Chapter 2 Qs Flashcards
Q2.1 Give an example of 2 drugs that should be stopped in a pt with haemoptysis
Antiplatelets: Aspirin
Anticoagulants: LMWH
Q2.1 Give an example of 2 pescriptions that should be stopped in a hyperkalaemic patient
ACEi (ramipril)
IV fluid with added potassium
Q2.2 What affect do these drugs have on K+
- Bendroflumethiazide
- Lisinopril
- Bendroflumethiazide, thiazide diuretic, hypokalaemia
- Lisinopril, ACEi, hyperkalaemia
Q2.2 What is the mechanism of action of the following antiemetics:
- Metoclopramide:
- Domperidone:
- Cyclizine:
- Metoclopramide: dopamine antagonist, crosses BBB, exacerbated parkinsonian symproms
- Domperidone: dopamine antagonist Doesn’t cross BBB, safe in PD
- Cyclizine: antihistamine anti-emetic
Q2.3 Name one drug which results in a dry cough as a SE
ACE-I cause dry cough through accumulation of bradykinin via reduced degradation by ACE.
Q2.3 What affects do the following drugs have on electrolytes:
- Lisinopril
- Bendroflumethiazide
- Lisinopril, ACE-i cause hyperkalaemia via reduced aldosterone production, and reduced K+ excretion in kidneys (aldosterone antagonists do this too).
- Bendroflumethiazide, is a thiazide diuretic which causes hypokalaemia (loop diuretics do this too)
Q2.4. How do the following two drugs cause ‘stomach upset’:
- Ibuprofen
- Prednisolone
- Ibuprofen, NSAID, inhibits prostaglandin synthesis needed for gastric mucosal protection.
- Prednisolone, Oral steroids inhibit gastric epithelial renewal.
Both → indigestion/dyspepsia.
Q2.4. How do the following two drugs cause renal falure:
- Ibuprofen
- Ramipril
- Ibuprofen, NSAID inhibits prostaglandin synthesis → reduced renal artery diameter → reduced kidney perfusion + function.
- Ramipril, ACEi, reduces angiotensin II profuction req for preserving glomerular filtration when blood flow is reduced
Q2.5. Give an example of a drug type that should be stopped if patient is constipated
STOP opioids e.g. co-codamol, codeine
Q2.6 Common PMHx contra-indication for Ibuprofen
Asthma: NSAIDs (e.g. ibuprofen) cause bronchoconstriction, so avoid unless strictly necessary + under supervision (not at home).
Q2.6 Important to remember regarding PRN medications
For prescription to be valid, must write maximum PRN frequency – can’t just write “as required” on its own.
Q2.6 CI for trimethoprim in a pt with RA on methotrexate
Trimethoprim = folate antagonist, so CI with methotrexate (also folate antagonist) as risk of BM toxicity → pancytopenia + neutropenic sepsis.
Q2.6 Important to remember in a septic pt on methotrexate
If on methotrexate + septic, must stop it pending exclusion of neutropenic sepsis.
Q2.7 Important side effect on CCB
CCBs (e.g. amlodipine) cause ankle swelling. Do not use in HF.