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PSA Flashcards

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1
Q

Prescriber mnemonic

A
  • Patient details
  • Reaction
  • Sign chart
  • Contraindications
  • Route
  • IV fluids
  • Blood clot prophylaxis
  • Anti Emetics
  • pain Relief
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2
Q

Contraindications for drugs that increase bleeding

A
  • bleeding
  • suspect of beeding
  • at risk of bleeding
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3
Q

SE for steroids

A
  • Stomach ulcers
  • Thin skin
  • Oedema
  • R and L HF
  • Osteoporosis
  • Infection
  • DM
  • Cushings
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4
Q

CI for NSAIDs

A
  • Renal failure
  • Systolic dysfunction = hf
  • Asthma
  • Indigestion
  • clotting abnormality
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5
Q

CI for anti hypertensives

A
  • hypotension
  • bradycardia
  • electrolyte disturbance
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6
Q

antiemetic choice if nauseated

A
  • cyclizine 50mg 8hrly
  • metoclpramide 10mg 8hrly if HF
  • ondansetrON 4MG Or 8mg 8hrly
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7
Q

anti emetic if not nauseated

A
  • cyclizine tomg up to 8hrly
  • met
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8
Q

when to avoid metoclopramide

A
  • parkinsons
  • young women
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9
Q

causes of hyponatraemia

A

Hypovolaemic
- Fluid loss
- Addissons
- Diuretics
Euvolaemic
- SIADH
- Polydipsia
- hypothyroid
Hypervolaemic
- HF
- Renal failure

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10
Q

Causes of hypokalaemia

A

DIRE
- Drugs = loop and thiazide
- Inadequate intake or intestinal loss
- Renal tubular acidosis
- Endocrine = cush and conn

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11
Q

causes of hyperkalaemia

A

DREAD
- Druhs = K sparing and ACEi
- Renal failure
- Endocrine = addison
- Artefact
- DKA

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12
Q

S+S digoxin toxicity

A
  • confusion
  • nausea
  • visual halos
  • arrhythmia
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13
Q

S+S lithium toxicity

A
  • early = tremor
  • intermediate = tired
  • late = arrythmia, seizure, coma, renal failure, DI
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14
Q

S+S phenytoin toxicity

A
  • gum hypertrophy
  • ataxia
  • nystagmus
  • peripheral neuropath
  • teratogenicity
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15
Q

S+S gent and vanc toxicity

A

-ototoxicity
- nephrotoxicity

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16
Q

usual dosing of gentamicin

A
  • high dose regimen of 5-7mg/kg once daily
  • RF or IE = 1mg/kg 12hrly
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17
Q

gent monitoring for divided daily dosing

A
  • peak = 1hr post dose = IE 3-5, else 5-10
  • trough = before enxt dose = IE <1 else <2
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18
Q

major bleed on warfarin

A
  • stop warfarin
  • 5-10mg IV vit K
  • give prothrombin complex
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19
Q

INR 5-8 and no bleeding

A

omit warfarin 2 days then reduce dose

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20
Q

INR 5-8 and minor bleeding

A
  • omit warwarin and gice 1-5mg IV vit K
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21
Q

INR >8 and no bleed

A

omit warfarin and give 1-5mg PO vit K

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22
Q

INR >8 and minor bleeding

A

Omit warfarin and give 1-5mg IV vit K

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23
Q

ramipril in pregnancy?

A

No - teratogenic
- switch to labetalol pre conception

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24
Q

Tamoxifen patient information

A
  • increases risk of endometrial cancer
  • increases efficacy of warfarin
  • increased VTE risk
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25
sulphonylureas patient info
- increased hypo risk - take in morning to avoid nocturnal hypo
26
monitoring for methotrexate
1-2 weekly bloof tests
27
what adjunct should be started with prednisolone
bisphosphonate if pred >3m
28
citalopram pateint info
- more photosensitive - suicidal thoughts - dry mouth
29
HRT patient info
- breask cancer risk higher for combined - excess risk persists >10yrs after stopping HRT
30
1% = ...
- 1g in 100 ml - 10mg in 1 ml
31
SE of gent and vanc
nephrotoxicity ototoxicity
32
ACEi SE
- hypotension - electrolyte abnormalities - AKI - dry cough
33
BB SE
- hypotension - bradycardia - wheeze in asthma - worsens acute HF
34
SE CCB
- hypotension - bradycardia - peripheral oedema - flushing
35
heparin SE
- haemorrhage (esp RF or <50kg)
36
aspirin se
- haemrrhage - peptic ulcers - gastritis - tinnitus (large doses)
37
digoxin SE
- nausea and vomiting - diarrhoea - blurred vision - confusion and drowiness - xanthopsia = halo vision, yellow/green
38
amiodarone SE
- ILD - thyroid disease - grey skin - corneal deposits
39
drugs with narrow therapeutic index
PC BRAS - Phenytoin - Carbamazepine - Barbiturates - Rifampicin - Alcohol - Sulphonylureas
40
Drugs needing careful dosage control
AODEVICES - Allopurinol - Omeprazole - Disulfiram - Erythromycin - Valproate - Isonizaid - Ciprofloxacin - Ethanol - Sulphonamides
41
what fluid to give if hypernatramic of hypoglycaemic
- 5% dextrose
42
what replacement fluid to give if ascites
human albumin solution
43
how much fluids to adults need
- 3L IV fluid in 24 hrs (2l if elderly) - adequate electrolytes provided by 1l 0.9% saline and 2l 5% dextrose
44
how fast to give maintenance fluids
- 3L a day = 8 hourly bags - 2L a day = 12 hourly bags
45
what does co-codomol 30/500 contain
- 30mg codein and 500mg paracetamol - no more than 4g paracetamol a day
46
why dont you prescribe CCB and BB together
- serious cardiac side effects = 1st degree heart block and brady
47
should CHC be stopped pre surgery
yes, 4 weeks prior to major elective surgery
48
what medications reduce efficacy of hormonal contraception
- enzyme inducing drugs = rifampicin, lamotrigine, carbamazepine
49
drugs to stop before surgery
I LACK OP - Insulin - Lithium = day before - Anticoagulants - COCP/HRT = 4 w before - K sparing diuretics = day of - Oral hypoglycaemics - Perindopril and ACEi
50
causes of hypernatraemia
- dehydration - drips - drugs - DI
51
causes of hyponatraemia
hypovolaemic - fluid loss, addisons, diuretics euvolaemic - SIADH, polydipsia, hypothyroid hypervolaemic - HF, RF, LF
52
Pre renal AKI
- Urea rise > creatinine - Dehydration - Renal artery stenosis
53
intrinsic AKI
- Urea rise < creatinine - Ischaemia - Nephrotoxic abx - ACEi, NSAIDs - Radio contrast - Injury - Gout
54
postrenal AKI
- Urea < creatinine - Stones - tumours
55
TSH <0.5
decrease thyroxine dose
56
TSH 0.5-5
same dose
57
TSH >5
increase thyroxine dose
58
what dose gent are most patients on
5-7mg/kg once daily
59
dose morphine and BB in N/STEMI
- 5-10mg IV with cyclizine 50mg IV - BB = 2.5mg oral
60
adult acute asthma tx
- 100% o2 - Salbutamol 5mg neb - Hydrocortisone 100mg IV or pred 40-60mg oral - Ipratropium 500mcg neb - aminophylline
61
PE tx
- abc - high flow o2 - morphine 5-10mg IV, cyclizine 50mg IV - LMWH e.g. tinz 175units/kg
62
8 Cs of GI bleed
- cannula x2 - catheter - crystalloid bolus - cross match 6 units - correct clotting - camera - call surgeon
63
bacterial meningitis
- 4-10mg dex - lp - 2g cefotaxime IV
64
Mx status
- loraz 2-4mg IV or 10mg diaz IV or buccal midaz 10 - after 5 repeat - still fitting = 15-20mg/kg ohenytoin
65
chronic heart failure tx
- ACEi e.g. lisinopril 2.5mg daily - BB = bisop 1.25mg daily - Sprionolactone 25mg daily
66
HTN with T2DM
ACEi
67
HTN, <55 and not black african
- ACEi
68
HTN and 55+
CCB
69
HTN and black african
CCB
70
CHA2D2S2VASc score
- CHF - HTN - Age >75 - Dm - Stroke/TIA - Vacular disase - Age 65-74 - Sex - 1 = in men use apixaba,, riv or warfarin - 2 = same
71
HASBLED score
- HTN - Abnormal renal function - Stroke - Bleeding - Labile INR - Elderly >65 - Drugs
72
asthma mx adults
- SABA - ICS - LABA - LTRTA
73
1g = how many mg
1g = 1000mg
73
1 mcg = ?ng
1mcg = 1000ng
74
1 milligram = how many mcg
1mg = 1000mcg
75
1st line choice for T1DM
- multiple daily injection basal bolus insulin - twice daily insulin detemir as ling acting basal insulin #
76
T2DM drugs
- metformin (not if obese) - SGLT2 inhibitor as well if HF
77
resuscitation fluids
- crystalloids with Na 130-154 - 500ml bolus - <15 minutes
78
speed to replace K
- no faster than 10mmol/h
79
emergency resus fluids
NaCl 0.9% 500ml 15mins
80
emergency hypoglycaemia fluids
glucose 10% 150ml 15 min
81
emergency hypokalaemia fluids
NaCl 0.9%/KCl 0.3% 1000ml 4hr
82
emergency hypercalcaemia fluids
NaCl 0.9% 1000ml 4hrs
83
maintenance fluids with deficits or losses
minimum 30ml/kg/24hr water and ensure electrolytes replaced, aim 4-6hr
84
how many mmol Na in 0.9%
150 mmol
85
how many mmol K in 0.3 and 0.15%
0.3% = 40mmol 0.15% = 20mmol
86
emergency resus fluids for children
NaCl 0.9% 10ml/kg 15 minutes
87
maintenance fluids for children
10ml/kg/24 hr if <10kg 50ml/kg/24hr 10-20kg 20ml/kg/24h for >20kg
88
anticoagulation treatment dvt
apixaban or rivaroxaban
89
anticoagulation prophylactic dvt
- LMWH = dalteparin, enoxaparin, tinzaparin - renal failure = unfractioned heparin
90
uterus intact and LMP <12 m ago hrt
- oral sequential combined oestrogen and progestogen = elleste-duet 1mg or 2mg - patch sequential combined oestrogen and progestogen = evorel sequi
91
uterus intact and LMP >12m ago
- oral continuous combined oestrogen and progestogen = elleste-duet conti - patch continuous combined oestrogen and progestogen = evorel conti, tibolone
92
hrt post hysterectomy
- oral or patch oestrogen = elleste solo or tibolone - estradiol
93
Missing 1 pill when the pill is >24hrs late
<72hrs since last pill was taken - Take missed pill ASAP even if 2 in 1 day - No extra protection needed
94
Missing >1 pill (>72hrs since last pill)
- take most recent pill ASAP - Additional contraception for 7 days - if days 1-7 emergency contraception - 8-14 no emergency contraception - 15-21 no emergency contraception and back to back
95
Who are sequential HRT preparations for
- intact uterus - Perimenopausal <12m
96
Tablet sequential HRT regimes
- Estradiol 1mg + norethisterone sequential - Estradiol 2mg + norethisterone sequential
97
transdermal sequential HRT
- estradiol 50mcg + levonorgestrel 10mcg SEQUI patch
98
who is continuous combined hrt for
- >12m last period - >54 - >3yrs on sequential
99
Continous tablet hrt
- Estradiol 2mg + norethisterone 1mg CONTI - Estradiol 0.5mg + norethisterone 1mg CONTI
100
Transdermal continuous hrt
- Estradiol 50mcg + norethisterone 7mcg CONTI patch
101
DDP4i meds are...
- linagliptin - improve insulin sensitivity - SE = pancreatitis - Increase weight
102
Sulfonylurea
- gliclazide - Enhance insulin secretion - Can cause hypo
103
SGLT2i
- empagliflozin - Reduce renal glucose reabsoprtion - SE = ketoacidosis, genital infection
104
|GLP1 analogue
- semaglutide - Increatin effect
105
name 3 rapid acting insulins
- novorapid - apidra - humalog
106
name 3 short acting insulins
- actrapid - humulin r - humulin s
107
name 2 intermediate insulins
- humulin I - insulatard
108
name 3 long acting
- tresiba - lantus - semglee
109
name 3 pre mixed insulins
- humulin M3 = short and inter - novomix 30 = novorapid annd another - humalog mix 25 and 50
110
paeds resus fluids
10ml/kg NaCl 0.9% <10 mins
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