Planning management Flashcards
(25 cards)
summarise HASBLED score
HTN Abnormlal renal / liver function Stroke Bleeding tendency Labile INR Elderly >65 Drugs (aspirin/NSAID) or alcohol
explain how you interpret HASBLED score
0= low risk, start anticoag if necescary 1-2 = consider anticoag 3+ = high risk of major bleeding
what route of administration contraceptive must you give for women on enzyme inducer /
NOT ORAL (as functioning dose will be affected)
important rules when taking biphosponates
once weekly preparations
do not take together with calcium - as calcium reduces biphossphonate absorption
avoid food for 2 hours (reduces absorption)
swalow with a full gla s of water and remain upright for 30mins
what is 1% weight/volume if volume is 100ml
1g
so
1% of a solution i 1g/100ml
do you need to measure plasma digoxin regularly?=
NO - unless you suspect toxicity or non compliiance
what should INR be on day before surgery
<1.5
what do you need to do if INR is >1.5 on day before surgery
give ORAL VIT K
what must you do to ALL ANTICOAGULANTS (incl aspirin) before surgey?
STOP THEM 5 DAYS BEFORE
INCL ASPIRIN
Why must you stop metformin the day before surgery?
if GFR <60
because otherwise there is a risk it will cause LACTIC ACIDOSIS or ISCHAEMIA (incl AKI)
what is first line therapy for DM in CKD
SULPHONYLUREA
NOT metformin if GFR less than 30
what must you do if pt on ACEi develops a cough
STOP ACEi
change to ARB
what ix must you do if on antipsychotic and some CV RF eg smoking
ECG 1 week after prescription
this will establish pt QT interval while on olanzapine
where can you search details about converting pred to other steroid doses in BNF
“GLUCOCORTICOID THERAPY”
what drug quickly solves dyspepsia / indigestion?
“ANTACID”
e.g. Magnesium carbonate
what is the BEST INDICATOR of resolution of DKA
serum ketones
what can you give if pt is having a MILD ALLERGIC REACTION (not bad enough for adrenaline(
give oral chlorphenamine
what time of day must you never give diuretics
in the EVENING (or patients will be up all night passing urine!)
which antiemetic is CONTRAINDICATED in parkinsons
METOCLOPRAMIDE
what is the effect of ALCOHOL on GLUCOSE
it causes HYPOGLYCAEMIA
what are common side effects of tramadol
agitation and hallucinations (esp in elderly)
what must you take into consideration when prescribing weak opioids to elderly=
their side effect profile
- codeine causes constip
- tramadol causes agitation and hallycinations
what weak opioid is best in elderly with diarrhoea
codine
whhat is the fastest clinical marker to show improvement of pneumonia
RR
