PSA Revision Flashcards
How long can you take lymecycline?
3 months
common SE to communicate lymecycline
Photosensitivity
SE for oestradiol
GI discomfort and weight changes
SE of opiods
- vomiting ( always give anti-emetics)
- euphoria
- pruiritis + sweating ( on withdrawal)
what to give for haemorrhoids?
ispaghula husk
vaccination during pregnancy?
Annual flu and whooping cough
important measure option to monitor dehydration
urine output
100kg = 50 ml per hour
70 kg = 25ml per hour
what to remember about thyroxine drug change?
change in increments, usually 25mg
What are the 2 fluids type qs and what to give ?
- Do i need to give resus fluids ( dry and needs fluid)
- 500 ml of crystalloid (0.9% sodium chloride) over 15 miniutes regardless of presence of HF.
- maintanence fluids - some reason they cannot drink (elective surgery) or have had a stroke
- over 8-10hours contains sodium, potassium and (dextrose)
what does 1 part drug to 4 parts solution mean?
Solution is a 1:5 dilution
what does equal volume of sodium chloride mean?
Means 1:2 dilution.
what does 10 to 90 parts mean?
1:10
what can we usually deprescribe in elderly people?
- bisphosphonates and statins
what to do for patients on carbimazole?
keep on carbimazole until euthyroid
How many ng in 1 mcg
how many mcg in 1 mg
how many mg in one g
1000 nanograms (ng) = 1 microgram (mcg)
1000 micrograms (mcg) = 1 milligram (mg)
1000 milligrams (mg) = 1 gram (g)
what is the equation for volume?
volume = dose/concentration
what is the equation for rate?
rate (volume-per-time) = dose-per-time/concentration
rate = dose/time
what does % w/v refer to and 1:1000 mean
% w/v refers to g in ml e.g. 1% cream means 1g in 100ml (1g/100ml concentration)
1:1000 refers to g in ml e.g. 1:1000 solution means 1g in 1000ml (1g/1000ml concentration)
what is emergency resus?
sodium chloride 0.9% solution, 500ml over 15m
how to treat emergency hypercalcaemia?
sodium chloride 0.9%, 1000ml over 4h
what are some signs requiring fluid resus?
Hypotension, tachycardia, reduced capillary refill or other evidence of hypovolaemia
what is the treatment for emergency hypoglycaemia?
glucose 20%, 100ml over 15m
how to treat emergency hypokalaemia?
sodium chloride 0.9% / potassium chloride 0.3% solution, 1000ml over 4h
Give an example of a maintanence fluid for the first bag and then the second bag
first bag: sodium chloride 0.9% / potassium chloride 0.3%, 1000ml over 8-12h
second bag: Glucose 5% / potassium chloride 0.15% 1000ml 8-12h
if pt is losing sodium and potassium quickly how would you change fluid mx
sodium chloride 0.9% / potassium chloride 0.3%, 1000ml over 4-6h
what is the rate for maintanence vs maintanence + replacement?
- Maintenance only – aim 1000ml over 8-12h
- Maintenance and replacement – aim 1000ml over 4-6h
what anti-hypertensive should you give for someone with diabetes or diabetes and black?
always ACEi
or ARB
How mg do you give for statins if they have CVS RF?
And how about if they had a stroke?
20mg instead of 10mg
or 80mg if they had a stroke.
what is the treatment for an acute asthma exacerbation?
O2, salbutamol 5mg,
ipratropium 500mcg,
hydrocortisone 100mg,
magnesium sulphate 1.2-2mg, aminophylline,
prednisolone 40-50mg PO once daily 5d
How to treat COPD exacerbation?
salbutamol + ipatropium nebs + prednisolone 30mg PO OD
what VTE prophylaxis do we give usually and when should this be considered carefully?
LMWH
Give unfractionated heparin in renal failure
summarise treatment for anticoagulation?
Treatment dose
Apixaban or rivaroxaban
Prophylactic dose
LMWH (dalteparin, enoxaparin or tinzaparin) unless renal failure then unfractioned heparin
what is the most common cause of hyperaldosteronism?
Bilateral idiopathic adrenal hyperplasia
what is the treatment for hypocalcaemia vs hypercalcaemia?
Hypocalcaemia: calcium gluconate 10%, 10ml over 10m
Hypercalcaemia: 0.9% sodium chloride, 1000ml over 4h
how to treat hypokalaemia and hyperkalaemia
Hypokalaemia: 0.3% potassium chloride, 1000ml over 4h
Hyperkalaemia: calcium gluconate 10% 30ml IV over 10m
what are the symptoms of hypocalcaemia?
CATs go numb:
Convulsions, Arrythmias, Tetany, Numbness also Trousseau’s sign and Chvostek’s sign
ECG - QT prolongation
For HRT
1. who do you give cyclical vs continous
2. oestrogen + progesterone or oestrogen only
- cyclical if LMP <12months
- progesterone if intact uterus
What are the risks of HRT?
Breast cancer, endometrial cancer, ovarian cancer, VTE (stop 4-6 weeks before surgery), stroke, CAD
What is the treatment for the different HRT?
1. Uterus intact + LMP <12mo – oral sequential combined oestrogen + progestogen (Elleste-Duet 1mg or 2mg) or patch sequential combined oestrogen + progestogen (Evorel Sequi)
#1 estradiol with norethisterone
2. Uterus intact + LMP >12mo – oral continuous combined oestrogen + progestogen (Elleste-Duet Conti), patch continuous combined oestrogen + progestogen (Evorel Conti), tibolone
3. Post-hysterectomy – oral or patch oestrogen (Elleste-Solo) or tibolone
#1 estradiol
Post-menopausal osteoporosis – alendronic acid or risedronate sodium
Vasomotor symptoms in someone that can’t take HRT – clonidine
Menopausal atrophic vaginitis – topic vaginal oestrogen (pessary or ring)
what to use for trigeminal neuralgia?
carbamazepine
what is the treatment for migraine acutely and preventative?
Acute treatment: no aura = aspirin or ibuprofen, aura = sumatriptan
Prevention: propranolol
what anti-emetic do you give in the following scenario:
1. Vertigo/motion sickness/vestibular disorders
2. Post-operatively
3. Palliative care
4. chemotherapy induced, acute or delayed
5. parkinsons
6. hyperemesis gravidarum
- Vertigo/motion sickness/vestibular disorders - cyclizine
- Post-operatively – ondansetron
- Palliative care – cyclizine, haloperidol, levopromazine
- Chemotherapy induced
Acute – ondansetron - Delayed – metoclopramide
- Parkinson’s disease – domperidone
- Hyperemesis gravidarum – promethazine
when do you stop different anticoagulants?
DOAC (48h)
Clopidogrel (7d)
Warfarin( briding plan)
what medications are prescribed in micograms
levothyroxine and digoxin
what medications are usually weekly
methotrexate and alendronate weekly (70mg) or alendronate (10mg) daily
when do you take statins?
nightly
when to take prednisolone
in the morning
what can cause oral candidiasis and what is the tx?
-antiobiotics
-steroids
-immunosupressants
Tx: nystatin drops
what type of diabetic drugs cause euglycaemic ketosis?
When to hold it off and what is it associated with?
SGLT2 inhibitors
Hold off during illness
Ass with fournier’s gangrene
Remember with methotrexate
take methotrexate and folic acid!
What caution with clozapine?
- should not stop abruptly
what caution with warfarin?
if he has blood in his urine he should seek medical attention. same with DOAC too
Important safety information for isoretinoin?
Using 2 forms of contraception
what to do for morphine overdose?
give IV naloxone and and put non-rebreathe 15L o2 (if respiratory distress)
what is the reversal for benzos
Flumenazil
important SE for ciprofloxacin
tendonitis and tendon rupture - stop immediately
what to monitor on children who take steroids?
Height and Weight
what can happen in metaclopramide?
can cause acute dystonic reaction and give procyclidine
oculocrisis
What drugs to avoid in parkinsons?
metaclopramide and olanzapine
most common drug that impairs hepatic function?
statins
