7.

Question 1

Best time of the day to give ACE inhibitor ?

Answer 1

Evening as it can cause postural hypotension

Question 2

Perindopril Erbumine - what time of the day to give?

Answer 2

In the morning - it’s the only ACE inhibitor that is recommended to be given in the morning

Question 3

What time should we give diuretics?

Answer 3

Morning

Question 4

Can salbutamol Neb be given back to back?

Answer 4

Yes, it’s total dose is only determined by tachycardia and tremor (SEs )

Question 5

Can ipratropium be given back to back ?

Answer 5

No. Should be given max x4 day

Question 6

What drugs can worsen seizure control (anti-epileptic drugs effectiveness)?

Answer 6

• alcohol, cocaine, amphetamines
• ciprofloxacin, levofloxacin
• aminophylline, theophylline
• bupropion
• methylphenidate (used in ADHD)
• mefenamic acid

Question 7

Which drugs may induce seizures while being withdrawn?

Answer 7

• benzodiazepines
• baclofen
• hydroxyzine

Question 8

Drugs that may cause SIADH

Answer 8

• sulfonylureas
• SSRIs, tricyclics
• carbamazepine
• vincristine
• cyclophosphamide

Question 9

Management of SIADH

Answer 9

• correction must be done slowly to avoid precipitating central pontine myelinolysis
• fluid restriction
• demeclocycline: reduces the responsiveness of the collecting tubule cells to ADH
• ADH (vasopressin) receptor antagonists have been developed

Question 10

Which other (than Penicillin) meds can’t be given to a patient with a penicillin allergy?

Answer 10

• phenoxymethylpenicillin
• benzylpenicillin
• flucloxacillin
• amoxicillin
• ampicillin
• co-amoxiclav (Augmentin)
• co-fluampicil (Magnapen)
• piperacillin with tazobactam (Tazocin)
• ticarcillin with clavulanic acid (Timentin)

Question 11

Antibiotics contraindicated in pregnancy

Answer 11

• tetracyclines
• aminoglycosides
• sulphonamides
• trimethoprim
• quinolones: the BNF advises to avoid due to arthropathy in some animal studies

Question 12

Other (than antibiotics) drugs contraindicated in pregnancy

Answer 12

• ACE inhibitors, angiotensin II receptor antagonists
• statins
• warfarin
• sulfonylureas
• retinoids (including topical)
• cytotoxic agents
• antiepileptic: including valproate, carbamazepine and phenytoin

Question 13

Can Hartmann’s solution be used in patients with hyperkalaemia?

Answer 13

No, as it contains potassium

Question 14

Electrolyte components of NaCl 0.9% in mmol/L

Answer 14

Question 15

Electrolyte component in 0.18% saline with 4% glucose in mmol/L?

Answer 15

Question 16

Electrolyte component of Hartmann’s solution in mmol/L

Answer 16

Question 17

What is the risk of using large volumes of 0.9% NaCl?

Answer 17

if large volumes are used there is an increased risk of hyperchloraemic metabolic acidosis

Question 18

Can Atorvastatin be taken in the morning?

Answer 18

Due to it’s longer half-life atorvastatin may be taken in the morning, unlike simvastatin

Question 19

What are peak and trough levels of Gentamicin?

Answer 19

Peak - 1 hour after administration

Trough - just before the next dose

• if the trough (pre-dose) level is high the interval between the doses should be increased
• if the peak (post-dose) level is high the dose should be decreased

Question 20

What to do if trough level of Gentamicin is low?