Management of Chronic Conditions Flashcards
(34 cards)
above which BP should antihypertensives be given?
over 150 / 95 ambulatory / home readings, or over 135 / 85 if any of these present also present:
- age >80 with clinic BP >150 / 90
- age <80 with target organ damage, CVD, renal disease or Q-risk 10% and above
- age <60 with Q-risk less than 10%
which patients receive an ACE-i or ARB as their first line treatment for HTN?
- age under 55
- white
- diabetic
which patients receive a CCB as their first line treatment for HTN?
- age over 55
- non-white
- non-diabetic
what is the target BP in a pt aged <80 with HTN?
- less than 140 / 90 in clinic
- less than 135 / 85 ambulatory / home readings
what is the target BP in a pt aged 80+ with HTN?
add 10 to systolic values:
- less than 150 / 90 in clinic
- less than 145 / 85 ambulatory / home readings
how is chronic heart failure managed?
- ACE-inhibitor + beta blocker
- then: increase doses
- then: add furosemide
- then: spironolactone
- then: specialist assessment
management algorithm for an acute asthma attack?
- salbutamol nebs
- ipratropium nebs
- 40mg prednisolone (or IV hydrocortisone)
- aminophylline infusion
- IV MgSO4
- ITU
- I+V
below what sats would you give O2 in acute asthma / COPD exacerbation?
<94%
management algorithm for an acute exacerbation of COPD?
- salbutamol nebs
- 30mg prednisolone (only if wheezy)
- ABx (amox / clarith) if infective signs
management of hypoglycemia in pt who is able to swallow?
2 tubes of 40% glucose gel, PO
management of hypoglycemia in pt who is unconscious (and not on a sulfonylurea / alcohol intoxicated)?
IM glucagon, 1mg
in which pts should IV glucose 10% / 20% be used to treat hypoglycemia?
- alcohol-induced hypoglycemia
- chronic hypoglycemia (e.g. from an SFU)
- adrenal insufficiency
- prolonged period of fasting
which AF pts are suitable for rhythm control?
- new onset <48h ago
- reversible cause is present
- it is causing HF
- symptomatic despite rate control
drug choices for pharmacological rhythm control?
- flecainide
- amiodarone
drug choices for rate control?
- BB (atenolol)
- CCB (diltiazem, avoid in HF)
- digoxin (only if sedentary)
first line treatment for uncomplicated gonorrhoea?
ceftriaxone 1g IM, once only
management of hyperkalaemia?
- calcium gluconate 10% by slow IV injection
- IV injection of soluble insulin with 50ml of glucose 50% over 5-15 mins
endocrine drug for ER+ br Ca in pre-menopausal women?
tamoxifen
endocrine drug for ER+ br Ca in post-menopausal women?
letrozole
first line fluid treatment for hypercalcaemia?
1L 0.9% NaCl over 4 hours (same time as in AKI fluids)
fluid treatment for hypoglycemia?
50 ml of glucose 20% over 5 mins
drugs which prolong QT interval?
- chlorpromazine
- haloperidol
- olanzapine
- quetiapine
- flecainide
- amitriptyline
- citalopram
- ondansetron
drugs which cause serotonin syndrome?
- SSRIs
- TCAs
- triptans
- opioids (tramadol, fentanyl etc)
- SNRIs (venlafaxine, duloxetine)
drug of choice for idiopathic diabetes insipidus?
desmopressin
