Medicines 57 Flashcards
(25 cards)
What is an important Consideration when treating a diabetic patient with a Statin?
Statins cause hyperglycemia.
Patients who have diabetes should
have a fasting blood glucose level before treatment
When do you reduce dose Of apixaban to 2.5mg
twice daily
At least two of the following
→ Age 80+
→ Body weight ≤ 60kg
→ Serum creatinine 133 micromole.
→ Crcl of 15-29 ml / min .
In what patients Should iron
Supplementation be halted?
Patients with C. Diff
→ can promore bacterial growth
→ It can worsen GI Symptoms
What is the relationship between esonophils and
montelukast ?
Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) has occurred very rarely in association with the use of montelukast; in many of the reported cases the reaction followed the reduction or withdrawal of oral corticosteroid therapy. Prescribers should be alert to the development of eosinophilia, vasculitic rash, worsening pulmonary symptoms, cardiac complications, or peripheral neuropathy.
What is the safest TCA to use in depression?
Lofepramine → Avoid amitriptylline and dosulepin as dangerous in overdose.
What medications are used in parkinson’s where motor symprons do not interfere with daily life?
→ Levodopa
→ Non- ergot depamine agonist
→ Mao-B inhibitors
Not A COMT inhibitor
These are ony added in
when wearing off Symptoms affect quality of life
Anbipsychotics that have highest risk of
Stroke
Risperidone + Olanzapine
stROke
What baseline monitoring is required before statin initiation?
✅ Essential Blood Tests:
Lipid profile
Renal, liver (incl. albumin), and thyroid function tests
HbA1c – to rule out secondary causes and co-morbidities
✅ Before Statin Initiation:
ALT or AST (liver transaminases) – measure baseline
Creatine Kinase (CK) – only if unexplained muscle pain present
🚫 Do NOT measure CK routinely if the patient is asymptomatic
When should statins be offered in CKD?
Offer atorvastatin 20mg for the primary or secondary prevention of CVD to
people with CKD (eGFR less than 60 mL/min/1.73m2
and/or albuminuria)
Increase the dose if a greater than 40% reduction in non-HDL-C is not achieved
and eGFR is 30 mL/min/1.73m2
or more.
Agree the use of higher doses with a renal specialist if eGFR is less than 30 mL/min/1.73m2
When should statin tratment be intensified?
When can clotrimazole be sold OTC to men?
1% cream can be sold to men for balanitis
2% cream - “It can also be applied to the sexual partner’s penis to prevent re-infection.”
What medication is licensed for pruritus?
Hydroxyzine hydrochloride - a sedating antihistamine
If a baby has oral thrush and the mother is breast feeding how should the mother use miconazole gel?
apply to nipples AFTER breastfeeding
What are the indications of methylnaltrexone?
Opioid-induced constipation in patients with chronic pain (except palliative care patients with advanced illness)
By subcutaneous injection
Adjunct to other laxatives in opioid-induced constipation in palliative care
for methylnaltrexone bromide
By subcutaneous injection
Which allergy should you be aware of with Naseptin Cream ?
Peanut allergy
Whats 1st line pain killer for lower back pain?
Paracetamol ineffective
Ibuprofen is a non-steroidal anti-inflammatory agent which are recommended first-line for lower back pain. Ibuprofen can be supplied over-the-counter for children and adults >12 years old. Patients should be counselled to not to take anymore than 1200mg in 24 hours. Ibuprofen should be used regularly for the shortest time necessary to relieve symptoms. If symptoms are no better after 10 days, advice from a GP should be sought.
Naproxen can be 1st line POM
Codiene 2nd line
When should dipyridimole be taken ? Counselling point
Dipyridamole is best taken on an empty stomach; 30-60 minutes before food for better absorption.
What dose of paracetamol should be given post meningitis vaccine
60mg TDS in the initial 8 week vaccination
Post-immunisation pyrexia can occur with all vaccines however it is more common after the meningococcal group B vaccine. The fever peaks at around 6 hours and has usually gone by 48 hours after vaccination. Paracetamol as a liquid (infant paracetamol suspension: 120mg/5mL) administered at a dose of 60mg TDS is recommended by Public Health England (PHE) to prevent post-immunisation pyrexia. The first-dose should be given as soon as possible after the vaccination; the second dose should be administered 4-6 hours later and the third dose administered 4-6 hours after the second dose. If the fever persists following the third dose additional doses of paracetamol may be administered at intervals of 4-6 hours for up to 48 hours. Note that these dosing recommendations are specific to paracetamol use in the 48 hours post meningococcal group B vaccination. Note that paracetamol should only be given to infants weighing over 4 kg and born after 37 weeks
What are the symptoms of respiratory depression?
Symptoms such as shortness of breath, tiredness, shallow breathing should be reported promptly
remember SOB doesnt necessarily mean Tachypnoea.
What is Furosemide?
A loop diuretic with its effects proportional to the dosage. When larger doses are required, they should be given as a controlled infusion at a rate not exceeding 4 mg/minute and titrated according to the response
When should Gliclazide be stopped in relation to surgery?
Sulphonylureas can cause hypoglycaemia upon fasting, hence it should always be omitted on the day of surgery and started again when the patient is eating and drinking again.
Sulphonylureas can be stopped a few days before but are then switched to insulin
Whats the blood pressure target in pregnancy ?
<135/85 mmHg
How long is treatment for a COPD exaccerbation?
5 days
When is the Men ACWY vaccine offered?
the meningitis ACWY vaccine has replaced meningitis C for 13-18 year-olds. This is due to an increased incidence of meningitis W disease in recent years. The ACWY vaccine will also be offered to new students (up to the age of 25 years) at university.
