Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PSA Revision > PSA - Prescription Review > Flashcards

PSA - Prescription Review Flashcards

1
Q

Side Effects of Steroids

A

S - Stomach ulcer
T - Thin skin
E - OEdema
R - R + L sided HF
O - Osteoperosis
I - Infection (+ candida)
D - Diabetes (common hyperglycaemia, rare DM)
S - Syndrome of CUSHING’S!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Cytochrome P450 Inducers (need more drug)

Cytochrome P450 Inhibitors (risk of OD)

A

Inducer:
P - phenytoin
C - carbamezapine
B - barbituates
R - rifampicin
A - alcohol (chronic)
S - sulfonylureas

Inhibitor:
A - allopurinol
O - omeprazole
D - disulfiram
E - erythromcin
V - valporate
I - isoniozid
C - ciprofloxacin
E - ethanol (acute)
S - sulfonamides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Drugs to stop before Operations and when

A

I - insulin (variable dose)

L - Lithium (day before)
A - Anticoag and Antiplatelet (variable)
C - COCP/ HRT (4 weeks before)
K - K+ sparing diuretic (same day)

O - Oral hypoglycaemic agents (variable)
P - Perandopril/ ACEi (same day)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Method for reviewing a prescription

A

P - Patient details
Re - Reaction/ allergies
S - Sign the doc
C - Contra-indications
R - Route of med
I - Infusion needed?
B - Blood clot prophylaxis
E - Anti-emetic
R - Relief of pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Common Contra-Indications to be aware of (4)

A
  1. Drugs which increase bleed risk
  2. Steroids
  3. NSAIDs
  4. Anti-hypertneisives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Side effects of anti-hypertensives

  1. All of them…
  2. B-blockers (3)
  3. ACEi (2)
  4. CCB - (2)
  5. Diuretics - generally!
    Thiazide -
    K+ sparing -
A
  1. All of them - postural hypotension
  2. B-blockers
    - Bradycardia (good chronic HF but not good cute)
    - Wheeze in asthmatics
    - erectile dysf.
  3. ACEi
    - Dry cough
    - Electrolyte disturbances inc. K+ and dec. Na+
  4. CCB
    - Facial flushing
    - peripheral oedema
  5. Diuretics - Renal failure!
    Thiazide - Gout
    K+ sparing - Gynaecomastia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Doses of common anti-emetics for all routes!

Cyclizine -

Clopramide -

A

Cyclizine - 50mg 8 hrly

Clopramide - 10mg 8 hrly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Replacement fluids
Give 0.9% sodium chloride unless (3)
-
-
-

A
  • Hypernatraemia or hypoglycaemia - 5% dextrose (hyoglycaemkc be thinking 10% 100ml over 15-20mins)
  • Ascites - human albumin
  • Shocked due to bleed - blood transfuse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

IV Fluids
If showing signs of shock give -

If oliguric (not due to obstruction) give -

A

If showing signs of shock give - 500ml bolus then reasses

If oliguric (not due to obstruction) give - 1L over 2-4hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Rough guide to predicting fluid loss

500ml depleted if -
1L depleted if -
> 2Ldepleted if -

A

500ml depleted if - Oliguric (<30ml/hr UO) or anuric
1L depleted if - Tachy + Oliguric
> 2Ldepleted if - Shocked + Tachy + Oliguric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How much KCl should be added if U=Es are normal?

A

40mmol/day therefore (2 x 20mmol in 2 of the 3 bags)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

REAL LIFE - 3 things you should do every time you prescribe fluids

A
  1. Check U+Es for additives
  2. Ausc. lungs, check ankles for overload
  3. Palpate bladder - retention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Blood clot prophylaxis

Prescribe what? drug/ class and route
Med prophylactic dose =
surgery prophlactic dose med risk = how long before surgery?
surgery prophlactic dose high risk = how long before surgery?
treatment dose is weight specific so look it up!

Contra-indications to prescribe this? (2)

Contra-indication for compression stockings? (1)

A

Prescribe what?
enoxiparin sodium s/c every
Med prophylactic dose = 40mg every 24 hours
surgery prophlactic dose med risk = 20mg 1 dose given 2hrs before surgery then 20mg every 24 hours
surgery prophlactic dose high risk = 40mg given 12 hrs before surgery and then 40mg every 24 hours
treatment dose is weight specific so look it up! (DOAC is better)

Contra-indications to prescribe this? (2)
- Bleed risk
- currently bleeding (including ischaemic stroke)

Contra-indication for compression stockings?
- PAD with ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

2 scenarios to avoid metoclopramide?

A
  1. PD patients - worsens symptoms
  2. Young females - causes dyskinesia (unwanted movements)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

first-line anti-emetic for pretty much all scenarios?
dose/route/ hourly?

Scenario that it shouldn’t be used? (1)

  • Its also avoided in the elderly due to what cause?

Instead give? dose and route and what hourly?

A

cyclizine 50mg 8 hourly IV/Oral/IM

Can cause fluid retention so don’t give in HF

Elderly- can cause confusion/ drowsiness due to anti-cholinergic properties/ burden

Metoclopramide 10mg 8 hourly IV/IM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Common trap - Paracetamol

  1. Max dose in most?
  2. Other pain med to take into account?
  3. Max dose in <50kg person?
A
  1. Max dose in most?
    4g/ day (8 x 500mg tablets)
  2. co-codamol contains paracetmol!
    30/500 - means 500mg paracetamol
  3. Max dose in <50kg person?
    500mg every 6 hours - 2g max!
16
Q

Neuropathic pain 3 options and doses, route
1. when is it taken and why?
2.
3. diabetic neuropathy…

A
  • Amitrityline 10mg PO nightly (sedative)
  • Pregabalin 75mg PO every 12 hours
  • Duloxetine 60mg daily (diabetic neuropathy)
17
Q

How does thiazide diuretic affect K+?
How does ACEi affect K+?

A

Thiazide causes hypokalaemia

ACEi causes hyperkalaemia

18
Q

side effect of cyclizine to be aware of in the elderly?

A

Drowsiness and confusion - ant-cholinergic properties

19
Q

Which common drugs cause hyperkalaemia? (2)
hypokalaemia (2)

A

HYPER K+
- ACEi
- K+ sparing diuretic (sprinolactone)

HYPO K+
- Thiazides
- Loop diuretics (furosamide)

20
Q

aspirin dose cardioprotective vs treatment for ACS

A

cardioprotective = 75mg

ACS tv = 300mg

21
Q

what anti-hypertensives should never be taken at the same time?

A

Rate limiting CCB (verpamil) and B-blocker

PSA Revision (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions