Drugs

Question 1

what medicine can cause aplastic anemia?

Answer 1

NSAIDs anti-epileptics (carbamazepine, phenytoin, valproic acid) sulfasalazine Nifedipine Chloramphenicol

Question 2

what supplement with methotrexate?

what is the effect of the supplement?

Answer 2

folic acid

• reduce AST/ALT elevation, GI intolerance, stomatitis –> increase the maximum tolerated dose of methotrexate
• prevents megaloblastic anemia,

Question 3

a patient develope Sx of UTI,

Hx of RA, on methotrexate and prednisone.

which ABx? what should be avoided?

Answer 3

Use cephalexin

Avoid drugs that increase the toxicity of methotrexate ( leukopenia) : trimethoprim, co-trimoxazole, amoxicilin, co-amoxiclav, ciprofloxacin)

Question 4

which drug causes symptoms like botulism?

Answer 4

gentamicin

CIx in preexisting disturbance of neuromuscular transmission.

Question 5

drugs that cause hirsutism

name 6

Answer 5

VPMTCD

valproic acid

phenytoin

minoxidil

testosterone

cyclosporin

danazol

Question 6

absolute CIx of progesterone only pills?

Answer 6

taking enzyme-inducing drugs

anti-epileptic drugs, rifampin, barbituates, etc

Question 7

bisphosphonate which one is PO? IV?

Adverse effects of PO, IV bisphosphonate?

Answer 7

• PO : alendronate
• Adverse effects : esophagitis,
• IV : pamidronate, zoledronate
• Adverse effects : osteonecrosis of jaw

Question 8

the most common side effect of CCB?

Answer 8

1. peripheral edema
2. headache

Question 9

Pt with depression, taking sertraline,

feeling tired, muscle cramps

reason?

Answer 9

hyponatremia due to secondary SIADH

SSRI and SNRI can cause SIADH –> hyponatremia

Question 10

which drug is analogue of niacin and suppresses its endogenous formation?

which drugs inhibit conversion of tryptophan to niacin?

Answer 10

niacin = VitB3

suppression of endogenous formation : isoniazid

inhibition of tryptophan to niacin : azathioprine, 5-flurouracil, 6-mercaptopurine, phenobarbitone

Question 11

A patient on warfarin for a.fib.

started on amiodarone for V Tach

what should be monitored?

Answer 11

bleeding, hematoma

Amiodarone decreses warfarin metabolism and increase the bleeding tendency.

Question 12

the most common pathologic abnormal ECG finding in amitriptyline intoxication?

Answer 12

QRS widening

Question 13

the most common abnormal ECG finding in Digoxin intoxication?

Answer 13

VPC

Question 14

salicylate overdose acid base derangement?

Answer 14

early : primary respiratory alklosis

late : metabolic acidosis

hypokalemia

hyperglycemia (or hypoglycemia)

Question 15

paracetamol overdose managent

Answer 15

< 200mg/kg ? –> reassure

> 200mg/kg or unknown dose?

• paracetamol level at 4 hr
• Tx if indicated

Question 16

a patient with kidney stone,

develops a tonic-clonic seizure.

which antiepilectic is contraindicated?

Answer 16

topiramate