extras Flashcards by B M

enzyme inhibitors (potentiate) ODEVICES

Omeprazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin/Cimetidine
Ethanol (acutely)
Sulphonamides

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enzyme inducers (decrease efficacy) - PCBRAS

Phenytoin
Carbamazepine

Barbiturates
Rifampicin
Alcohol (chronic)
Sulphonylureas

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alpha 1 adrenoreceptor agonist

decongestgants eg phenylephrine

vasopressors eg metraminol/norad

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alpha 1 adrenoreceptor antagonist

antagonist:
BPH eg tamsulosin
HTN eg doxasozin

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beta 1 adrenoceptor agonist

inotropes eg dobutamine

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beta 1 adrenoceptor antagonist

selective beta blockers eg bisoprolol

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beta 2 adrenoceptor agonist

bronchodilators eg salbutamol

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beta 2 adrenoceptor antagonist

non-selective beta blockers eg propanolol

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dopamine agonist

PD eg ROPINIROLE

prolactinomas eg BROMOCRIPTINE

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dopamine antagonist

antipsychotics eg HALOPERIDOL

anti-emetics eg METOCLOPRAMIDE

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GABA agonist

benzodiazepines

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GABA antagonist

flumazenil

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Histamine-1 Antagonist

antihistamines eg cetirizine

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Histamine-2 Antagonist

Antacids eg ranitidine

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mACh agonist

Glaucoma eg pilocarpine

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mACh antagonist

Brady eg atropine
Bronchodilators eg ipratropium
Urge incontinence eg oxybutynin

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nACh agonist

Smoking cessation eg varenicicline

Depolarising muscle relaxant eg suxamethonium

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nACh antagonist

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Non-depolarising muscle relaxant eg atracurium

Serotonin agonist

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acute migraine eg sumatriptan

Sertonin antagonist

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Anti-emetics eg ondansetron (5HT3A antagonist)

oral codeine or oral tramadol to oral morphine

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divide by 10

oral morphine to oral oxycodone

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divide by 1.5

preferred in mild-moderate renal impairment (eGFR 30-60)
causes less sedation/vomiting/pruritus

oral morphine to SC morphine

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divide by 2

oral morphine to SC diamorphine

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divide by 3

oral morphine to fentanyl 100 patch

dividie by 100 (over 24h)

SE of opiates x3

nausea (transient) vomiting (transient) constipation (persistent)

opiate for use if eGFR <30

alfentanil, fentanyl, buprenorphine

starting tx doses for opiods in palliative care - MR morphine, IR oromorph + one more thing

15mg MR morphine BD (= total 30mg oral morphine) + 1/6 of 30 = 5mg IR oromorph (for breakthrough pain) + laxative

general prescribing for nauseated individual

1st line: cyclizine 50mg 8 hourly (except in cardiac cases as can worsen fluid retention) 2nd line: metoclopramide, 10mg 8 hourly (avoid in PD, use domperidone instead, and avoid in young women, risk of acute dystonia)

general prescribing in vomiting without nausea

cyclizine 50mg up to 8 hourly | metoclopramide 10mg up to 8 hourly

N&V in palliative care: GASTRIC STASIS causes + drug of choice

causes; opiods | drugs; metoclopramide (CI - BOWEL OBSTR), domperidone

N&V in palliative care: CHEMICAL causes + drug of choice

causes; opiods, hypercalcaemia, chemo | drugs; ondansetron, haloperidol, levomepromazine

N&V in palliative care: VISCERAL/SEROSAL causes + drug of choice

causes; constipation, oral candidiasis | drugs; cyclizine, levopromazine

N&V in palliative care: RAISED ICP causes + drug of choice

causes; cerebral metastasis | drugs; cyclizine +/- dexamethasone

N&V in palliative care: VESTIBULAR causes + drug of choice

causes; motion-related, base of skull tumours | drugs; cyclizine

N&V in palliative care: CORTICAL causes + drug of choice

causes; anxiety, pain, fear, anticipatory nausea | drugs; BDZ (lorazepam), cyclizine

bony mets pain x3

1st - analgesia 2nd - bisphosphonates 3rd - radiotherapy

antihistamines; target, example, indications + SE

target H1>M>D2 acts on CTZ, vestibular, VC PROMETHAZINE - INDIC: motion sickness, labyrinth disorders, hyperemesis gravidarum, pre- and post-operatively - SE: dizziness, fatigue, tinnitus, sedation

D2 receptor antagonist; examples x2

METOCLOPRAMIDE (avoid in BO - prokinetic), DOMPERIDONE

D2 receptor antagonist; target, indications + SE

target D2>>H1>>>M acts on CTZ INDIC: GI motility disorders, uraemia, radiation sickness, cancer chemo SE: CNS - EPSEs, drowsy, dizzy, anxiety Endo - hyperprolactinaemia, galactorrhoea

M receptor antagonist - target + example

M>>>D2/H1 acts on CTZ, vestibular, VC -Hyoscine/scopolamine + Diphenhydramine (little effect once nausea est)

M receptor antagonist; indication + SE

indication: pre-op medication, motion sickness SE: antimuscarinic - dry mouth, mydriasis, constipation, drowsy

5-HT3 receptor antagonist - target, example, indication + SE

5-HT3 receptor antagonist, 5 HT2, acts on CTZ, peripherals ondansetron (mild nausea use alone, severe nausea combine with steroids) indication: chemo sickness, RT sickness, post-op N&V SE: headache, flushing, constipation

extras Flashcards

(43 cards)