PSA Part 2 Flashcards
What are tocolytic agents?
Drugs designed to inhibit contractions of myometrial smooth muscle cells
Used in premature labour
Trimethoprim is contraindicated in patients taking which drug, and why?
Methotrexate
Trimethoprim is a folate antagonist, and so is methotrexate, so combined usage can lead to toxicity and causes bone marrow suppression, pancytopenia, and neutropenia
Folate is used in DNA synthesis
What are common side-effects of Bisoprolol use?
Headache and dizziness
Bradycardia
Fatigue
Insomnia
When correcting Hypokalaemia under the normal range (3.5-5) of 2.5-3.5, what infusion at what rate do you give?
IV 1L of 0.9% NaCl with 40mmol KCl over 4 hours
Standard infusion rate for potassium is 10mmol KCl per hour
Only in extreme cases where potassium is below 2.5mmol/L, should the KCl rate be increased to 20mmol/hr
What is the fluids you give as maintenance if they also need potassium?
IV 1L of 0.9% NaCl with 40mmol KCl over 8 hours
Is Erythromycin safe to use in breastfeeding mothers?
It is safe
What is the name of the antidote drug used for reversal of anticoagulation from Apixaban and Rivaroxaban?
Andexanet alfa
What is the name of the antidote drug used for reversal of anticoagulation from Dabigatran?
Idarucizumab
What other class of drugs are people who are allergic to penicillin at risk of also reacting to?
Cephalosporins
Other beta-lactam antibacterials
Carbapenems (Meropenem)
What are the doses you give of the anti-histamine Chlorphenamine after when you have initiated the adrenaline in an anaphylaxis situation?
Adult and over 12yo - 10mg
Child 6-12 - 5mg
Child 6m-6y - 2.5mg
Child less than 6m 250micrograms/kg
What are the doses you give of hydrocortisone, after when you have initiated the adrenaline in an anaphylaxis situation?
Adult and child over 12yo - 200mg
6yo-12yo - 100mg
6m-6yo - 50mg
<6m - 25mg
What are side effects of GTN spray?
Headaches
Hypotension
Dizziness
What are some pharmacological risk factors associated with c.difficile infection?
Clindamycin
Acid suppressing drugs (PPIs)
Cephalosporins (especially third and fourth generation)
Fluoroquinolones
Broad-spectrum penicillins
What drug do you give prophylactically in children with sickle cell anaemia, to reduce the risk of pneumococcal infection?
PHENOXYMETHYLPENICILLIN
Do diabetic lorry, bus, and coach drivers need to tell the DVLA if they are being treated with insulin, non-insulin injections, or tablets? Do they need to tell the DVLA if their diabetes is diet controlled?
Yes if insulin, non-insulin injections or tablets
No if diet controlled
What electrolyte disturbances can loop diuretics, like furosemide, cause?
Hypokalaemia
Hyponatraemia
Hypocalcaemia
What drugs can lead to gynaecomastia as an adverse effect?
Spironolactone - potassium sparing diuretic
Finasteride - 5 alpha-reductase inhibitor
What is the first line management for digoxin toxicity?
Digibind
What is the first line management for digoxin toxicity?
Digibind
What common drug is a common cause of urticaria?
Aspirin
What are common side effects of amlodipine?
peripheral oedema, constipation and diarrhoea
What are common side effects of bisoprolol?
dizziness, headache, diarrhoea, nausea and vomiting
What are common side effects of losartan?
abdominal pain, diarrhoea and dizziness
What are common side effects of metformin?
Constipation, diarrhoea
Nausea and vomiting
Lactic acidosis
What two groups can potassium sparing diuretics be grouped into, and what are two examples for each group?
Epithelial sodium channel blockers - amiloride and triamterene
Aldosterone antagonists - spironolactone and eplerenone
What are 2 examples of drugs should you try to avoid in elderly people?
Hypoglycaemics - hypoglycaemic events
Antipsychotics - vascular events
What T2DM drugs is it best to avoid in AKI?
Metformin
Sitagliptin
What T2DM drugs is is ok to use in AKI?
Sulfonylureas
Insulin
What is a drug that is contraindicated in liver disease?
Statins
What are the fluid requirements for routine maintenance in adults?
25-30ml/kg/day of water
1mmol/kg/day of K+, Na+ and Cl-
50-100g/day of glucose - limit starvation ketosis
What are the primary toxicities of aminoglycosides like gentamicin?
Nephrotoxicity and ototoxicity
This patient has evidence of transaminitis, having recently started a new medication. He, therefore, has a drug-induced liver injury (DILI). As most medications are metabolised in the liver, it is a common site for toxicity. DILI is categorised as hepatocellular, cholestatic or a mixed pattern of injury, depending on the ALT : ALP ratio:<p></p>
ALT : ALP > 5 (ie significantly raised ALT, normal ALP): hepatocellular picture. Common causative agents include paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), statins and amiodarone
<li>ALT : ALP < 2 (ie significantly raised ALP, normal ALT): cholestatic picture. Common causative agents include co-amoxiclav, erythromycin, chlorpromazine and hormonal contraception</li>
<li>ALT : ALP 2–5 (ie ALT and ALP raised): mixed picture. Common causative agents include phenytoin, sulfonamides and carbamazepine.</li>
