Safe Prescribing — Flashcards
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When do you calculate adjusted calcium? _____
What drugs end with 'flozin'
What is an example of a 5-HT3 antagonist (blocks seratonin)?
What medication can cause neutrophilia?
What electrolyte disturbance can loop diuretics cause?
What has occured if a patient on Mesalazine is now experiencing epigatrium pain that radiated through to his back?
What are the adverse effects of SGLT-2 inhibitors?
What is Hydroxychloroquine used in?
What are adverse effects of Anastrazole?
What are the adverse effects of Hydroxycholorquine?
Safe Prescribing UK Medical PG Flashcards - Medical Study Cards
Master Safe Prescribing with OnCourse flashcards. These spaced repetition flashcards are designed for medical students preparing for NEET PG, USMLE Step 1, USMLE Step 2, MBBS exams, and other medical licensing examinations.
Safe Prescribing Flashcard Deck - 126 Cards
Flashcard 1: When do you calculate adjusted calcium? _____
Answer: hypo or hyperalbuminaemia
Flashcard 2: What drugs end with 'flozin'
Answer: SGLT-2 inhibitors
Flashcard 3: What is an example of a 5-HT3 antagonist (blocks seratonin)?
Answer: • Ondanestron
Flashcard 4: What medication can cause neutrophilia?
Answer: • Prednisolone
Flashcard 5: What electrolyte disturbance can loop diuretics cause?
Answer: Hyponatraemia
Flashcard 6: What has occured if a patient on Mesalazine is now experiencing epigatrium pain that radiated through to his back?
Answer: • Acute pacreatitis
Flashcard 7: What are the adverse effects of SGLT-2 inhibitors?
Answer: • UTIs
Flashcard 8: What is Hydroxychloroquine used in?
Answer: • Managment of Rheumatoid Arthritis • & SLE
Flashcard 9: What are adverse effects of Anastrazole?
Answer: • Osteoporosis
Flashcard 10: What are the adverse effects of Hydroxycholorquine?
Answer: • Bull's eye retinopathy - may result in severe and permanent visual loss
Flashcard 11: What is the management of Red Man Syndrome?
Answer: • Cessation of the vancomycin infusion • When symptoms have resolved -> recommencement at a slower rate
Flashcard 12: What type of infections is Vancomycin used to treat?
Answer: • Gram-positive • particularly MRSA
Flashcard 13: What medication can cause ototoxicity?
Answer: • Loop diuretics
Flashcard 14: What medication can cause hypercalcaemia?
Answer: • Thiazide diuretics
Flashcard 15: What is Red Man Syndrome?
Answer: • Adverse reaction of IV vancomycin use • symptoms (flushing, pruritis, burning)
Flashcard 16: What is the reversal agent of the anticoagulant effects of dabigatran?
Answer: • Idarucizumab
Flashcard 17: Which anti-hypertensive should you avoid prescribing in a patient with HbA1c 63mmol/mol?
Answer: • Indapamide *Thiazide - like Diuretic
Flashcard 18: Paracetamol overdose >150mg/kg presenting _____ hours post-ingestion is managed with NAC
Answer: 8-24
Flashcard 19: An ABG performed on a patient with _____ poisoning will show mixed respiratory alkalosis & metabolic acidosis
Answer: salicylate
Flashcard 20: _____ is the most common symptom of carbon monoxide poisoning?
Answer: Headache
Flashcard 21: An ABG performed on a patient with salicylate poisoning will show mixed respiratory alkalosis & metabolic acidosis. What causes the metabolic acidosis? _____
Answer: Direct acid effects of the salicylates (acids) & renal failure
Flashcard 22: Direct spectrophotometric measurement of HbCO will be chronically raised in _____
Answer: smokers
Flashcard 23: Carbon monoxide binds to haemoglobin to form _____
Answer: carboxyhaemoglobin
Flashcard 24: _____ toxicity is most commonly associated with thiazide diuretics
Answer: Lithium
Flashcard 25: Why should opioid overdose patients be monitored closely after the first dose of naloxone? _____
Answer: May need repeat dose
Flashcard 26: How does N-acetylcysteine treat paracetamol overdose? _____
Answer: Replenishes glutathione stores in the liver
Flashcard 27: Patients with suspected paracetamol overdose should have investigations to look at the synthetic liver function including: _____, glucose, clotting, ABG (acidosis)
Answer: LFT (ALT)
Flashcard 28: Management of severe lithium toxicity is _____
Answer: haemodialysis
Flashcard 29: Excretion of lithium primarily occurs in the _____
Answer: kidneys
Flashcard 30: Management of mild-to-moderate lithium toxicity is _____
Answer: fluid resuscitation with normal saline
Flashcard 31: The most commonly affected organ in salicylate poisoning is the _____
Answer: kidney
Flashcard 32: Initial management of lithium toxicity should include _____
Answer: stopping lithium/drugs precipitating toxicity
Flashcard 33: Lithium has a very _____ therapeutic range, toxicity occurs when levels are >1.5 mmol/L
Answer: narrow
Flashcard 34: _____ and bradycardia are cardiovascular features of opioid overdose
Answer: Hypotension
Flashcard 35: Management of patients who have taken a _____ paracetamol overdose involves NAC treatment regardless
Answer: staggered
Flashcard 36: Toxic alcohol poisoning initial treatment may involve _____ if the patient presents within 1 hour
Answer: gastric decontamination (e.g. gastric lavage, NG aspiration)
Flashcard 37: How can opioid overdose affect body temperature? _____
Answer: Hypothermia
Flashcard 38: Lithium toxicity can cause _____
Answer: 1st degree heart block
Flashcard 39: Pinpoint pupils, myoclonic jerks and seizures are neurological symptoms of _____ overdose
Answer: opioid
Flashcard 40: Respiratory depression is a respiratory symptom of _____ overdose
Answer: opioid
Flashcard 41: An ABG performed on a patient with salicylate poisoning will show mixed respiratory alkalosis & metabolic acidosis. What causes the respiratory alkalosis? _____
Answer: Early stimulation of the respiratory centre
Flashcard 42: In _____, the overriding ABG picture in salicylate poisoning is a metabolic acidosis
Answer: young children
Flashcard 43: _____ poisoning causes uncoupling of oxidative phosphorylation leading to reduced ATP production
Answer: Salicylate
Flashcard 44: Patients who have ingested a significant amount of lithium may require _____
Answer: whole bowel irrigation
Flashcard 45: Ethylene glycol poisoning that is refractory to treatment with fomepizole can be managed with _____
Answer: haemodialysis
Flashcard 46: The first line management of _____ poisoning is fomepizole
Answer: ethylene glycol
Flashcard 47: Ethylene glycol is broken down by the _____ into the toxic metabolites: glycoaldehyde and oxalic acid
Answer: liver
Flashcard 48: Severe carbon monoxide poisoning may present with _____
Answer: pink skin/mucosae
Flashcard 49: Constipation and reduced bowel sounds are GI symptoms of _____ overdose
Answer: opioid
Flashcard 50: _____ toxicity presents with a classic triad of altered mental state, pinpoint pupils (bilateral miosis) and respiratory depression
Answer: Opioid
Flashcard 51: The antidote for _____ overdose is Naloxone
Answer: opioid
Flashcard 52: _____ is the most common salicylate
Answer: Aspirin
Flashcard 53: The most characteristic symptom of _____ poisoning is tinnitus
Answer: salicylate
Flashcard 54: Lithium toxicity causes a _____ tremor
Answer: coarse
Flashcard 55: Ethylene glycol poisoning is diagnosed based on _____
Answer: clinical presenation
Flashcard 56: _____ is a colourless, odourless, sweet poisonous liquid found in antifreeze
Answer: Ethylene glycol
Flashcard 57: A 21 year old has recently started their second year of university. They have had a headache since moving into a new student house but now presents with altered mental status and pink mucosae. What is the most likely treatment for this patient? _____
Answer: 100% Oxygen via non-rebreathe mask (minimum 6 hours) - Carbon monoxide poisoning
Flashcard 58: A nomogram is plotted from the paracetamol level at _____ hours post-ingestion. If the serum concentration is above the treatment line, patients should be given NAC
Answer: 4
Flashcard 59: Seizures caused by TCA toxicity can be treated as normal with _____
Answer: benzodiazepines
Flashcard 60: Early symptoms of ethylene glycol toxicity are similar to those of _____ but can progress to decreased consciousness, headache and seizures
Answer: alcohol intoxication
Flashcard 61: In _____ poisoning, the pulse oximetry will be normal or raised
Answer: carbon monoxide
Flashcard 62: Carbon monoxide has a _____ affinity for haemoglobin which causes a left shift of the oxygen dissociation curve
Answer: higher
Flashcard 63: Which part of the ABCDE approach is most likely to be compromised in opioid overdose? _____ and B (respiratory depression)
Answer: A (may not be able to maintain their own airway)
Flashcard 64: A patient with known bipolar disorder presents to hospital with a coarse tremor, hyperreflexia and confusion. Shortly after admission they experience a seizure which progresses to a coma? Toxicity of what medication has most likely caused this? _____
Answer: Lithium
Flashcard 65: Salicylate poisoning may cause _____
Answer: hypokalaemia
Flashcard 66: ABG in patients with ethylene glycol toxicity will reveal a _____
Answer: metabolic acidosis with high anion gap & high osmolar gap
Flashcard 67: Peak plasma concentration of paracetamol is around _____
Answer: 1 hour
Flashcard 68: _____ is a competitive μ-opioid receptor antagonist
Answer: Naloxone
Flashcard 69: What is the management of carbon monoxide poisoning? _____
Answer: 100% normobaric oxygen via non-rebreathe mask (minimum 6 hours)
Flashcard 70: What ABG result would you expect in a paracetamol overdose? _____
Answer: Lactic acidosis
Flashcard 71: _____ is the antidote for benzodiazepine toxicity. However, it is not routinely used due to increased risk of seizures
Answer: Flumazenil
Flashcard 72: If salicylate poisoning does not respond to urinary alkalinisation with IV sodium bicarbonate then patients my be treated with _____
Answer: haemodialysis
Flashcard 73: _____ is the antidote for heparin toxicity
Answer: Protamine sulphate
Flashcard 74: Prior to administration of naloxone, initial managment of opioid overdose should involve _____ and oxygen
Answer: airway managment
Flashcard 75: What is the management of cerebral oedema in a patient with carbon monoxide poisoning? _____
Answer: IV mannitol
Flashcard 76: There is limited evidence to suggest that _____ may increase excretion of lithium by increasing the alakalinity of the urine
Answer: IV sodium bicarbonate
Flashcard 77: The most severe features of salicylate poisoning are _____ & coma
Answer: seiuzure
Flashcard 78: Patients with suspected carbon monoxide poisoning should have a _____ in addition to an ECG, ABG, LDH and U&Es done
Answer: direct spectrophotometric measurement of HbCO ("direct spec")
Flashcard 79: Management of _____ poisoning involves activated charcoal, urinary alkalinisation with IV sodium bicarbonate and haemodialysis
Answer: salicylate
Flashcard 80: Key investigations for suspected salicylate poisoning include: _____ and U&Es
Answer: serum salicylate level
Flashcard 81: _____ toxicity causes AKI (ATN) due to deposition of calcium oxalate crystals in renal tubules
Answer: Ethylene glycol
Flashcard 82: _____ is the antidote for beta-blockers in patients who are excessively bradycardic. In resistant cases, glucagon may be used
Answer: Atropine
Flashcard 83: U&Es blood test in patients with salicylate poisoning may show _____, raised urea, raised creatinine
Answer: hypokalaemia
Flashcard 84: _____ and U&Es are the most important investigations for suspected lithium toxicity
Answer: Serum lithium level
Flashcard 85: Lithium is a monovalent cation similar to _____. Therefore, anything that causes sodium or volume depletion can enhance lithium reabsorption in the kidneys
Answer: sodium
Flashcard 86: _____ is the antidote for benzodiazepine toxicity
Answer: Flumazenil
Flashcard 87: Patients with suspected digoxin toxicity should have an _____, serum digoxin, and U&Es
Answer: ECG
Flashcard 88: Digibind (digoxin-specific antibody fragments) will _____ potassium levels when administered. Therefore, target levels prior to administration should be on the upper level of normal
Answer: lower
Flashcard 89: cyproheptadine is a _____
Answer: 5-HT2A receptor antagonist
Flashcard 90: Serotonin syndrome may present with hyperthermia & hyperreflexia due to _____
Answer: neuromuscular excitability
Flashcard 91: What is the antidote to _____? Digoxin-specific antibody fragments (e.g. Digibind)
Answer: digoxin toxicity
Flashcard 92: Patients with TCA toxicity are at risk of neurological sequelae including _____ and coma
Answer: seizures
Flashcard 93: Which has a faster onset: _____
Answer: serotonin syndrome
Flashcard 94: What class of prescription medications most commonly causes serotonin syndrome? _____
Answer: Antidepressants (e.g. MAOIs, SSRIs)
Flashcard 95: _____ may be given to patients with suspected TCA overdose if the medication was taken in the past 1-2 hours
Answer: Activated charcoal
Flashcard 96: What is the mechanism of digoxin? _____
Answer: Inhibits the Na+/K+ pump → Increased intracellular Ca2+ → Increased force of contraction Decreases AV node conduction → Decreases heart rate
Flashcard 97: Serotonin syndrome may present with diaphoresis, mydriasis, hypertension & tachycardia due to _____
Answer: autonomic dysfunction
Flashcard 98: The management of severe/refractory serotonin syndrome involves _____
Answer: cyproheptadine
Flashcard 99: TCA toxicity causes inhibition of _____ receptors, muscarinic receptors, histamine receptors, sodium channels
Answer: alpha-adrenergic
Flashcard 100: _____ should be monitored closely in digoxin toxicity
Answer: Potassium
Flashcard 101: Inhibition of _____ enzymes in patients taking serotonergic drugs may cause serotonin syndrome
Answer: CYP450
Flashcard 102: _____ drugs may be used with senior support AND extreme caution in patients with TCA toxicity if IV hypertonic sodium bicarbonate fails
Answer: Anti-arrhythmic
Flashcard 103: The initial management of suspected serotonin syndrome involves _____ and supportive care (IV fluids)
Answer: stopping serotonergic drugs
Flashcard 104: The management of agitation & neuromuscular excitability in serotonin syndrome involves _____
Answer: benzodiazepines
Flashcard 105: _____ can be taken in suspected digoxin toxicity if it was taken within the last 1-2 hours
Answer: Activated charcoal
Flashcard 106: Management of hypokalaemia/hypomagnesaemia in digoxin toxicity should be with _____ and intravenous Mg2+
Answer: intravenous K+
Flashcard 107: Digoxin level blood test should be performed _____ after administration
Answer: 6 hours
Flashcard 108: How can serotonin syndrome be differentiated from other drug-induced hyperthermias? _____
Answer: Serotonin syndrome causes neuromuscular excitability (hyperreflexia & myoclonus - particularly lower limbs)
Flashcard 109: Administration of _____ serotonergic drugs simultaneously may result in serotonin syndrome
Answer: multiple
Flashcard 110: Recreational drugs such as _____ and cocaine may cause serotonin syndrome
Answer: Ecstasy (MDMA)
Flashcard 111: What condition does the following ECG show? _____
Answer: Digoxin toxicity [Life in the fast lane [Jul 2021] Digoxin Toxicity. Available from https://litfl.com/digoxin-toxicity-ecg-library/
Flashcard 112: The most important inhibitory effects of TCA toxicity are _____ inhibition and muscarinic ACh receptor inhibition
Answer: sodium channel
Flashcard 113: _____ poisoning may cause symptoms including: gastrointestinal symptoms, lethargy, confusion and vision changes such as Xanthopsia (yellow-tinted vision)
Answer: Digoxin
Flashcard 114: Patients with suspected serotonin syndrome may be given _____ if they have taken the causative drug within the past 1-2 hours
Answer: activated charcoal
Flashcard 115: _____ and widened QRS (>100ms) are found in patients with TCA toxicity?
Answer: Prolonged QTc interval
Flashcard 116: The management of autonomic instability in serotonin syndrome involves treatment with _____
Answer: antihypertensives
Flashcard 117: The first line managment of TCA overdose is _____
Answer: IV hypertonic sodium bicarbonate
Flashcard 118: Severe digoxin toxicity can cause heart _____, heart failure and cardiac arrhythmias
Answer: block
Flashcard 119: _____ and hypomagnesaemia may occur in patients with digoxin toxicity
Answer: Hyperkalaemia
Flashcard 120: The presentation of serotonin syndrome can be remembered by the mnemonic: _____
Answer: HAHA: • H: Hyperthermia • A: Autonomic dysfunction • H: Hyperreflexia • A: Altered mental status
Flashcard 121: Patients are at an increased risk of developing hepatotoxicity following a paracetamol overdose if they are taking _____ medications
Answer: liver enzyme-inducing
Flashcard 122: Liver transplantation is indicated for paracetamol overdose if arterial pH is _____ at 24 hours post ingestion
Answer: <7.3
Flashcard 123: Management of paracetamol overdose >2hrs after ingestion: _____
Answer: N-acetylcystine (NAC)
Flashcard 124: Management of paracetamol overdose <2hrs after ingestion: _____
Answer: Activated charcoal & N-acetylcystine (NAC)
Flashcard 125: Patients who have taken a paracetamol overdose should have a(n) _____ taken at 4 hours post-ingestion and 2 hours before completion of N-acetylcysteine
Answer: paracetamol level
Flashcard 126: A _____ may be used in paracetamol overdose to determine if treatment is indicated
Answer: nomogram
Keywords: Safe Prescribing flashcards, medical flashcards, NEET PG preparation, USMLE Step 1 flashcards, Anki alternative, spaced repetition medical, OnCourse flashcards
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