PSA revision Flashcards
drugs that exacerbate HF
Flecanide
NSAIDs
glucocorticoids
verapamil
thiazolidinediones
Drugs that cause cardiac arrhythmias
anti- ABCDEF
Arrythmias
Biotics
Cycotics (Psychotis)
Depressants
Emetics
Fungals
common SE of lymecycline
photosensitivity
type of laxatives used with haemorhoids
bulk forming laxatives
Glucocorticoid SEs
endocrine
- impaired glucose regulation
- increased appetite/weight gain
- hirsutism
- hyperlipidaemia
- Cushing’s syndrome
- moon face
- buffalo hump
- striae
musculoskeletal
- osteoporosis
- proximal myopathy
- avascular necrosis of the femoral head
immunosuppression
- increased susceptibility to severe infection
- reactivation of tuberculosis
psychiatric
- insomnia
- mania
- depression
- psychosis
gastrointestinal
- peptic ulceration
- acute pancreatitis
ophthalmic
- glaucoma
- cataracts
- suppression of growth in children
- intracranial hypertension
- neutrophilia
starting dose of statin ifQRISK >10%
20mg
starting dose of statin for secondary prevention (known IHD, CVD, PAD)
80mg
Steroids SEs
STEROIDS
Stomach ulcers
Thin skin
oEdema
Right and left HF
Osteroporosis
Infction (eg. candida)
Diabetes
cushings Syndrome
when to take caution with NSAIDs
NSAID
No urine
Systolic dysfunction (ie HF)
Asthma
Indigestion
Dyscrasia (clotting dysfunction)
how much fluid bolus should you give
500mls - usually
250 if HF
150 if very old
if reduced U/O and tachycardic give 1L
general rule: what volume of fluids do adults require per day?
adults: 3L/24hrs
elderly 2L/24hrs
daily requirement of KCl
40mmol
IV K should not be given more than 10mmol/hr
anti emetics of choice for N&V
- cyclizine 50mg 8-hrly IM/IV/oral
- metoclopramide 10mg up to 8/hrly IM/IV if HF
causes hypokalaemia
DIRE
Diuretics: (loop and thiazide)
Intestinal loss (D&V)
Renal tubular acidosis
Endocrine (cushings/ conns)
salbutamol
insulin
causes of hyperkalaemia
THREADD
Transfusions
Heparin
Reduced gfr/ renal failure
Endocrine (addisons)
Artefact
DKA,
Drugs (K sparing diuretics (spironolactone), ACEi, ARBs)
risks of pancytopenia and neutropenic sepsis
clozipine
carbimazole
trimethoprim and methotrexate (both folate antagonists)
chemotherapy
hypernatraemia casues
Ds
Dehydration
Drips (tto much NaCl)
Drugs
causes of microcytic anaemia
Fe deficiency
sideroblastic anaemia
thalassaemia
causes of normocytic anaemia
anaemia of chronic disease
major blood loss
causes of macrocytic anaemia
B12/folte deficiency
alcohol XS
hypothyroism
myeloproliferative disorders
causes of thrombocytopenia
reduced production:
- viral infection
- penicillamine
- myelodysplasia, myelofibrosis, myeloma
increased destruction:
- heparin
- hypersplenism
- DIC
- ITP
- HUS
-TTP
causes of high platelets
reactive:
- bleeding
-tissue damage/ infection/ inflammation
- post splenectomy
primary
- myeloproliferative disorders
causes of pre-renal AKI
hypovolaemia
dehydration
Renal artery stenosis
causes of intrinsic AKI
INTRINSIC
Ischaemia
Nephrotoxic abx (gentamycin, vancomycine, tetracyclines)
Tablets (ACEi/ NSAIDs)
Radiological contrast
Injury (rhabdomyolysis)
Neg bireferingent (gout)
Syndromes (nephritic/phrotic)
Inflammaition (vasculitis)
Cholesterol emboli
causes of post-renal AKI
obstructions
prostate enlargement
tumours
lymphadenopathy
what does 1% mean in terms of calculations
1g in 100mL
drugs CI in asthma and COPD / use with caution
NSAIDs
b blockers
adenosine
drugs that cause hyperkalaemia
ACEi/ARBs
NSAIDs
aldosterone antagonists
Trimethoprim
Ciclosporin
Heparin
drugs that cause hypokalaemia
B2 antagonists
Thiazides
Loop diuretic s
Insulin
drugs that cause hypernatraemia
NaCl
steroids
hormones
Lithium
demeclocycline
drugs that cause hyponatraemia
Thiazides
loop diuretics
carbemazepine
SSRIs
desmopressin
Glicazide
TCAs
opiates
PPIs
drugs that cause hypercalcaemia
Vit D
Vit A
Thiazide diuretics
Hormones
drugs that cause hypocalcaemia
bisphosphonates
calcitonin
phenytoin
phenobarbitol
rifampicin
clindamycin
blood transfusions
drugs that should be stopped before major surgery
I LACK OP
Insulin (short acting)
Lithium (24hrs)
Anticoagulants/ antiplatelets
COCP (4 weeks before)
K sparing diuretics
Oral hypoglycaemics
Penindopril (any ACEi) (24hrs)
drugs that cause urinary retention
anti muscarinics eg. cyclizine
procyclidine
opioids
NDAIDs
anticholinergics eg. antipsychotics, TCAs, SSRIs
antihistamines
alpha adrenergic agonists- eg. methyldopa
drugs that may cause hearing loss
loop diuretics
aminoglycosides (gentamycin)
aspirin in toxic doses
cytotoxics (ciclosporin, carboplatin)
drugs that accumulate in the kidneys
most opioids apart from fentanyl
allopurinol
drugs that cause confusion
benzos
opioids
steroids (especially in elderly)
bblockers
drugs to be avoided if egfr <45 (stage 3B+)
nitrofurantoin
target INR on day of surgery
<1.5
thromboprophylaxis of choice in someone with renal impairment
unfractionated heparin
methods of monitoring each anticoag class
warfarin
LMWH
DOAC
unfractionated heparin
warfarin- INR
LMWH- anti factor Xa
DOAC- monitor clinically
unfractionated- aPTT
features of hypocalcaemia
CATS go Numb
Convulsions
Arrhythmias
Tetany
Seizure
Numbness
Trosseaus sign
Chvosteks sign
QT prolongation
treatment of hypocalcameia
10mls calcium gluconate 10% IV
GP treatment of suspected bacterial meningitis
IM benzylpenicillin 1.2g
IM cefotaxime 1g
acute treatment of migraine with and without aura
+ prophylaxis Rx
without aura- aspirin or ibruprofen
with aura- sumitriptan
Prophylaxis- propranolol
acute Rx of clusterheadache and prophylaxis
acute: 100% O2 and sumitriptan
prophylaxis- verapamil
drugs to be avoided wehn egfr <30 (stage 4+)
metformin (glicazide therefore 1st line for pts with CKD)
opioids except fentanyl
taken with caution when egfr <45
features of lithium toxicity
coarse tremor (a fine tremor is seen in therapeutic levels)
hyperreflexia
acute confusion
polyuria
seizure
coma
causes of drug induced lupus
sulfonamides
isoniazid
hydralazine
penicillins
phenytoin
methyldopa
procainamide
griseofulvin
alernative to PPI if allergic
cimetidine
mmols of Na in 1L bag of 0.9% NaCl
150mmol
mmols of K in 1L bag 0.3%KCl
40
mmols of K in 1L bag 0.15%KCl
20
grams of glucose in 1L bag 5% glucose
50g
antiemetic used in parkinsons
domperidone best
cyclizine and ondansertron also safe but used short term
drugs that can cause hyperglycaemia
steroids
thiazides
antipsychotics
tacrolimus
drugs that cause incontinence
tamsulosin (alpha blockers)
diuretics
clozapine
anticholinesterase inhibitors
increased risk of gout
diuretics
drugs which lower seizure threshold
alcohol, cocaine, amphetamines
ciprofloxacin, levofloxacin
aminophylline, theophylline
bupropion
methylphenidate (used in ADHD)
mefenamic acid
clozapine
NB for fluids in patients whove had a stroke
avoid giving glucose as risk of cerebral oedema
