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PHARMACY: Pre registration > ADR's > Flashcards

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1
Q

Name some drugs that cause HYPO kalaemia?

A

Loop/thiazide diuretics, beta agonists, theophylline, corticosteroids, stimulant laxatives

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2
Q

Name some drugs that cause HYPER kalemia?

A

ACE/ARBS, tacrolimus, K sparing diuretics, heparins, NSAIDS, trimethoprim

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3
Q

Name some drugs that cause HYPO natremia?

A

Antidepressants, carbamazepine, NSAIDS, desmopresson

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4
Q

Drugs that have antimuscarinic SE’s?

A

Antimuscarinic drugs i.e. oxybutynin , hyoscine , Atropine, TCS, antihistamines, clozapine, antipsychotics

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5
Q

Drugs causing ototoxicity

A

Aminoglycosides, cisplatin, glycopeptides, loop diuretics, vinca alkaloids

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6
Q

Drugs that lower seizure threshold?

A 
Quinolones
Mefloquine
SSRIs
Antipsychotics
Tramadol 
Lithium
Baclofen
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7
Q

Drugs associated with QT prolongation

A 
CLAMS HMV
Citalopram
Lithium
AMiodarone
Sotalol 
Haloperidol
Macrolides
Venlafaxine
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8
Q

Drugs that cause photosensitivity?

A

QARTS

Q = quinine 
A = amiodarone 
R = Retinoids
T = tetracyclines
S = Sulfasalazine

Other = antimalarials, antipsychotics, tacrolimus, topical NSAIDS, voriconazole

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9
Q

What colour does dantron colour the urine?

A

Red

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10
Q

What colour does Doxorubicin colour the urine?

A

Red

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11
Q

What colour does Levodopa colour the urine?

A

Red

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12
Q

What colour does Rifampicin colour the urine?

A

Red/orange

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13
Q

What colour does sulfasalazine colour the urine?

A

Orange

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14
Q

What colour does senna colour the urine?

A

Yellow/brown

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15
Q

What colour does nitrofurantoin ?

A

rust yellow/brown

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16
Q

What colour do prostaglandin analogues colour the urine?

A

Brown

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17
Q

What colour does iron colour the bodily secretions i.e. stools?

A

Black

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18
Q

What colour does triamterene colour the urine?

A

Blue

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19
Q

Name the teratogenic drugs:

A 
MTX
Trimethoprim
Statins
Tetracyclines
Prostaglandin analogues 
ACE inhibitors/arbs
Isotretinoin
Lithium (avoid if possible)
Na valproate
Warfarin (not in 1st trimester)
Chloramphenicol (grey baby syndrome)
Aspirin/NSAIDS
Topiramate 
Finasteride 
Quinolones 
Aminoglycosides
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20
Q

Name some drugs affecting BFing

A

Ethosuximide, lamotrigine
Fluvastatin
Phenobarbital
Bromocriptine

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21
Q

Contraception required for isotretinoin?

A

Females of childbearing age must practise effective contraception for at least 1 month before starting treatment, during treatment, and for at least 1 month after stopping treatment.

They should be advised to use at least 1 highly effective method of contraception (i.e. a user-independent form such as an intra-uterine device or implant) or 2 complementary user-dependent forms of contraception (e.g. combined oral contraceptives and barrier method)

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22
Q

Name the enzyme inhibitors

A

SICKFACES.COM

Sodium valproate
Isoniazid
Cimetidine 
Ketoconazole
Fluconazole
Alcohol
Chloramphenicol
Erythromycin
Sulphonamides 
Ciprofloxacin 
Omeprazole 
Metronidazole
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23
Q

Name the enzyme inducers

A

BS CRAP GPS

Barbiturates
St johns wort
Carbamazepine 
Rifampicin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital 
Sulfonylureas
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24
Q

What drugs lead to a max dose of 20mg in simvastatin

A

VADAR

Verapamil
Amiodarone
Diltiazem
Amlodipine
Ranolazine
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25
Q

What are the high intensity statins?

A

Rosuvastatin 10mg and above
Atorvastatin 20mg and above
Simvastatin 80mg

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26
Q

When would you give a stimulant and osmotic laxative first line?

A

FOCOS

F= faecal impaction 
O = opioid induced
C = children
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27
Q

Name the smoking interactions

A

COAT

Clozapine, Olanzapine, Aminophylline and theophylline

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28
Q

Drugs that decrease effect of warfarin? THINK INDUCERS

A

SCRAP

St Johns Wart
Carbamazepine
Rifampicin
Alcohol
Phenytoin
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29
Q

Drugs that increase effect of warfarin? THINK INHIBITORS

A

McMACS

Metronidazole
Cranberry juice
Macrolides 
Azole antifungals
Ciprofloxacin
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30
Q

What antibiotics can’t you have with milk?

A

DOT

Demeclocycline, oxytetracycline, tetracycline
And ciprofloxacin

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31
Q

What tetracyclines can you have milk with?

A

Doxy, Lymecycline and minocycline

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32
Q

Safest abx in pregnancy?

A

PECC

Penicillins, erythromycin (risk benefit), clindamycin, cephalosporins

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33
Q

What drugs are used in TB (initial and continuation and durations)

A

RIPE

Rifampicin
Isoniazid (with pyroxidine)
Pyrazinamide
Ethambutol (eye toxicity, doesn’t cause liver toxicity like others)

Initial = 2 months of RIPE
Continuation = 4 months of RI
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34
Q

Use of pyridoxine?

A

Prevent peripheral neuropathy

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35
Q

Abx that you must take with food?

A

PMN

Pivemecillinam
Nitrofurantoin
Metronidazole

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36
Q

What are the short acting insulins?

A

LAG

Lispro (humalog)
Aspart (novo rapid/fiasp)
Glulisine (apirda)

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37
Q

What are the long acting insulins?

A

DDG

Insulin detemir (levemir)
Insulin degludec (tresiba)
Insulin glargine (lantus)
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38
Q

What are the warfarin colours and their corresponding doses?

A

BRUPE

Brown = 1mg
Blue = 3mg
Pink = 5mg
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39
Q

What age can naproxen be given etc for dysmennorhoea?

A

15-50 years

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40
Q

What is the dose for naproxen for dysmennorhoea?

A

1st dose = 2 tablets and 2nd dose after 6-8 hours is one more tablet if needed

No more than 3 a day and no more than 3 days of treatment in a month

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41
Q

Indication and age for tranexamic acid for menorrhagia?

A

18 and over, regular 21-35 days cycles and if no more than 3 days individual variability in cycle duration.

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42
Q

Contraindications for tranexamic acid?

A

Taking warfarin/any other anticoagulants
Taking COC or tamoxifen
Pregnancy
Mild to moderate renal insufficiency

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43
Q

Tranexamic acid dosage?

A

Take once heavy bleeding has started (2 tablets 2 times daily for as long as needed but for a maximum of 4 days) - no more than 8 tablets if severe

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44
Q

Age for tamsulosin?

A

45-75 years

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45
Q

Dosage for tamsulosin?

A

400micrograms capsule swallowed whole after the same meal each day

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46
Q

Contraindications for tamsulosin?

A

symptoms are <3 months duration
Prostate surgery
Unstable or undiagnosed diabetes
Postural hypotension

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47
Q

Counselling for tamsulosin?

A

Must see their doctor within 6 weeks of starting treatment and then every 12 months for confirmation that they can continue taking it

Interacts with antihypertensives

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48
Q

Indication for ED treatment with sildenafil?

A

Men over 18

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49
Q

Dose for sildenafil?

A

50mg an hour before SI - no more

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50
Q

Counselling points for sildenafil?

A
  • Healthy living advice

- General check up within 6 months of treatment

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51
Q

What treatments are available OTC for malaria?

A

Proguanil (paludrine 100mg tablet)
Chloroquine (avloclor 250mg tablet).
Atovaquone/proguanil (250/100) Maloff Protect

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52
Q

Dose for proguanil (paludrine)?

A

Daily dose week before entering country then 4 weeks after leaving the region.

Adutlts =200mg OD

53
Q

Dose for avloclor (chloroquine)?

A

Weekly dose - a week before entering malarial region, continue during stay, then 4 week after leaving region

2 tablets

54
Q

Dose for atovaquone/proguanil (250/100) Maloff protect?

A

Daily dose
1-2 days before entering malarial region and continue during stay
Carry on for another week after leaving the region
1 tablet

55
Q

Cautions and when to refer with proguanil (paludrine)?

A

Those with renal impairment

56
Q

Cautions and when to refer with avloclor (chloroquine)?

A 
Risk of hypoglycaemia 
Renal disease
History of epilepsy 
Those with psoriasis 
Those planning to conceive or are pregnant
57
Q

Cautions and when to refer with maloff (atovaquone/proguanil)?

A

Not for anyone who weights <40kg
Those planning to conceive or are pregnant/breastfeeding
Only licensed up to 12 weeks (may need rx or PGD)

58
Q

Contraindications for avloclor?

A

not to be used alongside amiodarone

59
Q

Contraindications for maloff protect?

A

If renal or hepatic impairment and in children and adolescents

60
Q

Interactions with paludrine (proguanil)

A

can increase effect of warfarin, antiretrovirals

Antacids must be taken 2 hours apart

61
Q

Interactions with avloclor?

A

Drugs that increase QT interval
Antacids
Increased TSH levels with concomincant use of levothyroxine

62
Q

Interactions with maloff protect?

A

Antiretrovirals

Rifampicin

63
Q

Cousnelling with antimalarials?

A

Always use bite repellant

Those that fall ill within 1 year and especially within 3 months after coming back should immediately see their doctor

64
Q

What drugs do you give in tonic clinical seizures:

A

SALOC

Sodium valp
Lamotrigine
Oxcarbamazepine
Carbamazepine

65
Q

Absense seizures??

A

SEAL

Sodium valproate
Ethosuximide
Levetiracetam
Topiramate

66
Q

Treatment for focal seizures?

A

FOCAL

Carbamazepine and lamotrigine

67
Q

Category 1 antiepileptics?

A

Carbamazepine, primidone, phenytoin, perampanel

68
Q

What are the extra pyramidal side effects?

A

ADAPT

Acute dystonia
Akathisia (an inability to remain still)
Parkinsonism
Tardiva dyskinesia

69
Q

Lithium monitoring?

A

Renal, plasma levels, cardiac and thyroid function

70
Q

How is lithium cleared?

71
Q

Side effects of lithium?

A 
GI disturbances, 
Visual disturbances 
CNS disturbances
Fine tremor 
Incontinence 
Signs and symptoms of hypothyroidism 
Signs of renal dysfunction (polyuria and polydispsia) 
Signs and symptoms of benign intracranial hypertension

MAKE SURE STICK TO SAME BRAND
Maintain adequate salt and oral intake

72
Q

What do you have to screen for with hydroxychloroquine?

A

Occular toxicity

73
Q

ADR’s with leflunamide?

A

Hepatic toxicity and teratogenic

74
Q

How long do you need contraception for for leflunamide?

A

2 years after treatment for women and 3 months for men

75
Q

How long before you can have kids with cyclophosphamide?

A

Permanent male sterility!

76
Q

How long do you need to be on contraception for after methotrexate?

A

3 months, both men and women

77
Q

What can be used to treat acute gout?

A

Colchicine or high dose NSAID

78
Q

What can be used to treat chronic gout?

A

Allopurinol first line or febuxostat

79
Q

What drugs can cause gout?

A
  • Diuretics
  • Ciclosporin, tacrolimus
  • Cytotoxics
  • Cancer drugs
80
Q

Maximum dose for colchicine?

A

6mg for course

500mcg 2-4 times a day

81
Q

Do you start long term control straight after gout attack?

82
Q

If attack occurs during prophylaxis, do you continue prophylactic treatment?

83
Q

Anti cholinesterase side effects?

A

Opposite of antimuscarinic so

  • Increased sweating
  • Increased saliva
  • Increased uterine motility
84
Q

Example of an anti-cholinesterase?

A

Neostigmine

85
Q

How do anti-cholinesterases work?

A

Prolong action of acetylcholine

86
Q

Side effects of quinine?

A

QT prolongation (MHRA), toxic in overdose

87
Q

Drug treatment for sciatica?

A
  • Oral NSAID
  • Weak opioid alone or with paracetamol
  • Benzo’s sometimes used
  • Tricyclics SHOULDNT BE USED FOR LOWER BACK PAIN
88
Q

NSAIDs should be taken on an empty stomach. True or false?

A

False - with or after food

89
Q

Can a GTN patch be applied to people with small veins to prevent extravasation?

90
Q

How is extravasation managed?

A

Corticosteroids, antihistamines, analgesics

91
Q

Side effects of tacrolimus?

A

Pretty much everything:
Cardiomyopathy, nephrotoxicity, hepatoxicity, blood dycrasias, hypertension, hyperglycaemia, hyperkalaemia, hyperurcaemia, headaches, tremors, blurred vision, can cause photosensitivity.

92
Q

Can you have mycophenlatep during pregnancy?

A

No - genotoxic and teratogenic

2 methods of contraception until 6 weeks after discontinuing in women
Men = condoms until 90 days after

93
Q

Is tacrolimus brand specific?

94
Q

Side effects of cyclosporin?

A

Nephrotoxic, hepatotoxicity, blood dycrasias, hyperlipidaemia, hypertension, high K and low Mg,
visual disturbances, gingival hyperplasia and photosensitivity

95
Q

What happens in tumour lysis syndrome?

A

Hyper K+, Urea, Hypocalcaemia

96
Q

What drugs does bone marrow suppression occur in?

A

All cytotoxic apart from vincristine and bleomycin

97
Q

How is hyperuricaemia prevented?

A

Allopurinol 24 hours before treating tumour

OR febuxistat 2 days before if allopurinol CI’ed

98
Q

Most emetogenic cancer drugs?

A

Cisplatin and high dose cyclophosphamide

99
Q

Treatment of chemo N+V?

A

Lorazepam for anticipatory and
if high risk = dexamethasone or lorazepam
If low risk/moderate = 5HT3 antagonist = ondansertron

100
Q

Drugs that are bad for extravasation?

A

Vinca alkaloids and anthrcyclines = worst case = amputation

101
Q

What are the anthracyclines?

A

Rubicins!

Doxorubicin

102
Q

Side effects of the anthracyclines (the rubicund)?

A

Cardiotoxicity (dose related) and red urine

103
Q

What are antineoplastic abx?

104
Q

Sife effects of antineoplastic abx?

A

Pulmonary toxicity, rest failure, hypersensitivity, dermatological toxicity

105
Q

Examples of vincalkaloids?

A

The vins
- Vincristine
- Vinblastine
IV ONLY

106
Q

Example of antimetabolites?

A

Methotrexate, flurouracil

107
Q

Side effects of antimetabolites?

A

Oral mucositis, myelosupression

108
Q

Examples of alkylating drugs?

A

Cyclophosphamide - permanent male sterility

109
Q

Treatment for breast cancer (post menopausal)

A

Aromotase inhibitors i.e. letrozole then tamoxifen if AI’s are inappropriate

110
Q

Treatment for breast cancer (pre menopausal and men)

A

Tamoxifen - if oestrogen receptor positive invasive breast cancer

111
Q

Bisphosphonate therapy in BC?

A

Zolendronic acid - every 3-4 weeks

112
Q

What biologic is used in BC and what is it recommended for?

A

Trastuzumab - treatment of her2 positive BC

113
Q

What to do if on HRT and get breast cancer?

A

Discontinue HRT

114
Q

Can aromatase inhibitors be used in pre menopausal women?

115
Q

What is the name of the chemo drug for prostate cancer?

116
Q

Treatment options for prostate cancer?

A
  • Anti angroden therapy
  • Active surveillance
  • Radical prostatectomy
  • Radiotherapy
  • Androgen depravation therapy
  • Chemo with docetaxel
117
Q

How often is hypromellose added?

118
Q

Is closed angle glaucoma an emergency?

119
Q

How long to refer for ulcers?

120
Q

How long can fusidic acid be used for in impetigo?

121
Q

Example of a mild topical steroid?

A

Hydrocortisone

122
Q

Example of a very potent topical steroid?

123
Q

How long do you need to continue contraception before and after isotretinoin?

A

1 month before, during and after

124
Q

What to do if you get psychiatric reactions with isotretinoin?

125
Q

Side effects of isoretinoin?

A

Hyperglycaemia, high cholesterol, dryness, pancreatitis , hepatoxicity, visual disturbances

126
Q

What common allergen is in the flu vaccine?

127
Q

Age for topical degongestants?

128
Q

Age for oral decongestants

A

6 - Max 5 days for 6-12

129
Q

Age for diphenhydramine?

PHARMACY: Pre registration (18 decks)

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