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234 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Is peristalsis & gastric emptying faster or slower in paeds & elderly? |
Slower |
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Do paeds & elderly have higher or lower plasma levels of medication? |
Higher |
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What’s the issue with gastric acid secretion in paeds? |
It’s uneven. Reduced absorption of acidic meds. |
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Do paeds & elderly have increased or decreased concentration of plasma proteins? |
Decreased - which means higher proportion of medication in blood |
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What age can kids start metabolising meds properly? |
Around 3 years |
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When do kids teach normal glomerular function? |
Age 1 |
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Where should IM for paeds be? |
Vastus Lateralis |
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What happens to the absorption of IM & SC in elderly? |
It’s reduced |
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What do you need to calculate in elderly? |
Creatinine clearance |
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Explain how GFR reduces with age |
By 1% each year after 40 |
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What (4) functions needs monitoring regularly in elderly? |
Renal Liver Cardiac Respiratory |
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What can acute illness do to the elderly in regards medication elimination? |
Rapid decline in renal function |
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Where should IM for elderly be? |
Dorsogluteal |
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Preferred analgesia for kids. Why? |
Paracetamol Risk of Reye’s syndrome |
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When should NSAIDS be avoided in pregnancy? |
Late pregnancy |
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What are catopril, enalopril, perindopril, ramipril? |
ACEI |
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What system do ACEI work on? |
Renin-angiotensin system |
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What should be stopped with ACEI? |
K+ supplements & K+ sparing diuretics |
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What drugs inhibit aldosterone? |
ACEI |
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What prevents conversion of angiotensin I to angiotensin II!? |
ACEI |
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What is irbesartan & candesartan? |
Angiotensin receptor antagonist |
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What is prazosin & Doxazosin |
Alpha antagonists |
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Do beta blockers effect renin release? |
Yes. They mediate renin release. |
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Why are beta blockers not 1st line treatment in hypertension? |
Do not reduce risk of MI or death Higher risk of stroke Specificity is a problem |
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When are beta blockers contraindicated? |
COPD, heart block, CF |
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What are nifedipine, felodipine, verapamil, diltiazem? |
Calcium channel antagonists |
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Are calcium channel antagonists good for long term management of HF? |
No |
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Name a loop diuretic |
Frusemide |
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What can thiazides cause? |
Hypokalamia |
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What are GTN, isosorbide dinitrate & isosorbide mononitrate? |
Peripheral vasodilators |
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What’s the shelf life of GTN tablets & spray? |
Spray - 2 years Tablets - 3 months |
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What is dipyridamole? |
Selective coronary vasodilator - prophylactic |
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What happens if you cease vasodilators abruptly? |
Risk of MI |
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What is Nicorandal? |
A potassium channel opener |
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What needs to be balanced in angina treatment? |
Myocardial 02 supply & demand |
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Increased SNS activity Activation of the renin-angiotensin system & Enlarged heart = what? |
Compensatory mechanisms of heart failure |
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Increased SNS activity Activation of the renin-angiotensin system & Enlarged heart = what? |
Compensatory mechanisms of heart failure |
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What is the gold standard for HF? |
ACEI loop diuretic B-blockers |
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What beta blocker is contraindicated in HF? |
Carvedilol |
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What beta blocker is contraindicated in HF? |
Carvedilol |
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If HF patient develops hypotension - what medication do you decrease? |
The diuretic |
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What beta blocker is contraindicated in HF? |
Carvedilol |
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If HF patient develops hypotension - what medication do you decrease? |
The diuretic |
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What clotting factor is inactivated by heparin? |
Xa |
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How soon after starting oral anticoagulants, do you withdraw heparin? |
48 hours |
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How soon after starting oral anticoagulants, do you withdraw heparin? |
48 hours |
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What is the antidote of heparin? |
Protamine sulphate |
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How soon after starting oral anticoagulants, do you withdraw heparin? |
48 hours |
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What is the antidote of heparin? |
Protamine sulphate |
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How is protamine given? |
Slow IV |
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How soon after starting oral anticoagulants, do you withdraw heparin? |
48 hours |
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What is the antidote of heparin? |
Protamine sulphate |
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How is protamine given? |
Slow IV |
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What’s the benefit of LMWH? (4) |
Longer 1/2 lives Safer in pregnancy Less monitoring Greater SC bioavailability |
Low molecular weight heparin |
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How soon after starting oral anticoagulants, do you withdraw heparin? |
48 hours |
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What is the antidote of heparin? |
Protamine sulphate |
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How is protamine given? |
Slow IV |
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What’s the benefit of LMWH? (4) |
Longer 1/2 lives Safer in pregnancy Less monitoring Greater SC bioavailability |
Low molecular weight heparin |
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What does warfarin inhibit? |
Epoxide reductase |
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How soon after starting oral anticoagulants, do you withdraw heparin? |
48 hours |
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What is the antidote of heparin? |
Protamine sulphate |
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How is protamine given? |
Slow IV |
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What’s the benefit of LMWH? (4) |
Longer 1/2 lives Safer in pregnancy Less monitoring Greater SC bioavailability |
Low molecular weight heparin |
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What does warfarin inhibit? |
Epoxide reductase |
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What should INR be in warfarin Tx? |
2-4 |
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How soon after starting oral anticoagulants, do you withdraw heparin? |
48 hours |
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What is the antidote of heparin? |
Protamine sulphate |
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How is protamine given? |
Slow IV |
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What’s the benefit of LMWH? (4) |
Longer 1/2 lives Safer in pregnancy Less monitoring Greater SC bioavailability |
Low molecular weight heparin |
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What does warfarin inhibit? |
Epoxide reductase |
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What should INR be in warfarin Tx? |
2-4 |
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What herbs interact with warfarin? |
Chamomile Garlic Ginkgo |
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How soon after starting oral anticoagulants, do you withdraw heparin? |
48 hours |
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What is the antidote of heparin? |
Protamine sulphate |
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How is protamine given? |
Slow IV |
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What’s the benefit of LMWH? (4) |
Longer 1/2 lives Safer in pregnancy Less monitoring Greater SC bioavailability |
Low molecular weight heparin |
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What does warfarin inhibit? |
Epoxide reductase |
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What should INR be in warfarin Tx? |
2-4 |
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What herbs interact with warfarin? |
Chamomile Garlic Ginkgo |
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What’s the antidote of warfarin? |
Vitamin K (phytomenadine) |
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How soon after starting oral anticoagulants, do you withdraw heparin? |
48 hours |
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What is the antidote of heparin? |
Protamine sulphate |
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How is protamine given? |
Slow IV |
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What’s the benefit of LMWH? (4) |
Longer 1/2 lives Safer in pregnancy Less monitoring Greater SC bioavailability |
Low molecular weight heparin |
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What does warfarin inhibit? |
Epoxide reductase |
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What should INR be in warfarin Tx? |
2-4 |
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What herbs interact with warfarin? |
Chamomile Garlic Ginkgo |
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What’s the antidote of warfarin? |
Vitamin K (phytomenadine) |
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Signs of bleeding? |
Nose bleeds Black stools Unexplained bruising Bleeding gums |
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How soon after starting oral anticoagulants, do you withdraw heparin? |
48 hours |
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What is the antidote of heparin? |
Protamine sulphate |
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How is protamine given? |
Slow IV |
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What’s the benefit of LMWH? (4) |
Longer 1/2 lives Safer in pregnancy Less monitoring Greater SC bioavailability |
Low molecular weight heparin |
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What does warfarin inhibit? |
Epoxide reductase |
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What should INR be in warfarin Tx? |
2-4 |
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What herbs interact with warfarin? |
Chamomile Garlic Ginkgo |
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What’s the antidote of warfarin? |
Vitamin K (phytomenadine) |
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Signs of bleeding? |
Nose bleeds Black stools Unexplained bruising Bleeding gums |
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What has significant antiplatelet properties? |
Aspirin |
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How soon after starting oral anticoagulants, do you withdraw heparin? |
48 hours |
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COX is needed in the synthesis of what? |
TXA2 |
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What is the antidote of heparin? |
Protamine sulphate |
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How is protamine given? |
Slow IV |
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What’s the benefit of LMWH? (4) |
Longer 1/2 lives Safer in pregnancy Less monitoring Greater SC bioavailability |
Low molecular weight heparin |
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What does warfarin inhibit? |
Epoxide reductase |
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What should INR be in warfarin Tx? |
2-4 |
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What herbs interact with warfarin? |
Chamomile Garlic Ginkgo |
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What’s the antidote of warfarin? |
Vitamin K (phytomenadine) |
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Signs of bleeding? |
Nose bleeds Black stools Unexplained bruising Bleeding gums |
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What has significant antiplatelet properties? |
Aspirin |
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What is the CV benefit of aspirin? |
Reduced risk of death in MI Reduced risk of plaque rupture |
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What are: Fibrates Nicotinic Acid & Acipimox Fish oil for? |
Hypertriglyceridaemia |
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What are: Fibrates Nicotinic Acid & Acipimox Fish oil for? |
Hypertriglyceridaemia |
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How do Fibrates work? |
Increase lipolysis in the tissues |
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What are: Fibrates Nicotinic Acid & Acipimox Fish oil for? |
Hypertriglyceridaemia |
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How do Fibrates work? |
Increase lipolysis in the tissues |
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Adverse effect of fibrates? |
Gallstones |
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What are: Fibrates Nicotinic Acid & Acipimox Fish oil for? |
Hypertriglyceridaemia |
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How do Fibrates work? |
Increase lipolysis in the tissues |
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Adverse effect of fibrates? |
Gallstones |
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Fish oil is needed in high doses to treat hypertryglyceridaemia. What’s the risk? |
Hypervitaminosis - high in vit A&D |
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What are: Fibrates Nicotinic Acid & Acipimox Fish oil for? |
Hypertriglyceridaemia |
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How do Fibrates work? |
Increase lipolysis in the tissues |
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Adverse effect of fibrates? |
Gallstones |
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Fish oil is needed in high doses to treat hypertryglyceridaemia. What’s the risk? |
Hypervitaminosis - high in vit A&D |
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What is the adverse effect of nicotinic acid & acipimox? |
Vasodilation Flushing & itching of skin GI upset |
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What are HMG-CoA inhibitors? |
Statins |
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What are HMG-CoA inhibitors? |
Statins |
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What is the action of a statin? |
Inhibition of HMG-CoA leads to: Decreased plasma cholesterol Reduced risk of CRP & stroke Stabilises plaques |
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What are HMG-CoA inhibitors? |
Statins |
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What is the action of a statin? |
Inhibition of HMG-CoA leads to: Decreased plasma cholesterol Reduced risk of CRP & stroke Stabilises plaques |
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What’s 2nd line Tx for hypercholesterolaemia? |
Anion exchange resins |
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What are HMG-CoA inhibitors? |
Statins |
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What is the action of a statin? |
Inhibition of HMG-CoA leads to: Decreased plasma cholesterol Reduced risk of CRP & stroke Stabilises plaques |
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What’s 2nd line Tx for hypercholesterolaemia? |
Anion exchange resins |
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What is gemfibrozil & fenofibrate? |
Fibrates |
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What are HMG-CoA inhibitors? |
Statins |
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What is the action of a statin? |
Inhibition of HMG-CoA leads to: Decreased plasma cholesterol Reduced risk of CRP & stroke Stabilises plaques |
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What’s 2nd line Tx for hypercholesterolaemia? |
Anion exchange resins |
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What is gemfibrozil & fenofibrate? |
Fibrates |
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How do anion exchange resins work? |
Bind irreversibly to bile salts |
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What are HMG-CoA inhibitors? |
Statins |
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What is the action of a statin? |
Inhibition of HMG-CoA leads to: Decreased plasma cholesterol Reduced risk of CRP & stroke Stabilises plaques |
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What’s 2nd line Tx for hypercholesterolaemia? |
Anion exchange resins |
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What is gemfibrozil & fenofibrate? |
Fibrates |
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How do anion exchange resins work? |
Bind irreversibly to bile salts |
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What type of hypercholesterolaemia does anion exchange resins not work for? |
Familial hypercholesterolaemia |
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What are HMG-CoA inhibitors? |
Statins |
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What is the action of a statin? |
Inhibition of HMG-CoA leads to: Decreased plasma cholesterol Reduced risk of CRP & stroke Stabilises plaques |
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What’s 2nd line Tx for hypercholesterolaemia? |
Anion exchange resins |
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What is gemfibrozil & fenofibrate? |
Fibrates |
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How do anion exchange resins work? |
Bind irreversibly to bile salts |
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What type of hypercholesterolaemia does anion exchange resins not work for? |
Familial hypercholesterolaemia |
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What is cholestyramine & colestipol? |
Anion exchange resins |
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What are HMG-CoA inhibitors? |
Statins |
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What is the action of a statin? |
Inhibition of HMG-CoA leads to: Decreased plasma cholesterol Reduced risk of CRP & stroke Stabilises plaques |
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What’s 2nd line Tx for hypercholesterolaemia? |
Anion exchange resins |
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What is gemfibrozil & fenofibrate? |
Fibrates |
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How do anion exchange resins work? |
Bind irreversibly to bile salts |
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What type of hypercholesterolaemia does anion exchange resins not work for? |
Familial hypercholesterolaemia |
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What is cholestyramine & colestipol? |
Anion exchange resins |
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Why do anion exchange resins tend to have poor compliance? |
Taste / feel like concrete |
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What are HMG-CoA inhibitors? |
Statins |
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What is the action of a statin? |
Inhibition of HMG-CoA leads to: Decreased plasma cholesterol Reduced risk of CRP & stroke Stabilises plaques |
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What’s 2nd line Tx for hypercholesterolaemia? |
Anion exchange resins |
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What is gemfibrozil & fenofibrate? |
Fibrates |
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How do anion exchange resins work? |
Bind irreversibly to bile salts |
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What type of hypercholesterolaemia does anion exchange resins not work for? |
Familial hypercholesterolaemia |
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What is cholestyramine & colestipol? |
Anion exchange resins |
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Why do anion exchange resins tend to have poor compliance? |
Taste / feel like concrete |
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What is Neomycin for? |
3rd line tx for hypercholesterolaemia
(Prevents absorption of cholesterol from gut) |
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What are HMG-CoA inhibitors? |
Statins |
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What is the action of a statin? |
Inhibition of HMG-CoA leads to: Decreased plasma cholesterol Reduced risk of CRP & stroke Stabilises plaques |
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What’s 2nd line Tx for hypercholesterolaemia? |
Anion exchange resins |
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What is gemfibrozil & fenofibrate? |
Fibrates |
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How do anion exchange resins work? |
Bind irreversibly to bile salts |
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What type of hypercholesterolaemia does anion exchange resins not work for? |
Familial hypercholesterolaemia |
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What is cholestyramine & colestipol? |
Anion exchange resins |
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Why do anion exchange resins tend to have poor compliance? |
Taste / feel like concrete |
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What is Neomycin for? |
3rd line tx for hypercholesterolaemia
(Prevents absorption of cholesterol from gut) |
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What is Ezetimibe |
Inhibits absorption of cholesterol. Can be used with a statin. |
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What are 5 adverse effects of glucocorticoids? |
Elevated BG Protein catabolism Lipolysis - rise in plasma fatty acid Suppressed immune response Oedema - HTN Peptic ulcers Depression Loss of bone mass |
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4 teaching points for glucocorticoids |
Eat foods high in K+ No immunisations during treatment Take with food Monitor for infection Monitor BGL’s |
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When do you know an asthma review if needed? |
SABA needed more than 4 times per week or attacks occur more than 6 weekly |
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When do you know an asthma review if needed? |
SABA needed more than 4 times per week or attacks occur more than 6 weekly |
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What is the mnemonic for anticholinergics? |
Can’t see Can’t pee Can’t spit Can’t **** |
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When do you know an asthma review if needed? |
SABA needed more than 4 times per week or attacks occur more than 6 weekly |
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What is the mnemonic for anticholinergics? |
Can’t see Can’t pee Can’t spit Can’t **** |
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How do the antimuscarinic agents ipratropium & tiotropium work? |
Block M3 receptors associated with PNS stimulation of bronchial air passageways |
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How do the methylxanthines (theophylline & aminophylline) work? |
Bronchodilation via adrenergic or cholinergic receptor cAMP |
For when bronchodilator needed despite max corticosteroids |
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How do ICS’ work? |
Potent anti-inflammatory Inhibits rupture of mast cell Immune cell activity suppressed Oedema, mucous & bronchodilation reduced |
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How do ICS’ work? |
Potent anti-inflammatory Inhibits rupture of mast cell Immune cell activity suppressed Oedema, mucous & bronchodilation reduced |
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What are the side effects of ICS? |
Candida Hoarse voice |
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How do ICS’ work? |
Potent anti-inflammatory Inhibits rupture of mast cell Immune cell activity suppressed Oedema, mucous & bronchodilation reduced |
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What are the side effects of ICS? |
Candida Hoarse voice |
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Name the drug that is a leukotriene receptor antagonist |
Montelukast |
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How do ICS’ work? |
Potent anti-inflammatory Inhibits rupture of mast cell Immune cell activity suppressed Oedema, mucous & bronchodilation reduced |
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What are the side effects of ICS? |
Candida Hoarse voice |
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Name the drug that is a leukotriene receptor antagonist |
Montelukast |
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Simply, what is a leukotriene receptor antagonist? |
Inflammatory mediator |
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How do ICS’ work? |
Potent anti-inflammatory Inhibits rupture of mast cell Immune cell activity suppressed Oedema, mucous & bronchodilation reduced |
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What are the side effects of ICS? |
Candida Hoarse voice |
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Name the drug that is a leukotriene receptor antagonist |
Montelukast |
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Simply, what is a leukotriene receptor antagonist? |
Inflammatory mediator |
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What drugs are antitussives? |
Narcotics / opiates Morphine derivatives (dextramethorphan) |
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How do ICS’ work? |
Potent anti-inflammatory Inhibits rupture of mast cell Immune cell activity suppressed Oedema, mucous & bronchodilation reduced |
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What are the side effects of ICS? |
Candida Hoarse voice |
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Name the drug that is a leukotriene receptor antagonist |
Montelukast |
|
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Simply, what is a leukotriene receptor antagonist? |
Inflammatory mediator |
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What drugs are antitussives? |
Narcotics / opiates Morphine derivatives (dextramethorphan) |
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How / where do antitussives work? |
Medulla Interrupt the tissues reflux |
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How do ICS’ work? |
Potent anti-inflammatory Inhibits rupture of mast cell Immune cell activity suppressed Oedema, mucous & bronchodilation reduced |
|
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What are the side effects of ICS? |
Candida Hoarse voice |
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Name the drug that is a leukotriene receptor antagonist |
Montelukast |
|
|
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Simply, what is a leukotriene receptor antagonist? |
Inflammatory mediator |
|
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What drugs are antitussives? |
Narcotics / opiates Morphine derivatives (dextramethorphan) |
|
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How / where do antitussives work? |
Medulla Interrupt the tissues reflux |
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Bromhexine, Acetlycysteine, Mannitol inhaler, salt water gargles & Dornase Alfa are...? |
Mucolytics
Hyperosmotic - draw fluid into airways |
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How do ICS’ work? |
Potent anti-inflammatory Inhibits rupture of mast cell Immune cell activity suppressed Oedema, mucous & bronchodilation reduced |
|
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What are the side effects of ICS? |
Candida Hoarse voice |
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Name the drug that is a leukotriene receptor antagonist |
Montelukast |
|
|
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Simply, what is a leukotriene receptor antagonist? |
Inflammatory mediator |
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What drugs are antitussives? |
Narcotics / opiates Morphine derivatives (dextramethorphan) |
|
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How / where do antitussives work? |
Medulla Interrupt the tissues reflux |
|
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Bromhexine, Acetlycysteine, Mannitol inhaler, salt water gargles & Dornase Alfa are...? |
Mucolytics
Hyperosmotic - draw fluid into airways |
|
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What drug should be avoided in colds & flus? |
Antihistamines |
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How do ICS’ work? |
Potent anti-inflammatory Inhibits rupture of mast cell Immune cell activity suppressed Oedema, mucous & bronchodilation reduced |
|
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What are the side effects of ICS? |
Candida Hoarse voice |
|
|
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Name the drug that is a leukotriene receptor antagonist |
Montelukast |
|
|
|
Simply, what is a leukotriene receptor antagonist? |
Inflammatory mediator |
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|
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What drugs are antitussives? |
Narcotics / opiates Morphine derivatives (dextramethorphan) |
|
|
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How / where do antitussives work? |
Medulla Interrupt the tissues reflux |
|
|
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Bromhexine, Acetlycysteine, Mannitol inhaler, salt water gargles & Dornase Alfa are...? |
Mucolytics
Hyperosmotic - draw fluid into airways |
|
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What drug should be avoided in colds & flus? |
Antihistamines |
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