PSA Flashcards by Nadja Auerbach

Drugs causing urinary retention

tricyclic antidepressants
anticholinergics
opioids
NSAIDs
BENZOS
Anaesthetics

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NSTEMI key difference

No PCI, instead :

Clopi 300mg
LMWH 1mg/kg bd SC

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Drugs to stop before surgery

CALIA OP

COCP/HRT (4wks before)
Anticoagulants/antiplatelets
Lithium (day before)
Insulin
ACEis (day of)
Oral hypoglycaemics 
Potassium sparing diuretics (day of)

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Drugs causing HYPERkalaemia

“K CHAT”

K sparing diuretics
Ciclosporin
Heparins
ACEis
Tacrolimus

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DKA insulin rules?

Short-acting SC insulin should be stopped, and long-acting insulin should be continued. Patient requires fixed-rate IV insulin alongside fluid resuscitation.

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Drugs that worsen heart failure

Diltiazem
Prenisolone
Thiazolididinoes 
Verapamil
NSAIDs
Class I antiarrythmic

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COPD infective exacerbation drugs and doses

 30mg prednisolone 7-14 days
 salbutamol 5mg max every 4h
 ipratropium 500 micrograms QDS
 24-18% venturi
Hydrocortisone 200mg or oral pred – 30mg – continue for 7 days
4. Amoxicillin 500mg tds ; clarithromycin or doxycycline
5. IV aminophyline

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Causes of low neutrophils

Viral infection
Clozapine
Carbimazole
Chemo

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Statins

Measure LFTs; lipids at baseline

Measure LFTs at baseline, 3 and 12 months

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If INR >1.5 on day of surgery?

Give phytomenadione

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drugs that can precipitate serotonin syndrome?

SSRIs

If you combine with opioids, can cause serotonin syndrome

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Fondaparinux CIs?

Renal impairment

Active bleeding

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Tamoxifen risks

VTE

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Treating AF

Beta blocker

if asthmatic, give VERAPAMIL

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VTE prophylaxis in needle phobics

“RAD”

RIVAROXABAN
APIXIBAN
DABIGATRAN

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Drugs to withhold poor renal function/AKI

Allopurinol (100mg or less until renal recovers)
ACEis
Statins (caution)
ARBs
Ciclosporin
Abx: Tetracycline, Vancomycin, Gentamicin, Nitrofurantoin

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Carbamazepine, when not to give?

SIADH

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Patients at high risk of VTE who have had to stop warfarin before surgery, what do you give them?

Bridging therapy - LMWH

Stop it 24 hours before surgery though

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Mx of irregular narrow complex tachycardia

Probable AF. Control rate with

beta blocker or diltiazem
digoxin or amiodarone if contraindications ( asthma or heart failure )

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Drugs causing peripheral neuropathy

amiodarone
isoniazid
vincristine
nitrofurantoin
metronidazole

“VAIN Me”

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Changing doses of thyroxine in response to TSH?

<0.5: decrease dose
0.5-5; do nothing
>5; increase dose

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Liver enzyme inducers

PC BRAS

Phenytoin
Carbamazepine
Barbiturates
Rifampicin
Alcohol CHRONIC
Sulphonylureas

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anti emetics first line?

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If unknown cause/idiopathic,

CYCLIZINE 50mg 8 hourly IM/IV/oral

however causes fluid retention, so in heart failure,

METOCLOPRAMIDE 10mg 8 hourly IM/IV
(avoid in Parkinson’s, young women -> dystonia)

Clarithomycin and wafarin?

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Increases bleeding

Verapamil can't be combined with which drugs?

Beta blockers

Breakthrough pain, dosing?

1/6th of 24 hour dose every 4 hours as required

Patients on warfarin who need emergency surgery

If can be delayed 6-12 hours, give phytomeniadone If not, give dried prothrombin complex in addition

Maintenance fluids; which and how much?

30ml/kg/24 hr - approx 3L per 24 hours, 2L in elderly 1 salty 2 sweet (0.9% saline and 5% dextrose) Approx 100mL per hour, so 500ml every 5/6 hours ash

Tx for DVT

LMWH - Dalteparin

Mx of irregular narrow complex tachycardia

Probable AF. Control rate with - beta blocker or diltiazem - digoxin or amiodarone if contraindications ( asthma or heart failure )

Co-amoxiclav can cause hepatitis and jaundice

Treating hyperkalaemia

Calcium gluconate does NOT lower potassium give: Short acting insulin (Actrapid) and glucose Salbutamol ALL THE 5's: e.g. 5 units of ActRapid in 50ml of 50% glucose over 5 mins IV

Drugs that are dangerous to combine with alcoho

``` Methotrexate Metronidazole Mao inhibitors NSAIDs Warfarin Opioids/barbs/benzos ```

ACEis contraindications?

Pregnancy Renal Artery Stenosis Kidney failure Hx of angiodema

Drugs causing HYPOnatraemia

Thiazides ACEis SSRIs

Monitoring and co prescribing on methotrexate

folic acid 5mg once weekly should be co-prescribed, taken more than 24 hours after methotrexate dose FBC, U&E and LFTs need to be regularly monitored

Commonest drugs with major contraindications

Aspirin/heparin/warfarin - Patients bleeding or at risk of bleeding ``` Steroids - STEROIDS Stomach ulcers Thin skin Edema Right and left heart failure Osteoporosis Infection Diabetes Syndrome Cushings ``` ``` NSAIDS No urine Systolic dysfunction Asthma Indigestion Dyscrasia (clotting abnormality) ```

Drugs to increase during surgery

Patients on long term corticosteroids (i.e. Addison's)

Electrolyte disturbances caused by ACEIs Thiazides

ACEIs, K-sparing diuretics: HyperK Thiazides and Loop diuretics: HypoK All diuretics - HyperNa

Drugs causing pulmonary fibrosis

BAMENS ``` Amiodarone Methotrexate Ergo derivatives = bromocriptine, ergolide, pergolide Nitrofurantoin Sulfasalazine drugs Busulphan, bleomycin ```

Monitoring before starting azathioprine?

thiopurine methyltransferase (TPMT)

How fast to give fluids?

If tachycardia or hypotensive, give 500ml bolus then reassess HR, urine output, BP for next bag If oliguric (<30ml/hr) (NOT DUE TO OBSTRUCTION) give 1L over 2-4 hours then reassess Never prescribe more than 2L for a patient

NSTEMI key difference

No PCI, instead : Clopi 300mg LMWH 1mg/kg bd SC

Raised urea?

Think dehydration | or if low Hb also, Upper GI bleed

Dangerous side effect of heparin?

Heparin induced thrombocytopenia

Opioids in renal impairment?

Morphine will accumulate in the kidney, so better to give Oxycodone

Liver enzyme inhibitors

AO DEVICES ``` Allopurinol Omeprazole Disulfuram Erythromycin Valproate Isoniazid Ciprofloxacin Ethanol (ACUTE) Sulphonamides ```

Starting out on a statin?

Atorvastatin 20mg

Acute dystonia

Procyclidine 10mg IV

Treating hypoglycaemia

Glucose 20% is first line IV treatment of hypoglycaemia. If glucose 20 % is not available, glucose 10% is an alternative. Volumes delivering between 10–20 g of glucose in 20 minutes are optimal, so 20% glucose in 50-100ml over 20 mins

Prophylactic enoxaparin is contraindicated following acute stroke!

When to avoid nitrofurantoin

if eGFR less than 45

Drugs that worsen seizure control

Aminophylline Ciprofloxacin/levofloxacin Alcohol and drugs Mefenamic acid

Gentamicin levels

If trough level high, increase interval If peak level high, reduce dose

What exacerbates psoriasis?

``` Lithium Alcohol Beta blockers Anti malarial NSAIDS ```

PSA Flashcards

(55 cards)