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1
Q

What does a 1% medication mean?

A

1g per 100ml
1g per 100g

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2
Q

Normal potassium intake per day for fluids

A

1mmol/kg/24hr

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3
Q

Most common enzyme inducers (decrease other drug concentrations)

A

PC BRAS

Phenytoin
Carbamazepine

Barbiturates
Rifampicin
Alcohol (chronic)
Sulphonylureas

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4
Q

Most common enzyme inhibitors (increase other drug concentrations)

A

MAO DEVICES

Metronidazole
Allopurinol
Omeprazole

Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin
Ethanol (acute)
Sulphonamides

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5
Q

Drugs to stop before surgery and when

A

COCP and HRT: 4 weeks
Herbal medications: 2 weeks
Clopidogrel: 7 days
Warfarin: 6 days (if not minor surgery)

Lithium: 1 day
Spironolactone, ACEi, metformin: day of surgery

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6
Q

Should CCB and BB be stopped before surgery

A

No

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7
Q

Which diuretics can cause gout?

A

Thiazide diuretics

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8
Q

Which diuretics can cause gynaecomastia?

A

Potassium-sparing diuretics

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9
Q

Which drugs can worsen acute heart failure but help chronic heart failure?

A

Beta blockers

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10
Q

Can a NBM patient still take oral medication?

A

Yes, even before surgery

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11
Q

Which fluids should be given if someone is hypernatraemic or hypoglycaemic?

A

5% dextrose

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12
Q

Which fluids should be given if someone has ascites?

A

Human-albumin solution

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13
Q

What urine output is oliguric?

A

<30ml/h

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14
Q

What amount of fluid should be initially given if oliguric?

A

1L over 2-4h

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15
Q

Maintenence fluid for adults and elderly

A

Adults: 3L per 24 hours
Elderly: 2L per 24 hours

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16
Q

Who should dopamine antagonists e.g. metoclopramide be avoided in?

A

Parkinson’s
Young women

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17
Q

As required medication for mild pain

A

Codeine 30mg up to 6 hourly

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18
Q

Severe pain regular medication

A

Co-codamol 30/500 2 tablets 6 hourly

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19
Q

Which drugs can cause low platelets?

A

Penicillamine
Heparin

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20
Q

Which antibiotics are nephrotoxic?

A

Gentamicin
Vancomycin
Tetracycline

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21
Q

Which drugs can cause cholestasis?

A

Flucloxacillin
Co-amoxiclav
Nitrofurantoin
Steroids
Sulphonylurea

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22
Q

What to do if gentamicin monitoring point is above q48h area

A

Repeat the gentamicin level and only re-dose when concentration is <1mg/L

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23
Q

How to treat insomnia

A

Deal with problem causing insomnia first e.g. give steroids in the morning

Zopiclone 7.5mg adults / 3.75mg elderly

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24
Q

Anaphylaxis adrenaline dose for adults

A

0.5mg (1:1000 dilution)

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25
Cardiac arrest adrenaline dose for adults
1mg (1:10,000 dilution)
26
At what serum concentrations are toxic levels of lithium likely to manifest?
above 1.5mmol/L
27
What should be monitored before and regularly in a patient prescribed olanzapine?
Glucose Risk of diabetes
28
Baseline investigation before amiodarone treatment
CXR
29
Which abx is contraindicated with methotrexate?
Trimethoprim due to bone marrow suppression
30
Normal glucose intake
50-100g/24hrs
31
Which drugs can cause hyperkalaemia?
ACEi and ARBs LMWH Tacrolimus Ciclosporin Potassium-sparing diuretics e.g. amiloride
32
Which drugs can cause hyponatraemia
Diuretics TCAs e.g. amitriptyline SSRIs Carbamazepine Sulfonylureas Cyclophosphamide
33
Drugs that can cause low neutrophil count
Carbamazepine Clozapine Methotrexate Trimethoprim
34
What is the loading dose of vancomycin based on?
Weight
35
What electrolyte imbalance does metformin cause?
Lactic acidosis
36
How much is long acting insulin changed by before surgery?
Reduce by 20%
37
NBM insulin requirements
Continue basal, stop bolus
38
Insulin requirments if sick
Just monitor more
39
Metformin changes if >1 meal missed
Omit metformin and start VRII
40
Low and high risk of AKI, metformin change
Continue if low Stop and start VRII if high
41
When should surgery be delayed if a diabetic is on insulin
glucose >12 ketones >3 or +++
42
How is VRII made up
50U actrapid in 50ml 0.9% saline IV glucose given alongside
43
Cancer risk in COCP (ethinylestradiol with levonorgestrel)
Breast and cervical
44
Is contraception needed when starting COCP or POP
Condoms for 7 days (if COCP) or 2 days (if POP) if not started in first 5 days of cycle
45
At what point in taking COCP is emergency contraception needed if 2+ pills are missed?
Pill-free interval or week 1
46
What happens if you miss 2+ COCP in week 3?
Finish the pills in her current pack and start a new pack the next day; thus omitting the pill free interval
47
What is the maximum potassium rate?
10mmol/hour
48
Fluid for hypernatraemia?
5% dextrose
49
Paediatrics fluids
100ml/kg for first 10kg 50ml/kg for 11-20kg 20ml/kg for next above 20kg Max 2L in females, 2.5L in males
50
Fluid bolus if HF, ACS, old, child
250ml STAT over 15 mins
51
Max amount of fluid bolus before you need to call for help
2000ml
52
Which fluids should be avoided in stroke patients?
Glucose (risk of cerebral oedema)
53
Which drug should be avoided in patients allergic to aspirin?
Sulfalazine
54
Which drug should not be prescribed with a statin?
Clarithromycin
55
What should be done if the trough and peak levels of gentamicin are raised?
Trough - increase intervals e.g. TDS to BD Peak - reduce dose
56
When should acetylcysteine be started in paracetamol OD?
Staggered overdose 8-24 hours after ingestion of an acute overdose of more than 150 mg/kg >24 hours and symptoms
57
Which medications are usually taken at night?
Statins Amitriptyline
58
When do steroids need to be tapered?
Received more than 40mg prednisolone daily for more than one week Received more than 3 weeks treatment
59
Examples of rapid, short, and long acting insulin
Rapid: aspart (NovoRapid), lispro (Humalog) Short: Actrapid, Humilin Long: detemir (Levemir), glargine (Lantus)
60
Drugs causing renal impairment
DAMN L Diuretics, digoxin ACEi, ARBs Metformin NSAIDs Lithium
61
At what BP should HRT be stopped?
>160/>95
62
At what ALT level should statins be stopped?
>3x upper limit
63
Which laxative should be used when taking opioids?
Lactulose
64
Treatment of hypoglycaemia if unconscious and IV access present
100ml 20% glucose for 20 mins
65
Anti-emetic post abdo surgery
1. Ondansetron 2. Cyclizine
66
When is haloperidol used as an anti-emetic?
Chemical causes Renal failure Drug induced
67
Which opioids are safe in renal impairment?
Fentanyl Buprenorphine
68
Which opioid if eGFR 30-60?
Oxycodone

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