Basic principles of prescribing Flashcards

1
Q

What is an enzyme inducer

A

increase activity of P450 thereby increasing metabolism of drugs and drugs will have a reduced effect

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2
Q

What is an enzyme inhibitor

A

decrease activity of P450, decreasing metabolism of drugs and therefore drug concentration will build up

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3
Q

Examples of enzyme inducers (low drug concentration)

A
PC BRAS
Phenytoin
Carbamazepine
Barbiturates 
Rifampicin
Alcohol (chronic excess)
sulphonylureas
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4
Q

Examples of enzyme inhibitors (high drug concentration)

A
AODEVICES
Allopurinol
Omeprazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin
Ethanol (acute intoxication)
Sulfonamides
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5
Q

Mnemonic for drugs to stop before surgery

A
I LACK OP
Insulin
Lithium
Anticoagulants
COCP/HRT
K-sparing diuretics
Oral hypoglycaemics
Perindopril and other ACEi
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6
Q

Stopping COCP before surgery

A

4 weeks

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7
Q

Stopping lithium before surgery

A

day before

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8
Q

Stopping K-sparing diuretics and ACE inhibitors

A

day of surgery

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9
Q

Stopping anticoagulants and antiplatalets

A

variable

Warfarin usually bridged with LMWH

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10
Q

Stopping oral hypoglycaemics and insulin

A

variable
Patients often NBM
Metformin can cause lactic acidosis

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