PSA Flashcards
(221 cards)
1
Q
Dosage of LMWH for surgical
A
20mg SC- low risk- 2hrs pre
40mg SC high risk - 12 hrs pre
2
Q
Reversal agent of LMWH
A
Protamine sulphate
3
Q
Types of LMWH
A
Daltaparin/enoxiparin sodium
Fondaparinux
4
Q
SE of LMWH
A
Heparin induced thrombo
Hyperkalaemia
Avoid in GFR <15
5
Q
Tx of DVT/PE
A
Apixiban 10mg BD 7 days
Then 5mg BD 3 months
6
Q
When to avoid DOACs
A
Pregnancy
GFR <15
7
Q
Treatment of A fib
A
Beta blocker- atenolol 50-100mg OD
or RL CCB- verapamil or diltiazem
Apixiban 5mg BD if CHADVASC
8
Q
When to use each antiemetic
A
Haloperidol- drug and chemical
Metoclopramide- GIT
Ondansetron- chemo and abdo surgery
Cyclizine- CNS and ear
9
Q
Tx of DKA
A
1L saline- 1hr, then 2hr, then 4, 8
Insulin FRII
Start glucose when <14
10
Q
Tx of HHS
A
1hr saline 2 hrs
11
Q
When to stop insulin for surgery
A
Stop short acting
Give VRII
Reduce long by 20%
12
Q
When to stop lithium for surgery
A
Day before
13
Q
When to stop warfarin and DOACs for surgery
A
5 days for warfarin
2 days for DOACs
14
Q
When to stop COCP for surgery and start again
A
4 weeks
restart 2 weeks after using POP in-between
15
Q
When to stop sulphonylureas for surgery
A
day of surgery
16
Q
When to stop ACEi, ARB and spironolactone for surgery
A
Day of surgery
17
Q
What to do to steroid dose for surgery
A
Doubler it
18
Q
When to start VRII for surgery
A
T1DM
>1 meal missed- stop metformin too
Poor BM >69
Post MI
19
Q
Drugs that inhibit CYP450
A
Azoles/amiodarone/allopurinol
Macrolides
Valproate
Cipro
Statins
20
Q
Steroids SE
A
Stomach ulcers
Thin skin
Oedema
Right/Left HF
OP
Infections
Diabetes
Syndrome- Cushing
21
Q
NSAIDs SE
A
No urine- Renal
Systolic dysfunction_HF
Asthma
Indigestion
BlooD clotting abnormal
22
Q
SE of ACEi
A
Dry cough
Prescribe ARB instead
23
Q
SE of BB
A
Asthma
Worsen acute HF
ED
24
Q
CCB SE
A
Peripheral oedema and flushing
Verpamil Constipation
25
Diuretics SE
Renal failure
loop- fureosomide- gout, hypokalaemia
Thiazide- hypokalaemia, gout
Spirono- hyperkalaemia, gynaecologist
26
Diuretics SE
Renal failure
loop- fureosomide- gout, hypokalaemia
Thiazide- hypokalaemia, gout
Spirono- hyperkalaemia, gynaec
27
Trimethoprim SE
Agranulocytosis
Neutropaenic sepsis
Folate
28
Drugs causing low neutrophils
Clozapine
Carbimazole
29
WCC in bacterial vs viral
Neutrophils high- Bacterial
Lymphs high- viral
30
Cause of low plts
Heparin
DIC
ITP- child post URTI
HUS- E coli- diarrhoea, haemolytic anaemia, low plt, renal failure
TTP- ", fever and neuro
31
Urea vs creatinine rise in AKI
Urea> creatine in pre renal
Creatinine> in intrinsic and post
32
Cholestatic drugs
Co amox
Fluclox
Steroids
Nitro
Sulphonyl
33
Target O2 for no resp failure vs T2 resp failure
>94%
COPD- 88-92%
34
What oxygen delivery for acute COPD
High flow if bad but titrate to
Blue Venturi
24% can go up to 28%
35
Nasal Cannula flows
1L
2L
4L- may cause irritation
36
What O2 to give in emergency
Non rebreather Mask
15L
37
Gentamicin and vancomycin SE
Ototoxicity and nephrotoxicity
38
Lithium SE
Early- tremor
Intermediate- tiredness
Later- arrhythmia, seizure, DI
39
Paracetamol OD treatment
<1hr- activate charcoal
Measure 4hrs- graph- NAC
40
Tx of Warfarin OD
INR 5-8 no bleeding- miss 2 doses
5-8 minor bleed- stop and IV vit K restart when <5
>8 no bleeding- stop, PO vit K, restart <5
Minor bleed >8- " IV vit k
Major Bleed- Stop, IV vit K 5mg, IV PCC
41
AE-Asthma Tx
Salbutamol, Neb. 5mg
Ipratropium bromide, Neb. 0.5mg (500mcg)
Hydrocortisone, IV 100mg / PO 50mg
42
SE of sulphonylureas
Hypog
Weight gain
43
Info for patients taking steroids
Regular BM monitoring
PPI
>3m- bisphosphonates
44
SE of bisphosphonates
Osteonecrosis
Oesophageal reactions
Atypical femur fracture
45
Monitoring with statins
CK if lose in risk of myopathy
ALTs
46
When to stop statins
Taking macrolide
47
CI of ACEi
Aortic stenosis
48
Which drugs are contraindicated with lithium
ACEi, thiazides, loops
NSAIDs
Use CCBs
49
Rapid acting insulin
Nororapid
Humalog
50
Short acting insulin
Actrapid
Humulin S
51
Long acting
Lantus
Levemir
52
Intermediate insulin
Humulin I
Insulatard
53
Hypoglycaemia treatment
Conscious- BM<4- glucotabs
Unconscious- IM glucagon
or Glucose 20% 100ml if IV access
54
When to add to metformin for DM
When Hb1ac >58
55
Thiazaolidinedione CI
HF and bladder cancer
56
CI drugs in HF
TVNG
Thiazola
Verapamil
NSAIDs
Glucocorticoids
57
Steroid ladder
Hydrocortisone
Clobetasone
Betamethasone
Clobetasol
58
When does the LFTs make you stop taking statins
ALT/AST x3 ULN
59
Opioids used in renal failure
Fentanyl
Alfentanil
Buprenorphine
60
Dihydrocoedine to morphine oral
/10
61
Morphone oral to SC
/2
62
Morphine oral to oxycodone
/1.5
Used to be 2
63
Non palliative opioid dosing
Oromorph 2.5-5
4 hourly
64
Conversion of modified release
Half the immediate BD
65
Anti emetic in Parkinsons
Doperidone
66
When to take diuretics
Morning
67
Tx of hyperkalaemia
10ml 10% Ca gluconate
125ml of 20% dextrose
10U insulin
68
Drugs causing urinary retention
Opioids
Anticholinergics
GA
A adrenal agonists
Benzos
NSAIDs
CCBs
Antihistamine
69
Drugs causing confusion
Morphine
Metoclopramide
Anti-cholinergics, psychotics, depressants, convulsants
70
Folic acid dosage
400mcg
5mg- prev NTD, DM, epilepsy, obese, SCD, IBD, thala
71
Drugs causing hyponatraemia through SIADH
SSRI , TCA
PPI
Sulphonylurea
Carbamazepine
72
Monitoring with ACE/ARB
U&E before
Expect small rise <20% creatinine
73
What to monitor with cyclosporin
Nephrotox- U&E
HTN- BP
74
How long should antiplatelets be stopped before surgery
7 days
Including aspirin
75
When to stop allopurinol
In decreased renal function
76
Breakthrough pain for fentanyl patch
If on >25mcg fentanyl
Nasal fentanyl
77
When is nitrofurantoin CI
GFR< 45
At term
78
Tx of alcohol withdrawal
Chlordiazepoxide
79
If INR >1.5 on day of surgery who stopped taking warfarin what do you give
Phytomenadione
Vit K
2mg PO
80
Info for taking SSRI
Do not stop suddenly
Suicide ideation may increase for up to 4 weeks
81
How to take rivaroxiban
With food
82
Effects of toprimate with POP
Induces CYP450
Decrease POP
Need another contraception
83
Drugs inducing CYP450
Phenytoin
Carbamazepine
Barbituates
Rifampicin
Toprimate
Sulphonylurea
84
How to monitor furosemide
Weight
85
SE of trimethoprim
Tubular dysfunction
Hyperkalaemia
86
Tx of Migraine
Triptan and NSAID
Prophylaxis- toprimate or propanolol
Toprimate is teratogenic
87
SE of toprimate
Teratogenic- cleft lip
Reduced POP efficacy
88
Pregnancy thrush
Oral metronidazole BD 7d 400mg
89
Tx of UTI in pregnancy
Nitrofuratoin
No trimethoprim
90
Drug causing facial swelling
ACEi- angioedema
91
CI of triptan use
IHD, cerebrovascular disease
92
SE of triptans
Tingling
Heat
Tightness
93
SSRI and sodium
Causes SIADH and hyponatraemia
94
If low sodium what should you check
Which drugs cause SIADH
95
When should enoxiparin be stopped
If bleeding
Blood in sputum
If recent stroke
96
Max dosage of paracetamol per day
4g
97
Max dosage of NSAIDs per day
2.4g
98
When should methotrexate be stopped
In active infection
99
Tacrolismus SE
Tremor
100
Methotrexate SE
Myelosuppression
Mucositis
Liver fibrosis
Lung fibrosis
101
Cyclophosphamide SE
Myelosuppression
TC carcinoma
102
Cyclophosphamide SE
Myelosuppression
TC carcinoma
103
Doxycyline SE
Oesophagitis, photosensitivity
104
3 drugs CI in asthma
Adenosine
BB
NSAIDs
105
ng to mcg to mg
1000ng= 1mcg =0.0001 g
106
What sign means you have increased risk of problems in asthma
Nasal polyps
107
What should be measured in digoxin toxicity
Digoxin level
U&E
ECG
108
Tx of urge vs stress incontinence
Stress- duloxetine 40mg BD
Urge- oxybutinin 5mg BD
109
Drugs CI in pregnancy
WASTE ASS
Warfarin
Amino
Sulphamides
Tetras
ACE
Statine
Sulphonylyurea
110
When should you avoid giving glucose fluids
In stroke patients
111
Common dosages in analgesia
Para- 1g QDS
Ibru- 200-400 TDS
Codeine- 30-60 qds
Co-codamol- 2 tabs qds- 8/500, 30/500
112
Common AE dosages
Cyclizine 50mg tds
Meto 10mg tds
113
Common AB doseages
Amox- 500mg tds
Clarithro- "
114
PPI doseages
Lansoprazole 15-30 OD
Omeprazole 20-40 OD
115
Common CVD doses
Aspirin 75-300 od
Clopi "
Artovostatin 10-80 ON
Atenolol 25-100 OD
Ramipril 1.25-10 ID
Bendro- 2.5 OD
Furos- 20mg OD -80 BD
Amlodipine 5-10 mg OD
116
Common endocrine drugs doses
Levo 25-200mcg
Metformin 500mg OD 1g BD
117
Which statin to use for secondary prevention
Atorvastatin 80mg On
118
Lithium levels
0.4-1
119
If troughs are high in Gentamicin what should you do
Change TDS to BD
Increase interval
120
Croup Tx
Dexamethasone
150mcg/kg
121
Drugs to avoid in BF
ABC SML
Aspirin, amiodarone
Benzo
Cipro, carbimazole
Sulph
Methotrexate
Lithium
122
When should you gradually withdraw steroids
>40mg pred >7d
>3 weeks tx
Repeated courses
123
When should you measure digoxin
8-12 hours after last
124
Fluids and electrolytes needed per day
30ml/kg/day
1 K/Na/Cl
50-100g glucose /day
124
Fluids and electrolytes needed per day
30ml/kg/day
1 K/Na/Cl
50-100g glucose /day
125
Each 5% Dextrose day contains how much glucose
50g
126
Common SE of aspirin
Urticaria
127
ECG changes with tricyclic OD
Sinus tachy
Wide QRS
Prolonged QT
128
Digoxin OD sx
N+V
Blurred vision- yellow green, haloes
Palpitation
Confusion
129
Tx of digoxin OD
Digibind, monitor K- treat accordingly
130
What can interact with SSRI to cause serotonin syndrome
Tramadol
131
Amox SE
Rash with IM
132
Fluclox SE
Cholestasis
133
Cirpo SE
Lower seizure threshold
Prolonged QT
134
Metronidazole SE
Reaction with alcohol
135
Trimethoprim SE
Rash, photo, pruritus, Haem suppression
136
Which 2 diuretics cannot be prescribed together
Amiloride and spironolactone
Cause hyperkalaemia
137
What should you co prescribe for TB
Pyridoxine
138
How long should you stop metformin with a CT scan with contrast
For 48 hours after
139
Indications of HRT
Flushing, insomnia, headaches
Premature menopasue- continue until 50
140
When to give certain types of HRT
Monthly- oestrgoen 28d+ prog last 14d
Regular periods and menopause sx
3 monthly- oestogren for 3 months+ Prog 14d
Irregular
Oestrogen only if hysterectomy
Transdermal- if risk of VTE
141
Cancer risks with HRT/COCP
Oestrogen- breast and endo
Combined- breast, cocp cervical
142
Alternative meds for menopausal sx other than hormonal
SSRI- fluoxetine- vasomotor
Citalopram 2nd
Vaginal dryness- lubricants
OP- bisphosphonates
143
COCP and POP names
Microgynon- cocp
Levongestrel, norethisterone, desogestrel- POP
144
Absolute CI to COCP
BF <6w
BMI >40
>35 and smoke >15
HTN >160/95
VTW
Migraine and aura
Breast cancer
145
If miss dose of COCP what happens
If miss 1- take 2
Miss 2-
First week- emergency contraception
Week 2- nothing
Week 3- omit pack free
Use condoms for 7 days
146
Miss dose of POP what happens
Traditional
If miss 1<3 hours - take 2
>3 hours- emergency contraception
Desogestrel
<12hrs- normal
>12 hours- take, 48 hours condoms
147
SE of Herceptin/trastuzumab
Cardiac toxicity - echo before and after tx
Flu like symtptoms
148
Most important prognostic factor of paracetamol OD
pH <7.3
149
What must be done 6 monthly in amiodarone
TFT and LFT
150
Adrenaline amount for ALS
If PEA/Asystole- 10ml 1:10000
151
Common SE of sildenafil
Headaches, flushing, dyspepsia, green tinge of vision
152
TCA SE
Arrhythmias, seizures
Metabolic acidosis
Sinus achy, wide QRS, QT
Early AC- dry mouth, dilated pupils, blurred vision
153
Drugs to avoid in G6PD
Nitro, sulphonylurea, cipro , antimalarials
NASC
154
What is protective in paracetamol OD
Anything that inhibits Py450- Acute alcohol
Anything inducing e.g carbamazepine increases risk
155
Risk of NSAID and SSRI
GI bleed- require PPI
156
When is diclofrenac CI
IHD, PAD, CVD, CHF
157
What to do if heparin induced thrombocytopaenia
Stop heparin and start argatroben- direct thrombin inhibitor
158
What can precipitate lithium toxicity
NSAIDS
Renal failure
Dehydration
Diuretics, ACE, metronidazoel
159
Effects of amiodarone on thyroid
Hypothyroid
Thyrotoxicosis
160
Antidote for methanol poisoning
Ethanol
161
Antidote for BDZ OD
Flumezanil
162
Beta blocker toxicity tx
Atropine if Brady
Resistant- glucagon
163
Mx of organophosphate OD
Atropine
164
Tamoxifen adverse affects
Vaginal bleeding, amenorrhoea
Hot flushes
VTE
Endometrial cancer
165
What is high on VBG for smokers
COHb up to 10%
166
What electrolyte abnormality does PPI cause
Hypomagnesia
167
NAC reaction tx
Stop the IV infusion
Give nebuliser salbutamol
Re start at slower
168
Anti freeze tx
Fomepizole
169
Features of oculogyric crisis
Restlessness
Upward gaze of eyes
170
Causes of oculogyric crisis
AP, metoclopramide
171
Tests vital before RIPE tx
LFTs
Visual and renal for ethambutol
172
Organophosphate sx
Pinpoint pupils
Excessive urination
Bradycardia
173
SE of cipro on MSK
Achilels tendon rupture due to tendinopathy
174
Statin, ACE and amiodarone monitoring
Statin- LFT- baseline, 3m, 12m
ACE- U+E- prior, increasing, annually
Amiodarone- TFT, LFT- Every 6m
U+E and CXR prior
175
Azathiprine and methotrexate monitoring
Meth- FBC, LFT, U+E
Repeated until stabilised, every 2-3m
Aza- FBC, LFT- 3 months
FBC weekly first 4w
176
Lithium and SV monitoring
Lithium level, TFT, U+E- LLweekly until stable, TFT U+E 6m
SV- LFT- periodically first 6m
177
Thiazolidinedione monitoring
LFT
178
Digoxin monitoring
No monitoring levels needed unless toxicity - 8-12 hrs after
Should monitor renal levels tho as is excreted really
179
Tx of LSD OD
Lorazepam
180
SE of Mg
Diarrhoea
181
Electrolyte abnormality in chronic alcoholics
Low Mg
182
Cyclizine affect cholinergic system
Anti cholinergic
183
If taking enzyme inducing drugs what contraceptive should you be on
POP
184
Tx of gestational HTN
Labetalol 1st
Nifedipine
Methyldopa
185
Tx of eclampsia
Magnisum Sulphate
186
Pre-eclamspia
HTN >20w and proteinuria/organ dysfunction
187
Blood pressure control before conception
Stop ACEi before conception
Start labetolol
188
When should you be cautious when taking ACEi
If develop N+V- can cause AKI
189
What HRT has the highest risk for breast cancer
Combined
190
When should you not give metformin and choose alternate AD
GFR <30 , creatine >150
Gliclazide
191
What should be checked as baseline with AP
Glucose
192
Monitoring in sodium valproate
Hepatotoxicity so LFT measured
193
Dark stool meaning
Bleed- likely steroid or NSAID use
194
Gabapentin SE
Neutropenia
195
Amiloride SE
Hyperkalaemia
196
Stroke patients fluid requirement
Day 1- 1L Nacl, 1L Nacl
Day 2- 1 glucose, 1 NaCl
197
Types of movement disorders and sx
Acute dystonia- upward eyes, stiff neck, abnormal posture
Tardive dyskinesia- sudden irregualr
Parkinsons
Akathasia- restless
198
Tx of movement disordes
Procyclidine- all
Tardive- tetrabenazine
199
What to give in addition to nebulisers in exacerbation of COPD
Prednisilone
200
Combined HRT
Estradiol and northisterone
201
CI in PAD
BB
ACEi in severe
202
If fungal infection what presipitates
Antibiotics and steroids
203
If warfarin INR in range and on macrolide what do you do
Measure INR again in 48 hours if in range
204
When does it count as 2 pills missed in COCP
When missed 1st and 24 hours after meant to take 2nd
205
K sparing diuretics monitoring
Potassium after 1 week
206
Contraception and methotrexate
6 months after stopping
207
Monitoring effectiveness of BB in AF
Heart rate
208
Monitoring in amiodarone
Potassium as hypokalaemia dangerous
209
If on statin in muscle ache and high CK what do you do
Stop statin restart when resolved
210
Morphine to fentanyl patch
/100
211
Common SE of metoclopromide
Dirrhoea
212
PPI electrolyte abnormality
Hyponatraemia
Low Mg
213
If Creatine over 150 and Hba1c >48 what do you give
Gliclazide
214
What causes ATN quickly vs slowly
Contrast- hours
Drugs- week
215
What to change to if omeprazole causes hyponatraemia
Ranitidine
216
Drugs that interact with amiodarone
PaWSD
Phenytoin
Warfarin
Statin
Digoxin
217
Immediate vs long term relief of dyspepsia
Magnesium carbonate short
Omeprazole long
218
Laxative to give if bloated
NOT osmotic
Give Senna
219
Tx of CAP vs HAP
CAP- mild- amox
Severe- co amox +clarith
HAP- mild co amox
Severe- tazosin
220
Post op N+V with long QT which AE do you use
Cyzlizine as ondansetron CI
