Other mocks Flashcards
When in prochlorperazine contraindicated?
Parkinson’s
Can result in extra-pyramidal side effects
Which anti-emetic should be avoided after gastrectomy?
Metoclopramide (pro-kinetic)
What is the dose and route of ondansetron in post-operative nausea?
4mg (IV preferred if patient has cannula in situ, but can also be given IM)
What is the first line antidepressant in children?
Fluoxetine
The initial dose is 10mg once-daily orally, which can be administered as a single or divided dose.
It is the only antidepressant for which trials show that the risks are outweighed by the benefits. It has a long half-life which makes it useful in younger group of patients whose adherence to medication may be sub-optimal.
In a child with status epilepticus secondary to febrile seizures, which drugs can be given?
Diazepam (PR)
Midazolam (buccally)
Also: lorazepam (IV)
Which blood pressure medication should be used in pre-eclampsia?
Labetalol 20mg/hour IV
There is no fixed dose stated for labetalol as it is given as a continuous infusion, hence a rate instead is recommended which is titrated every 30 minutes according to clinical improvement.
Although labetalol can be taken orally, the patient is having nausea and a cannula has been inserted, making the intravenous route preferred.
Other options include nifedipine or methyldopa. As she does not have any major complications (haemodynamically unstable, coagulation abnormalities or HELLP syndrome), she can be managed conservatively for now i.e. without delivery of the foetus.
What is the first line treatment for otitis media in children?
Amoxicillin 500mg PO TDS
If penicillin allergy: clarithromycin
What is the first line management of constupation in children?
If no signs of faecal impaction, use regular maintenance laxatives.
Osmotic (stool softening) laxatives are the first-line drug prescribed in children with constipation. The macrogol ‘Movicol’ (Polyethylene glycol 3350 plus electrolytes) or Lactulose are recommended as first-line treatment.
Stimulant laxatives such as Senna and sodium picosulphate should be used as second-line and so would not be appropriate in this instance.
Duration: often 28 days
If a patient’s asthma is not well controlled on SABA + ICS, what is the next step?
Montelukast 10mg PO OD
What is the first line treatment for hypothyroidism?
25-50 micrograms per day (with titration for adults aged 65 or over and adults with a history of cardiovascular disease).
It should be taken in the morning on an empty stomach and before any other medication has been taken. The dose can be uptitrated every 4 weeks by 25-50mcg. The patient should be reviewed and have TSH levels every 3 months after initiation of levothyroxine therapy and adjust the dose according to symptoms and TFT results.
Which drug classes commonly cause QTc interval prolongation?
Typical (haloperidol), atypical (risperidone) antipsychotics and SSRIs (fluoxetine)
What is the maximum dose of haloperidol that can be given to patients with schizophrenia?
20mg daily
T1DM recovering after elective surgery. Was kept on long acting insulin and started on VRII. Once able to eat and drink, what should be done?
As the patient is able to eat and drink, she should restart her usual subcutaneous fastacting insulin with her next meal with the VRIl running for 30-60 minutes afterwards to ensure stable BMs.
First line treatment for ADHD
Methylphenidate hydrochloride 5mg PO OD
Lisdexamfetamine mesilate
When should you consider uptitrating fluoxetine?
The BNF says: Patients should be reviewed every 1-2 weeks at the start of antidepressant treatment. Treatment should be continued for at least 4 weeks (6 weeks in the elderly) before considering whether to switch antidepressant due to lack of efficacy. In cases of partial response, continue for a further 2-4 weeks (elderly patients may take longer to respond).
