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high value stuff Flashcards

1
Q

what are the common CYP450 inducers

A

These are the SCRAPB ones that keep going
Sulphonyureas
Carbamezapine
Rifampacin
Alcohol (chronic)
Phenytoin
Barbituates

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2
Q

what are the common CYP 450 inhibitors

A

AO DEVICES

Allupourinol
Oemeprazole
Disulfarim
ETOH (acute, think competing)
Valproate
Isoniazid (with macrolides think TB!)
Ciprofoxacin
erythromycin
Sulphonamides (Abx)

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3
Q

FTU

A

finger tip unit that is use or topical Tx and is enough to cover one side of an adult hand

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4
Q

What drugs should be stopped pre-operatively

A

I LACK OP

Insulin (often day of? take pt experiece)
lithium (day before)
Anticoags/platelets
COCP/HRT
K+ sparing diuretics

Oral hypoglycaemics
Perindopril and other ACEi

Blleding drugs
glucose drugs
K+ increasing drugs
Lithium

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5
Q

what complication occurs when stopping A?metformin and B? other oral hypoglycaemics and insulin when a patient is NBM

A

A) metabolic lactic acidosis

B) hypoglycaemia

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6
Q

when reviewing ACEi what parameter should be checked

A

Serum potassium and stop/hold if high and avoid fluid containing K+

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7
Q

when reviewing a prescription what should be checked per drug

A

PRrSCRIBER

Pt details (Name DOB and Hospital number)
Reactions and allergies
Sign the front of the answers
Contraindications for each drug
Route
IV fluids needed?
Blood clot prophylaxis needed?
anti-Emetic needed?
pain Relief needed?

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8
Q

Glucocortidoid side effects

A

STEROIDS

Stomach ulcers
Thin skin
oEdema
Right and left heart failure
Osteoperosis
Infections
Diabetes
cushings Syndrome

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9
Q

common NSAID side effects

A

Lungs: asthma
Heart: HF
GI: ulcers/dyspepsia, bleeds
Renal: pre-renal AKI
Blood: bleeds and anaemias / dyscrasias

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10
Q

which antihypertensive causes gout?

A

thiazide diuretics
(they increase PCT uric acid resorption)

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11
Q

which antihypertensive causes gynaecomastia

A

Spironolactone

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12
Q

side effects of antihypertensives

A

hypotension
bradycardias - BB, rate slowing CCB
electrolyte disturbances - ACEi, diuretics

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13
Q

NBM and medications?

A

they should usually continue to receive oral medications ? If Safe swallow

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14
Q

crystalloid vs colloid in acute resus?

A

crystalloid. colloid (which has proteins with similar levels to blood to prevent intravascular fluid depletion by keepign oncotic pressure high) has increased risk of anaphylaxis

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15
Q

fluid replacement in ascites

A

HAS
useful as it maintains oncotic pressure preventing third spacing. useful before therapeutic paracentesis when ascites may compress vessels so when uncompressed there will be intravascular depletion

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16
Q

maximal rate of potassium administration

A

nothing more than 10mmol/hour

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17
Q

fluid bolus for resus/dehydration if hypotensive or tachycardic

A

500ml STAT IV 0.9% SODIUM CHLORIDE

(250ml if Hx of HF)

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18
Q

fluid replacement if oliguric?

A

ENSURE THERE IS NO URINARY OBSTRUCTION

give 1L over 2-4 hours and then reassess

(if only oliguric/anuric: 500ml fluid depletion, if oliguric/anuric + tachy: 1L fluid deficit, if oliguric/anuric + tachy + hypotensive >2L fluid depletion)

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19
Q

daily maintanence luid requirements

A

3L over 24 hours for adults (can be 2 for elderly)

One 0.9% NaCl and then 2 5% dextrose (all over 8 hours if 3 bags or 2 hours if 2 bags)

40mmol potassium per day (!!!!if there is normal potassium!!!) usually 20mmol KCl over 2 bags

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20
Q

what should you check before prescribing fluids

A

Fluids status: JVP, lung fields, sacral and peripheral oedema, BP, mucous membranes and skin turgor

is there any indication there is Era
obstruction
Hx HF

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21
Q

CI of VTE compression stockings

A

Signs of PAD or ABPI <0.6

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22
Q

CI of metoclopromide

A

works through dopamine receptor antagonism. this should be avoided in parkinson’s patients (worsening) or young women (dyskinesias especailly acute dystonia)

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23
Q

Analgesia of painful diabetic neuropathy

A

duloxetine 60 mg PO OD

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24
Q

Analgesia of neuropathic pain

A

amitryptilline or pregabalin
then amitryptilline and pregabalin
refer to specialist with tramadol in the interim

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25
morphine sulphate routes and strength
oral oramorph < SC < IV but they should ALL be prescribed as oramorph
26
maximum paracetamol dose in patients <50Kg
500mg 6 hourly (total 2g) as opposed to 1g 6 hourly (total 4g) if >50kg
27
which diuretics raise potassium lower potassium
raise: ACEi/ARB, potassium sparing diuretics Lower: loop/thiazides
28
causes of hypernatraemia
dehydration drips -> Na rich fluids or too much saline Drugs DI (dehydration) hyperldosteronism
29
hyponatraemia causes
hypovolaemic: fluid loss -> darrhoea, vomiting, diuretics, addisons euvolaemic: Psychogenic polydipsia, hypothyroidism, SIADH hypervolaemic: HF, renal failure (no resorption)
30
nephrotoxic ABx
gentamycin, vancomycin, tetracyclines
31
how should you titrate thyroxine doses for hypothyroidism
use the TSH aiming for 0.5 - 5 mIU /L and use the smallest increment offered <0.5 reduce the dose 0.5 - 5 no change >5 increase the dose
32
cholestatic drugs
CAPS COCP Antibiotics: flucloxacillin, co-amoxiclav, erythromycin Phenothiazines (Chlorpromazine, prochlorpromazine) Sulphyonylureas
33
gentamicin montoring and adjustmenet
you want gent to be above a threshold level when given and to fall to low levels between doses If the gentamicin is a divided daily dosing regime -reduce dose if the dose an hour after administration is too high -increase the interval between doses if the dose is too high in the trough (just before next administration) If gentamicin is on a once daily regimen: -use the nomogram (check it's the right one for the dose) and plot the gent level in the blood at the hours after administration. If beow 24 hour line all good. if above 24 hours but under 36 hours line change dose to 36 hourly. if above 24 hours but below th e48 hour line change dose to 48 hourly. if above the 48 hour line hold until serum gent level <1.0
34
loads of side effects including Dry mouth or constipation? what drug class should you consider
antimuscarinics Oxybutinin Amitriptyline cyclizine
35
Drugs that raise ALT in hepatitic pattern
PASS Paracetamol Alcohol Sodium Valproate Statins
36
when do you stop COCP before an op and restart it after
stop 4 weeks before and restart 2 wees after
37
starting morphine dose for pain in palliative care how should it be increased
oral modified release morphine or oral immediate release morphine with 5mg breakthrough pain increase basal pain by 30-50% steps
38
formula relating dose, conc and volume
dose = conc x volume
39
unit conversions g, mg, mcg
40
when are ACEi taken
nightly as they can cause postural hypotension. Perindopril erbumine and perindopril arginine are the only exceptions
41
what should never be given with azathioprine
allopurinol both xanthine oxidase inhibitors with risk of bone marrow suppression
42
co-amoxiclav which component is better to serach for reactions of
the clavalunic acid has far more many interactions (atorvastatin)
43
Advice for patient taking subcut insulin into a lumpy area
be aware that injections can cause lipodystrophy, cutaneous amyloid and other skin reactions which reduce the efficacy of insulin injected into them to avoid hypoglycaemia they should see a Dr before switching sites and closely monitor blood sugars after switching
44
What do you do about an insulin dose due after a hypo?
do NOT Stop (info on hypoglycaemia page) restart IV when blood glucose >3.5 and with dextrose and review dosage stopping can cause reflex hyperglycaemia
45
artificial tears
hypromellose sodium hylarunate
46
COCP
combined is oral progesterone and oestrogen usually 21/7 but can be taken 21/4 or 63/7
47
Common COCP brand
microgynon
48
POP
Only preogesterone Norithisterone levonorgestrel Desogestrel (cerelle) Take continuous and strict missed pill rules
49
contraceptive info
Starting advice on drug pages and formulations in medicinal forms General doses etc on the contraceptives, hormonal (tableheaded preparation choice)
50
monophasic vs multiphasic hormonal contraceptiion
Monophasic: always same dose in each tablet, doesnt matter if the order is mixed, fewer side effects of changing hormone levels Mulitphasics: hormone dose per tablet changes to mimic the natural menstrual cycle and tablets must be taken in a strict order. Reduces overall hormone exposure (if asked to prescirbe mutlipahsic they are under contraceptive hormonal, multiphasic table and are in the order they are taken)
51
missed pill COCP POP
COCP: -1 missed pill (>24 hours) take missed when you rememebr and continue. -2 or more take the last missed pill and abstain or barrier contraception for 7/7 -missed pill in the last week, continue the active pills to make sure there are 7 uninterrupted days of cover (omit inactive or pill free break) POP: 3 hour window except for -missed <3 hours take missed pill straight away -missed pill >3 hours take missed pill straight away and abstain or use barrier contraception 2/7 -IF DESOGESTREL SAME BUT 12 HOUR WINDOW emergency contraception if UPSI during not protected time
52
Diarrhoea or vomiting after pill
Vomiting <2 hours after must be repeated If diarrhoea for >24 hours the pill must be considered missed until diarrhoea is no longer severe
53
Risks of COCP vs POP
COCP: VTE, MI, Stroke, Breast and cervical cancer POP: ovarian cyst and breast cancer **b**oth **b**reast **C**OCP **C**ervical
54
endometriosis
Norethisterone Specific Indication
55
Decision tree for HRT
56
drug monitoring
Beneficial response -> what you want the drug to do!! e.g. digoxin HR Adverse effects -> risk of side effects (e.g. digoxin -> renal and electrolytes)
57
miinimum sertraline dose
50mg
58
steroid equivalence tables
glucocorticoid treatment summary
59
paeds fluids shock rehydration maintanence
Shock: Bolus Rehydration: -5% is 50ml/kg/24 hours -10% is 100ml/kg/24hours Maintenence: fluids over 24 hours 100ml per kg first 10 kg 50ml per kg next 10 kg 20ml per kg every kilo thereafter
60
ICS ICS LABA LAMA LABA ICS/LAMA/LABA
Beclomethasone Symbicort LAMA LABA = glycopyrronium + Indacetarol Trelegy
61
paediatric bolus
10ml/kg (10 letters in paediatric)

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