Communicating information

Question 1

Can ramipril be taken during pregnancy?

Answer 1

ACE inhibtiros are teratogenic in the first trimester, patients should be converted to labetalol before conception

Question 2

Give some side effects of tamoxifen and it’s interaction with warfarin

Answer 2

• increased risk of endometrial Ca
• increased risk of VTE
• hot flushes
• increases efficacy of warfarin

Question 3

Do sulfonylureas (gliclazide) cause hypos?

Answer 3

YES

these drugs INCREASE INSULIN PRODUCTION. Patients should not miss meals to reduce risks of hypo

Question 4

Give the typical drug regime for methotrexate, list some key adverse reactions and drug interactions and use in pregnancy

Answer 4

• methotrexate is taken weekly
• FBC, u&e LFTs need to be taken regularly
• folic acid 5mg to be prescribed, taken more than 24 hours after the methotrexate dose
• starting dose is 7.5mg weekly

Adverse reactions:
- mucositis, myelosurpression, penumonitis, pul. fibrosis, liver fibrosis

Interactions:
trimethoprim or co-trimox (increased risk of marrow aplasia)
- high dose aspritn

Preganancy:
avoid pregnancy for at least 6 months after treatment has stopped
men should also be on adequate contraception