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General practice > PSA/Pharm > Flashcards

PSA/Pharm Flashcards

1
Q

What does 1% conc w/v mean

A

1g in 100 mL

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2
Q

Eznyme inhibitors

A

AODEVICES

Allopurinol 
Omeprazole 
Disulfiram 
Erythromycin 
Valproate 
Isoniazid 
Criprofloxacin 
Ethanol(acute intoxication) 
Sulphonamides
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3
Q

Enzyme inducers

A

PC BRAS

Phenytoin 
Carbamazepine 
Barbiturates 
Rifampicin 
Alcohol(chronic excess) 
Sulphonylureas
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4
Q

Which drug is important to increase during surgery

A

Patients on long-term corticosteroids(they commonly have adrenal atrophy; they are therefore unable to mount an adequate physiological stress response to surgery) –> profound hypotension

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5
Q

Drugs to stop before surgery

A 
COCP and HRT
Lithium 
Potassium-sparing diuretics and ACE-i
Anticoagulants 
Oral hypoglycaemic drugs and insulin
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6
Q

Key side effects of steroids

A 
STEROIDS
Stomach ulcers 
Thin skin 
oEdema 
Right and left heart failure 
Osteoporosis 
Infection(candida) 
Diabetes 
cushing's Syndrome
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7
Q

NSAIDs cautions and contraindications

A

NSAID

No urine(renal failure) 
Systolic dysfunction(heart failure) 
Asthma 
Indigestion 
Dyscrasia(clotting abnormality)
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8
Q

What type of fluid should be given in ascites

A

Human-albumin solution - albumin maintains oncotic pressure; furthermore, the higher sodium content of 0.9% saline will worsen ascites

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9
Q

Max rate for IV potassium

A

Not more than 10 mmol/hr

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10
Q

In which patients should metoclopramide be avoided in

A

Patients with Parkinson’s disease due to the risk of
exacerbating symptoms.

Young women due to the risk of dyskinesia, i.e. unwanted
movements especially acute dystonia.

Gastric stasis

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11
Q

General analgesic choice for mild pain

A

Regular paracetamol 1g 6-hourly oral

Codeine 30mg up to 6 hourly oral as required

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12
Q

General analgesic choice for severe pain

A

Co-codamol 30/500, 2 tablets 6-hourly oral - regular

Morphine sulphate 10 mg up to 6hourly oral - as required

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13
Q

Medication causes of hypokalaemia

A 
Diuretics(thiazide-like and loop) 
Laxatives(large doses) 
Sympathomimetic drugs(beta-adrenergic bronchodilators) 
Theophylline 
Glucocorticoids 
Insulin(not significant)
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14
Q

Medication causes of hyperkalaemia

A

ACE inhibitors/ARBs
Beta blockers
NSAIDs
Spironolactone

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15
Q

Medication causes of dyspepsia

A 
Corticosteroids
Aspirin 
Beta-blockers 
NSAIDs 
TCAs 
Alpha-blockers
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16
Q

Medication causes of constipation

A

Opioids
Anticholinergics(tricyclics, phenothiazines)
Iron

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17
Q

Key contraindication of trimethoprim

A

Trimethoprim is a folate antagonist, and is a direct contraindication to patients taking methotrexate (another folate
antagonist) due to the risk of bone marrow toxicity.

This can lead to pancytopenia and neutropenic sepsis.

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18
Q

UKMEC 4 conditions for COCP

A

more than 35 years old and smoking more than 15 cigarettes/day
migraine with aura
history of thromboembolic disease or thrombogenic mutation
history of stroke or ischaemic heart disease
breast feeding < 6 weeks post-partum
uncontrolled hypertension
current breast cancer
major surgery with prolonged immobilisation

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19
Q

Which meds are usually prescribed once a week

A

Bisphosphonates

Methotrexate

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20
Q

Causes of low MCV

A

IDA
Thalassaemia
Sideroblastic anaemia

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21
Q

Causes of normocytic anaemia

A

Anaemia of chronic disease
Acute blood loss
Haemolytic anaemia
Renal failure(chronic)

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22
Q

Causes of macrocytic MCV

A 
B12/folate def 
Excess alcohol 
Liver disease
Hypothyroidism 
MDS/multiple myeloma
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23
Q

Causes of neutrophilia

A

Bacterial infection
Tissue damage(inflammation/infarct/malignancy)
Steroids

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24
Q

Causes of lymphocytosis

A

Viral infection
Lymphoma
Chronic lymphocytic leukaemia

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25
Q

Causes of neutropenia

A

Viral infection
Chemotherapy or radiotherapy
Clozapine
Carbimazole

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26
Q

Causes of thrombocytopenia linked to reduced production

A

Infection(usually viral)
Drugs
MDS/Myelofibrosis
Myeloma

27
Q

Causes of thrombocytopenia linked to increased destruction

A 
Heparin 
Hypersplenism 
DIC
ITP 
HUS
28
Q

Causes of thrombocytosis

A 
Bleeding 
Tissue damage(infection/inflammation/malignancy/post-splenectomy)

Myeloproliferative disorders

29
Q

Which drug specifically is associated with thrombocytopenia

A

Penicillamine

30
Q

General causes of hypokalaemia

A

DIRE

Drugs
Inadequate intake or intestinal loss(diarrhoea/vomiting)
Renal tubular acidosis
Endocrine(cushing’s and conn’s syndrome)

31
Q

General causes of hyperkalaemia

A

DREAD

Drugs 
Renal failure 
Endocrine(Addison's) 
Artefact(common due to clotted sample) 
DKA
32
Q

Biochemical disturbance pattern in prerenal AKI

A

Urea rise&raquo_space; creatinine rise

33
Q

Biochemical disturbance pattern in intrinsic AKI

A

Urea rise &laquo_space;creatinine rise

34
Q

Biochemical disturbance pattern in post renal AKI

A

Urea rise &laquo_space;creatinine rise

Bladder or hydronephrosis may be palpable

35
Q

What does a raised bilirubin on its own indicate

A

Prehepatic jaundice - usually haemolytic

36
Q

Common causes of raised ALP

A

ALKPHOS

Any fracture 
Liver damage 
K (Cancer) 
Paget's disease of bone and pregnancy 
Hyperparathyroidism 
Osteomalacia 
Surgery
37
Q

Prehepatic causes of LFT derangement

A

Haemolysis

Gilbert’s

38
Q

Intrahepatic causes of deranged LFTs

A 
Fatty liver 
Hepatitis 
Cirrhosis 
Malignancy 
Metabolic(Wilson's)
39
Q

Posthepatic causes of deranged LFTs

A 
Gallstones 
Cholangiocarcinoma 
PBC
PSC
Pancreatic or gastric cancer
40
Q

Which drugs can cause cholestasis

A

Paracetamol overdose
Statins
Rifampicin

41
Q

Which drugs may worsen seizure control in patients with epilepsy

A 
Alcohol 
Ciproflox, levoflox 
Aminophylline 
Buproprion 
Methophenidate
42
Q

How can liver disease increase a patient’s PT and INR

A

Liver disease can impair the synthesis of vitamin K and hence increase a patients prothrombin time and INR

43
Q

Preferred opioid in renal impairment in palliative prescribing

A

Oxycodone is preferred to morphine

44
Q

Breakthrough pain dosage for morphine

A

1/6th of dose

45
Q

Advice when increasing opioid dosage

A

When increasing the dose of opioids the next dose should be increased by 30-50%.

46
Q

Which meds may exacerbate heart failure

A

thiazolidinediones
verapamil
NSAIDs/glucocorticoids flecainide

47
Q

Which meds should be avoided in IHD

A

NSAIDs
oestrogens: e.g. combined oral contraceptive pill, hormone replacement therapy
varenicline

48
Q

Drugs which can cause hepatocellular picture in jaundice

A 
Paracetamol
Sodium valproate, phenytoin
MAOIs
Anti-TB meds
Statins
Alcohol
Amiodarone 
Methyldopa
Nitrofurantoin
49
Q

Drugs which can cause cholestasis

A 
COCP
Fluclox,co-amox, erythromycin 
Analbolic steroids 
Chlorpromazine 
Sulphonylureas
Fibrates
50
Q

Which antibiotics should be avoided in CKD

A

Tetracyclines

Nitrofurantoin

51
Q

Criteria for liver transplantation in paracetamol overdose

A

arterial pH<7.3
24 hours after ingestion or:

PT>100 secs
creatinine>300umol/l
grade III or IV encephalopathy

52
Q

TB meds side effects

A

RIPE ONGO

Rifampicin: Orange secretions
Isoniazid: Neuropathy
Pyrazinamide: Gout
Ethambutol: Optic Neuritis

53
Q

Indications for HRT

A

Vasomotor symptoms

Premature menopause

54
Q

How long should HRT be continued for for premature menopause

A

Should be continued until the age of 50 years

55
Q

Types of HRT

A

Oestrogens
Progestogens
Tibolone

56
Q

When is transdermal HRT preferred

A

If at risk of VTE

57
Q

Adverse effects of heparins

A

Bleeding
Thrombocytopenia
Osteoporosis and an increased risk of fractures
hyperkalaemia(inhibition of aldosterone secretion)

58
Q

Monitoring for standard heparin

A

APTT

59
Q

Monitoring for LMWH

A

Anti-factor Xa(routine monitoring not required)

60
Q

Drugs which can cause low magnesium

A

Diuretics

PPIs

61
Q

General causes of hypomagnesaemia

A 
Drugs 
TPN 
Diarrhea 
Alcohol 
Hypokalaemia 
Hypercalcaemia
62
Q

Features of hypomagnesaemia

A 
paraesthesia
tetany
seizures
arrhythmias
exacerbates digoxin toxicity
63
Q

Mx of hypomagnesaemia if <0.4 mmol/L

A

<0.4 mmol/L or tetany, arrhythmias, or seizures

intravenous magnesium replacement is commonly given.

an example regime would be 40 mmol of magnesium sulphate over 24 hours

64
Q

Mx of hypomagnesaemia if > 0.4mmol/l

A

oral magnesium salts (10-20 mmol orally per day in divided doses)

diarrhoea can occur with oral magnesium salts

General practice (26 decks)

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