PSA Flashcards
(95 cards)
1
Q
Adren Doses:
Anaphylaxis
Non-Shock
A
Adren: (Anaphylaxis):
- < 6mo: IM 0.1-0.15mg (1:1000)
- 6mo – 6yo: IM 0.15mg (1:1000)
- 6-12yo: IM 0.3mg (1:1000)
- Adult: IM 0.5mg (1:1000)
Adren: (Non-Shockable Rhythm: PEA/Asystole):
- IV 1mg (1:10,000)
2
Q
HC (Anaphylaxis, Asthma)
Chlorpheniramine
Atropine
A
HC: 200mg (Anaphylaxis), 100mg (Asthma)
Chlorpheniramine: 10mg
Atropine: 0.5mg (Post-MI BradyC)
3
Q
Hyperkalaemia Doses
A
Ca2+ Gluconate: 10ml (10%)
Insulin/Dextrose Infusion: (Hyperkalaemia): 10 Units Actrapid + 50ml Dextrose (50%)
4
Q
Hypoglycaemia Doses
A
- Conscious, Orientated: 15-20g Fast-acting Carbohydrate
- Conscious, Disorientated: 1.5-2 tubes of Glucogel
- Unconscious: IM Glucagon 1mg
- Prolonged/Persistent: IV 20% Glucose 100ml (over 15mins)
5
Q
Morphine Doses
Naloxone Doses
A
Morphine: (MI): IV 10mg (w/ IV Metacloperamide 10mg)
Naloxone: IV 0.4mg
6
Q
Drugs prescribed in Micrograms
Drugs taken weekly
A
Digoxin
Levothyroxine
Methotrexate (Non-oncological)
Alendronate
7
Q
Indications for Fluid Resus + Mx
A
- Syst BP < 100
- HR > 90
- RR > 20
- CRT > 2s
- NEWS > 5
IV 0.9% NaCl 500ml over 15min
8
Q
Routine Maintenance Fluid:
H2O
K+/Na+/Cl-
Glu
A
25-30ml/Kg/day H2O
1mmol/Kg/day K+/Na+/Cl-
100g/day Glu
9
Q
ADR of: Amlodipine Beta-blockers ACEi Amiodarone
A
Amlodipine: Periph Oedema
Beta-blockers: Changes in BP, BradyC, ED
ACEi: Dry Cough, Changes in BP
Amiodarone: BradyC, Pulmon Fibrosis, Thyroid Dysfunction
10
Q
ADR of: Ferrous Supplements Warfarin/Aspirin/NSAIDs Statins Metformin
A
Ferrous Supplements: Constipation
Warfarin/Aspirin/NSAIDs: Bleeding, Gastritis
Statins: Gastritis, Myopathy
Metformin: Lactic Acidosis
11
Q
ADR of: Benzos/TCA’s/Gabapentin Prednisolone Phenytoin Clozapine Alendronate
A
Benzos/TCA’s/Gabapentin: Drowsiness, Falls
(TCA’s: Blurred vision, Dry mouth/Xerostomia)
Prednisolone: Changes in BP
Phenytoin: Skin Reactions
Clozapine: Agranulocytosis
Alendronate: Gastritis
12
Q
CVS Drug Montioring: Statins ACEi Amiodarone Furosemide Anti-coags
A
Statins (LFTs) ACEi (U+E) Amiodarone (TFT, LFT, Serum K+) Furosemide (Weight) Anti-coags (Pt reports of bruising)
13
Q
Rheum Drug Monitoring:
Methotrexate
Azathioprine
Cyclosporin
A
Methotrexate (FBC, LFT, U+Es)
Azathioprine (TMPT/FBC, LFT)
Cyclosporin (Reg U+Es)
14
Q
Neuro Drug Monitoring:
Lithium
Na+ Valproate
A
Lithium (Li, TFT, U+E)
Na+ Valproate (LFT)
15
Q
Endo Drug Monitoring:
Glitazones
OCP
A
Glitazones (LFT)
OCP (BP)
16
Q
Drugs Contraindicated in Pregnancy - 7
A
ACEi/ARB’s Antibiotics Cytotoxic Agents (Azathioprine, Cyclophosphamide, Methotrexate) Statins Sulfonylureas (Glicazide) Retinoids (Incl topical) Warfarin
17
Q
Drugs Contraindicated in Asthma:
A
NSAIDs
Beta-blockers
Adenosine
18
Q
Drugs Contraindicated in AKI:
A
ACEi/ARBs, Antihypertensives, NSAIDs Contrast Opiates (Codeine, Morphine) Penicillins, Aminoglycosides (Gentamicin), Sulphonamides Immunosupp (Tacrolimus, Cyclosporin) Allopurinol
19
Q
Drugs Contraindicated in HF:
A
Glitazones
CCB (Amlodipine safe), Class I + II Antiarrythmics (Flecainide, Bisoprolol), Alpha-blockers
NSAIDs
Glucocorticoids (Pred, Dexamethasone, HC)
20
Q
Drugs Causing Hyperkalaemia:
A
K+ sparing (ACEi/ARBs, Spironolactone) NSAIDs Beta-blockers Heparin Yasmin contraception Trimethoprim Immunosupp (Tacrolimus, Cyclosporin)
21
Q
Drugs Causing Hypokalaemia:
A
Loop/Thiazides Diuretics Insulin Beta-Agonists, Theophyllines Laxatives Topiramate
22
Q
Drugs Causing Hypernatraemia:
A
Lithium
Vit A/D
23
Q
Drugs Causing Hyponatraemia:
A
SSRi TCAs Anti-psychotics AEDs (Carbamazepine) ChemoTx
24
Q
(CYP450 Inhib): (Raised INR):
A
A: Allopurinol O: Omeprazole D: Disulphiram E: Erythromycin V: Valproate I: Isoniazid C: Ciprofloxacin E: Ethanol S: Sulphonamides
25
(CYP450 Induc): (Lowered INR):
```
P: Phenytoin
C: Carbamazepine
B: Barbiturates
R: Rifampicin
A: Alcohol (Chronic Excess)
S: Sulphonlyureas
```
26
Pre-Op Med to Stop
```
Anti-Coag’s, Anti-platelets, NSAIDs
ACEi/ARBs, Diuretics
Lithium, MAOi
PO DM
HRT/OCP (4wks before)
ST Drugs (Vitamins)
```
27
Pre-Op Med to Cont
```
Beta-blockers + other CVS drugs
AEDs
Steroids + other Immunosupp
Asthma Inhalers
PPi/H2-Antag
Thyroid Med
Anti-D, Anxiolytics, Anti-psychotics, Anti-PD
```
28
Serotonergic SE’s
```
Restlessness/Agitation
Headaches
N+V
Sexual Dysfunction
Weight changes
```
29
Muscarinic SE’s:
Dry Mouth
Hot, dry, flushed skin
Urinary Retention
30
Histaminic SE’s:
Sedation
| N+V
31
Miscellaneous Insulin Rules
Never Omit during Illness
If Resistant: Raise by ~ 10%
Rise in AM dose => Drop in PM BM
32
When to take Rivoroxaban
w/ Food
33
Alendronate Instructions
Before breakfast (Empty stomach)
Sat up during and after for 30mins
w/ plenty of Water
Avoid eating Food for 2hrs after + Avoid taking w/ Ca2+ Supplements (=> Reduced Absorption)
34
Beta-blocker Contras
w/ CCB
| PVD
35
When to take Statins/Amitriptyline
At night before bed
36
Digoxin Monitoring
Measure Serum Digoxin levels 6 hourly
| Monitor U+Es
37
Statin Discontinuation
If Serum Transaminases > 3 x Baseline
| If Sx resolve: Restart at lower dose
38
CCB +
CCB + Pred => Worsening of HF
| CCB + Naproxen => Oedema
39
SSRi Warnings, Interactions + Monitoring
Reduced mood in first month
+ DOAC => Bleeding
+ Tramadol => Serotonin Synd
(No routine Monitoring)
40
Alendronate Interactions
+ Pred => Dyspepsia
| + PPi => Diarrh
41
Opioid Toxicity/AKI Mx
Switch Morphine for Oxycodone (Semi-opioid)
42
Post-Op N+V Mx
IV Cyclizine
43
Diarrh Mx + Instructions
Loperamide taken as 4mg + 2mg after each loose stool (max 16mg/day)
44
GTN Rules
Repeat after 5 mins
| If no benefit after 2: Call Ambulance
45
Maj Bleeding Mx
IV Phytomenadione (Vit K) + Prothrombin Complex
46
Anti-Coag Warning + Monitoring
Avoid IM Injections
Recheck INR after 48hrs
(Heparin requires 6 hourly APTT)
47
Carbimazole Indication + SE
```
Graves D (HyperTh)
Neutropenia, Agranulocytosis
```
48
Hypoglycaemia Tx
IV 20% Glucose 100ml (15mins)
49
ATTB Tx SE
R+I: Accelerated metabolism of OCP
R+I+P: Hepatotoxicity
I: Periph Neuropathy (Pyridoxine)
E: Retrobulbar Neuritis
50
Co-Amox SE
Jaundice
51
Nitrofurantoin Contras
```
eGFR < 45
3rd Trimester (Neonatal Haemolysis)
(Avoid Trimethoprim in 1st Trimester)
```
52
Contras:
Aspirin/Heparin/Warfarin
NSAIDs
Aspirin/Heparin/Warfarin: Bleeding, Stroke
| NSAIDs: AKI, HF, Asthma, Indigestion, Bleeding D
53
Contras/SE:
Anti-HT
(Beta-blockers, CCB)
(Diuretics)
Anti-HT: HypoT
Beta-blockers, CCB (Verapamil/Diltazem): BradyC
Diuretics: Electrolyte disturbance, Renal Fail
(Beta-blockers: Asthma, Acute HF)
(Amlodipine: Periph Oedema)
(ACEi: Dry Cough, Hyperkalaemia)
(Loop: Gout, Hypokalaemia)
54
Comm cause of Dyskinesia/PD Sx
Metocloperamide, Haloperidol (crosses BBB)
55
Antiemetic
Cyclizine
56
Fluid Prescribing (Maintenance)
Adults: 3L (1 Salty + 2 Sweet)
Elderly: 2L
(K+: 40mmol/day)
57
Step-up Pain Mx
No Pain: No Reg, Paracetamol PRN (1g QDS)
Mild Pain: Paracetamol Reg, Codeine PRN (30mg QDS)
Severe Pain: Co-codamol Reg, Morphine PRN (10mg QDS)
58
Insulin Route
```
All SC
Except SA (Novorapid, Actrapid)
```
59
AF Types Mx
Slow AF: Rhythm Control (Amiodarone, Beta-blocker, DC - If < 48hrs)
Fast AF: Rate Control (Beta-blocker - Contra: Asthma, CCB - Contra: Fluid retention, Digoxin)
60
1st Line Hypnotic (Insomnia)
Zopiclone
61
Grams in 1% sol
1g in 100ml
| 10mg in 1ml
62
PE 1st Line Tx
SC Dalteparin
63
Mild Pain in ACS
SL GTN
64
1st Line Tx for lowering Hyperkalaemia
IV Actrapid 10 Units in 100ml of Dextrose 20% over 30mins
65
1st line Diabetic control
If Overweight: Metformin
| If Underweight/Cr > 150: Gliclazide
66
Statin monitoring
ALT (Baseline, 3 months, 12 months)
| If Myopathy Risk Factors: CK
67
Lithium Monitoring
Serum conc should be measured 12hrs after last dose
Lithium levels can be affected by Dietary Sodium Intake
Lithium levels should be checked weekly at start and after each dose change then 3 monthly
68
Methotrexate monitoring
```
Baseline LFT monitoring
FBC monitoring (Once stable every 2-3 months) - Drop in WBC/RBC/Plt => Stop Methotrexate
```
69
Amiodarone monitoring
Baseline CXR
TFTs, LFTs
(Caution in Pt’s w/ Hypokalaemia)
70
Carbimazole monitoring
FBC (esp Neutrophil Count)
71
Gentamicin monitoring
For a multiple daily dosing regimen: Pre and Post dose levels should be monitored
Renally excreted => Renal monitoring
72
Digoxin monitoring
```
Serum Cr (Renally excreted)
Serum digoxin levels only needed if: Toxicity, Non-compliance, Inadequate Effect
```
73
Na+ Valproate monitoring
Serum LFTs
| +/- => Pancreatitis: Amylase/Lipase
74
Clozapine monitoring
FBC Weekly for 18wks
75
Drugs with narrow Therapeutic window
Warfarin
Digoxin
Phenytoin
76
Common ADR of:
Beta-agonists
Beta-blockers
Beta-agonists: TachyC/HyperT, Heat Intolerance, Tremor
| Beta-blockers: BradyC/HypoT, Cold Intolerance, Fatigue
77
Warfarin Interactions
Erythromycin, Clarithromycin (CYP450 Inhib) => Raised INR
78
Aspirin in AKI/Surg
| Co-codamol in AKI
Aspirin can continue (Should be stopped in Surg)
| Co-codamol cannot
79
Drugs interacting w/ Lithium
Lithium affected by NSAIDs/Diuretics/ACEi
| If Diuretic needed: Furosemide safest
80
Dose adjustment Rules
Amend doses by least amount
81
Fluid guidelines
2 Salty + 1 Sweet
If High Na+: Give Dextrose, If Low Na+: Give NaCl
Never give KCl > 20mmmol/hr
82
DM control w/ CKD
Sulphonylureas safer than Metformin
83
Vent Mx:
T1RF
T2RF
T1RF: CPAP
T2RF: BPAP
84
HypoT after Fluid Bolus given Mx
IV Colloid (Gelofusine)
85
Statin interaction w/ Clarithromycin
Stop Statin
86
Sign of Pneumonia Resolution
SpO2
| RR
87
SSRi Monitoring
Suicide Assessment
88
Tacrolimus Monitoring
Pre-dose levels
89
ABx Prescribing
Requires Indication + Duration (R/v day)
90
Prescribing Timings
If given nightly (Statin, Senna)
91
Pain Mx
If constant: Regular Meds, If Variable: PRN
| Start Mild + Titrate up
92
Cyclizine SE’s
| Acetylcholinesterase Inhib SE’s
Cyclizine: Antimuscarinic (Anti-SLUDGE)
AChi: Cholinergic Crisis (SLUDGE)
93
Mild Allergy Mx
PO Chlorpheniramine
94
Raised INR w/ Bleeding
IV Vit K (Slow Infusion)
95
HF (w/ Asthma)
ACEi (taken at night)
