PSA paper Flashcards
(151 cards)
1
Q
What type of insulin should you use in FRII
A
Actrapid or Humulin S
2
Q
What do you monitor with abortion
A
BP
3
Q
If person with low GFR how should you administer Trimethoprim
A
Normal dose then half dose after 3 days
4
Q
What should you administer for suspected Wernickes
A
Pabrinex
Dose is in parts
5
Q
What do you monitor with prednisilone in children
A
Bp and glucose
6
Q
If wanting morning after pill and on carbamazepine what should you do
A
Give higher dose
7
Q
Enzyme Inducers
A
Phenytoin
Carbamazepine
Barbituates
Rifampicin
Chronic alcohol
Sulphonylureas
8
Q
Enzyme inhibitors
A
Acute alcohol
Azoles
Allopurinol
Cipro/cimetidine
Disulifram
Erythromycin
Valproate
9
Q
Drugs metabolised by CYP450
A
COWEST
Ciclosporin
OCP
Warfarin
Epileptic: phenytoin, carbamazepine
Statins
Theophyline
10
Q
Different HRT treatment
A
If large BMI or VTE risk- transdermal
If cyclical
Oestrogen for 28 days then both
If continuous and no bleed- can use if postmenopausal
Both constantly
If no uterus- can give oestrogen only
If have LNG coil- can give oestrogen only
11
Q
What to give in thrush
A
Fluconazole
Clotrimazole pessary if pregnant
12
Q
Sx and treatment of endometriosis
A
Pain before periods- deep pain
Pain during sex
Tx- paracetamol or NSAIDs pain
COCP if not
13
Q
Tx of incontinence medically
A
Stress- duloxetine
Urge- oxybutynin
14
Q
Sx and tx of PCOS
A
Irregular periods, hirsutism, cystic ovaries
COCP
If want to be fertile co-cypriniol
15
Q
Emergency contraception types and uses
A
Levongestrel- 72 hours- larger dose if >26BMI or 70 kg
Ullipristal- 120 hours- not in severe asthma
16
Q
Tx of hyperemesis in pregnancy
A
Search nausea
Antihistamines- cyclizine/promethazien
2ns ondansetron
17
Q
Fluid resus and maintenance in paeds
A
100ml first 10
50 next 10
20 thereafter
Resus
% weight change x original weight
18
Q
Treatment of DVT in pregnancy
A
LMWH
Major- unfractionated heparin
19
Q
What DVT prophylaxis should be given in GFR <15 and when scared of needles
A
GFR- unfractionated
Needles- Apixaban
20
Q
Bolus given to dehydrated children
A
20ml/kg in 10 mins
If DKA- 10ml/kg
Unless shock- 20ml
21
Q
Stepping up pain medication
A
Paracetamol
Give NSAIDs too- but not if on SSRI, recent TIA, bleedin g
Give weak opioid next- codeine
22
Q
Drugs you cant give with sildenafil
A
Ivobradine
GTN
Nicorandil
23
Q
What drugs cause oedema
A
Insulin and amlodipine
24
Q
If cant find hyperkalaemia at side effects what should you do
A
Go to monitoring
25
Important info for zopiclone
Withdrawal causes rebound insomnia
26
Monitoring in first week with clozapine
Laying and standing BP
FBC
27
How to monitor vancomycin
Trough levels
Required on 2nd day before next dose
Renal function stable
2x weekly
28
Monitoring gestational hypertension in the community
BP and urine dip 2x a week
Until below 135/85
29
If converting rectal to oral or vice versa
Search dose and conversion
30
First line for constipation in kids
Macrogel
31
If allergic to penicillin, tx of H pylori
Clarith and met
32
What cant be prescribed with colchicine
Statins
33
When should glucose measurements be taken
Before meals and bedtime
34
Application of steroid cream
One FTU- from tip to crease
Enough to cover hand front and back
Apply cream thinly to affected areas
In direct on hair
Once or twice daily
Emolients 3-4 times
35
Contraception with HRT
Continue to use contraception until 2 years after last period- if <50
If >50 continue until 1 year after
36
Which antibiotics interact with insulin to increase hypos
Macrolides
37
Monitoring with allopurinol
Liver dysfunction
LFTs
38
What medication do you stop with C diff
PPIs- since can cause
39
When to stop COCP
HTN >160/100
40
If asking for how much K needed what should you do
Calculate kg
1mmol per Kg
Round to nearest 40/20
41
If pregnant and test + for strep B what do you do
Give intrapartum benzylpenicillin
42
Drugs you cant give with lithium
Renal excreted
So ACEi, diuretics and NSAIDs CI
43
Administration of salbutamol as inhaler
In mcg
44
Max paracetamol and ibuprofen
para- 4g
Ibru- 2.4g
45
Delierious Parkinson's patent mx
Lorazepam
46
Target Hba1c and changes to meds
Target 48- so if higher- increase metformin
If 58- add medication
47
Insulin and pioglitazone together can increase risk of
HF
48
How GTN should be taken
Sat down
Sublingual
49
What do you need to check before giving heparin
IF CKD
check potassium - as inhibits aldosterone and increases K
50
Monitoring before metformin
Renal function
51
Monitoring of lithium
ECG, renal and thyroid
52
Normal TSH but high T4 hypothyroid
what should you do with thyroxine medication
No change as TSH normal
Base changes off TSH
if High- increase
low- decrease
53
Fluids for diabetics for surgery
NaCl 0.45%
Glucose 5%
Kcl. 0.15%
With VRII
54
Common SE of alendrotnic acid
Renal impairment
55
If unable to find dose of chemo where should you look
Safety info- may say one type of route only
56
Drug that can cause DKA
Dapagliflozin
57
CI drugs in DKA
Dapa
Sitagliptin
Metformin
58
If hyperthyroid due to too high levo what should you do
Withhold for 2 days
Give at a lower dose
59
Opioid constipation tx
Osmotic with senna
60
Important info for lithium
Maintain balanced diet- since low salt and dehydratioon increases toxicity
61
Drug that reduces absorption of drugs
Ferrous sulphate
But search on interactions as iron
62
Tx of malignant hyperthermia
Dantrolene
63
Monitoring with iron
Hb
64
Glucose target before meals
4-7
65
When to use HRT
If vasomotor symptoms
Continue above 50
66
Drugs that could be dose wrong as have to calculate their dose
Dexamethasone- croup
Heparin/LMWH
Aciclovir
67
Pain relief in varicella
Paracetamol first
Neuropathic
68
If T4 high on amiodarone
Withhold it
69
How much glucose per day
50-100g
No weight dependence
5%= 50g
70
When to stop methotrextaet
Active Infection
71
What to stop after stroke
LMWH
72
What cant you prescribe azathiprone with
Allopurinol
73
Monitoring tool for digoxin
Ventricular rate
74
What should be avoided with amiodarone
Diltiazam, Verapamil or Digoxin as this can precipitate heart block
75
Drugs causing impaired glucose
1. Thiazide diuretics
2. Tacrolimus
3. Ciclosporin
4. Steroids
5. Atypical antipsychotics
76
Drugs causing impaired glucose
1. Thiazide diuretics
2. Tacrolimus
3. Ciclosporin
4. Steroids
5. Atypical antipsychotics
77
AE prescription
Cyclizine unless fluid retention
Metoclopramdie
78
Important info on warfarin and drinking
If patient wishes to drink, it should be moderate + spread out over the week to have the least impact
on INR
79
Important info with ACEi
caution should be taken if the patient develops diarrhoea/vomiting, esp in elderly (AKI risk)
o If dev cough à could trial Losartan
o 1-2wk following initiation = monitor renal function
80
Important info of alendrotnic acid
tablet needs to be swallowed with a full glass of water + remain upright for 30 minutes
afterwards (minimises gastric SEs)
o Food should be avoided 2h after taking Alendronic acid as it reduces its absorption
o Ca salts (Adcal D3) reduce the absorption of bisphosphonates and should not be taken at the same
time of the day
o = a one weekly preparation
o Reduce risk of fractures but do not prevent all fractures
See dentist before
81
When are statins CI
>3ULN LFTs
or active liver disease
82
When to stop allopurinol
Renal impaire
83
When to stop AP
7 days before
84
When to stop DOACs
2 days
85
when to avoid BB
asthma
PVD
if on verapamil
86
What opioids to take in renal failure
30-60 -oxycodone
<30- afentynyl, fentynyl and buprenorphine
87
Missed pills taking rules
COCP
If 24 hours after pill was meant to be taken- 1 missed
If 2 missed in 1st- emergency
2nd- nothing
3rd- omit pill free
Condoms for 7 days
POP
Others- 3hours after missed
Desogestrel - 12 hours- missed
88
If taking COCP and rifampicin for <2 months what do you do
Add condoms - up to 4 weeks after stopping
Can find on contraceptive interactions page
89
What should you always check before prescribing
Bleeding risk
GFR
Drug reactions
Asthma
90
CI of each laxatives
Stimulant- bowel obstruction
Prokinetic- BO, cramps, colitis
Osmotic- bloating
91
When to give HAS
Ascites
92
If bleeding shock and no blood available what do you give
Cystalloid
93
Fluid requirements and rules
25ml per day
1mmol of K and Na
50-100g of glucose
1 salty 2 sweet
If elderly or HF- 1 of each
So if maintenance- L1 0.9% NaCl +0.3% KCl in 8 hours
1L of 5% glucose with 0.15% KCl in 8 hours
94
If taking furosemide and lithium
May Increase lithium conc
Use lower dose
95
Paracetamol IV
>50 kg- 1g over 15 mins
<50kg 15mg/kg over 15 mins
96
Tamoxifen info
Endometrial cancer
Warfarin increase INR
Hot flushes and VTE
97
Ciclodporin info
Regular U +Es
every 2w
98
Drug monitoring rules
If low drug but adequate response- do not increase
If low drug and inadequate- increase
If high and adequate- decrease
99
Causes of peripheral oedema
NSAIDs
CCB
100
If ischaemic stroke what should you prescribe if <4.5 hours
Alteplase
10mg Injection
101
What should be monitored with LMWH
Plt
102
Tx of GCA with eye loss
Methylprednisolone 1g daily 3 days
103
Route for creams
Topical
104
antiemetic for nausea in pregnancy
Cyclizine oral
Then ondansetron
105
Pulmonary effect of nitrofurantoin
Pulmonary fibrosis
Reaction
106
Dose of BB
2.5-10mg
107
Dosing of rivoroxiban
20mg
108
Clarithromycin interactions
Statin
CCB
Digoxin
109
If cannot find gout what should you search
Hyperuricaemiai
Aspirin
110
DAPT choice
Aspirin with prasugrel if <60kg and>75 5mg daily
if above 10 mg
12 months- discontinue
111
Chaning depression medication
Increase after 4 weeks
Until max dose
Then change
To another SSRI or mitrazipine
112
if cancer what VTE prophylaxis
LMWH
113
If cant tolerate metformin MR what should you do
Change to another med
GLiptin, thio, sulph
114
If adding bendro what should you look out for
History of gout
115
Changing from LMWH to oral DOAC
Stop LMWH on next and take DOAC when next was meant to be
116
Cetrizine info
May cause sleepiness
117
How to take SC injection
Right angle
Full needle
118
First signs of lidocaine toxicity
Tingling
Anaesthesia
Dizzy
119
Monitoring with levo
Just TSH
120
Monitoring of dalteparin
Anti X
121
Monitoring of donepezil function
Cognitive assessment
122
Monitoring of HC and FC effectiveness in addisons
Weight, BP, electrolytes
123
If lithium in range but symptoms
Increase dose
124
If INR >1.5 on day of surgery what do you give
Phytomenadione PO
125
Threadworm tx
Mebendazole 14d
126
Hypokalaemia reuss
1L 0.9% NaCl with 0.3%KCl
127
If lithium levels >2
Haemodialysis
128
Problems with amiodarone
Hypokalaemia can cause arrhythmia
Pulmonary fibrosis
CXR should be done
129
Drugs that may cause digoxin toxicity
Vit D
Aminophylline
Thiazide
Steroids
Furosemide
Salbumtmol
130
Higher risk of paracetamol OD
HIV, anorexia or inducer
131
When to suspend metformin
If D n V
132
Drugs causing birth abnormalities
Lithium- heart- Epstein
ACE- head
Valproate- NTD
Chlorampenicol- grey baby
133
Symptoms of lithium toxicity
coarse tremor (a fine tremor is seen in therapeutic levels- chronic lithium use)
hyperreflexia
acute confusion
polyuria
seizure
coma
134
Urinary retention drugs
Opioids
TCA
NSAIDs
Antichol
135
AB lowering seizure threshold
Cipro
136
Ethylene antidote
Fomepizole
137
If on oral diabetic medication what are the rules with surgery
If short and well controlled- no changes
If longer or poorly controlled- omit and VRII
138
Which TB medication causes gout
Pyrizidamide
139
When to start prophylactic gout meds
2 weeks after normally
If frequent- can be during attack
140
Drugs causing reflex tachy
CCBs
141
Vision disorders cause
Green digoxin
Blue- sildenafil
142
Communication with meth
Take with food
Stop with infection
143
Warfarin communication
Avoid alcohol
Take at same time
144
SSRI Comm
Dont abrupto stop
DnV
145
TCA comms
Ach SE
Dont stop abruptly
146
What to give in palliative SOB and confusion
SOB- morphine
Confusion- midazolam
With hallucination- haloperidol
147
When to use each laxative
Bulk with IBS- not with opioid
Osmotic- hepatic encephalopathy
148
Giving glucose in hypoglycaemia
10% 150ml in <10 mind
149
Hyperkalaemia tx
10% Ca gluconate 10ml
10% glucose 250ml
Actrapid insulin 10 u
150
UTI with low GFR
Trimethoprim even if folate deficient
151
What do you stop 7 days before surgery
NSAIDs
AP
