BNF treatment summaries Flashcards
(155 cards)
1
Q
first line drug options for MILD Alzheimers (give 3). What type of drug are they?
A
donepezil
galantamine
rivastigmine
(acetylcholinesterase inhibitors)
2
Q
first line drug for SEVERE Alzheimer’s?
A
memantine hydrochloride
3
Q
drug class used to treat wet AMD?
A
intravitreal anti-VEGF
aflibercept
4
Q
name three aminoglycoside Abx
A
gentamycin
neomycin
streptomycin
5
Q
2 drug options for acute alcohol withdrawal
A
chlordiazepoxide
diazepam
(both benzos)
6
Q
first line for delirium tremens
A
oral lorazepam
7
Q
2 drugs for pharma Rx of alcohol dependence
A
acamprosate
naltrexone
8
Q
drug for wernicke’s
A
IV pabrinex
thiamine
9
Q
3 drugs for iron def anaemia
A
ferrous fumarate (200mg) ferrous sulfate (300mg) ferrous gluconate (300mg)
10
Q
name 3 antispasmodics for IBS
A
peppermint oil
mebeverine
buscopan (hyoscine butylbromide)
11
Q
what class of drug is hyoscine butylbromide?
A
antimuscarinic
12
Q
first line for ADHD
A
methylphenidate
13
Q
second line for ADHD
A
atomoxetine
14
Q
long acting alternative of sildenafil
A
tadalafil
“taadaa”
15
Q
second line for ED
A
intracavernosal/intraurethral/topical ALPROSTADIL
16
Q
first line for gonorrohoea
A
azithromycin stat + im ceftriaxone
17
Q
PID Rx
A
doxycycline + metronidazole + im ceftriaxone
18
Q
what do you give with isoniazid in TB treatment
A
pyridoxine hydrochloride to prevent isoniazid-induced neuropathy
19
Q
name 3 macrolides
A
azithromycin
clarithromycin
erythromycin
20
Q
abortive Rx for migraine
A
sumitriptan
or just aspirin/ibuprofen/paracetamol
21
Q
first line preventive drug for migraine
A
propanolol
22
Q
second line preventive drug for migraine
A
topiramate (if beta blockers dont work)
sometimes amitriptyline
23
Q
pts undergoing PCI should receive what drugs?
A
eptifibatide and unfractionated heparin
24
Q
migraine treatment summary?
A
abortive - NSAIDs, sumitriptan
preventive - propanolol, topiramate, amtriptyline
25
name a glycprotein IIb/IIIa inhibitor?
eptifibatide
26
in pts who cant get PCI within 90 minutes, what should they be given?
thrombolysis (streptokinase, alteplase)
| and unfractionated heparin / or fondaparinux
27
in which pts are diltiazem / veraparmil contraindicated?
in those with LV dysfunction
28
state 5 long term drugs after STEMI
```
aspirin and clopidogrel
beta blocker (metoprolol)
ACE inhibitor
nitrates
statins
```
29
adult can't talk in sentences, peak flow 33-50% of predicted, RR >25, HR >110. what kind of asthma attack is this?
severe
30
define some parameters of a life threatening asthma attack in an adult
```
silent chest
<33% pefr
<92% sats
cyanosis
normal paco2
```
31
when use nebulised ipratropium bromide in asthma attack?
poor initial response to salbutamol or
| severe/lifethreatening
32
if severe asthma attack, with not a good response to inhaled bronchodilators, what do you use?
IV mg sulfate
IV salbutamol
sometimes IV aminophylline
33
dont forget what in asthma attack
oral prednisolone
| if not - IV hydrocortisone
34
how soon should pts GP practice be informed of asthma attack following discharge
within 24hrs
35
a woman has a womb. what HRT do you give?
progesterone and oestrogen
36
a woman doesn't have a womb. what HRT do you give?
oestrogen-only
37
what's the period free HRT?
tibolone
38
what kind of HRT DOESNT increase stroke/IHD risk?
transdermal (gel/patch)
39
what are the options for HRT delivery?
transdermal
oral
implant
40
two advantages of HRT (disease wise)
less risk of osteoporosis and colorectal ca
41
combined HRT increases risk of what
breast cancer
| stroke/VTE if oral
42
oestrogen-only HRT increases risk of what
endometrial ca
43
how do antibiotics work?
bac-static (stop growing, decrease toxin prod)
| bac-cidal (kill)
44
name the 5Cs that cause c-diff
```
Ciprofloxacin
Clindamycin
Cephalosporins
Co-amoxiclav
Carbapenems
```
45
why do abx cause c-diff?
all other bac in gut killed exc c diff - crazy
46
what is in co-amoxiclav?
amoxicillin and clavulanic acid (a beta lactamase inhibitor)
47
what kind of antibiotic are vancomycin and teicoplanin?
glycopeptides
48
what abx can be used for MRSA?
vancomycin
49
what is tazocin made up of?
piperacillin and tazobactam (beta lactamase inhibitor)
50
give example of a quinolone
ciprofloxacin
51
does ciprofloxacin cause c diff?
yes
52
does clindamycin cause c diff?
yes
53
do cephalosporins cause c diff?
yes
54
does co-amoxiclav cause c diff?
yes
55
do carbapenems cause c diff?
yes
56
what are the first line drugs for focal seizures?
carbamazepine and lamotrigine
57
what is the first line for generalised tonic clonic seizures?
sodium valproate
58
first line for generalised tonic clonic seizures in females of childbearing potential?
lamotrigine instead of valproate
59
only in what circumstances can valproate be used in females of childbearing potential?
when conditions of the Pregnancy Prevention Programme are met and alternative treatments are ineffective or not tolerated.
60
what is the alternative to valproate for pre-meopausal females?
lamotrigine
61
what is first line for absence seizures ?
ethosuximide
or valproate
62
is carbamazepine recommended for absence or myoclonic seizures?
no.
63
what antiepileptic ISNT recommended for myoclonic and absence seizures?
carbmazepine
64
what is the first line for myoclonic seziures?
valproate
65
what should people watch out for on carbamazepine?
signs of blood liver or skin disorders
e.g. fever, rash, mouth ulcers, bruising, bleeding
(acute liver disease, leucopenia, Steve jonhson)
--> seek immediate medical attention
66
apart from epilepsy, what else can carbamazepine be used to treat?
trigeminal neuralgia
67
two SEs of lamotrigine (clue: you get them in carbamazepine too)?
bone marrow failure, steven johnson
| hypersensitivity thing
68
pts on antiepileptics should be informed that they can increase suicidal thoughts.
yes. report any emergence of these or depression .
69
```
phenytoin SEs:
P= P450 inducer
H = Hirsutism
E = Enlarged gums
N = Nystagmus
Y = Yellow-browning of the skin
T = Teratogenic
O = Osteomalacia
I = Interferes with folate metabolism, leads to anaemia
N = Neuropathies: vertigo, ataxia, headaches
```
eek
70
name some unpleasant SEs of valproate
```
aggression
deafness
menstrual disturbance
hair loss (regrowth of curly!)
weight gain
```
71
what fatal thing can valproate cause
fatal liver failure
also pancreatitis
72
what bloods often need monitoring on antiepileptics
FBC and LFT
73
what blood needs checking 6monthly on valproate
LFT
74
describe the stepwise treatment of chronic asthma
1. ICS preventer
2. SABA reliever
3. add on LRTA or LABA
4. high dose ICS
OR add muscarinic antagonist (tioptropium) or theophylline mr OR asthma specialist
6. oral prednisolone or Mab
75
what asthma medication can cause bad dreamz
montelukast
76
name a monocloncal antibody drug used for severe persistent allergic athma
omalizumab
77
n/b ian thingy says ICS preventer first but i think nice guidelines say SABA reliever first
right, thanks :)
78
if a 3yr olds asthma isnt controlled on low dose ICE and montelukast, what should you do?
refer to asthma specialist
79
pts should be maintained at lowest possible dose of ICS. true or false?
true. consider decreasing maintence therapy when been controlled for at least three months (obvs review regularly during)
80
give an example of a combination of an ICS and LABA in a single inhaler,
beclometasone with formoterol
budesonide w formoterol
81
what is sodium cromoglicate
mast cell stabiliser used sometimes in asthma prophylaxis
82
name a short acting muscarinic
ipratropium bromide
83
name a long acting muscarinic
tioptropium bromide
84
what is the initial management for COPD?
SABA (salbutamol)
or
SAMA (ipratropium)
85
what is the next step in COPD management after not controlled w salbutamol/ipratropium
LABA
or
LAMA (tiotropium)
86
if tiooptropium is started in a COPD pt who wasnt controlled on ipratropium inhaler, do you discontinue the ipratropium?
yes
87
if LABA started in COPD pt who wasnt controlled on salbutamol inhaler, do you discontinue the salbutamol?
no. can continue salbutamol throughout all stages of COPD.
88
if COPD not controlled w SABA/SAMA or LABA/LAMA, what's next?
add ICS
89
when are mucolytics used in COPD?
chronic productive cough, getting relief from mucolytics
90
if all other treatment optimised and still having loads of exacerbations, what prophylactic abx might be considered
azithromycin
91
first and second line treament for UTI in pregnant women?
1: nitrofurantoin
2: amoxicillin
(dont use trimethoprim in preg)
92
people with raging pyelonephritis sensitivity not known:
IV cefuroxime
if not that unwell - oral cefalexin
(also suitable in preggers)
93
abx for 7 days if uti in who
preggers, men, catheter
94
once bm falls below 14 in dka treatment, what should be given by IV infusion
glucose 10% at 125ml/hr
95
drug treatment for pts w life long premature ejaculation
dapoxetine
| short acting SSRI, use on nights when required ;
96
name two monoamine oxidase-B inhibitors for parkinsons
rasagiline
| selegiline
97
In early stages of Parkinson's disease, patients whose motor symptoms decrease their quality of life should be offered what?
co-careldopa
or
co-beneldopa
98
what is co-careldopa?
levodopa and carbidopa
99
what actually is carbidopa?
```
decarboxylase inhibitor
(given alongside Levodopa)
```
100
what is co-beneldopa?
levodopa ad benserazide
101
what is levodopa + benserazide?
co-beneldopa
102
Parkinson's disease patients whose motor symptoms do not affect their quality of life, could be prescribed a choice of...?
levodopa
dopamine agonists
MAO-B inhibitors
103
Parksinons patient is having hypersexuality and compulsive gambling. What drug is this likely linked to?
dopamine agonists
104
excessive sleepiness, hallucinations, and impulse control disorders are all SEs of what
dopamine agonists
105
What are the three main side effects of levodopa therapy?
dyskinesia
on/off freezing
wearing off / motor fluctuations
106
What is being 'on' and 'off' in parkinson's?
on = symptoms controlled
off = symptoms come back (L-dopa not working properly/worn off)
FREEZING CAN HAPPEN DURING ON OR OFF PERIODS
107
What are pramipexole and ropinirole?
dopamine agonists
108
What are selegiline and rasagiline?
MAO-B inhibitors
109
name some features of impulse control disorders on dopaminergic therapy in parkinsons
compulsive gambling
hypersexuality
binge eating
obsessive shopping
110
combined hormonal contraception can decrease risk of which cancers
endometrial, ovarian, colorectal
111
combined hormonal contraception increases risk of which cancer (slightly)
breast
112
what is category 3 of UK MEC? (medical eligibility criteria)
a condition where risks of contraception outweigh benefits
113
what is category 4 UK MEC?
a condition which represents unacceptable health risk if method is used
114
as well as COCP, how else can u get combined hormonal contraceptives?
transdermal patches
vaginal rings
traditionally 21 days then 7 days break
115
what is a monophasic vs multiphasic COCP?
monophasic = fixed amount of oestrogen + progestogen in each tablet
multiphasic = varying
116
what is tricycling of COCP?
9 weeks of continuous use then 4-7 day hormone free interval
can also just have continuous use - no safety difference
117
how do progestogen only contraceptives work mainly?
thickening cervical mucus to prevent sperm penetration
some inhibit ovulation too
118
should you use Depo-provera for more than two years?
hmmm probably not. evaluate benefits against risks.
119
is Depo-Provera good for women w osteoporosis risk?
no. consider something else.
120
how long does Nexplanon implant last for ?
up to 3 yrs
121
does contraceptive effect reverse quickly on removal of implant?
yes - rapid
unlike depo-provera - takes longer to get fertility back
122
Depo-Provera is a progestogen only injection (medroxyprogesterone acetate). Name another brand.
SAYANA PRESS
| Noristerat is injection that lasts 8wks
123
what do Mirena, Jaydess and Levosert release into uterus?
levonorgestrel
124
which IUS is licensed for menorrhagia
Levosert
125
does fertility return rapidly after you get coil out?
yes
126
how does the IUS prevent contraception?
thickens cervical mucus
prevents womb lining prolif (so helps menorrhagia)
sometimes inhibits ovulation
127
name some UK MEC category 4s for COCP
```
breastfeeding <6wks
smokers aged >35yrs
BMI >40
HTN >160
VTE
DM w complications
IHD
migraines with aura
severe cirrhosis
```
128
name some UK MEC category 3s for COCP
```
BMI >35
HTN >140
on CYP inducers
Hx breast ca
mild cirrhosis
migraine without aura
```
129
theresa has BMI of 36 , mild liver cirrhosis and migraine without aura. she wants the COCP. what UKMEC category is she in?
3
130
yvonne has a BMI of 41, DM w nephropathy, and Hx of DVT. she wants the COCP. what UK MEC category is she in?
4
131
name some oestrogenic SEs
breast tenderness
nausea
headaches
vaginal discharge
132
name some progestogenic SEs of pill
acne
mood swings/low mood
breakthrough bleeding
133
the oestrogen in the COCP is what
ethinylestradiol
134
marvelon pill is a monophasic COCP with what in
ethinylestradiol 30mcg and desogestrel 150mcg
135
if you miss a pill you can take it how many hrs after the last one?
can take pill up to 72hrs after the last one
136
janet missed a pill and didnt take the next one >72hrs later. how long should she use condoms for
7 days
assess need for emergency contraception
137
what can POP do to your periods?
amenorrhoea / irregular bleeding
138
how soon after starting is POP effective?
48hrs
139
how long do u need to use condoms after implant insertion?
7 days
140
what is main side effect of implant?
irregular bleeding
141
how long does Depo-Provera last?
12 wks
142
how long does Noristerat injection last?
8wks
143
which is the contraceptive method where there can be a delay back to fertility?
injection
144
which is the only contraceptive method which has been shown to potentially cause weight gain?
injection
145
what can injection do to your bone density?
reduce
| not recommended for those at risk of osteoporosis
146
can mirena be used as endometrial protection with oestrogen only HRT in women w wombs?
yes
147
are injection and IUS affected by liver enzyme inducers?
no
148
name some emergency contraceptions
copper coil
Levonellle (72hrs)
EllaOne (120hrs)
149
Levonelle morning after pill is levonorgestrel. what is EllaOne?
ulipristal acetate
150
how long can u leave Jaydess coil in for?
3yrs
151
spermicide not recommended for use with condoms. what barriers methods can you use a spermicide with?
diaphragm and caps
152
oil based lubricants decrease efficacy of latex condoms - true or false?
true
153
name two contraceptive methods not affected by liver enzyme inducers
IUS
| and injection
154
is implant affected by liver enzymes inducers?
yes
155
name some liver enzyme inducer that you need to watch out for w contraception
```
carbamazepine, phenytoin
rifampicin
topiramate
st john's wort
some antiretrovirals
(injection often better for pts w HIV)
```
