Medicines 54 Flashcards
(25 cards)
Which laxatives are given for bowel cleansing prior to surgery ? BNF
LOOK FOR NICHE COMBINATIONS
Bowel cleansing preparations are used before colonic surgery, colonoscopy or radiological examination to ensure the bowel is free of solid contents; examples include:
macrogol 3350 with anhydrous sodium sulfate, potassium chloride, sodium bicarbonate and sodium chloride ,
citric acid with magnesium carbonate,
magnesium citrate with sodium picosulfate and
sodium acid phosphate with sodium phosphate.
Bowel cleansing treatments are not treatments for constipation.
What is the treatment for thrush ?
CAS formulary:
Fluconazole 1st line
Clotrimazole 500g pessary 2nd line
Clotrimazole intravaginal cream 3rd line
Adjunct therapy
Clotrimazole 1% or 2% cream
EMC states for Clotrimazole 2% cream: recommended for the treatment of candidal vulvitis. It should be used as an adjunct to treatment of candidal vaginitis.
What should dietary cautions does isoniazid have?
Patients should be advised against ingesting foods rich in tyramine and/or histamine during treatment with isoniazid, such as cured meat, some cheeses (e.g. matured cheeses), wine, beer and some fish (e.g. tuna, mackerel, salmon). (EMC)
Is Shingles contagious ?
people with active lesions, particularly if they are immunosuppressed, can transmit the virus to susceptible people (who have not had chickenpox or the varicella vaccine) to cause chickenpox.
The person with shingles is infectious until all the vesicles have crusted over (approximately 7 days after rash onset). (NICE)
What treatments would you usually expect to see with someone with sickle cell disease?
💉 Infection Prevention
• Vaccines: Pneumococcal, Hib, Influenza (annual), Hepatitis B (if non-immune).
• Prophylaxis: Lifelong penicillin recommended.
⸻
🌿 Folate Supplementation
• Haemolytic anaemia → ↑ erythropoiesis → ↑ folate needs.
• Folic acid supplementation advised (dose per specialist).
⸻
💊 Hydroxycarbamide (Hydroxyurea)
• Reduces acute chest syndrome, pain crises, and transfusion need.
• Effects take several months to appear.
Which symptom of a hypo is not masked by beta blockers
(e.g. tachycardia, tremor,
blurred vision, hunger & headache) except
sweating
What is the advice around emergency contraception if a progesterone only pill has been missed ?
If more than one pill is missed wit the Combined oral contraceptive what is the advice?
if one active pill is missed, there is no need to take additional precautions
if two active pills are missed, additional precautions should be taken for the next 7 days
What is the counselling with the cholera vaccine
The vaccine is given as a drink. For adults, 2 doses (given 1 to 6 weeks apart) can provide protection for up to 2 years.
How does pioglitazone affect the bones?
BNF:
Increased risk of bone fractures, especially in women
How do you treat scabies in pregnancy?
malathion instead of permethrin
Which macrolide is fine to take alongside statins
Azithromycin - SPS
How long does the effect of warfarin take post dose?
Vitamin K antagonist -takes at least 48 to 72 hoursfor the anticoagulant effect to develop fully.
What is the MHRA alert with Hydrochlorothiazide? (thiazide diuretic)
risk of non-melanoma skin cancer, particularly in long-term use
When does diltiazem have to be prescribed by brand?
Basically over 60mg MR
The standard formulations containing 60 mg diltiazem hydrochloride are licensed as generics and there is no requirement for brand name dispensing. Although their means of formulation has called for the strict designation ‘modified-release’, their duration of action corresponds to that of tablets requiring administration more frequently.
Different versions of modified-release preparations containing more than 60 mg diltiazem hydrochloride may not have the same clinical effect. To avoid confusion between these different formulations of diltiazem, prescribers should specify the brand to be dispensed.
How do you prime an insulin pen?
Priming involves dialing a small dose (usually 2 units) on the pen, pointing the needle upwards, and pressing the injection button until a drop of insulin appears at the needle tip
List some:
Antimetabolites
Alkylating drugs
Vinca Alkaloids
Anthracycline antibiotics
Aromotase inhibitors
Antimetabolites: GMF
➢Gemcitabine
➢Methotrexate
➢Fluorouracil
Alkylating drugs:
➢Cyclophosphamide
➢Ifosfamide
➢Cisplatin
➢Melphalan
➢Lomustine
➢Carmustine
Vinca Alkaloids:
➢Vinblastine sulfate
➢Vincristine sulfate
➢Vindesine sulfate
Anthracycline antibiotics:End in RUBICIN
➢Daunorubicin
➢Doxorubicin hydrochloride
➢Epirubicin hydrochloride
➢Idarubicin hydrochloride
Aromotase inhibitors:
Letrozole
anastrazole
What are the side effects with Vancomycin?
With intravenous use
➢Vancomycin infusion reaction
Frequency not known
➢Agranulocytosis
➢Hypersensitivity
➢Nephritis tubulointerstitial
➢Neutropenia (more common after 1 week or cumulative dose of 25g)
➢Renal failure
➢Severe cutaneous adverse reactions (SCARs)
➢Tinnitus (discontinue)
➢Vertigo
Vancomycin is associated with a higher incidence of nephrotoxicity than teicoplanin
When does the risk of Digitalis toxicity increase with DIgoxin in terms of electrolytes?
Risk of digitalis toxicity increases with HYPERcalcaemia,
HYPOkalaemia,
hypoxia and HYPOmagnesaemia.
What are some cautions with Phenytoin treatment?
HLA allele
➢Limited evidence suggests that the presence of HLA-B*1502 allele, particularly in individuals of Han Chinese or Thai origin, may be associated with an increased risk of Stevens-Johnson syndrome.
Seizure exacerbation
➢Phenytoin may exacerbate seizures in patients with absence or myoclonic seizures (including juvenile myoclonic epilepsy), and myoclonic-atonic seizures.
Vitamin D
➢Vitamin D supplementation in patients who are immobilised for long periods or who have inadequate sun exposure or dietary intake of calcium
What is the patient and carer advice for lithium treatment?
Patient and Carer Advice
➢Report signs and symptoms of Lithium toxicity
- Hypothyroidism
- Renal dysfunction (including polyuria and polydipsia)
- Benign intracranial hypertension (persistent headache and visual disturbance).
➢Maintain adequate fluid intake
➢Avoid dietary changes which reduce or increase sodium intake.
➢Lithium treatment packsshould be given on initiation which consists of
- Patient information bookletoLithium alert cardoRecord book for tracking serum-lithium concentration
What are the monitoring requirements with Lithium?
➢Before treatment initiation
- Renalfunction and serum electrolytes
- Cardiac (ECG is recommended in patients with cardiovascular disease or risk factors for it)
- Thyroid function
- Body Mass Index (BMI)
- Full Blood Count
➢Every 6 months during treatment (more often if there is evidence of impaired renal or thyroid function, or raised calcium levels)
- BMI
- Serum electrolytes
- eGFR
- Thyroid function
**LFTs NOT NEEDED **
What are the monitoring requirements with Methotrexate ?
Full blood count, renal and liver function tests repeated every 1–2 weeks until therapy stabilised, thereafter every 2–3 months.
Which tests should not be done within 2 weeks of PPI treatment or 4 weeks of antibiotics with H.Pylori
PHE advise that the urea breath test and SAT should not be performed within 2 weeks of treatment with a proton pump inhibitor or within 4 weeks of antibacterial treatment, as this can lead to false negatives.
