Drug choices

Question 1

Suggest the best medications for a patient that has failed metformin monotherapy that needs to take a second tablet.

Answer 1

Glizacide 40-80mg PO daily with breakfast
Glipizide
Tolbutamide

Question 2

Give a IV infusion that may help correct potassium levels.

Answer 2

IV fusion of phosphate

Question 3

What is the most appropriate laxative prescribed to pregnant women?

Answer 3

For Fybogel one sachet or two level 5ml spoonfools in water twice daily after meals

Question 4

What booster should be given to a child that was bitten by a dog?

Answer 4

Repevax 0.5ml IM

Question 5

How is amiodarone given?

Answer 5

300mg over 20-120 minutes as a continous IV infusion.

Question 6

What is first line LMWH given to patients for VTE prophylaxis not in renal failure undergoing orthopoedic surgery?

Answer 6

Dalteparin 2500 units 1-2 hours pre surgery, then 2500 units after surgery 8-12 hours

Question 7

What is the reversal agent for dalteparin?

Answer 7

Idarucizumab

Question 8

What is first line for patients with meningiococcal disease and penicllin allergy?

Answer 8

Cefotaxime (900mg or 1g) by IV or IM injection
Ceftriaxone

Question 9

What is the correct treatment for a stroke?

Answer 9

aspirin 300mg for 14 days before switching to clopidogrel

Question 10

How is furosemide prescribed?

Answer 10

50mg (up to 1.5g) daily by continous IV infusion with 4mg/min.

Question 11

What form of morphine is used following an MI?

Answer 11

5mg Diamorphine by slow IV infusion

Question 12

What drug can be used for antisickness in Parkinsons

Answer 12

Domperidome does not cross BBB

Question 13

What is the first line anticoagulant in patients that cannot take oral anticoagulants?

Answer 13

Dalteparin

Question 14

What antiplatelet should be prescribed following an MI?

Answer 14

75MG od po clopidogrel for 12 months

Question 15

When should plasma theophylline levels be taken?

Answer 15

monitor theophylline concentration after 5 days Plasma theophylline concentration taken 4 - 6 hours after an oral dose is the correct timing for sampling of plasma theophylline concentrations. The average half-life of theophylline is approximately 6 - 9 hours. The target plasma concentration for bronchodilation is 10 - 20mg/l, although lower levels may be adequate in some patients.

Question 16

What is given in benzodizepine overdose?

Answer 16

Flumazenil
200ug
IV
15 seconds

Question 17

What is given in organophosphate poisoning?

Answer 17

Pralidoxime

Question 18

What antibiotics should be prescribed for chlamydia in pregnancy?

Answer 18

Azithromycin 1 g once daily for 1 day, then 500 mg once daily for 2 days
Erythromycin 500mg PO BD for 14 days

Question 19

Suggest first line treatment for bacterial meningitis in children.

Answer 19

The most likely diagnosis in this patient is meningitis - inflammation of the meninges. Whilst viral meningitis is more common than bacterial meningitis, all cases should be suspected as bacterial until proven otherwise due to the high mortality and morbidity. The BNF recommends cefotaxime or ceftriaxone in all patients aged between 3 months and 50 years as the initial empirical therapy of choice.

Question 20

What is the treatment for severe hypoglycaemia?

Answer 20

150 – 200ml 10% glucose IV is the most appropriate treatment for severe hypoglycaemia in a patient who is unresponsive. Alternatively, 20% glucose solution can be used.

Question 21

What can be used in nausea associated with migraine?

Answer 21

This patient is complaining of nausea and vomiting associated with recurrent migraines. Antiemetics specifically licenced for the treatment of nausea associated with migraines include:

Prochlorperazine 3-6mg buccal PRN - up to twice daily. Tablets should be placed high between the upper lip and gum and then left to dissolve (BNF link)
Metoclopramide 10mg PO PRN - up to 3 doses daily (BNF link)

Question 22

Scarlet fever drug

Answer 22

Scarlet fever is usually treated with a 10-day course of antibiotics. This is often in the form of penicillin or amoxicillin tablets, although liquid may be used for young children.

Question 23

Feboxustat

Answer 23

Febuxostat is used to lower hyperuricemia (high uric acid in the blood) in patients with gout who have been treated with allopurinol that did not work well or cannot be treated with allopurinol.

Question 24

Bacterial vaginosis in a female with alcohol dependency

Answer 24

Question 25

First line for haemorrhoids

Answer 25

Haemorrhoids are common in pregnancy and are associated with straining due to constipation. A bulk-forming laxative such as Ispaghula husk is the first choice of laxative in pregnancy, after increasing dietary fibre and fluid intake.

Question 26

What drug is used for eclamptic seizures?

Answer 26

magnesium sulfate is the recommended medication to treat eclamptic seizures

Question 27

What drug should be prescribed with sickness and heart failure?

Answer 27

Ondansetron

Cyclizine is contra-indicated in light of her heart failure

Question 28

What are some examples of stool softeners?

Answer 28

Lactulose, movicol, macrogol

Question 29

When are statins stopped or discontinued?

Answer 29

The BNF advises if serum transaminases are greater than 3 times the upper limit of the reference range then statin therapy should be discontinued.

Question 30

When should a patient stop taking microgynon?

Answer 30

A systolic blood pressure of over 160mmHg (or >100mmHg diastolic) is a contraindication to COCP usage and it should be stopped.

Question 31

What should you do if statin results is less than 3 times the normal ALT?

Answer 31

If the transaminase are raised but less than 3 times upper limit of normal , continue statin and repeat LFT in a month.

Question 32

How should morphine be managed when patient is recovering?

Answer 32

Stop regular and give PRN

Question 33

What should be prescribed in end organ damage?

Answer 33

As there is evidence of nephropathy in this patient, she should be started on a renoprotective agent pending a repeat urine dip and/or confirmation of end-organ damage