Smart drug Flashcards
SEVERE OESPHAGITIS
i) what is first line treatment?
ii) which drug can be associated with hyponatremia? give three symptoms
iii) what other drug class can be used in oesophagitis?
i) omeprazole
ii) lanzoprazole > N+V, muscle weakness, lethargy
iii) H2 receptor antagonists eg femotidine and ranitidine
OESOPHAGEAL VARICES/ALCOHOLISM
i) what is first line treatment?
ii) what drug can be given in ETOH withdrawal? why is it favoured over diazepam?
iii) what is used for secondary prophylaxis of variceal bleeding?
iv) what is first line treatment for hepatic encephalopathy? how does it work
i) terlipressin > vasocontric of GI blood vessels
ii) give chlordiazepozide (long acting benzo) > facoured over diazepam as its more likely to be abused
iii) non selective beta blocker eg propanolol > vasoscontric > decreased bleeding risk
iv) HE > lactulose > decreases abs of ammonia into portal blood stream
ANTI EMETICS
i) what is akathisia? what can cause it?
ii) name two anti emetics that can cause EPS? which two groups is this more common in
i) figety and cant sit still > metaclopramide
ii) metoclop and prochloperazine > most common in children and young women
BIPOLAR DISORDER
i) what drugs need to be removed?
ii) which type of drug is first line for mania with psychotic features? give an example
iii) what can lithium be used for? which two things need to be monitored? what level should blood levels be below?
i) remove anti depressants eg SSRIs
ii) mood stabilisers eg olanzapine
iii) lithium can be used in BPAD maintenance
- need to monitor kidney and thyroid
- narrow therapeutic window - keep levels <1
PANIC DISORDER
i) what two treatments are given?
ii) what is given if someone is very anxious and failed attempts to calm them?
i) CBT and an anti depressant
ii) lorazepam (short acting benzo)
DEPRESSION
i) what is needed for a dx of moderate depression?
ii) what drug class can be given if unresponsive to pysch therapy?
iii) what can be done it that doesnt work?
iv) how long should anti depressants carry on being taken after pts has resolution of symptoms?
i) 2 of - low mood, anhedonia and lack of energy
3 of poor appettite, low sleep, conc, hopelessness
ii) SSRIs - increase dose weekly
iii) give different anti dep eg SNRI
iv) 6 months
CARDIOLOGY
i) what cant be given for AF is patient has asthma? what can be given if a CCB is contraindicated? which elec abnorms are assoc with AF (2)
ii) what anti coag can be given long term in AF? which two organs may amiodarone be toxic to?
iii) name two symptoms of left HF? what is given first line?
iv) what can be added into treatment for chronic HF with reduced EF? why do you get a cough? what can be given if symptoms worsen?
i) dont give a beta blocker
- give digoxin if CCB CI
- K+ and Mg2+
ii) DOAC eg rivaroxaban
- amiodarone > test liver and thyroid function
iii) sudden onset SOB without chest pain > give furosemids IV first line
iv) chronic HF > ACEi
- cough due to bradykinin build up (ACEi)
- give spiro if symptoms worsen (aldo antag)
ELDERLY
i) what can be given if stroke onset <4hrs? what is given if >4hrs?
ii) name an osmotic laxative and stimulant?
iii) what risk score is used for stroke risk in AF? over what score needs anti coag? which drug is used? (2)
iv) what is given for secondary stroke prevention? what is first line
v) how can antibiotics affect statin levels
i) <4hrs = alteplase
>4hrs = high dose aspirin
ii) osmotic - lactulose/movicol
stimulant = senna
iii) CHADVASC - score over 2 needs anti coag
- use warfarin or DOAC (rivaroxaban - renal impair safe)
iv) secondary prev - statin (atorvastatin)
v) some abx can inhibit CYP450 so increase exposure to statin
ASTHMA
i) what is given first line for mild asthma
ii) what is given if not controlled x3
iii) what can be given in chronic asthma
i) SABA eg salbutamol
ii) add ICS (beclo) > add LTRA (monte) > add LABA (formet/salmet)
iii) theophyline
EMERGENCY
i) what anti coag is safe in renal impair? name a side effect?
ii) why may antibiotics be implicated in overdose?
iii) how does SVT look on ECG? what is first line treatment? what pharma agent can be given?
iv) what is given for bradycardia?
v) which two drugs are CI in asthma for SVT? which drug is given instead
i) UFH > SE is thrombocytopenia
ii) some abx can inhibit CYP450 so prevent metab of drugs like opiates
iii) SVT = narrow QRS and regular
- first line is valsalva manoeuvre, carotid massage
- can also give adenosine
iv) brad > give atropine
v) dont give adeosine or BB if asthma > give CCB (verap)
ENDOCRINOLOGY
i) what is first line for T2DM if normal kidney function? what is first line for diabetic nephropathy? what should be stopped in HF and T2DM?
ii) what is humulin 3?
iii) what is given first line in addisons didsease?
i) metformin
rampril for neph
stop pioglitazone in HF
ii) biphasic insulin > short and long acting
iii) hydrocortisone
