Random 5 - own notes Flashcards
When can you switch from IV to oral antibiotics?
If all of the below met:
o Oral fluids tolerated
o Temperature >36 or <38 for 24hrs
o No tachycardia and HR <100bpm for 12hrs
o WCC 4-12 and CRP returning to normal
o No absorption problems
o Suitable oral drug available
o Non-immunocompromised
Metoclopramide maximum length of treatment?
5 days
Below which weight may you have to adjust medication doses?
<60kg or <50kg for some
Which medications should not be taken around the same time as Calcium?
Cirpofloxacin/quinolones (give 2hrs before the Ca or 4hrs after)
Bisphosphonates
Iron
Levothyroxine
How do you treat vitamin D deficiency?
Osteoporosis:
Calcium carbonate 1.25 gram, Colecalciferol 400 unit
1 tablet
PO
BD
Vitamin D only:
Colecalciferol
2000 units
PO
OD
Why should tiotropium and ipratropium not be prescribed together?
Both antimuscarinic -> urinary retention, dry mouth, constipation
NB: tiotropium is INH, ipratropium is NEB
What symbols may be used for 1 vs 2 tablets?
A “T” with a dot over it is, “1”. Two dots over a “T” with two legs is, “2”, and so on.
When does warfarin need daily INR monitoring?
When on: WARFOAC
Warfarin on:
Antibiotics
Regular tramadol
Fluconazole
Omeprazole
Amiodarone
Corticosteroids at high dose
What types of Humalog are available?
Humalog = rapid acting
Humalog mix 25 = 25% rapid acting
Humalog mix 50 = 50% rapid acting
When prescribing need to state the type of device (pre-filled device, cartridge, vial) and brand used.
What is the brand name for insulin aspart?
Novorapid
Apart from illness, when should you increase hydrocortisone in hospital?
Surgery
Anaesthetic
Should have 100mg IV QDS in these cases.
What is the maximum dose of statin when given with amlodipine?
With amlodipine, ditiazem or verapamil the maximum dose of statin is 20mg
Consider changing to other CCB or other statin which does not interact with amlodipine.
i.e. Pravastatin, fluvastatin or rosuvastatin do not interact with amlodipine.
Clarithromycin and tacrolimus?
Do not prescribe together as clari/erythromycin inhibits metabolism of tacrolimus -> AKI
Seretide inhaler?
Salmeterol and fluticasone (i.e. LABA ICS)
Are phenytoin capsules and suspension bioequivalent?
NO - less suspension for same effect
100 = 92
Which antihyperglycaemic has bladder cancer risk?
Pioglitazone (PEEaglitazone)
CIWA score cut offs?
<8 - very mild
8-14 - mild
15-20 - moderate
>=20 - severe
How to prescribe rapid acting insulin?
BRAND NAME
e.g. actrapid 2 units SC PRN
What is the correction factor in insulin use?
How much 1 unit of insulin drops the glucose levels
Calculated by:
100/(no of units per day)
e.g. If using 39 units per day
100/39 = 2.5. so every unit will lower BMs by 2.5 mmol/mol
Stiff hand and knee joints worse on movement?
Topical ibuprofen prescribed as:
5% ibuprofen gel
1 application
topical
PRN
Otitis media antibiotic?
Bulging membrane -> amoxicillin
In contrast to otitis externa which may use flucloxacillin.
Bell’s palsy steroid dose?
Prednisolone 60mg PO OD 5 days if presenting within 72hrs of disease onset
OR prednisolone 50mg PO OD 10days
Are edoxaban and dabigatran oral?
Yes BUT require 5 days parenteral LMWH anticoagulation prior in most cases except ortho-related VTE tx/px
Time frames for fluids in hypercalcaemia?
1L over 1-2hrs initially
4-6L over 24hrs needed
