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Prescribing Flashcards

1
Q

What is the max duration of Lymecycline?

A

6 months

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2
Q

What is the name of estrogens on hrt ?

A

Equine (conjugated estrogens)

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3
Q

If someone is hyponatraemic, what is the fluid restriction limit?

A

1.5 litres a day

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4
Q

what do we givee to induce a withdrawal bleed?

A

Medroxyprogesterone 10 mg oral once a day

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5
Q

waht drug do we prescribe to treat parkinsons?

A

L-DOPA

on BNF it is; Co-Beneldopa

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6
Q

side effects of methyldopa?

A 
nausea or vomiting
• postural hypotension
• worsening of peptic ulcer symptoms
• sweating
• discoloration of urine/sweat

• with long-term use:
– Motor fluctuations and dyskinesias.
– Neuropsychiatric problems. Confusion,
hallucinations, psychosis.

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7
Q

oral thrush prescription?

A

Drug: Nystatin 100,000units/ml oral solution

dose; 1ml

route: PO
duration: QDS

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8
Q

3 drugs likely to cause arrhythmia in patients on cocktail of drugs and has COPD?

A

Ramipril

Salmeterol - and all B2 antagonist

isosorbide mononitrate

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9
Q

drug most likely to cause sore mouth in COPD patient?

A

Beclomethasone

Penicillins - Amoxicillin

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10
Q

an elderly person is found confused at home and seems to be going into shock, with a SJS rash - you are given a list of drugs. which drugs should you STOP immediately.

A

Search on BNF “STOPP” - click on prescription in the elderly

This shows you stop/start criteria, drugs you stop in elderly when tehy become conffused etc.

Phenytoin - causing the SJS rash
Co-codamol - make sure they are not overdosing on paracetamol !

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11
Q

A patient is taking Co-codamol 1g QDS and Parcaetamol 1g QDS. what problems might this pose?

A

co-codamol contains paracetamol

cannot take more than 4g day

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12
Q

pregnant woman taking salbutamol had stage 2 hypertention and proteinuria. rx?

A

Nifedipine!

because cant have labetalol cosov asthma.

or take 3rd line methyldopa

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13
Q

woman has unprotected sex and wants emergency contaception. she is taking carbamazepine. what to prescribe her?

A

if you look at interactions of carbamazepine - ulipristal and levonogestrel are listed there

it is a cyp450 inducer

give copper icd

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14
Q

You are prscribing a new drug for a patient. You have to give them information about key safety-netting things. where do you find this?

A

Patient and Carer ADvice section under the drug

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15
Q

When you need to find description for treatment of overdose how do you search?

A

“Poisoning” on BNF

has useful info as in when to start rx eg paracetamol levels etc

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16
Q

In late pregnancy, near term, what do you prescribe a woman who develops UTI?

A

A. Cefalexin 500mg PO twice daily for 7 days

Nitrofurantoin should be avoided in late pregnancy/at
term, due to neonatal haemolysis.

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17
Q

side effects of ACE inhibitors eg ramipril?

A

Dry cough
Hyperkalaemia
AKI

Avoid in pregnancy

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18
Q

Contraindications of NSAIDs eg naproxen & diclofenac?

A

Asthma
CCF
Bleeding

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19
Q

common inducers of P450?

issue?

A

Carbemazepine
Riifampicin

issue: breaks down more drug = lower levels

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20
Q

common inhibitors of P450?

issue?

A

clarithromycin
ciprofloxacin

issue: inhibits drug breakdown = higher circulatory concentrations

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21
Q

Common drugs inhibitors cause issues with?

A

Warfarin

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22
Q

potential allergy from Augmentin use?

A

Penicillin

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23
Q

Want to know if to stop or continue drug before surgery. how to search on BNF?

A

Surgery and long-term medication

on treatment summaries

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24
Q

methotrexate is stopped in ?

A

acute infections

causes bone marrow suppression

25
precipitators of lithium toxicity?
NSAIDs Loop diuretics Thiazide diuretics ACEis
26
drug causes of hyperglycaemia?
Steroids Thiazide diuretics
27
how to find contraceptive and HRT info on BNF?
treatment summary - > C -> contraceptives or desogesterol for prog alone HRT; Sex hormones
28
drug reactions; Which drugs cause agranulocytosis?
Carbimazole - thyroid disease Clozapine Phenytoin Methotrexate
29
drug reactions; which drugs raixe INR in combination with warfarin?
Erythromycin Clarithromycin Ciprofloxacin Fluconazole often due to cyp450 enzymes
30
you are looking to use a CCB alongside a B-Blocker. which CCB would you not use?
Non-dihydropyradine ones eg Verapamil, ditiazem becuase reduce cardiac contractility leading to bradycardia
31
what is the dose of for routine maintenance fluids?
25-30 ml/kg/day of IV sodium chloride this calculates requirement over 24 hours then /by3 for 8 hourly preparation. routine fluid used eg if aptient nbm before surgery.
32
patients comes in with anaemia secondary to IBD. how to treat?
avoid oral iron as can make IBD worse! IV transfusion - iron dextran
33
in hypothyroidism, how do we adjust drug dose?
based on TSH levels TSH >5 ; increase levothyroxine TSH <0.4; reduce levo
34
what do we prescribe in neutropaenic sepsis?
IV Tazocin -> piperacillin and Tazobactam
35
where to find info on managing drug reactions?
poisoning emergency treatment on bnf
36
which drug interaction with clarithromycin are we most concerned of?
warfarin becuase its so common - dangerous
37
a woman is on hrt - progynova - her LFTs become deranged and she becomes jaundiced. what to do next?
stop the hrt
38
what is the first line pain relief in renal colic?
NSAID eg Diclofenac sodium once only or Naproxen once only
39
in the prescription of hydrocortisone, what strength should you start?
1% NOT 0.5
40
which drugs incrrease lithium cocentration and why?
NSAIDs, ACEIs they reduce GFR if they increase serum lithium levels, stop both them and lithium, with view to restart lithium
41
in amending opioid prescriptions, what should the new maintenance and breakthrough dose be as %?
maintenance should be 50% of current daily dose breakthough dose should be 1/6th of current daily dose see jan mscaa mock
42
How do we prescribe ibuprofen usually?
400mg TDS
43
Which opiates are fine in renal impairment?
TraMadol Buprenorphine Fentanyl Oxycodone
44
If a patient is taking an opiate short release preparation and the pain is not improving, next step?
Calculate how much he’s using now to determine how much to prescribe Give modified release instead which stays around longer (MR dose; total dose divided by 2 then give 2x a day).
45
Where do you find conversion fractions for opiates ?
Prescribing in palliative care - you find a whole table Also on the paper in the PSA exam
46
woman has had hysterectomy. what hrt should she have?
estrogen only; PO or patch eg FemSeven 50 Progynova
47
which meds should be stopped before surgery?
BNF -> Surgery and longterm meds I LACK OP ``` insulin Lithium antiplatelets/ anticoagualnts cocp/hrt potassium sparing diuretics ``` oral anti-hypoglycaemics perindopril & Aceis
48
a patient with severe copd needs O2. they have urosepsis, what o2 do we gie?
15L BY NON REBREATHE MASK not venturi 24% as they are unwell and dont know if they are a retainer. hypoxia kills before hypercapnia.
49
someone comes in with asthma and their sats are 89% what o2 to give?
2-6L/min O2 via nasal cannula if sats are less than 85% then can start on 15L NRB
50
in which situations would 2-6L/min O2 via nasal cannula | be needed?
ACS; acute coronary syndromes eg STEMI Stroke Pregnancy and obstetric emergencies Hyperventilation and dysfunctional breathing
51
dose conversions for mg, mcg and ng?
1 mg = 1000mcg 1 mcg = 1000ng
52
30% solution is equivalent to what g in ml?
30% = 30g in 100ml
53
1 in 1000 adrenaline in ml?
equivalent to 1mg/ml
54
1 in 10,000 adrenaline in ml?
1mg/10ml
55
a ptient with high INR on warfarin is bleeding, what must you do?
give Vitamin K - BNF is "Phytomenadione" or type on treatment summaries "anticoagulants" Give IV if bleed otherwise PO if INR>8
56
INR high on warfarin, reduce dose or stop warfarin?
INR 5-8 : stop warfarin or 2 days then reintroduce INR high: reduce
57
you want info on HRT contraindications. which treatment summary?
Sex hormones
58
List some names of HRT to know!
e2 only; Ellleste solo Femseven Progynova combined; Elleste duet - estradiol with norethisterone -> remember need to specify number in the pack eg femseven 50
59
what drugs do they love in the PSA?
Gentamicin - peak trough Simvastatin - adverse reactions especially with clarithromycin. myalgia ACEi - renal impairment. electrolyte disturbance NSAIDs - above and ulcers contraceptive/hrt review

Year 6 (17 decks)

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