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Y6 PSA > [REV] Prescription reviews > Flashcards

[REV] Prescription reviews Flashcards

1
Q

Which drugs are enzymes inducers? (so need the other drug dose to be increased)

A

PC BRAS
Phenytoin
Carbamazepine
Barbituates
Rifampicin
Alcohol (chronic eccess)
Sulphonylurea

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2
Q

Which drugs are enzymes inhibitors (so need lower other drug dose)

A

ZAG DEVICES

-zoles (omeprazole, ketoconazole, fluconazole)
allopurinol
grapefruit juice
disulfirm
erythromycin
valproate
isoniazd
ciproflox
ethanol
sulphnnamides, STATINS

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3
Q

How long before surgery must you stop the COCP?

A

28 days

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4
Q

How long before surgery must you stop lithium?

A

1 day before

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5
Q

How long before surgery must you stop insulin?

A

0 - and replace with sliding scale

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6
Q

How long before surgery must you stop anticoags / platelets ?

A

5 days before

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7
Q

How long before surgery must you stop ACEi, ARB, K sparing?

A

0

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8
Q

When and by how much do you change steroids during surgery?

A

ON the day of surgery

DOUBLE the steroid dose

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9
Q

Which important class of drugs must you avoid giving to someone on an enzyme inhibitor?

A

Drugs that INCREASE BLEEDING (aspirin, heparin, wartfarin)

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10
Q

When must you be cautious with NSAIDS?

A

NSAID

No urine
Systolic dysfunction
Asthma
Indigestion
Dyscrasia of blood (clotting abnormalitYy)

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11
Q

Explain how you should prescribe beta blocker in the context of HF

A

NOT in acute HF (will worsen it)

YES in chronic HF

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12
Q

What broad condition should you avoid diuretics in?

A

AVOID diuretics in RENAL FAILURE

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13
Q

What can loop diuretics precipitate?

A

GOUT

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14
Q

What can spironolactone cause?

A

Gynaecomastia

Replace with epleronone

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15
Q

What is first line antiemetic in most cases?

A

Cyclizine

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16
Q

Contraindication of cyclizine

A

NOT in HF (as may cause fluid retention)

17
Q

Contraindications of metoclopramide?

A

NOT in PARKINSONS (Da antagonist > use domperidone)

NOT in young women (risk of dyskinesia)

18
Q

Which antibiotic do you NEVER give warfarin with?

A

Erythromycin / clarythromycin

19
Q

What medication should you double in ill patients with adrenal insufficiency (Addison’s)?

A

DOUBLE the steroid

20
Q

CHECK - Antibiotics for neutropoenic sepsis?

A

Tazocin + gentamiciin

21
Q

Drug for arrythmia and hypotension

A

Digoxin

22
Q

What baseline blood do you need to do when starting statins?

A

RF: CK
No RF: ALT

23
Q

When must you check LFTs for statins?

A

At 3 months and 12 months

24
Q

What antibiotic must you stop statins for?

A

MACROLIDE (clarythromycin/erythromycin)

25
Q

When do you monitor lithium dose?

A

12 hours after last dose

monitor WEEKLY until levels stable, then every THREE MONTHHS

26
Q

What must you monitor for OCP

A

Blood pressure monitoring (as it may cause sodium retenton)

27
Q

What must you check before prescribing antipsychotics and why?

A

ECG - only if RF of CVD

28
Q

What must you monitor when prescribing carbimazole?

A

FBC (neutrophils) - as it can cause neutropoenia

29
Q

What must you monitor for gentamicin?

A

UE (AS IT IS HIGHLY NEPHROTOXCIC) - measure pre-dose through and 1 hour peak

+ auditory monitoring and vestiibular monitoring

30
Q

What cardiac condition are ACEi contraindicated?

A

Aortic stenosis

31
Q

SE ACEi

A

Hyperkalaemia
Hyponatraemia
AKI
Cough
Angioedema

32
Q

What do you need to do for ACEi monitoring?

A

UE

33
Q

Digoxin monitoring

A

UE (min 6 hours post dose)

34
Q

How do you monitor clozpine?

A

every week for 18 weeks
every 2 weeks up to 1year
every 4 weeks thereafter

35
Q

How often is cyclizine given?

A

8 hourly (three times daily)

36
Q

Can pilocarpine be given to asthmatics?

A

Oral pilocarpine is contraindicated in patients with uncontrolled asthma. Topical pilocarpine is not contraindicated.

37
Q

Can timolol be given as acute angle-closure glaucoma treatment in asthmatics?

A

BNF advises caution due to the risk of bronchospasm

Y6 PSA (32 decks)

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