TCA =
Benzodiazepines =
CO =
Methanol =
Iron =
Heparin =
Ethylene glycol (antifreeze) =
Digoxin =

A

B- blocker = atropine
Lithium = IV NaCl
TCA = IV sodium bicarb
Benzodiazepines = flumazenil
CO = 100% oxygen
Methanol = Fomepizole / ethanol
Iron = desferrioxamine
Heparin = Protamine sulphate
Ethylene glycol (antifreeze) = fomepizole / ethanol
Digoxin = digiband

139
Q

daily requirement of glucose

A

50-100g

140
Q

Drugs causing pulmonary fibrosis

A

AMEN
Amiodarone
Methotrexate, Sulfasalazine
Ergot derived dopamine EG bromocriptine, cabergoline, pergolide
Nitrofurantoin
Cytotoxic agent (bleomycin)

141
Q

drugs causing urinary retention

A

TCA’s (eg amitriptyline)
Anticholinergics
Opioids
NSAIDs

142
Q

VTE prophylaxis enoxaparin dose

A

Write in MG and Units (1mg = 100units)
20mg every 24 hours if moderate risk surgical
40 mg every 24 hours if high risk surgical (eg orthopaedic)

143
Q

what to prescribe FIRST for suspected meningitis in GP and in hospital

A

Prescribe benzylpenicillin in GP
Prescribe Ceftriaxone (2g IV) / cefotaxime in hospital

144
Q

Glucose for reduced GCS hypoglycaemic

A

Glucose 20% solution IV 50-100ml over 15min.
or
Glucose 10% solution IV 150ml over 15min

145
Q

what antibiotic is used for acne in children

A

doxycycline

146
Q

when to stop anti-platelets before surgery

A

1 week prior to surgery eg aspirin.

147
Q

what to use for breakthrough pain in fentanyl patch users

A

fentanyl nasal spray 50micrograms into one nostril.

148
Q

avoid nitrofurantoin if renal function is what level

A

<45

149
Q

can you give trimethoprim if folate deficient

A

yes Can give a short course of trimethoprim even if folate deficient.

150
Q

INR for surgery

A

INR needs to be <1.5 for surgery. Give Phytomenadione (vitamin K) if it is not.
1-5mg PO.

151
Q

rivaroxaban administration instructions

A

Rivaroxaban should be taken with food to improve absorbtion

152
Q

topiramate and oral contraceptives

A

Topiramate makes oral contraceptives not as effective. So should change to alternative method of contraception until 4 weeks after stopping taking topiramate.

153
Q

citalopram and dabigatran interaction

A

Citalopram can increase bleeding. Especially when paired with dabigatran and increases GI haemorrhage

154
Q

What rise in creatinine is acceptable after starting an ACEi?

A

<20%

155
Q

How should the beneficial effect of furosemide be monitored?

A

weight reduction

156
Q

ACEi measuring adverse effects and beneficial effects of therapy

A

Measure serum creatinine for adverse effects of therapy
Measure exercise tolerance to monitor beneficial effects of ACEi.

157
Q

Most serious side effects of ciclosporin

A

nephrotoxicity and hypertension
Before treatment assess renal function and every 2 weeks until stable. Also monitor BP.

158
Q

how to manage A rise in glucose after starting steroids on T1DM

A

increase insulin by 10%.

159
Q

How do you know if statin dose is effective?

A

> 40% reduction in non-HDL cholesterol

160
Q

What is given for all exacerbations of COPD?

A

30mg prednisolone PO daily for 5 days

161
Q

after 2L NaCL 0.9% in 24hrs glucose is required, how is it given

A

Glucose 5%/potassium chloride 0.3%.

162
Q

After stroke it is recommended to maintain glucose between

A

5 and 15.

163
Q

HRT patch dosing

A

Estradiol 50 microgram per 24 hour, Levonorgestrel 7 microgram per 24 hour in a transdermal patch once weekly.

164
Q

CCB (diltiazem) and prednisolone can contribute to

A

biventricular failure

165
Q

Usual dose of citalopram is

A

is 10-20mg PO daily (max 20mg daily)

166
Q

If glycaemic control needs to be improved on insulin in the afternoon then

A

increase breakfast novomix dose.

167
Q

Scarlet fever abx treatment

A

phenoxymethylpenicillin 125mg PO 6 hourly for 10 days

168
Q

clarithromycin and INR

A

Clarithromycin increases INR.

169
Q

missing 1st pill of pack after break COCP

A

Starting a pack one day late is not an issue. Take 2 pills in once day.
A missed pill is more than 24 hours late with COCP.

170
Q

What should be monitored when starting K+ sparing diuretic? and when?

A

Serum potassium 1 week after starting.

171
Q

Mirtazapine can cause

A

sleep disturbance and abnormal dreams

172
Q

Monitoring beneficial effects of B-blockers using ..

A

Heart rate.

173
Q

Before starting amiodarone need to check

A

serum potassium as hypokalaemia is a caution and needs to be corrected prior to starting treatment.

174
Q

Sertraline monitoring

A

no routine blood monitoring needed.

175
Q

Hepatic impairment and sertraline

A

doses may need to be reduced

176
Q

CK markedly raised at what level on statins?

A

5X the upper limit of normal.

177
Q

what to do if Statin causing raised CK

A

stop statin, when symptoms resolve and CK reduces to normal then restart at a lower dose.

178
Q

Ondansetron is contraindicated if ? what to use instead

A

prolonged QT interval. Cyclizine is preferred.

179
Q

1st and 2nd line for PONV?

A

Ondansetron and cyclizine

180
Q

ciclosporin caues what electrolyte abnormality

A

hyperkalaemia

181
Q

Epleronone is

A

potassium sparing diuretic

182
Q

Drugs causing dyspepsia

A

prednisolone, nsaids and alendronic acid

183
Q

Drugs causing diarrhoea

A

PPIs and alendronic acid.

184
Q

Drugs that can cause ankle oedema

A

Amlodipine and naproxen

185
Q

How long should a clotrimazole pessary be given for thrush in pregnancy

A

= 7 days

186
Q

first line analgesic for pain in shingles

A

Paracetamol

187
Q

when to use loperamide

A

after each loose stool up to 16mg per day

188
Q

monitoring on cyclosporin

A

kidney function must be monitored every 2 weeks for first 3 months

189
Q

tramadol can cause what complication

A

serotonin syndrome

190
Q

Rifampicin can effect and reduce effectiveness of what

A

oral contraceptives

191
Q

COCP should be stopped if BP is what?

A

> 160/95

192
Q

What should be checked before starting azathioprine?

A

TPMT activity.

193
Q

How to check for adverse effects of apixaban?

A

Patients reporting of bleeding or bruising

194
Q

what to do if amiodarone has caused thyroid issues

A

In hyperthyroidism (thyrotoxicosis) stop amiodarone at least temporarily to achieve control
In hypothyroidism continue amiodarone and replace thyroxine.

195
Q

Dose of salbutamol neb

A

2.5mg

196
Q

Why don’t you give IV glucose straight after a stroke if normal glucose level?

A

Can exacerbate cerebral injury

197
Q

ching for sodium chloride fluids with potassium

A

type in potassium chloride with sodium chloride and go to medicinal forms

198
Q

For sodium chloride 0.9% with Potassium chloride 0.3% how many mmol of potassium in 500ml

A

20mmol

199
Q

For sodium chloride 0.9% with Potassium chloride 0.15% how many mmol of potassium in 500ml

A

10mmol

200
Q

IV potassium should not be given faster than

A

10mmol/hour.

201
Q

What is the indication in the BNF for a statin due to high QRISK?

A

Primary prevention of cardiovascular events

202
Q

Aspirin can cause what deficiency

A

Iron deficiency anemia

203
Q

Can Pioglitazone cause hypoglycaemia

A

Yes

204
Q

how do opiates reduce urine output

A

Opiates can cause urinary retention

205
Q

Morphine and metoclopramide can both cause

A

disorientation and confusion

206
Q

When is IV sedation with a benzodiazepine contraindicated?

A

In a patient who is confused and disorientated.

207
Q

Mx for FH of spina bifida in pregnancy?

A

5mg folic acid to 12 weeks

208
Q

Pregnancy and no RF for neural tube defect?

A

400 micrograms folic acid

209
Q

Oestrogen + progesterone HRT reduces what risk?

A

Risk of endometrial cancer

210
Q

Oestrogen + progesterone HRT increases what risk?

A

Risk of breast cancer

211
Q

Very common blood result in methotrexate use?

A

Leucopenia (low WCC)

212
Q

How to assess the beneficial effects of allopurinol?

A

Serum urate

213
Q

When to stop statin based on LFT?

A

If ALT >3X upper limit. If not then can continue statin.

214
Q

If the thyroxine dose needs to be increased then increase it by up to …

A

50%.

215
Q

Thyroxine can exacerbate which condition?

A

Angina. (not contraindicated)

216
Q

Gentamycin - If high peak concentration post-dose

A

reduce the dose

217
Q

Gentamycin - If high trough concentration

A

= increase the interval between dose

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