Drugs

Question 1

Ketoconazole

Answer 1

Hepatotoxic measure LFTS before and weekly for one month then monthly for six months
Oral formulation only for cushings
Do ECG as it prolongs QT interval
Adrenal suppression moniter for effects
Nausea anorexia hyperkalemia hypoglycaemia
Hyponatremia

Question 2

Desmopressin

Answer 2

Manufacture says avoid with concomitant use of drugs that increase ADH secretion e.g. TCA
Moniter sodium levels
Stop if have nausea and vomiting
Avoid fluid overload esp during swim as it can cause hyponatremia convulsions
Review in three months if no improvement STOP
It is Better than ADH as it is potent longer duration of action and no vasoconstriction effect
Also used for nocturnal entries in children over five
AIM is to cause slight duiresis every 24hours

Question 3

Mefloquine

Answer 3

Use contraception during and three months after
Use alert card patient alert card
Not allowed in psychiatric issues depression pilots etc
Not allowed in pregnancy
Contraindicated in epilepsy same as chlorine
Weekly dose same as chloroquine