Contraindications

Question 1

Beta blockers avoid

Answer 1

In asthma due to effects on B2, cause bronchospasms (metoprolol & atenolol are B1 selective still don’t use)

Question 2

Beta blockers can cause

Answer 2

HF

Question 3

Beta blockers worsen

Answer 3

Heart block, reduces exercise tolerance, exertion dyspnoea, fatigue, hypotension, bradycardia

Question 4

Beta blockers inhibit

Answer 4

Lipoprotein lipase - worsen lipid profile

Question 5

Beta blockers CNS effects

Answer 5

Nighmeres

Question 6

Alpha 1 blockers

Answer 6

Postural hypotension, depression, drowsiness, nasal stuffiness, increases GI motility (diarrhoea), urinalysis incontinence

Question 7

Alpha 2 agonist

Answer 7

-C & -I effects may promote HF

Question 8

ACE inhibitors related to bradykinin increase

Answer 8

Persistent dry cough, and rarely angioedema

Question 9

ACE inhibitor

Answer 9

Initial hypotension, rash, dysgeusia, foetal abnormalities.
Exacerbates impairment in bilateral renal artery stenosis

Question 10

ACE inhibitors caution

Answer 10

Concurrent use with diuretics and NSAIDS

Question 11

Angiotensin receptor blocker

Answer 11

Usually well tolerated but hypotension, dizzy, rash

Question 12

Angiotensin receptor blocker GI

Answer 12

Nausea, vomit, diarrhoea, hyperkalaemia, renal issues if bilateral renal artery stenosis, teratogenic

Question 13

Statins

Answer 13

Myopathy and rhambdomyolysis (breakdown of muscle fibres releasing myoglobin to plasma and eventually kidneys)

Question 14

Statins teratogen

Answer 14

Inhibiting cholesterol formation can affect developmental genes, avoid in pregnancy

Question 15

Statins increased chances of adverse effects

Answer 15

High dose in elderly, and drug interactions

Question 16

Fibrates GI

Answer 16

GI-related effects are minor and are resolved with withdrawal

Question 17

Fibrates interactions with statins

Answer 17

Some statins causing myalgia (muscle pain) possible with some Fibrates

Question 18

Low dose aspirin

Answer 18

Gastric ulceration and bleeding, Reye’s syndrome

Question 19

Clopidogrel

Answer 19

Bleeding, haemorrhage, thrombocytopenia

Question 20

Enoxaparin

Answer 20

Associated with fewer side effects than UF heparin.
Risk of haemorrhage, bruising, hyperkalaemia, elevated AST & ALT

Question 21

Warfarin

Answer 21

Narrow therapeutic index
Haemorrhage (storke), GI tract loss, bruising, teratogenic, skin necrosis.
Several drug interactions

Question 22

Fibrinolytics

Answer 22

Bleeding, haemorrhage, nausea, vomiting

Question 23

Fibrinolytics do not use with

Answer 23

Anticoagulants

Question 24

Amlodipine conindicated in

Answer 24

Unstable angina as it causes reflex tachycardia to maintain BP when TPR drops, increasing myocardial O2 demand

Question 25

Amlodipine AE

Answer 25

Flushing, oedema, dizzy, nausea, constipation

Question 26

Verapamil AE

Answer 26

Flushing, oedema, dizzy, nausea, constipation

Question 27

Verapamil contraindications

Answer 27

HF, bradycardia, conduction defects. Cannot use with BB

Question 28

Diltiazem contraindications

Answer 28

HF, bradycardia, conduction defects. Cannot use with BB

Question 29

Nitrates and nitrodilators AE

Answer 29

Flushing, headache, reflex, tachycardia, palpitations dizzy, hypotension

Question 30

Nitrates and nitrodilators interactions

Answer 30

Alcohol, BB, CCB, viagra

Question 31

Nitrates and nitrodilators tolerance and withdrawal

Answer 31

Tolerance can develop. avoid abrupt withdrawal

Question 32

Osmotic diuretic

Answer 32

Increased ECF vol - pulmonary congestion, hypersensitivity reactions, headache, nausea, vomit

Question 33

Loop diuretics

Answer 33

Hypovolemia, dizzy, syncope, Na+ K+ Ca2+ Mg2+ loss, hyperuricemia - gout, metabolic alkalosis

Question 34

Loop diuretics prolonged use

Answer 34

Hearing loss, increase renal toxicity of cephalosporins

Question 35

Thiazide diuretics

Answer 35

Dehydration, postural hypotension, hyponatremia (lead to Li+ accumulation), metabolic alkalosis, gout, hypokalemia, impotence, hyperglycaemia, prolonged QT interval

Question 36

Potassium sparing diuretics

Answer 36

Hyperkalaemia, androgen modulating effects (steroid structure), gynecomastia, GI disturbances

Question 37

Sodium channel antagonist

Answer 37

Can induce arrhythmias by slowing conduction

Question 38

Potassium channel antagonist

Answer 38

Photosensitive skin rashes, thyroid abnormalities, pulmonary fibrosis, corneal deposits, neurological and GI disturbances

Question 39

Potassium channel antagonist pregnancy and breast feeding

Answer 39

Don’t use in pregnancy, expressed in breastmilk

Question 40

Cardiac glycoside

Answer 40

Nausea, vomit, confusion

Question 41

Cardiac glycoside can cause

Answer 41

Arrhythmias

Question 42

Cardiac glycoside AE

Answer 42

Nausea, vomit, confusion