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patient MCQ > all drugs from MCQ list > Flashcards

all drugs from MCQ list Flashcards

1
Q

which drugs are contraindicated in auditory disorders?

A

gentamycin

zoledronic acid: osteonecrosis of the jaw

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2
Q

what interaction would amiodarone and an -ivir drug have?

a) severe bradycardia and heart block
b) reduced eGFR
c) QT-prolongation
d) AKI
e) hypermagnesemia
f) HF
g) Blood disorders
h) visual disturbances

A

severe bradycardia and heart block

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3
Q

which drugs can cause visual disturbances

A

infliximab, pioglitazone and hydrocortisone

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4
Q

which drug must you screen for TB before use

A

infliximab

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5
Q

accidental card oops

A

hi x

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6
Q

which drug can transiently raise LFTs?

A

sodium valproate

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7
Q

what would be the most likely ADR for ceftazidime and gentamycin?

A

gentamycin- nephrotoxicity

reduce eGFR: AKI risk

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8
Q

which drugs can cause skin reactions

A

gentamycin

omeprazole

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9
Q

which drugs should NOT be given in renal impairment

A 
furosemide
metformin (LA risk) if <30 
zoledronic acid if eGFR<30
parecoxib- avoid or use lowest dose/ time/ frequency
ceftazidime
gentamycin
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10
Q

what do the drugs zoledronic acid

sodium valproate have in common?

A

cannot be given in children of child bearing potential

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11
Q

monitoring requirements of: gentamycin (IV as well)

A 
electrolytes 
renal before and during 
auditory and vestibular function 
measure peaks and troughs if IV
concentration after 3-4 doses in children
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12
Q

monitoring requirements of: sodium valproate

A

LFTs- transient normally but monitor for 6m
FBC to ensure no bleeding risk
blood disorders
pancreatitis

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13
Q

monitoring requirements of hydrocortisone

A

height and weight in children

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14
Q

monitoring in amiodarone (IV as well)

A

LFTs before and every 6 months
potassium levels before
CRX before
thyroid before and every 6 months

IV: ECG and ensure resuscitation facilities.
liver transaminases closely

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15
Q

monitoring in salbutamol

A

potassium levels (risk of hypokalaemia) and blood glucose if they have diabetes

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16
Q

monitoring requirements of parecoxib

A

if renal impairment then monitor function and potassium/ water retention

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17
Q

which drug must you monitor magnesium with? especially when….

A

omeprazole

if used with other drugs causing hypermagnesemia e.g. digoxin

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18
Q

what is the likely interation between digoxin and omeprazole

a) severe bradycardia and heart block
b) reduced eGFR
c) QT-prolongation
d) AKI
e) hypermagnesemia
f) HF
g) Blood disorders
h) visual disturbances

A

hypermagnesemia

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19
Q

monitoring requirements for metformin?

A

renal function before and annually thereafter (twice yearly if risk factors)

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20
Q

monitoring requirements for infliximab (IV also)

A

infection- before, during and 6m after
periodic skin exam for non-melanoma skin cancer
blood disorders: fever, sore throat, bruising and bleeding
hypersensitivity reactions
TB before and 3 monthly thereafter

IV: 1-2 hours after w resuscitation equipment

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21
Q

what should be done if someone has TB and infliximab must be prescribed?

A

treat for 2 months at least and then screen every 3 months month

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22
Q

pioglitazone monitoring

A

liver function: if nausea, vomiting, abdopain, fatigue or dark urine
report haematurea

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23
Q

when is the risk of hypersensitivity to infliximab highest?

A

first 2 infusions

if not received any for >16 weeks

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24
Q

which patients must pioglitazone be avoided in?

A

bladder cancer
uninvestigated haematuria
HF or history of HF
hepatic impairment

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25
Q

symptoms of hypersensitivity reaction? commonly occurs in which drug and when

A

infliximab, if not been given for >16 weeks

fever, chest pain, BP changes, dyspnoea, transient visual loss, pruritus

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26
Q

which drugs should be avoided in hepatic impairment

A 
pioglitazone 
zoledronic acid 
furosemide 
parecoxib- 1/2 dose! 
sodium valproate
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27
Q

zoledronic acid monitoring requirements

A

renal function

liver function

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28
Q

what should patients look out for on zoledronic acid therapy?

A

hip, groin or thigh pain: atypical femoral fracture
jaw pain, discharge, non-healing sores, dental mobility - osteonecrosis of the jaw
ear pain, infections: osteonecrosis of the ear

29
Q

risk factors for osteonecrosis of the ear and jaw? common with which drug

A

zoledronic acid
jaw: potency of drug (more common at IV doses for cancer), smoking, dental disease

ear: steroid use, chemotherapy, infections, ear operations, cotton bud use

30
Q

monitoring requirements of furosemide?

A

electrolytes

potassium and sodium levels- can precipitate encephalopathy if liver impairment

31
Q

4 severe safety considerations in ciprofloxacin use, what should you counsel for each?

A

1.tendon damage- can occur within 48 hours and up to 2 months after use

  1. aortic aneurism and dissection- look out for severe sudden abdo, chest or back pain
    heart valve regurgitation
  2. severe irreversible musculoskeletal or neurological side effects
  3. heart valve regurgitation: rapid onset SOB when lying down, swelling on ankles, feet, abdomen and new heart palpitations
32
Q

when should ciprofloxacin be discontinued?

A

neuro, psychiatric, tendon or hypersensitivity reactions occur

33
Q

drugs to be cautioned in HF

A

pioglitazone: especially when given with insulin
amiodarone
hydrocortisone

34
Q

which drug interacts with dairy and mineral fortified drinks

A

ciprofloxacin

35
Q

drugs never to be used in HF

A

parecoxib- NSAID

36
Q

which drug can impair skill based tasks such as driving?

A

ciprofloxacin

37
Q

what is an interaction between pioglitazone and insulin?

a) severe bradycardia and heart block
b) reduced eGFR
c) QT-prolongation
d) AKI
e) hypermagnesemia
f) HF
g) Blood disorders
h) visual disturbances

A

HF risk is increased, especially if risk factors (past MI, stroke etc)

38
Q

which patients can hydrocortisone not be used in?

A

CHF, diabetes, epilepsy, diverticulitis,

viral, fungal or bacterial legions,acne

39
Q

drugs which can cause agranulocytosis?

A

sodium valproate

infliximab

40
Q

which drug should be used in caution in lupus

A

omeprazole- omeprazole can cause

sodium valproate

41
Q

risk of using amiodarone in pregnancy?

A

neonatal goitre, only use if no alternative

42
Q

which drugs need to be used in caution in those who are susceptible to QT prolongation

A

salbutamol
granisetron(n&v drug)
ciprofloxacin

43
Q

which drugs should be cautioned in those at risk of cardiac events?

A

amiodarone- last line for arrhythmia
salbutamol
parecoxib

44
Q

2 drugs which should be used in caution in mitochondrial disorders and why?

A

sodium valproate- higher rate of acute liver failure and liver related deaths
gentamycin- risk of deafness

45
Q

which drugs need their electrolytes monitoring

A

furosemide- hypokalemia (careful in CVD and those being treated with cardiac glycosides), in hepatic impairment hypokalaemia can precipitate encephalopathy

amiodarone (potassium levels before)

parecoxib (sodium and water retention must be monitored= renal deterioration

omeprazole- hypermagnesaemia

granisetron: can have electrolyte disturbnaces- caution in patients with QT prolongation

46
Q

most likely cause of ADE caused by granisetron and ciprofloxacin?

a) severe bradycardia and heart block
b) reduced eGFR
c) QT-prolongation
d) AKI
e) hypermagnesemia
f) HF
g) Blood disorders
h) visual disturbances

A

QT interval prolongation

47
Q

sTF: salbutamol can be used in arrhythmias

A

false, it can cause arrhythmias, however can be used with caution

48
Q

infliximab and sodium valproate could increase the risk of

A

blood disorders

49
Q

infliximab and sodium valproate interaction would most likely cause:

b) reduced eGFR
c) QT-prolongation
d) AKI
e) hypermagnesemia
f) HF
g) Blood disorders
h) visual disturbances

A

blood disorders

50
Q

gentamicin use in patients with mitochondrial disorders increases the risk of

A

deafness

51
Q

which drug is C/I in myasthenia gravis? and why?

A

gentamycin- impairs neuromuscular transmission

52
Q

which of the drugs must be avoided in pregnancy (highlight if they can be used but only if no alternative)

A

yes if no alternative:
amiodarone (risk of neonatal goitre only use if no alternative)
parecoxib- avoid unless necessary, avoid in 3rd trimester
infliximab- ensure effective contraception, only use if essential
ciprofloxacin: a single dose may be used for meningococcal meningitis (eye only if benefits outweigh the risks)

AVOID:
pioglitazone
zoledronic acid
Granisetron

53
Q

which of the drugs can you not abruptly withdraw

A

sodium valproate

54
Q

which drug can transiently cause infertility?

A

parecoxib (long term use of several NSAID do this but stops after treatment is stopped)

55
Q

patients in which furosemide is contraindicated

A

hypokalaemia
hyponatraemia
hypovolaemia
hepatic impairment

56
Q

which drug has a high risk of bladder cancer

A

pioglitazone

57
Q

what can high doses or rapid IV administration of furosemide cause?

A

tinnitus and deafness

58
Q

why must furosemide be used in caution in patients with liver impairment

A

can cause hypokalaemia and hyponatraemia which can precipitate encephalopathy

59
Q

which drug must be stopped if dehydration occurs and why?

A

metformin- increased risk of AKI

60
Q

which type of diuretic should be used to prevent hepatic encephalopathy

A

potassium sparing diuretic e.g. thiazide like

61
Q

which type of diuretic should be used to prevent hepatic encephalopathy

A

potassium sparing diuretic e.g. thiazide like

62
Q 
most likely interaction between sodium valproate
infliximab 
a) severe bradycardia and heart block 
b)reduced eGFR
c) QT-prolongation
d) AKI
e)hypermagnesemia
f)HF 
g) Blood disorders 
h) visual disturbances
A

blood disorders e.g. bruising, fever, bleeding, sore throat

63
Q

interaction between pioglitazone and hydrocortisone would most likely cause?

a) severe bradycardia and heart block
b) reduced eGFR
c) QT-prolongation
d) AKI
e) hypermagnesemia
f) HF
g) Blood disorders
h) visual disturbances

A

visual disturbances

64
Q

most likely interaction between salbutamol and infliximab

a) severe bradycardia and heart block
b) reduced eGFR
c) QT-prolongation
d) AKI
e) arrhythmia
f) hypermagnesemia
g) HF
h) Blood disorders
i) visual disturbances

A

arrhythmia

65
Q

theophylline and quinolones interaction?

A

increased risk of seizures

66
Q

half life of amiodarone? drug loading dose?

A

200mg TDS for 7 days
200mg BD for 7 days
200mg OD as maintenance

50 days half life, so need a loading dose

67
Q

what should be reported if on carbimazole?

A

sore throat, fever, malice, bleeding, ulcers

68
Q

side effects of amiodarone

A

Nausea and vomitting and taste disurbance

Thyroid function- Hypo and Hyperthyroidism through action of IODINE in the drug

Phototoxic skin reactions: burning sensation, erythema, slate grey skin discolouration

Pulmonary toxicity- persisitent SOB/ Cough

Tremor- peripheral neuropathy- numbness in hands and feet

Corneal microdepositis in eyes- dazzled by headlights- common SE: this is reversible once drug stopped

patient MCQ (22 decks)

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