7. Flashcards
(20 cards)
Best time of the day to give ACE inhibitor ?
Evening as it can cause postural hypotension
Perindopril Erbumine - what time of the day to give?
In the morning - it’s the only ACE inhibitor that is recommended to be given in the morning
What time should we give diuretics?
Morning
Can salbutamol Neb be given back to back?
Yes, it’s total dose is only determined by tachycardia and tremor (SEs )
Can ipratropium be given back to back ?
No. Should be given max x4 day
What drugs can worsen seizure control (anti-epileptic drugs effectiveness)?
- alcohol, cocaine, amphetamines
- ciprofloxacin, levofloxacin
- aminophylline, theophylline
- bupropion
- methylphenidate (used in ADHD)
- mefenamic acid
Which drugs may induce seizures while being withdrawn?
- benzodiazepines
- baclofen
- hydroxyzine
Drugs that may cause SIADH
- sulfonylureas
- SSRIs, tricyclics
- carbamazepine
- vincristine
- cyclophosphamide
Management of SIADH
- correction must be done slowly to avoid precipitating central pontine myelinolysis
- fluid restriction
- demeclocycline: reduces the responsiveness of the collecting tubule cells to ADH
- ADH (vasopressin) receptor antagonists have been developed
Which other (than Penicillin) meds can’t be given to a patient with a penicillin allergy?
- phenoxymethylpenicillin
- benzylpenicillin
- flucloxacillin
- amoxicillin
- ampicillin
- co-amoxiclav (Augmentin)
- co-fluampicil (Magnapen)
- piperacillin with tazobactam (Tazocin)
- ticarcillin with clavulanic acid (Timentin)
Antibiotics contraindicated in pregnancy
- tetracyclines
- aminoglycosides
- sulphonamides
- trimethoprim
- quinolones: the BNF advises to avoid due to arthropathy in some animal studies
Other (than antibiotics) drugs contraindicated in pregnancy
- ACE inhibitors, angiotensin II receptor antagonists
- statins
- warfarin
- sulfonylureas
- retinoids (including topical)
- cytotoxic agents
- antiepileptic: including valproate, carbamazepine and phenytoin
Can Hartmann’s solution be used in patients with hyperkalaemia?
No, as it contains potassium
Electrolyte components of NaCl 0.9% in mmol/L
Electrolyte component in 0.18% saline with 4% glucose in mmol/L?
Electrolyte component of Hartmann’s solution in mmol/L
What is the risk of using large volumes of 0.9% NaCl?
if large volumes are used there is an increased risk of hyperchloraemic metabolic acidosis
Can Atorvastatin be taken in the morning?
Due to it’s longer half-life atorvastatin may be taken in the morning, unlike simvastatin
What are peak and trough levels of Gentamicin?
Peak - 1 hour after administration
Trough - just before the next dose
- if the trough (pre-dose) level is high the interval between the doses should be increased
- if the peak (post-dose) level is high the dose should be decreased
What to do if trough level of Gentamicin is low?
