CPT QUIZ Flashcards by Katherine Bowman

What is the drug class of Ramipril?

ACEi

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What is the mechanism of action of Clopidogrel?

ADP receptor (P2Y12) antagonist

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Aside from asking a patient, how else could you find out their medication history?

prescriptions
-GP/hospital letters
-dosette box
-medical records

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Give some drugs which cause hyperkalaemia…

ACEi (indirect via aldosterone, reduced expression eNac and downstream K+ excretion)
ARB
Spironolactone (potassium sparing diuretic)
heparin

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what is the drug class of Doxazosin?

alpha 1 blocker

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give an example of an aminoglycoside…

gentamicin

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what is a side effect associated with bendroflumethiazide?

hypokalaemia

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which antibiotic is used for tonsillitis treatment?

Penicillin V (phenoxymethylpenicillin)

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what is the usual dosage of paracetamol? up to what dose?

500mg to 1g QDS, up to a maximum of 4g/24hr

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what is the first-line management of C difficile gastroenteritis?

vancomycin (oral) — haemodynamically stable patients
Metronidazole (IV) In addition —- haemodynamically unstable patients

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give an example of a LMWH

dalteparin, enoxaparin, tinzaparin

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which class of antibiotic can cause Achilles tendon rupture?

quinolones (ciprofloxacin)

Must give safety netting advice when prescribing, if patient begins to feel pain over the insertion of the Achilles tendon they should stop the antibiotic and seek medical attention.

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Can methotrexate be taken in pregnancy?

no- teratogenic
Due to MoA being folate antagonist- interferes with development of the neural tube.

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give signs of dehydration on physical examination?

reduced skin turgor, dry mucous membranes, sunken eyes

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what is the drug class of chlorphenamine?

antihistamine— H2 receptor antagonist

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in CURB65 what does each element stand for? and what is the specific parameter?

C- confusion- new onset
Urea- >7 mmol/L
Respiratory rate- >30 breaths per minute
Blood pressure- <90 systolic, <60 diastolic
Age over 65

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what is the drug class of amitriptyline?

tricyclic antidepressant

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which enzyme is it important to measure before starting azathioprine?

TPMT (thiopurine S-methyltransferase)

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what is a side effect of gentamicin?

nephrotoxic/ototoxic
Due to favouring the OAT1 receptor which is favourably expressed at these sites.

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how do you treat an opioid overdose? what is the mechanism of action?

naloxone
competitive opioid receptor antagonist

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which drug do patients often buy over the counter when they get diarrhoea on holiday? Mechanism of action?

loperamide
Binds to opioid receptors causes decreased gut motility— constipation

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give an example of a dihydropyridine calcium channel blocker

amlodipine, nifedipine, nimodipine

what is the drug class of Ranitidine?

H2 receptor antagonist

what is the mechanism of action of Spironolactone?

aldosterone antagonist— reduces expression of eNac channels, reducing Na+ reabsorption and osmotic movement of water
Also reduced expression of ROMK channels- hyperkalaemia as a result of

what is the DDI between methotrexate and trimethoprim? why?

severe bone marrow suppression (myelosuppression) due to both drugs being folate antagonists-- required for new cell lines via DNA synthesis

which antimicrobial agents can stain urine orange? when are these commonly used?

nitrofurantoin (uncomplicated UTIs) rifampicin (therapy for TB)

which antibiotic is used for management of bacterial vaginosis? in what other circumstances is this antibiotic used?

metronidazole IV treatment for C difficile gastroenteritis (unstable patient/not responsive to Vanc alone)

how can we treat a heparin overdose? How does this work?

protamine sulphate Forms inactive complexes with heparin, dissociating it from ATIII- irreversible binding.

what should be the first line management for HTN in a 50 yr old with diabetes?

ACEi/ARB

give an example of an SGLT2 inhibitor

dapagliflozin, empagliflozin

what is the mechanism of action of methotrexate? (In cancer treatment)

folate antagonist Inhibits dihydrofolate reductase

is sodium valproate a CYP enzyme inhibitor or inducer?

inhibitor

what is the mechanism of action of atorvastatin?

competitive inhibition of HMG-CoA reductase

what is the drug class of Metoprolol?

beta blocker

what is the mechanism of action of apixaban?

antiplatelet therapy via inhibition of factor Xa (both free and bound by ant-thrombin III)

what is the mechanism of action of Celecoxib?

selective COX-2 inhibitor (NSAID)

what are some indications of azathioprine?

IBD, vasculitis, SLE

give examples of DOACs

apixaban (Xa), rivaroxaban (Xa), dabigatran (IIa) Inhibit both free Xa and that bound to anti-thrombin III in complex. Inhibit free IIa and that in thrombus complex.

can you give Co-amoxiclav to patients with a penicillin allergy?

NO! contains amoxicillin which is a penicillin-- will cause a type I hypersensitivity reaction

what is the antibiotic given to manage a lower UTI in a non pregnant female with eGFR of 30?

trimethoprim (Inhibits folic acid synthesis)

what is the first- line antibiotic for otitis media with bacterial cause? What is the likely causative bacteria?

amoxicillin Streptococcus pneumoniae/ Haemophilus influenzae

if we are suspecting GCA, what is the first line management? what is the drug class?

prednisolone (high dose, oral) corticosteroid

what drugs are provided as part of a COPD rescue pack?

steroids antibiotics

what risk do you need to consider when prescribing ICS in patients with COPD?

increased risk of pneumonia (due to immune suppression associated with steroids) Caused by organisms— Streptococcus pneumoniae, Moraxella catarrhalis, Haemophilus influenzae

what is ventolin the brand name for? what is this drug class?

salbutamol SABA

Rifampicin is used to treat which disease? Alongside which other agents?

TB - Isoniazid - Pryrazinamide - Ethambutol Quadruple therapy for 2 months, then dual therapy with rifampicin and isoniazid for a further 4 months. Medications may have to be taken under supervision if adherence is questioned.

what is the first line drug class in a status epilepticus?

benzodiazepine ie lorazepam (IV), midazolam (buccal), diazepam (rectal)

can we prescribe a COMT inhibitor ie entacapone as monotherapy for Parkinson's disease?

no, must be used in conjunction with another therapy as will not have a clinical effect used in isolation--- doesn't resolve underlying dopamine deficiency. MoA= to reduce peripheral (outside blood brain barrier) degradation of dopamine via inhibition of COMT (catechol-o-methyl transferase)

what is the systolic ambulatory BP needed to diagnose a patient with HTN?

>135 ambulatory >140 clinic

how high does the Q risk have to be before considering statin prescription?

>10%

how does infliximab work? In what circumstances is it used?

TNF-alpha inhibitor Rheumatoid arthritis, IBD

what is the first line management of hepatic encephalopathy?

lactulose (Promotes excretion of ammonia from the bone, also stimulates breakdown of ammonia by gut bacteria)

in what condition of children is aspirin no longer contraindicated?

Kawasaki disease