- What quantity of sodium is in 1l of 0.9% NaCl?
- If you forget answer to 1. where can answer be found on NICE?
150mmol
can be found on fluids and electrolytes in BNF
What quantity of potassium is in 1l of 0.3% KCl
40mmol
(therefore 0.15% osly 20mmol)
What quantity of glucose is in 1l of 5% dextrose
50g
what are the daily requirements for
- water
- Na + K
- glucose
25-30ml/kg/24h water
1mmol/kg/24h Na and K (and Cl)
50-100g/24h glucose
What’s the fastest rate potassium can be replaced
10 mmol / hr
What fluids should be given for
1. hypokalaemia
2. hypercalcaemia
- NaCl 0.9% / KCl 0.3% 1 litre over 4 hours
- NaCl 0.9% 1 litre over 4 hours
What should be given for maintenance fluids if deficits or losses e.g. Na or K low or vomiting, diarrhoea
NaCl 0.9% / KCl 0.3% 1 litre over 4 hours
What should be given for emergency resus in
1. adults
2. children
- 500ml 0.9% NaCl over 15 mins
- 10ml/kg 0.9% NaCl over 15 mins
What maintenance fluids should be given for children
for first 10kg: 100ml/kg/24hr
for kilograms between 10-20kg: 50ml/kg/24hr
for all kilograms over 20kg: 20ml/kg/24hr
e.g. 28kg would require 1660mls / 24hr
How should the following anticoagulants be monitored?
- LMWH
- unfractionated heparin
- NOACs
- warfarin
- anti-factor Xa
- APTT
- clinically (patients watches for bruising)
- INR
What’s the management for trigeminal neuralgia?
carbamazepine
what medications should be stopped if the patient is unwell?
metformin
statins
-flozins (SGLT2 inhibitors)
What drugs can worsen heart failure?
- TZD (-tazone)
- CCBs
- NSAIDs
What antiemetic drugs should not be given in Parkinsons?
- metoclopramide
- chlorpromazine
- prochlorperazine
What advice should you give to someone who has diabetes when they’re sick (sick day rules)
- stay hydrated
- keep taking medications (except SGLT2i)
- check blood sugar every 4 hours
- test for ketones regardless (normally told only check when 15 or 13 when have pump)
- keep eating / drinking sugary drinks: if vomiting and can’t keep food down get medical help
What should be taken with methotrexate?
folate
Methotrexate Mondays, Folate Fridays
What should be avoided when taking warfarin / NOACs?
- binge drinking
- getting pregnant (teratogenic in first + third trimesters)
What do you need to tell someone taking oral isotretinoin (roaccutane)?
- LFTs and lipids need monitored
- limit alcohol
- it is teratogenic (therefore contraception must be in place)
- there is a risk of neuropsychiatric reactions
Where in the BNF do you find information on
a) COCP
b) POP
a) ethinylestradiol with Desogestrel
b) Desogestrel
What drug is used to reverse benzodiazepines?
flumazenil
What should be done for children on long term corticosteroids?
annual height and weight
What is vitamin K known as in the BNF?
Phytomenadione
