clw 2

Question 1

cream disadvantages

Answer 1

• not as adhesive, contact time too short
• lack of occlusive effect, decrease penetration of drug

Question 2

benefit of ointment

Answer 2

• more adhesive, longer contact time with skin, increased absorption
• occlusive
• lipophilic, prevents easy evaporation from skin surface
• swelling of stratum corneum, widening of intercellular spaces, thus enhanced penetration of drug via paracellular transport

Question 3

faecal occult blood test positive means

Answer 3

bleeding somewhere in GIT

Question 4

general inflammatory markers

Answer 4

ESR, CRP

Question 5

RA specific inflammatory markers

Answer 5

rheumatoid factor, anti-CCP

Question 6

how to know if got gout

Answer 6

presence of uric acid crystals in joint aspirate (synovial fluid)

Question 7

arthritic pain prn use what

Answer 7

tramadol 50mg tds

Question 8

tramadol ddi with ssri

Answer 8

serotonin syndrome

Agitation or restlessness.
Insomnia.
Confusion.
Rapid heart rate and high blood pressure.
Dilated pupils.
Loss of muscle coordination or twitching muscles.
High blood pressure.
Muscle rigidity.

Question 9

topical nsaid is not significant to worsen pud

Question 10

gout/ra non pharm

Answer 10

reduce alcohol intake, avoid purine rich foods

Question 11

side effects of dmards

Answer 11

malignancy due to immunosuppresion
hepatotoxicity
skin rxn
infusion related rxn
Rash, allergic reaction.
Liver problems.
Increased risk of infections (personal hygiene)
Low white cell count (leukopenia),
red blood cell count (anemia)
platelet count (thrombocytopenia).

Question 11

what to monitor for dmards

Answer 11

CBC, LFT, renal every 3 to 6 months.

hepatotoxicity, myelosupprx might only appear at 6 week mark

Question 12

omeprazole metabolism

Answer 12

cyp2c19 inhibitor

Question 13

need to redo fobt?

Answer 13

no. Even aft bleed has resolved, FOBT may still be positive → should not use it to guide therapy

Question 14

non pharm for psoriasis

Answer 14

mineral sunscreen
regular use of emollients
do not pick on plaques

Question 15

benefits of lyophilisation

Answer 15

• The product is processed in an aseptic environment.
• Water is removed without heat which prevents product degradation during drying.
• The shelf life of the drug product is extended, and stability is enhanced

Question 16

Sc injection vs IV

Answer 16

SC can also afford to load higher drug amount to act as depot.

SC injections are generally used for depots and slow release so it has higher conc. Infusing this directly into veins (IV) may have adverse effects, eg. faster absorption (higher conc), irritation (excipients), embolism

Question 17

for immunosuppressants, what to screen before starting

Answer 17

TB, hep B to make sure no infection, else treat first