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Year 4 CCC conditions > Core Medications > Flashcards

Flashcards in Core Medications Deck (33)
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1
Q

examples of SABA

A

salbutamol

Terbutaline

2
Q

examples of LABA

A

salmeterol

formoterol

3
Q

MOA of beta agonist

A

beta2 receptors on smooth muscles, GI tracts, Heart and bronchi

activation of Beta2 receptors = relaxation of muscles by causing the Na+/K- ATPase pumps to shift K+ extacellular to intracellular

4
Q

indications for beta agonist

A

asthma
COPD
hyperkalaemia

5
Q

SE of beta agonist

A
tachycardia 
palpitation 
anxiety 
inc glucose level 
inc serum lactate level if high dose - cause the breakdown of smooth muscles 
muscle cramps
6
Q

examples of short-acting antimuscarinic

A

ipratropium

7
Q

examples of long-acting antimuscarinic

A

Tiotropium

8
Q

MOA of antimuscarinic

A

binds to the muscarinic receptors and act as competitive inhibitors of ACTH

block parasympathetic effects = dec smooth muscle tone and dec secretion

9
Q

indication of antimuscarinic

A

asthma

COPD

10
Q

contra-indications of antimuscarinic

A

angle closure glaucoma - can cause inc intraocular pressure

11
Q

SE of antimuscarinic

A

dry mouth

12
Q

examples of ICS

A

beclometasone
budesonide
fluticasone

13
Q

MOA of ICS

A

meds pass through the membrane to get into the nucleus of the cells to modify gene transcription

pro-inflammatory interleukins, cytokines and chemokines are downregulated

dec mucosal inflammation, widen the airways and dec mucus secretion

14
Q

Indications of ICS

A

asthma

COPD

15
Q

contra-indications of ICS

A

COPD patient with a pneumonia

child - growth stint

16
Q

SE of ICS

A

oral candida
horse voice
pneumonia in COPD pts

17
Q

advice to avoid pneumonia when using ICS

A

wash your mouth straight afterwards

18
Q

pathology of type 1 DM

A

autoimmune destruction of the pancreatic beta cell

19
Q

pathology of type 2 DM

A

insulin resistance - free fatty acids and pro-inflammatory cytokines in plasma

reduce glucose transport into muscle cells, inc hepatic glucose production and in break down of fate and dec insulin production

20
Q

RF for T1DM

A

other autoimmune diseases eg thyroid disease and coeliac disease

younger age (<50)

genetic (30%)

exact cause unknown

21
Q

RF for T2DM

A

older age
obesity
ethnicity - asian, african
FH - 80% genetics

low birth weight 
non-alcoholic liver disease 
excess alcohol 
hypertension 
previous gestational diabetes
22
Q

symptoms of T1DM

A
polyuria 
polydipsia 
lethargy
unexplained weight loss
hyperglycaemia 
ketosis
23
Q

symptoms of T2DM

A

polyuria
polydipsia
lethargy
recurrent infection - thrush

24
Q

symptoms of DKA

A
D+V
polyuria 
polydipsia 
weight loss 
inability to tolerate fluids 
abdo pain 
lethargy/confusion 

ketonuria
fruity smelling breathe - acetone
Kusmaul breathing

25
Q

hypoglycaemia

A
hypogylcaemia - 3.5 mmol 
lethargy 
confusion 
irriration 
hungry 
anixety/irritability 
tingling tips 
sweating 
impaired vision 

seizures
loss of consciousness
coma

26
Q

what are the signs of dehydration

A

mild - clinical detectable only - BP etc

moderate - dry skin/mucous membrane, reduced skin turgor

severe - sunken eyes, prolonged cap refill

shock

27
Q

diagnosis of T1DM

A

urine dip + cap blood glucose

C-peptide, anti-islet cells bodies, anti-glutamic acid decarboxylase antibodies - not routinely tested but if atypical presentation eg unusual pattern of symptoms BMI > 25, not in teenage/young adult

28
Q

diagnosis of T2DM

A

urine dip/ACR

diagnostic bloods - if symptomatic then 1 +ve test is enough, if not then 2 +ve tests are required

1) venous bloods - fasting >7, random > 11
2) HbA1c - > 48 (42-47 pre-diabetic state) - does not work with people who have anaemia

29
Q

when to refer a patient with DM?

A

same day referral to an endocrinologist if a young/teenage person suspected of T1DM

if stage 4/5 CKD - nephrologist

DKA

sudden loss of vision, rubeosis iriditis, pre-retinal/vitreous haemorrhage, retinal detachment

moderate-high risk of developing diabetic foot problems - refer to foot protection service

30
Q

what is the sick day rule of diabetes

A

continue to take insulin during illness to maintain blood sugar level and try to maintain a diet and good hydration 3L

if solid food not toleratable - try to drink sugary drinks and take ORS

measure blood glucose 3-4 hours a day

31
Q

what is the target of blood glucose level in T1DM

A

before meal/fasting - 4-7

after meal - 5-9

32
Q

who should you inform when you are diagnosed with diabetes

A

DVLA - due to risk of hypoglycaemia

33
Q

management of T1DM

A

3 regimes

1) basal-bolus - intermediate/long-acting throughout the day + rapid/short acting before/immediate after meal
2) multiple daily injections of short/rapid-acting insulin
3) continuous insulin pump - rapid/short-acting insulin

need to check blood glucose 4-5 times a day