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FINALS > PSA revision > Flashcards

PSA revision Flashcards

1
Q

what are the most common enzyme activity inducers?

A

PC BRAS:

Phenytoin
Carbamazepine
Barbiturates
Rifampicin
Alcohol (in chronic XS)
Sulphonylureas
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2
Q

What do enzyme inducers cause in terms of drug concentration?

A

decrease drug concentration

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3
Q

How do enzyme inducers cause changes to drug concentration?

A

They cause cytochrome P450 to increase its activity, increasing drug metabolism - this breaks down the drugs faster reducing their activity

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4
Q

what are the common enzyme activity inhibitors?

A

A-O DEVICES

Allopurinol
Omeprazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin
Ethanol (acute ingestion)
Sulphonamides
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5
Q

What drugs should NEVER be stopped before surgery?

A

calcium channel blockers

B Blockers

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6
Q

What drugs should be increased for surgery?

A

Corticosteroids in patients with long term CS use.

Follow ‘sick-day’ rules of doubling dose at anaesthesia

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7
Q

What drugs should be stopped before surgery?

A

I LACK OP

Insulin

Lithium
Anticoagulants/antiplatelets
COCP/HRT
K - sparing diuretics

Oral hypoglycemics (Metformin, Sulfonylureas)
Perindopril + other ACEi
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8
Q

When should you stop HRT/COCP before surgery?

A

4 weeks before

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9
Q

When should you stop lithium before surgery?

A

day before

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10
Q

When should you stop K sparing diuretics before surgery?

A

day of surgery

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11
Q

When should you stop ACEi before surgery?

A

day of surgery

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12
Q

what is the PReSCRIBER pneumonic?

A 
Patient details
Reaction / allergies
Sign the front of the chart
Contraindications for each drug
Route of each drug
IV fluids - prescribe
Blood clot prophylaxis - prescribe
antiEmetics - prescribe
pain Relief - prescribe
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13
Q

what two commonly used drug names contain penicillin?

A

co-amoxicav and tazocin

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14
Q

what are the 4 important drug classes to know contraindications for?

A
  1. antiplatelets and anticoagulants
  2. steroids
  3. NSAIDS inc. asprin
  4. antihypertensives
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15
Q

when are anti-platelets and anticoagulants CI?

A

when patients is suspected of bleeding

patient at risk of bleeding:
- prolonged PPT / liver disease

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16
Q

a patient has had an acute ischaemic stroke which drug should not be prescribed

A

profylactic heparin

17
Q

a patient is prescribed a new drug. Their DHx includes warfarin.

After this new drug was prescribed their INR began to increase

what drug was likely prescribed?

A

erythromycin

increases PPT and so increases INR

18
Q

what side effects are associated with steroids?

A

STEROIDS

Stomach ulcers
Thin skin
oEdema
R + L heart failure
Osteoporosis
Infections including candida
Diabetes - hyperglycaemia occurring more commonly than full flown diabetes
Syndrome (cushings)
19
Q

when are NSAIDS contraindicated

A

NSAID

No urine (renal failure)
Systolic dysfunction (ie heart failure)
Asthma
Indigestion + reflux
Dyscrasia of clotting (clotting abnormality)
20
Q

How might hypotension occur with BB or some CCB

A

bradycardia

21
Q

how might hypotension occur with ACE-i or diuretics

A

electrolyte disturbances

22
Q

a patient has hypertension they are prescribed a drug to manage this.

Shortly after starting this new drug they develop a dry cough.

What drug was likely prescribed?

A

ACEi

23
Q

a patient has hypertension they are prescribed a drug to manage this.

They have asthma. What drug is C/I and why?

A

Beta blocker

causes wheeze in asthmatics

24
Q

in which type of heart failure are B Blockers C/I

A

acute - worsen Sx

but useful in chronic

25
Q

a patient has hypertension they are prescribed a drug to manage this.

Shortly after starting this new drug they develop red skin - not sore only slightly warm.

What drug was likely prescribed?

A

CCB - causes skin flushing

26
Q

a patient has hypertension they are prescribed a drug to manage this.

Shortly after starting this new drug they develop a peripheral oedema.

What drug was likely prescribed?

A

CCB

27
Q

a patient has hypertension they are prescribed a drug to manage this.

Shortly after starting this new drug they develop severely painful and swollen toe joint.

What drug was likely prescribed?

A

Thiazide like diuretic - causes gout

28
Q

a patient has hypertension they are prescribed a drug to manage this.

Shortly after starting this new drug they develop gynaecomastia.

What drug was likely prescribed?

A

spironolactone (k sparing diuretics)

29
Q

a patient has hypertension they are prescribed a drug to manage this.

Shortly after starting this new drug they develop anuria.

What drug was likely prescribed?

A

diuretics - can cause renal failure

FINALS (24 decks)

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