PSA

Question 1

How to prescribe potassium fluids (amount)

Answer 1

Comes in premade bag of sodium chloride- 0.15% corellates to 20 mmol

0.3% corellates to 40 mmols

Question 2

Tazocin real name

Answer 2

Piperacillin

Question 3

How do decide which laxative to give in elderly care

Answer 3

If bloated dont give osmotic e.g. lactulose or bulk-forming e.g. ispaghula husk

If stool is already soft dont give softener e.g. docusate

SO give stimulant e.g. Senna

IF bowel obstructiondont give stimulant

Question 4

What laxative to give in opioid-induced constipation

Answer 4

Osmotic laxative AND stimulant laxative- e.g. Lactulose AND Senna

Don’t give bulk-forming e.g. ispaghula husk

Question 5

T2DM neuropathy ?

Answer 5

Gabapentin

Question 6

How much sodium in 1L of 0.9% NaCl

Answer 6

Around 154

Someone needs 1mmol/kg of it

Question 7

8 drug types which cause delirium / acute confusion

Answer 7

Sedatives e.g. benzos
Zopiclone
Opioids
Anticholinergicse.g. Atropine, oxybutynin
Anticonvulsants e.g. pregablin
Antidepressants e.g. trazodone (SARI), ?SSRIs?
Antipsychotics
Metoclopramide

Also consider drugs which may induce electrolyte imbalance or dehydration

Question 8

What do you change in peak and trough readings for e.g. gentamycin

Answer 8

If peak is high then change dose of drug

If trough is high then change interval of drug

Question 11

4 drugs that commonly cause ototoxicity

Answer 11

Gentamicin
Vancomycin
Bumetanide
Furosemide

Question 12

4 drug causes of c. Diff

Answer 12

Co-amoxiclav
Ciprofloxacin
Clindamycin
Cephalosporins (all the cefs)

Question 13

Opioid overdose drug mx

Answer 13

Naloxone IM 400 micrograms every 2-3 mins

Question 14

How to differentiate between serotonin syndrome and neuroleptic malignant syndrome

Answer 14

Onset= abrupt for SS, gradual for NMS

Hyperreflexia in SS, hypo in NMS

Dilated pupil in SS, not in NMS

Myoclonus and tremor in SS, rigidity in NMS

SS rapidly resolves, NMS is prolonged

Question 15

2 drugs to manage neuroleptic malignant syndrome

Answer 15

Dantrolene

Bromocriptine

Question 16

3 adverse effects of quinolones e.g. ciprofloxacin

Answer 16

Increased risk of tendon rupture e.g. Achilles

Long QT

Reduce seizure threshold

Question 17

What do you type in to look at INR and warfarin reversal

Answer 17

Oral anticoagulants

Question 18

What is warfarin reversal agent

Answer 18

Phytomenadione

Question 20

8 types of drugs to stop pre-operatively

Answer 20

ACEi
ARBs
Anticoagulants/ antiplatelets
Diuretics
HRT
COCP
Lithium
NSAIDs

ALSO omit SOME T2DM meds:
- sulphonylureas e.g. gliclazide
- gliflozins
- omit lunchtime dose of metformin if TDS

Question 21

Which T2DM meds do you omit pre-operatively

Answer 21

Omit gliflozins on the day of

Omit morning dose of sulphonylureas e.g. gliclazide

Omit lunchtime dose of metformin if taken TDS

Question 22

What is max rate of potassium someone can have

Answer 22

10 mmol in an hour

Question 24

Name one combined HRT

Answer 24

Kliovance

Estradiol 1mg / Norethisterone acetate 1mg

Question 25

What is the relationship between digoxin and potassium

Answer 25

Digoxin toxicity is worsened in hypokalaemia Because they use the same co-transporter So less potassium-> more digoxin Reverse tick sign on ECG

Question 26

Reverse tick sign on ECG

Answer 26

Digoxin toxicity Worsened in hypokalaemia