Stopping drugs

Question 1

hyperkalaemia?

Answer 1

K sparing diuretic (spirinolactone)
ACEi
fluid containing IV KCl
oral KCl tablets

Question 2

AKI?

Answer 2

ACEi/ARB
NSAIDs
diuretics
gentamicin

Question 3

bleeding?

Answer 3

warfarin
DOAC
LMWH
antiplatelets

Question 4

hypokalaemia?

Answer 4

furosemide
bumetanide
thiazide

Question 5

hyponatraemia?

Answer 5

PPI
SSRIs
carbamazapine
diuretics

Question 6

indigestion?

Answer 6

NSAIDs
steroids
SSRIs
bisphosphonates

Question 7

constipation?

Answer 7

all opiate-derived drugs should be withheld (codeine and co-codamol)

Question 8

If a patient on methotrexate has suspected sepsis?

Answer 8

methotrexate withheld pending exclusion of neutropenic sepsis

if doubt and waiting to hear from haematology - still withhold!

Question 9

ischaemic stroke?

Answer 9

heparin thromboprophylaxis
(for around 2 months - varies)

Question 10

if a patient started on statin has serum creatine kinase 1500 U/L (24–195)?

Answer 10

stop statin and restart at half dose if Sx resolve

• when a statin is suspected to be the cause of myopathy and CK is markedly elevated (>5 x upper limit), or if muscular Sx are severe, Tx should be discontinued
• if Sx resolve, and CK levels return to normal, statin should be reintroduced at a lower dose

Question 11

does aspirin need to be stopped in an AKI?

Answer 11

no - it’s an NSAID but doesn’t cause renal failure

Question 12

if BF?

Answer 12

B - benzos
R - radioactive isotopes
E - ethosuximide
A - amiodarone
S - sex hormones, senna
T - tetracycline