Drugs Flashcards
What dose of adrenaline is given to a < 6 month old having an anaphylaxis reaction?
150mcg (0.15ml of 1:1000)
What dose of adrenaline is given to a 6 month- 6yrs old having an anaphylaxis reaction?
150mcg (0.15ml of 1:1000)
What dose of adrenaline is given to a 6-12year old having an anaphylaxis reaction?
300mcg (0.3ml of 1:1000)
What dose of adrenaline is given to an adult (>12yrs) having an anaphylaxis reaction?
500mcg (0.5ml of 1:1000)
In addition to adrenaline what other two drugs should be given for an anapylactic reaction?
Hydrocortisone
Chlorphenamine
What is the most common electrolyte imbalance associated with Bisoprolol?
Hyponatremia
You are in a GP clinic and change a dose of Ramipril from 5mg to 10mg OD. What action must be taken?
Book U+E’s to be monitored in 14 days time
A patient is switched from furosemide to bumetanide, what is the strength relationship between the two drugs?
1mg Bumetanide = 40mg Furosemide
An elderly lady in your practice has just been started on Aspirin, what additional medication should be prescribed?
Omeprazole
You are prescribing naproxen to a patient for the first time (for pain). What 2 key things must you ask about in the history?
Allergies
History of stomach ulcers etc
You are prescribing labetalol to a pregnant patient to control her blood pressure, what must you ask about in the history before starting this drug? (2)
Allergies
History of asthma
What are the most common side effects of anti-cholinergic medicines?
Dry mouth, dry eyes, constipation and blurred vision
Name three common medicines which cause hyperprolactinaemia?
Verapamil
Tramadol
Thioxanthenes (Zuclopenthixol, Flupenthixol - anti-pyschoctics)
A 57 year old man is admitted to hospital with a 3 day history of LRTI and one day history of rash. He was started on antibiotics 3 days ago. What is the most likely drug responsible for his rash?
Amoxicillin
used for LRTI’s - note rashes are a common side effect of all penicillin medications
What is first line drug management for shingles (Herpes Zoster) for an adult?
Aciclovir 800mg 5x/day for 7 days
A 45 year old caucasian male presents with a BP of 170/110. What is the most appropriate drug/ dose to start him on?
Ramiprill 2.5mg
White <55
What is the most important information that should be communicated to a patient about taking Gliclazide?
Can cause hypo’s (know symptoms)
Take with breakfast
Can cause weight gain
You are starting a patient on carbimazole for hyperthyroidism, what is the main SE you should counsel them on?
Agranulocytosis (immediate help if sore throat, mouth ulcers, brusing, fever, malaise)
A patient with UC presents for his 3 month review after being started on mesalazine, what monitoring should patients on mesalazine recieve?
Renal function (start, 3 months, yearly)
What blood test should be conducted when starting steroids in a 60 year old man? What additional medications should be prescribed?
Glucose (can worsen diabetes)
Also prescribe PPI
Name 2 common side effects of denosumab?
Hypocalcaemia (can be used to treat hypercalcemia)
Osteonecrosis of the jaw
The chemotherapy agent Vinblastine is most commonly associated with which side effect?
Peripheral neuropathy
How long after a prescription is dated can it be picked up?
6 months
How long can the contraceptive pill be prescribed for on a single prescription?
6 months
Which opiates can come in a patch?
Fentanyl
Buprenorphine
How do you find the opiate conversion tables in the electronic BNF?
Guidance tab at the bottom
Prescribing in paliative care
You are writing a prescription for a fentanyl patch (a 75 microgram patch) which should be given one every 72 hours. How do you write this prescription?
FENTANYL 75 (SEVENTY-FIVE) MICROGRAM PATCH Replace ONE (1) patch every 72 (SEVENTY-TWO) hours Supply FIVE (5) patches
When replacing opiate patches what is the guidance around replacing the patches?
Replace at a different site!
When starting take last dose of other opiates (i.e. oral MR) then immediately put patch on (as it takes a bit of time to work)
A patient under the paliative care team is using fentanyl patches (equivalent to 180mg morphine daily) however needs extra support for breakthrough pain, what should she be prescribed?
Oromorph
1/6 to 1/10 of daily dose (18 to 30mg)
When increasing opiates what is the maximum change you should make?
Do not increase more than 50% of current dose
i.e. if on 100mg/ day don’t go to more than 150mg/day
When counselling for Warfarin vs. NOAC what are the main points which should be covered?
Warfarin - individualised treatment and INR is monitored
- Diet has to be monitored more in warfarin
- Much more monitoring requirement for warfarin
- Reversible with vit K
NOACS
- Less monitoring and less lifestyle impact
- Note Dabigatran can be reversed, others can’t initially (so if high fall risk should Wafarin be considered?)
What surface area should one fingertip unit of steroid cream cover?
Approx size of face or both palms
Name three drugs which could help a patient trying to come off alcohol?
Naltrexone/ Baclofen- Make alcohol use less rewarding
Acamprosate- Reduces craving
Disulfiram- Causes sickness when alcohol ingested (v.low adherence)
Name three side effects/ increased risks when taking the COC pill? When should this pill be taken?
Each day at same time for 21days, 7 day break
Small risk of blood clots
Very small risk of heart attacks and strokes
Increased risk of breast cancer and cervical cancer
What are bisphosphonates used for and what is the most common side effect of them?
E.g Alendronic acid
Used to strengthen bones
- Most common SE is inflammaton/ ulceration/ irritation of the oesophagus
(So take 30min before food and don’t lie down for 30min after)
What is the most important side effect of rispiridone?
Hyperprolactinaemia
Change in periods, galactorrhea, painful intercourse, acne and hirsutism
You are about to start a patient on ramiprill and are reviewing some bloods they have just had done, what key areas must you look at? (3)
Baseline potassium (ACEI can cause hyperkalaemia) Baseline renal function (ACEI cause decreased renal function, up to 25% increase in urea/creatinine is acceptable) - Px to return in 7-10days to have renal function monitored
A patient is about to be started on treatment for their newly diagnosed pulmonary TB infection, what agents are started?
- What must be checked before starting
Isoniazid - 6months Rifampicin- 6months Pyrazinamide- 2months Ethambutol- 2months All causes liver toxicity so check LFTs, also check kidney function and caution starting ethambutol if kidney pathology
You are about to start a patient on Metronidazole, what is the single most important lifestyle factor you must council on?
ALCOHOL MUST BE AVOIDED
- There is a very severe reaction
- All AB’s may have some small reaction but the reaction between alcohol and metronidazole is very severe
Name 3 drugs which can cause lung fibrosis?
Amiodarone, methotrexate, nitrofurantoin (used for UTI) , bleomycin
Name 6 common side effects of iron supplementation?
Constipation Black stools Diarrhoea Heartburn Nausea Abdominal/epigastric pain
A patient is diagnosed with impertigo, what is the best treatment?
Fucidic acid
Flucloxacillin if very severe
A patient on antibiotics complains of orange tears and orange urine, what is the most likely antibiotic they are taking?
Rifampicin
Where does metoclopramide act and what are some of it’s most important side effects?
Acts on the gut (so good for gastroenteritis, or other motility problems)
- Can cause tardive dyskinesia and extra pyramidal problems
