EXTRA REVISION NOTES Flashcards

Question

4 ANTIFOLATE DRUGS - (Concomitant use will lead to teratogenicity + blood dysrcasias):

Answer 1

❖ Phenytoin ❖ Methotrexate ❖ Trimethoprim ❖ Co-Trimoxazole

Answer 2

``` ★ Vomiting bright red blood ★ Vomiting coffee-like material ★ Passing Black tarry stools ★ Rectal bleeding ★ Lightheadedness ★ Shortness of breath ★ Abdominal Pain *Risk minimized by co-prescribing PPI to suppress stomach acid production ```

Answer 3

``` ● Corticosteroids ● Carbocisteine ● DOAC e.g Rivaroxaban ● Anti-platelets e.g. Aspirin ● Warfarin ● NSAIDs ● SSRIs ```

Answer 4

C - Clozapine R - Risperidone O - Olanzapine Q - Quetiapine

Answer 5

``` ● Senna – red/yellow ● Dantron containing preparations e.g. co-danthramer, co-danthrusate – red ● Sulfasalazine – yellow-orange ● Phenindione – pink/orange ● Triamterene containing preparations e.g. co-triamterzide, Frusene – blue in some lights ● Levodopa containing preparations e.g. co-beneldopa, co-careldopa – reddish/darker in colour ● Entacapone – reddish-brown ● Nefopam – pink ● Clofazimine – red ● Nitrofurantoin – yellow/brown ● Rifabutin – orange-red ● Rifampicin – orange-red ● Deferiprone – reddish-brown ```

Answer 6

``` ➔ Pregabalin / Gabapentin ➔ Opioids - morphine, tramadol, heroin, or fentanyl ➔ Benzodiazepines - tamazepam ➔ Alcohol ➔ Barbiturates - phenobarbital ```

Answer 7

``` ● Fatigue ● Confusion ● Headache / Dizziness ● Nausea and/or vomiting ● Fluctuations in BP ● Abnormal breathing sounds e.g. whistling or crackling sound ● Apnea (abnormally long pauses in between breaths followed by a long sigh) ● Bluish or grayish skin ● Rapid heart rate ```

Answer 8

``` M - Myosis O - Out of it (Sedation) R - Respiratory Depression P - Pneumonia (Aspiration) H - Hypotension I - Infrequency (Constipation) N - Nausea E - Emesis ```

Answer 9

``` ● Insulin ● Sulphonylureas ● Steroids ● Antipsychotics ● Carbamazepine ```

Answer 10

❖ Antidepressants ❖ Antipsychotics ❖ Opioids - especially tramadol ❖ Quinolones e.g. ciprofloxacin + NSAID combo

Answer 11

``` S - ST.JOHN’S WORT C - CARBAMAZEPINE R - RIFAMPICIN / RIFABUTIN A - ALCOHOL (CHRONIC) P - PHENYTOIN ``` G - GRISEOFULVIN P - PHENOBARBITAL S - SULPHONYLUREAS

Answer 12

``` S - SODIUM VALPROATE I - ISONIAZID C - CIMETIDINE K - KETOCONAZOLE F - FLUCONAZOLE A - ALCOHOL (BINGE) C - CHLORAMPHENICOL E - ERYTHROMYCIN (macrolides) S - SULFANAMIDE -TRIMETHOPRIM . C - CIPROFLOXACIN O - OMEPRAZOLE M - METRONIDAZOLE ``` ``` G - GRAPEFRUIT A - AMIODARONE V - VERAPAMIL I - ITRACONAZOLE D - DILTIAZEM ```

Answer 13

``` ➔ STATINS ➔ WARFARIN ➔ ORAL CONTRACEPTIVES ➔ TRICYCLIC ANTIDEPRESSANTS ```

Answer 14

``` SEPSIS - ★ Sepsis is a life-threatening reaction to an infection. It happens when your immune system overreacts to an infection and starts to damage your body's own tissues and organs. ★ If not treated immediately, sepsis can result in organ failure and death. Yet with early diagnosis, it can be treated with antibiotics. HOW TO SPOT SEPSIS IN ADULTS - ❖ Slurred speech or confusion ❖ Extreme shivering or muscle pain ❖ Passing no urine (in a day) ❖ Severe breathlessness ❖ It feels like you’re going to die ❖ Skin mottled or discoloured high temperature (fever) or low body temp, a fast heartbeat, fast breathing ``` ``` HOW TO SPOT SEPSIS IN CHILDREN 1. Is breathing very fast 2. Has a ‘fit’ or convulsion 3. Looks mottled, bluish, or pale 4. Has a rash that does not fade when you press it 5. Is very lethargic or difficult to wake 6. Feels abnormally cold to touch If you spot any of these signs, call 999 or go straight to A&E ``` ``` A child under 5 may have sepsis if he or she: 1. Is not feeding 2. Is vomiting repeatedly 3. Has not passed urine for 12 hours ```

Answer 15

``` SHOCK - A serious life threatening condition where vital organs in the body are not getting enough blood flow resulting n organ failure ``` Causes: Bleeding, cardiac event, loosing bodily fluids e.g. severe vomiting, allergic rct Signs of shock: - Cold clammy skin - Sweating - Rapid shallow breathing - Weakness + dizziness - Nausea or vomiting - Thirst - Yawning SEPTIC SHOCK - Life-threatening condition that happens when your blood pressure drops to a dangerously low level after an infection

Answer 16

``` ★ Feeling lightheaded or faint ★ breathing difficulties: fast / shallow breathing ★ a fast heartbeat ★ clammy skin ★ confusion and anxiety ★ collapsing or losing consciousness ★ other allergy symptoms: an itchy, raised rash (hives), angioedema ```

Answer 17

``` TREATMENT - ★ Start cardiopulmonary resuscitation (CPR) immediately. ★ Call 999 for an ambulance 999 ★ Begin initial treatment for anaphylaxis: ``` Intramuscular adrenaline /epinephrine should be given as 1st line treatment for anaphylaxis. ``` A repeat dose of intramuscular adrenaline/epinephrine (1mg/ml) should be given after a 5-minute interval if there is no improvement in the patient’s condition. ``` ADRENALINE DOSES: ➔ 5 years or below: 150 mcg ➔ 6-11 years: 300 mcg ➔ 12+ years: 500 mcg

Answer 18

MUMPS Contagious viral infection ``` SYMPTOMS - ● painful swellings in the side of the face under the ears (the parotid glands) ● Headaches ● Joint pain ● a high temperature ``` ``` TREATMENT - No cure ● Plenty of rest and fluids ● Painkillers e.g. Paracetamol ● Warm or cool compress to the swollen glands to help relieve pain ```

Answer 19

``` MEASLES Usually starts with cold-like symptoms, followed by a rash a few days later. Some people may also get small spots in their mouth. The first symptoms of measles include: ● a high temperature ● a runny or blocked nose ● sneezing ● a cough ● red, sore, watery eyes Small white spots (KOPLIK spots) may appear inside the cheeks and on the back of the lips a few days later. ``` ``` Measles rash - (Not itchy) & Red/brown ❖ Starts on the face and behind the ears before spreading to the rest of the body. ❖ The spots of the measles rash are sometimes raised and join together to form blotchy patches ```

Answer 20

``` RUBELLA “German Measles” A red or pink spotty rash that feels rough. - swollen glands in your neck, aching fingers, wrists, or knees and a high temperature. MMR Vaccine - 2 doses can give lifelong protection against measles, mumps, and rubella. ```

Answer 21

MENINGITIS An infection of the protective membranes that surround the brain and spinal cord (meninges). ``` Symptoms of meningitis develop suddenly and can include: ● a high temperature ● cold hands and feet ● vomiting ● confusion ● breathing quickly ● muscle and joint pain ● pale, mottled or blotchy skin ● spots or a rash ● headache ● a stiff neck ● a dislike of bright lights ● being very sleepy or difficult to wake ● fits (seizures) Babies may also: ● refuse feeds / be irritable ● have a high-pitched cry ● stiff body/ floppy or unresponsive ● have a bulging soft spot on the top of their head (Fontanele) Meningitis rash starts as small, red pinpricks before spreading quickly into red or purple blotches. ``` ``` The meningitis glass test - ● Press the side of a clear glass firmly against the skin ● Spots/rash may fade at first ● Keep checking ● Fever with spots/rash that do not fade under pressure is a medical emergency ``` Call 999 for an ambulance or go to your nearest A&E if you think you or your child might be seriously ill.

Answer 22

``` SCARLET FEVER The first signs can be flu-like symptoms, including a high temperature, a sore throat and swollen neck glands (a large lump on the side of your neck). ``` A blanching rash usually develops on the trunk 12–48 hours after initial symptoms, before spreading to the rest of the body and flexures. the rash is red/pink and makes your skin feel rough, like sandpaper. White coating on tongue aka - strawberry tongue Refer to GP for Treatment with antibiotics e.g. phenoxymethylpenicillin

Answer 23

IMPETIGO Highly contagious skin infection that often starts with sores or blisters on the face or hands that burst and leave crusty, golden-brown patches. They can look a bit like cornflakes stuck to your skin. Treatment - - topical fusidic acid - if widespread oral flucloxacillin

Answer 24

Glandular fever Mostly affects teenagers and young adults. It gets better without treatment, but it can make you feel very ill and last for weeks. ``` SYMPTOMS: ● a very high temperature or you feel hot and shivery ● a severe sore throat ● swelling either side of your neck – swollen glands ● extreme tiredness or exhaustion ● tonsillitis that is not getting better ``` Don't treat sore throat with ABX e.g. amoxicillin as it can cause maculopapular rash if glandular fever

Answer 25

``` PARACETAMOL MAX DOSAGE ● 3-5 Months - 60mg ● 6-23 Months - 120mg ● 2-3 Years - 180 mg ● 4-5 years - 240 mg ● 6-7 years - 250 mg ● 8-9 years - 375 mg ● 10-11 years - 500 mg ● 12-15 years - 750 mg ● 16+ years - 1000mg ``` Maximum of 4 times a day

Answer 26

``` IBUPROFEN MAX DOSAGE ● 3-5 months: 50mg TDS (150 mg) ● 6-11 months: 50mg QDS (200 mg) ● 1-3 years: 100mg TDS (300 mg) ● 4-6 years: 150mg TDS (450 mg) ● 7-9 years: 200mg TDS (600 mg) ● 10-11 years: 300mg TDS (900 mg) ● 12-17 years: 400mg QDS (1200mg) ```

Answer 27

MHRA - risk of neuropsychiatric reactions Be alert of speech impairment and ocd symptoms, hallucinations, sleep disorders and suicidal behaviour

Answer 28

1 month - 5 yrs = 150mcg 6-11yrs = 300mcg 12+ = 500mcg Repeat adrenaline after 5 min interval if necessary

Answer 29

Solifenacin or tolterodine

Answer 30

Loperamide or codeine die to paralytic ileus as it increases risk of toxic mega colon

Answer 31

Rectum and colon

Answer 32

Inflammation of rectum Give suppositories 1st line aminosalicyclate (rectal) mesalazine or sulfasalazine

Answer 33

Oral treatment High dose oral aminosalicylate

Answer 34

Foam preparation

Answer 35

Inflammation of GI tract from mouth to anus

Answer 36

Lansoprazole - take 30-60 mins before food PPI cautions - - mask symptoms of gastric cancer - increased risk of fractures and osteoporosis - increased risk of GI infections e.g C. difficile - hypomagnesia

EXTRA REVISION NOTES Flashcards

(61 cards)