RPS Flashcards
When to wean corticosteroid doses
Taken more than 40 mg oral prednisolone daily or equivalent for more than 1 week.
Taken repeated evening doses of corticosteroids.
Received more than 3 weeks of corticosteroid treatment.
Recently received repeated courses of corticosteroids (especially if taken for longer than 3 weeks), such as short courses repeatedly prescribed for the treatment of acute exacerbations of asthma.
A history of previous long-term therapy (months or years).
Other possible causes of adrenal suppression, such as excessive alcohol consumption or stress.
Antibiotics for COPD exacerbation
Amoxicillin, Doxycycline, Clarithromycin
COPD exacerbation
Treatment duration: 5 days
Prednisolone in COPD vs Asthma exacerbations
COPD: 30mg OD for 5 days
Asthma: 40mg OD for 5 days
Theophylline-smoking
When patient quits smoking, their theophylline conc will rise.
Signs of theophylline toxicity
Vomiting Agitation Restlessness Arrhythmias Convulsions
Theophylline range
10-20mg/L or 55-110 micromol/L
When to measure plasma theophylline concentration after starting treatment
5 days after initiating
After initiating, take levels 4-6 hours after last dose
What electrolyte disturbance can be caused by aminophylline/theophylline?
Hypokalaemia, particularly in conjunction with salbutamol and steroids
Monitoring for aminophylline/theophylline
Plasma theophylline levels
Liver function
Potassium levels
Symptoms of an ulcer
Pain in stomach/back/neck- usually starts after eating Indigestion Heartburn/dyspepsia Loss of appetite Nausea and vomiting Weight loss
Symptoms of GI bleed
Vomiting blood
Black sticky stools (malaena)
Sharp stomach pain
Symptoms of anaemia- fatigue/fainting/breathless/palpitations
Endoscopy GI bleed
Do not give PPIs prior to endoscopy for patients with suspected non-variceal upper GI bleeding
Phenytoin conversion
100mg phenytoin sodium (tablets) approx equivalent to 92mg phenytoin base (liquid)
No dose switch needed between capsules to IV but IV has a shorter half life (300mg ON= 100mg IV TDS)
Risk of PPI use
Gastric cancer
GI infections
Fractures
Osteoporosis
What anti-emetic is usually given for when Parkinson’s medicines are first started?
Domperidone
Advice for someone with impetigo
Stay away from work until she has been taking antibiotics for 48 hours
Max OTC omeprazole sale
Omeprazole 10mg caps at a maximum dose of 20mg once a day for 4 weeks
What age can be sold omeprazole 10mg or pantoprazole 20mg OTC?
18 years
Minimum age for beclometasone nasal spray
18 years
Loratidine minimum weight
30kg
Metformin mechanism of action
Decreasing gluconeogenesis and by increasing peripheral utilisation of glucose, since it only acts in the presence of endogenous insulin it is effective only if there are some residual functioning islet cells
Treating hypos
15-20g (3-4 heaped teaspoonfuls of sugar in water)
or 150-200ml pure fruit juice or 4-7 glucose tablets
Repeat after 10-15 mins if necessary
Senna age for supply
Can be sold OTC over 12 years old and licensed as POM>6 years.
