PSA revision Flashcards by Isobel Elliott

drugs that exacerbate HF

Flecanide
NSAIDs
glucocorticoids
verapamil
thiazolidinediones

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Drugs that cause cardiac arrhythmias

anti- ABCDEF

Arrythmias
Biotics
Cycotics (Psychotis)
Depressants
Emetics
Fungals

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common SE of lymecycline

photosensitivity

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type of laxatives used with haemorhoids

bulk forming laxatives

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Glucocorticoid SEs

endocrine
- impaired glucose regulation
- increased appetite/weight gain
- hirsutism
- hyperlipidaemia
- Cushing’s syndrome
- moon face
- buffalo hump
- striae
musculoskeletal
- osteoporosis
- proximal myopathy
- avascular necrosis of the femoral head
immunosuppression
- increased susceptibility to severe infection
- reactivation of tuberculosis
psychiatric
- insomnia
- mania
- depression
- psychosis
gastrointestinal
- peptic ulceration
- acute pancreatitis
ophthalmic
- glaucoma
- cataracts

suppression of growth in children
intracranial hypertension
neutrophilia

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starting dose of statin ifQRISK >10%

20mg

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starting dose of statin for secondary prevention (known IHD, CVD, PAD)

80mg

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Steroids SEs

STEROIDS

Stomach ulcers
Thin skin
oEdema
Right and left HF
Osteroporosis
Infction (eg. candida)
Diabetes
cushings Syndrome

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when to take caution with NSAIDs

NSAID

No urine
Systolic dysfunction (ie HF)
Asthma
Indigestion
Dyscrasia (clotting dysfunction)

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how much fluid bolus should you give

500mls - usually
250 if HF
150 if very old
if reduced U/O and tachycardic give 1L

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general rule: what volume of fluids do adults require per day?

adults: 3L/24hrs
elderly 2L/24hrs

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daily requirement of KCl

40mmol
IV K should not be given more than 10mmol/hr

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anti emetics of choice for N&V

cyclizine 50mg 8-hrly IM/IV/oral
metoclopramide 10mg up to 8/hrly IM/IV if HF

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causes hypokalaemia

DIRE
Diuretics: (loop and thiazide)
Intestinal loss (D&V)
Renal tubular acidosis
Endocrine (cushings/ conns)
salbutamol
insulin

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causes of hyperkalaemia

THREADD

Transfusions
Heparin
Reduced gfr/ renal failure
Endocrine (addisons)
Artefact
DKA,
Drugs (K sparing diuretics (spironolactone), ACEi, ARBs)

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risks of pancytopenia and neutropenic sepsis

clozipine
carbimazole
trimethoprim and methotrexate (both folate antagonists)
chemotherapy

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hypernatraemia casues

Dehydration
Drips (tto much NaCl)
Drugs

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causes of microcytic anaemia

Fe deficiency
sideroblastic anaemia
thalassaemia

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causes of normocytic anaemia

anaemia of chronic disease
major blood loss

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causes of macrocytic anaemia

B12/folte deficiency
alcohol XS
hypothyroism
myeloproliferative disorders

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causes of thrombocytopenia

reduced production:
- viral infection
- penicillamine
- myelodysplasia, myelofibrosis, myeloma

increased destruction:
- heparin
- hypersplenism
- DIC
- ITP
- HUS
-TTP

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causes of high platelets

reactive:
- bleeding
-tissue damage/ infection/ inflammation
- post splenectomy

primary
- myeloproliferative disorders

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causes of pre-renal AKI

hypovolaemia
dehydration
Renal artery stenosis

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causes of intrinsic AKI

INTRINSIC

Ischaemia
Nephrotoxic abx (gentamycin, vancomycine, tetracyclines)
Tablets (ACEi/ NSAIDs)
Radiological contrast
Injury (rhabdomyolysis)
Neg bireferingent (gout)
Syndromes (nephritic/phrotic)
Inflammaition (vasculitis)
Cholesterol emboli

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causes of post-renal AKI

obstructions prostate enlargement tumours lymphadenopathy

what does 1% mean in terms of calculations

1g in 100mL

drugs CI in asthma and COPD / use with caution

NSAIDs b blockers adenosine

drugs that cause hyperkalaemia

ACEi/ARBs NSAIDs aldosterone antagonists Trimethoprim Ciclosporin Heparin

drugs that cause hypokalaemia

B2 antagonists Thiazides Loop diuretic s Insulin

drugs that cause hypernatraemia

NaCl steroids hormones Lithium demeclocycline

drugs that cause hyponatraemia

Thiazides loop diuretics carbemazepine SSRIs desmopressin Glicazide TCAs opiates PPIs

drugs that cause hypercalcaemia

Vit D Vit A Thiazide diuretics Hormones

drugs that cause hypocalcaemia

bisphosphonates calcitonin phenytoin phenobarbitol rifampicin clindamycin blood transfusions

drugs that should be stopped before major surgery

I LACK OP Insulin (short acting) Lithium (24hrs) Anticoagulants/ antiplatelets COCP (4 weeks before) K sparing diuretics Oral hypoglycaemics Penindopril (any ACEi) (24hrs)

drugs that cause urinary retention

anti muscarinics eg. cyclizine procyclidine opioids NDAIDs anticholinergics eg. antipsychotics, TCAs, SSRIs antihistamines alpha adrenergic agonists- eg. methyldopa

drugs that may cause hearing loss

loop diuretics aminoglycosides (gentamycin) aspirin in toxic doses cytotoxics (ciclosporin, carboplatin)

drugs that accumulate in the kidneys

most opioids apart from fentanyl allopurinol

drugs that cause confusion

benzos opioids steroids (especially in elderly) bblockers

drugs to be avoided if egfr <45 (stage 3B+)

nitrofurantoin

target INR on day of surgery

<1.5

thromboprophylaxis of choice in someone with renal impairment

unfractionated heparin

methods of monitoring each anticoag class warfarin LMWH DOAC unfractionated heparin

warfarin- INR LMWH- anti factor Xa DOAC- monitor clinically unfractionated- aPTT

features of hypocalcaemia

CATS go Numb Convulsions Arrhythmias Tetany Seizure Numbness Trosseaus sign Chvosteks sign QT prolongation

treatment of hypocalcameia

10mls calcium gluconate 10% IV

GP treatment of suspected bacterial meningitis

IM benzylpenicillin 1.2g IM cefotaxime 1g

acute treatment of migraine with and without aura + prophylaxis Rx

without aura- aspirin or ibruprofen with aura- sumitriptan Prophylaxis- propranolol

acute Rx of clusterheadache and prophylaxis

acute: 100% O2 and sumitriptan prophylaxis- verapamil

drugs to be avoided wehn egfr <30 (stage 4+)

metformin (glicazide therefore 1st line for pts with CKD) opioids except fentanyl taken with caution when egfr <45

features of lithium toxicity

coarse tremor (a fine tremor is seen in therapeutic levels) hyperreflexia acute confusion polyuria seizure coma

causes of drug induced lupus

sulfonamides isoniazid hydralazine penicillins phenytoin methyldopa procainamide griseofulvin

alernative to PPI if allergic

cimetidine

mmols of Na in 1L bag of 0.9% NaCl

150mmol

mmols of K in 1L bag 0.3%KCl

mmols of K in 1L bag 0.15%KCl

grams of glucose in 1L bag 5% glucose

50g

antiemetic used in parkinsons

domperidone best cyclizine and ondansertron also safe but used short term

drugs that can cause hyperglycaemia

steroids thiazides antipsychotics tacrolimus

drugs that cause incontinence

tamsulosin (alpha blockers) diuretics clozapine anticholinesterase inhibitors

increased risk of gout

diuretics

drugs which lower seizure threshold

alcohol, cocaine, amphetamines ciprofloxacin, levofloxacin aminophylline, theophylline bupropion methylphenidate (used in ADHD) mefenamic acid clozapine

NB for fluids in patients whove had a stroke

avoid giving glucose as risk of cerebral oedema