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Prescribing Safety Assessment > Section 4 - Planning Management > Flashcards

Section 4 - Planning Management Flashcards

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1
Q

Myocardial Infarction Management

(Raised Troponin/ ST-Elevation)

A
  1. A-E Assessment (15L O2 NRBM)
  2. Hx, Inv, Exam
  3. Aspirin 300mg PO
  4. Morphine 5-10mg IV + Cyclizine 50mg IV
  5. GTN Spray

If STEMI:
PCI + Beta-blocker
If NSTEMI:
Clopidogrel 300mg PO
LMWH

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2
Q

Acute Left Ventricular Failure Management

A
  1. A-E Assessment (15L O2 NRBM)
  2. Hx, Inv., Exam.
  3. Sit Patient Up
  4. Morphine 5-10mg IV + Cyclizine 50mg IV
  5. GTN
  6. Furosemide IV 40-80mg

If needed:
* Isosorbide Dinitrate
* CPAP

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3
Q

Management of Anaphylaxis

A
  1. A-E Assessment (15L O2 NRBM)
  2. Hx, Inv., Exam.
  3. Stop Infusion
  4. Adrenaline 500 micrograms 1:1000 IM
  5. Chlorphenamine 10mg IV
  6. Hydrocortisone 200mg IV
  7. Treat asthmatic symptoms if present.
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4
Q

Treatment of Tachycardia w/ Adverse Features

(Shock, Syncope, MI, HF)

A
  1. Up to 3 DC Shocks
  2. Amiodarone 300mg IV over 10-20 min
  3. Repeat Shock
  4. Amiodarone 900mg IV over 24 Hours.
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5
Q

Management of Tachycardia w/o Adverse Features

A

Broad QRS (>0.12s):
* VT - Amiodarone 300mg IV over 20-60min, then 900mg Over 24 Hours.
* Previous Confirmed SVT/BBB - Adenosine 6mg IV BOLUS then 12mg Repeats.

Narrow QRS (< 0.12s):
Regular Rhythm:
1. Vagal Maneouvers
1. Adenosine 6mg IV BOLUS, 12mg, 12mg.
Irregular Rhythm (AF):
1. Beta-Blocker/Diltiazem
1. Digoxin or Amiodarone

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6
Q

Management of Acute Asthma Exacerbation

(OSHITME)

A
  1. A-E Assessment (15L O2 NRBM)
  2. Hx, Inv., Exam.
  3. Salbutamol 5mg NEB
  4. Hydrocortisone 100mg IV/Prednisolone 50mg PO
  5. Ipratropium Bromide 500 micrograms NEB
  6. Aminophylline

(Similar Treament for ECOPD)

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7
Q

Management of Pneumothorax

A

Primary Pneumothorax (No Underlying Cause):
* < 2cm + Not SOB - F/u in 4w.
* > 2cm / SOB - Aspirate/Drain

Secondary Pneumothorax (Lung Disease):
* >2cm / SOB / > 50 Y.O - Insert Chest drain.
* Else - Aspirate

Tension:
* Emergency Aspiration

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8
Q

Management of Pneumonia (CAP)

A

Assess severity w/CURB65:
* 1 - Treat at home. (Amoxicillin, Clarithromycin)
* 2-3 - Hospital Treatment (Oral/IV Abx) (Co-Amoxiclav)
* 3 + - ITU (Co-Amoxiclav)

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9
Q

Management of Pulmonary Embolism

A
  1. A-E Assessment (15L O2 NRBM)
  2. Hx, Inv., Exam.
  3. Morphine 5-10mg IV
  4. Cyclizine 50mg IV
  5. LMWH
  6. ITU
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10
Q

Management of GI Bleed

A
  1. A-E Assessment (15L O2 NRBM)
  2. X2 Large Bore Cannulae
  3. Catheterise
  4. Crystaloid BOLUS
  5. Cross-Match (6 Units)
  6. Correct Clotting - Stop Culprit Drugs
  7. Camera & Surgeons
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11
Q

Management of Bacterial Meningitis

A
  1. A-E Assessment (15L O2 NRBM)
  2. Hx, Inv., Exam.
  3. IV Fluids
  4. 4-10mg Dexamethasone
  5. LP +/- CT
  6. 2g Cefotaxime IV +/- 2g Ampicillin (>55y.o or Immunocompromised)
  7. ITU
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12
Q

Management of Seizures/Status Epilepticus

A
  1. A-E Assessment (15L O2 NRBM)
  2. Recovery Position

Status:
1. Benzodiazpines - Lorazepam 2-4mg IV, Diazepam IV, Midazolam Buccal
1. Repeat Benzo after 5 mins.
1. Anaesthetics
1. After 5 mins - Phenytoin 15-20 mg/Kg IV
1. After 5 mins - Anaesthetise.

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13
Q

What should be given for Ischemic Strokes & TIA?

A

300mg Aspirin PO OD

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14
Q

Management of DKA and HHS

A

A-E Assessment (15L O2 NRBM)

Hx, Inv., Exam.

Fluids: 0.9% NaCl 1L STAT then:
* Over 1Hr
* Over 2 Hrs
* Over 4 Hrs
* Over 8 Hrs

Fixed-Rate Insulin Infusion

Monitor Ketones, Glucose and Potassium

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15
Q

Management of Hypoglycaemia

A

BM < 4 mmol/L:
Concious - Sugar-Rich Snack (Juice/Biscuits)
Unconcious -
* Cannulated - IV Glucose 100ml 20%
* Uncannulated - IM Glucagon 1mg

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16
Q

What are the 3 Aims of Poisoning Management?

A
  1. Reduce Absorption
  2. Increase Elimination
  3. Psychiatric Management
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17
Q

What are the thresholds for BP treatment?

Study These Flashcards
A

> 150/95 mmHg or >135/85 mmHg + Target Organ Damage or 10% CV Risk.

18
Q

First Line Anti-Hypertensive for Patients with T2DM

19
Q

First Line Anti-Hypertensive for Afro-Carribbean Patients

20
Q

First Line Antihypertensive for Patients < 55

21
Q

First Line Anti-Hypertensive for >55Y/O

22
Q

Management of Chronic Heart Failure

Study These Flashcards
A
  1. ACEi/ARB + Beta Blocker
  2. +/- Spironolactone
  3. Furosemide (Symptomatic)
23
Q

What are the aims of AF treatment?

Study These Flashcards
A
  1. Prevent Stroke
  2. Control Rate and Rhythm
24
Q

CHA2DS2-VASc Score

Study These Flashcards
A

Assesses the Indication for Anticogulation in AF:
Congestive HF (1)
HTN (1)
Age >75 (2)
DM (1)
Stroke or TIA (2)
Vascular Disease (1)
Age 65-74 (1)
Sex (Female) (1)

**0 Points - No Indication
1 Point - Indication in Men
2 Points - Indicated **

25
ORBIT Score
Assesses the Bleeding risk in Anticoagulation for AF: Older Age (>74) (1) Renal Impairment (1) Bleeding History (2) Insufficient Hb (Anaemia) (1) Treatment w/ Antiplatelet (1)
26
Which drugs are used for Stroke Prevention in AF?
Direct Oral Anticoagulants (DOACs) (e.g., apixaban, rivaroxaban, dabigatran, edoxaban) are preferred over warfarin unless contraindicated.
27
Which patients get Rhythm Control for AF vs Rate Control?
Rhythm Control: * New-onset AF (< 48 hours) * Symptomatic despite rate control * Younger patients * First presentation of AF * Heart failure thought to be caused by AF Rate Control: * Over 65 * With minimal symptoms * With persistent/permanent AF
28
How to Establish Rhythm Control in AF?
Electrical Cardioversion or Chemical (Flecainide or Amiodarone)
29
How to establish Rate Control in AF?
Beta-Blocker, Diltiazem +/- Diagoxin.
30
Management of Stable Angina
1. PRN GTN Spray 1. Secondary Prevention - Aspirin, Statins, RF modification 1. Anti-anginal drug (Isosorbide Mononitrate) 1. Beta-Blocker/CCB
31
Management of Chronic Asthma
**Aged 12+:** 1. ICS + Formeterol Combination Reliever 1. MART (Maintanence and Reliever) 1. LTRA + LAMA **Children 5-11:** * ICS BD + PRN SABA * Low Dose MART or LTRA * Low Dose LABA/ICS Combination
32
First Line Drug For COPD
PRN SABA/SAMA
33
Management of T1DM
Insulin
34
Management of T2DM
HbA1c (> 48mmol/L) - Metformin Additional (HbA1c >58mmol/L): DPP-4i, Pioglitazone, Sulphonylurea, SGLT2 Inhibitor
35
1st Line Medication for Parkinson's Disease
Co-Beneldopa
36
Anti-Epileptic Drugs | Myoclonic, Tonic, Focal Absence and Generalised Tonic Clonic Seizures
**Myoclonic Seizures** * Males - Valproate * Females - Levertiracetam **Tonic Seizures** * Males - Valproate * Females - Lamotrigine **Focal Seizures** * Carbamazepine, Lamotrigine **Absence Seizures** * Males - Valproate * Females - Ethosuximide **Generalised Tonic Clonic Seizures** * Males - Valproate * Females - Lamotrigine
37
Management of Alzheimer's Disease
Donepezil, Rivastigmine, Galantamine Severe - Memantine (NMDA Antagonist)
38
Crohn's Disease Management
**Inducing Remission -** Prednisolone 20-40mg, Hydrocrotisone 100-500mg IV (Systemic Illness) **Maintaining Remission - **Azathioprine
39
Management of Rheumatoid Arthritis
Methotrexate Flares - IM Methylprednisolone 80mg.
40
Management of Fever
Paracetamol 1g QDS
41
Management of Constipation
**Laxatives (Unless evidence of Obstruction):** * Short Duration - Bulk Forming (Ispahgula Husk) * Hard Stools - Osmotic (Lactulose) * Soft Stools - Stimulant (Senna) * Opioid Induced - Osmotic + Stimulant * Impaction - Macrogol
42
Management of Diarrhoea
Loperamide 2mg PO up to 3 Hourly (Do NOT give if infective)

Prescribing Safety Assessment (7 decks)

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