Em extending + rps23e Flashcards
A 34-year-old woman with bipolar disorder is prescribed tramadol for pain. Her current
medication includes lithium.
o Risk of bleeding
o Risk of QT prolongation
o Risk of serotonin syndrome
o Reduced seizure threshold
o Risk of nephrotoxicty
o Risk of myopathy
o Risk of hypotension
o Risk of hypertension
Tramadol interacts with lithium (increased risk of serotonin syndrome)
A 56-year-old man is started on simvastatin 40mg ON. His current medication includes
amlodipine, aspirin and levothyroxine.
o Risk of bleeding
o Risk of QT prolongation
o Risk of serotonin syndrome
o Reduced seizure threshold
o Risk of nephrotoxicty
o Risk of myopathy
o Risk of hypotension
o Risk of hypertension
Amlodipine interacts with simvastatin (amlodipine causesanincrease in exposure of simvastatin, increasing the risk of myopathy). The maximum recommended dose of simvastatin is 20mg ON when used with amlodipine
A 62-year-old woman has a flare up of osteoarthritis, and she is prescribed naproxen
with lansoprazole. She takes ramipril and indapamide for hypertension. Her recent clinic BP
reading was 125/79. She has no other medical conditions.
o Risk of bleeding
o Risk of QT prolongation
o Risk of serotonin syndrome
o Reduced seizure threshold
o Risk of nephrotoxicty
o Risk of myopathy
o Risk of hypotension
o Risk of hypertension
The patient is prescribed an NSAID, ACEinhibitor and diuretic; this combination of medications increases the risk of AKI, so we are most concerned about the risk of nephrotoxicity.Note that she has a PPI (lansoprazole) as gastroprotection on the NSAID (reducing the risk of GI bleed).Her blood pressure is within target
- A 70-year-old man is prescribed sertraline. His current medication includes apixaban and
amlodipine.
o Risk of bleeding
o Risk of QT prolongation
o Risk of serotonin syndrome
o Reduced seizure threshold
o Risk of nephrotoxicty
o Risk of myopathy
o Risk of hypotension
o Risk of hypertension
Risk of bleeding. Both apixban and sertraline can cause bleeding (increased risk when used to together
An elderly woman was recently started on citalopram by her GP. She presents to the
emergency department with confusion, nausea and vomiting
o Hyponatraemia
o Hypernatraemia
o Hypokalemia
o Hyperkalemia
o Hypocalcaemia
o Hypercalcaemia
o Hypomagnesemia
o Hypermagnesemia
Citalopram is an SSRI and can cause hyponatraemia(low sodium). Confusion, nausea and vomiting are potential symptoms of hyponatraemia
A patient takes both ramipril and eplerenone and their blood test shows an electrolyte
disturbance.
o Hyponatraemia
o Hypernatraemia
o Hypokalemia
o Hyperkalemia
o Hypocalcaemia
o Hypercalcaemia
o Hypomagnesemia
o Hypermagnesemia
Both ramipril (an ACE inhibitor) and eplerenone (a mineralocorticoid receptor antagonist) can cause hyperkalemia (high potassium)
A patient has been taking omeprazole on a long-term basis. She complains of symptoms
of nausea, weakness, twitching and cramps.
o Hyponatraemia
o Hypernatraemia
o Hypokalemia
o Hyperkalemia
o Hypocalcaemia
o Hypercalcaemia
o Hypomagnesemia
o Hypermagnesemia
Omeprazole is a proton pump inhibitor, whichcan cause hypomagnesemia(low magnesium),particularly with prolonged use. Nausea, weakness, twitchingand cramping are potential symptoms of magnesium deficiency
A patient was started on furosemide for heart failure. They complain of fatigue and
palpitations.
o Hyponatraemia
o Hypernatraemia
o Hypokalemia
o Hyperkalemia
o Hypocalcaemia
o Hypercalcaemia
o Hypomagnesemia
o Hypermagnesemia
Furosemide is a loop diuretic, which can cause hypokalemia (low potassium). Fatigueand palpitations are potential symptoms of hypokalaemia
This electrolyte disturbance must be corrected before a patient is started on alendronic
acid.
o Hyponatraemia
o Hypernatraemia
o Hypokalemia
o Hyperkalemia
o Hypocalcaemia
o Hypercalcaemia
o Hypomagnesemia
o Hypermagnesemia
Alendronic acid (bisphosphonate) is contraindicated in hypocalcaemia
A patient has type 1 diabetes. He injects a long-acting basal insulin twice daily as part
of his insulin regime.
o Insulin lispro
o Insulin glargine
o Insulin aspart
o Insulin degludec
o Humulin I
o Humulin M3
o Insulin glulisine
o Insulin detemir
Insulin detemir is a long-actingbasal insulin which can beinjected twice a day. Insulin glargine and insulin degludec are also long acting, but these are injected once daily
A patient injects a biphasic insulin.
o Insulin lispro
o Insulin glargine
o Insulin aspart
o Insulin degludec
o Humulin I
o Humulin M3
o Insulin glulisine
o Insulin detemir
Humulin M3 is a biphasic insulin.It contains both asuspensionof bothrapid-acting insulin and an intermediate-acting insulin
A patient has recently started an intermediate acting insulin
o Insulin lispro
o Insulin glargine
o Insulin aspart
o Insulin degludec
o Humulin I
o Humulin M3
o Insulin glulisine
o Insulin detemir
Humbling I is an intermediate acting insulin
After 5 years of taking this medication, a patient attends an annual eye check as part of
the monitoring for this medication.
o Digoxin
o Amiodarone
o Leflunomide
o Warfarin
o Sodium valproate
o Hydroxychloroquine
o Carbimazole
o Tacrolimus
Hydroxychloroquine carries a risk of retinopathy. Annual ophthalmological monitoring is recommended in patients who have taken hydroxychloroquine for over 5 years, althoughnote thatthis may be started earlier when there are risk factors for retinopathy
This medication is a DMARD which is indicated for active rheumatoid arthritis, and a
patient attends for blood pressure monitoring as part of the monitoring for this medication.
o Digoxin
o Amiodarone
o Leflunomide
o Warfarin
o Sodium valproate
o Hydroxychloroquine
o Carbimazole
o Tacrolimus
Leflunomide is a DMARD which is indicated for active rheumatoid arthritis, and blood pressure should be monitored on leflunomide
This medication must always be prescribed by brand if given orally
o Digoxin
o Amiodarone
o Leflunomide
o Warfarin
o Sodium valproate
o Hydroxychloroquine
o Carbimazole
o Tacrolimus
Tacrolimus as switching between brands has been linked to cases of toxicity and graft rejection
A patient attends for a blood test for thyroid function tests, liver function tests, and
serum potassium before starting treatment with this medication.
o Digoxin
o Amiodarone
o Leflunomide
o Warfarin
o Sodium valproate
o Hydroxychloroquine
o Carbimazole
o Tacrolimus
Before treatment, amiodarone requires monitoring ofthyroid function tests,liver function tests, and serum potassium (and alsoa chest x-ray). Top Tip: Learn the reasons why certain monitoring requirements for medicationsare required. This will make the monitoring easier to remember as you understandthe reasons why it is needed. Forexample, amiodarone can cause pulmonary toxicity, which is why a chest x-ray is needed. Also note thatTFTs are needed as amiodarone can cause hypothyroidism and hyperthyroidism.LFTs are needed as amiodarone can cause hepatoxicity
A gp asks for advice for a recommendation ov a very potent steroid cream
o Hydrocortisone 1% cream
o Timodine cream
o Permethrin cream
o Coal tar ointment
o Clobetasone cream
o Clobetasol cream
o E45 cream
o Dermol 500 lotion
Clobetasol (dermovate) is a steroid cream which is considered very potent
A cream containing antimicrobials which can only be given on prescription
o Hydrocortisone 1% cream
o Timodine cream
o Permethrin cream
o Coal tar ointment
o Clobetasone cream
o Clobetasol cream
o E45 cream
o Dermol 500 lotion
Timodine
This is a steroid cream which is available over the counter, licensed for short term
treatment of eczema for adults and children greater than 12 years of age
o Hydrocortisone 1% cream
o Timodine cream
o Permethrin cream
o Coal tar ointment
o Clobetasone cream
o Clobetasol cream
o E45 cream
o Dermol 500 lotion
Clobetasone cream (eumovate) is available OTC and is licensed for children over 12 years old. Note that hydrocortisone 1% cream is also available OTC but minimum licensing age is 10 years old
You decline an OTC sale of sumatriptan because the patient is over this age.
o 2 years
o 6 years
o 10 years
o 12 years
o 16 years
o 18 years
o 60 years
o 65 years
65 years. The OTC licensing age of sumatriptan is 18-65 years old
This is the minimum OTC licensing age for benzoyl peroxide gel for acne
o 2 years
o 6 years
o 10 years
o 12 years
o 16 years
o 18 years
o 60 years
o 65 years
12
You decline the sale of OTC chloramphenicol eye drops as the patient is under this age
o 2 years
o 6 years
o 10 years
o 12 years
o 16 years
o 18 years
o 60 years
o 65 years
2 years
A patient must be over this age to be treated with viagra connect
o 2 years
o 6 years
o 10 years
o 12 years
o 16 years
o 18 years
o 60 years
o 65 years
18 years
For an acute exacerbation of COPD, this is the usual treatment duration of
prednisolone
o 1 day
o 2 days
o 3 days
o 5 days
o 7 days
o 14 days
o 28 days
o 30 days
Usual dose is 30mg OD for 5 days
This is the maximum number of days’ supply which should be given on an oral
isotretinoin prescription for a 23-year-old woman
o 1 day
o 2 days
o 3 days
o 5 days
o 7 days
o 14 days
o 28 days
o 30 days
In women of child-bearing potential, each isotretinoinprescription should be limited to up to a max supply of 30 days’ treatment(and must be dispensed within 7 days
Duration of treatment with co-codamol should be limited to this amount of treatment
when bought OTC
o 1 day
o 2 days
o 3 days
o 5 days
o 7 days
o 14 days
o 28 days
o 30 days
3 days - due to risk of addiction
This is the usual course length for the first line triple-therapy regimen for eradication of
H. Pylori.
o 1 day
o 2 days
o 3 days
o 5 days
o 7 days
o 14 days
o 28 days
o 30 days
Treatment for H pylori eradication usually consists of a PPI and two antibacterials (consult the BNF for details of regimens).The first line regimen has a 7-daycourse
This is a dopamine receptor agonist used in Parkinson’s disease, available as a patch
formulation.
o Ropinirole
o Rasagiline
o Rotigotine
o Entacapone
o Amantadine
o Co-beneldopa
o Co-careldopa
o Apomorphine
Rotigotine is a dopamine receptor agonist indicatedfor Parkinson’s disease. It is available as a transdermal patch formulation. Ropinirole, amantadine, and apomorphine are also dopamine receptor agonists but these are not available in a patch formulation
This is a COMT inhibitor which may discolour urine reddish-brown.
Ropinirole
o Rasagiline
o Rotigotine
o Entacapone
o Amantadine
o Co-beneldopa
o Co-careldopa
o Apomorphine
Entacapone is a COMT inhibitor. Patients should be counselled that entacapone can cause urine to be coloured reddish-brown
This can be given by subcutaneous injection or by continuous subcutaneous infusion
o Ropinirole
o Rasagiline
o Rotigotine
o Entacapone
o Amantadine
o Co-beneldopa
o Co-careldopa
o Apomorphine
Apomorphine is a dopamine receptor agonist which can be given as a subcutaneous injectionor by continuous subcutaneous infusion
A 36-year-old man has a sore tongue. His tongue and cheeks are coated with white
plaques. He is not experiencing any pain.
Which of the following medicines is most likely to have caused the patient’s
symptoms?
A Amlodipine tablets
B Beclometasone inhaler
C Furosemide tablets
D Lamotrigine tablets
E Paracetamol tablets
F Ramipril capsules
G Salbutamol inhaler
H Warfarin tablets
Steroid inhalers are highly likely to cause oral thrush (pseudomembranous oral candidiasis). Symptoms includepatches of curd-like, white or yellowish plaques that can occur anywhere in the mouth, especially the cheeks, gums,palate, and tongue. These are easily removed, revealing an underlying red base that is not usually painful.To avoid this adverse effect, it is recommended that patients rinse their mouth after using their inhaler
A patient comes into the pharmacy. Their ankles and feet have been quite swollen
recently and they think it is because of their new medicines.
Which of the following medicines is responsible?
A Amlodipine tablets
B Beclometasone inhaler
C Furosemide tablets
D Lamotrigine tablets
E Paracetamol tablets
F Ramipril capsules
G Salbutamol inhaler
H Warfarin tablets
Oedema (swelling in the ankles, feet and legs caused by a build-up of fluid in these areas)is a common side effect of calcium-channel blockerssuch as amlodipine
A 15-year-old boy has been started on a new anti-epileptic medication. You make sure
that the boy and his parents understand the risks associated with over-heating and
dehydration while he is on this medication.
Which of the following medicines is this patient most likely to be taking
A Diazepam
B Ethosuximide
C Gabapentin
D Midazolam
E Phenobarbitone
F Sodium valproate
G Topiramate
H Zonisamide
Zonisamide - avoid overheating and ensure adequate hydration especially in children, during strenuous activity or if in warm environment (fatal cases of heat stroke reported in children)
A patient is being discharged from hospital following on-going episodes of seizures
lasting longer than ten minutes. The epilepsy nurse would like the patient to leave with
a ‘rescue’ medication. The contents of the medication are to be inserted slowly into the
space between the gum and cheek.
Which of the following medicines is this patient most likely to be taking?
A Diazepam
B Ethosuximide
C Gabapentin
D Midazolam
E Phenobarbitone
F Sodium valproate
G Topiramate
H Zonisamide
Midazolam is often a part of patient’s anti-epileptic rescue medication plan. It is available for oromucosal use and adequate counselling on its use should be provided.
An 83-year-old patient has increased seizure activity due to a potential infection. He is
hard to cannulate, vomiting medications and would prefer a medication that can be
administered rectally.
Which of the following medicines is most suitable for this patient
A Diazepam
B Ethosuximide
C Gabapentin
D Midazolam
E Phenobarbitone
F Sodium valproate
G Topiramate
H Zonisamide
From the options available, diazepam is the only medication that is available as an enema allowing rectal administration. It is of great benefit in medical emergencies and where other routes of administration are not suitable. Diazepam can sometimes be seen as a part of patient’sepilepsy ‘rescue’ plan.
A 38-year-old woman with a past medical history of asthma is exhibiting symptoms of
severe vomiting, appears agitated and has a racing heartbeat.
Which of the following medicines is most likely to have caused this patient’s
symptoms?
A Carbocisteine
B Chlorphenamine
C Fluticasone
D Montelukast
E Prednisolone
F Pseudoephedrine
G Salmeterol
H Theophylline
Theophylline in overdose can cause vomiting (which may be severe and intractable), agitation, restlessness, dilated pupils, sinus tachycardia, and hyperglycaemia. More serious effects are haematemesis, convulsions, and supraventricular and ventricular arrhythmias. Severe hypokalaemia may develop rapidly
A 42-year-old man with a past medical history of asthma has been admitted to hospital
with difficulty speaking, body weakness, and tremor. They are also repetitively cleaning
and washing their hands.
Which of the following medicines is most likely to have caused this patient’s
symptoms?
A Carbocisteine
B Chlorphenamine
C Fluticasone
D Montelukast
E Prednisolone
F Pseudoephedrine
G Salmeterol
H Theophylline
Uncommon and rare adverse effects of montelukast includeakathisia, asthenia, abnormal behaviour, and obsessive-compulsive symptoms.An adverse effect of steroids, such as fluticasone and prednisolone, is also abnormal behaviour. However, the other symptoms experienced by the patient are not reported adverse effects of fluticasone or prednisolone
A 61-year-old man recently had a stroke. He is now having difficulty swallowing his
medicines and asks for your advice on what to do.
Which of the following healthcare professionals would be the most appropriate to refer
this patient to?
A Dispenser
B Doctor
C Nurse
D Occupational therapist
E Pharmacy technician
F Physiotherapist
G Social worker
H Speech and language therapist
Speech and language therapists can aid patients who have swallowing difficulties ensuring they are suffering no form of aspiration. This can help pharmacists advise on the most appropriate forms of medication
A 96-year-old woman is scheduled to be discharged from hospital. She lives alone after
her husband passed away and her two children live abroad. You are slightly concerned
that she may struggle to adjust to being on her own again after discharge.
Which of the following healthcare professionals would be the most appropriate to refer
this patient onto?
A Dispenser
B Doctor
C Nurse
D Occupational therapist
E Pharmacy technician
F Physiotherapist
G Social worker
H Speech and language therapist
Social workers help their patients to live their lives more successfully by finding solutions to their problems
A 33-year-old man currently in the first month of tuberculosis treatment is reporting
symptoms of muscle aches, weakness and pins and needles in his feet. He takes
isoniazid, rifampicin, pyrazinamide and ethambutoL
A Adcal D3 chewable tablet
B Alfacalcidol tablets
C Ascorbic acid tablets
D Calcichew chewable tablet
E Magnesium aspartate sachets
F Phosphate Sandoz effervescent tablets
G Pyridoxine tablets
H Sevelamer tablets
These are typical symptoms of isoniazid included neuropathy. Pyridoxine is licensed to manage this
A 42-year-old woman with a history of gastro-oesophageal reflux disease who has
been taking omeprazole 40mg once daily for the past six months is reporting nausea
and vomiting, pins and needles, fatigue and muscle twitches.
Which of the following medicines is most suitable for managing these adverse
effects?
A Adcal D3 chewable tablet
B Alfacalcidol tablets
C Ascorbic acid tablets
D Calcichew chewable tablet
E Magnesium aspartate sachets
F Phosphate Sandoz effervescent tablets
G Pyridoxine tablets
H Sevelamer tablets
A known side effect of omeprazole is hypomagnesaemia, which these are typical symptoms of.
A 52-year-old woman was recently started on levothyroxine 25 micrograms once daily
following a presentation to her GP with symptoms of unexplained weight gain, cold
intolerance, and fatigue. Thyroid function tests indicated the development of
hypothyroidism
A Amiodarone
B Ciclosporin
C Digoxin
D Gentamicin
E Methotrexate
F Phenytoin
G Theophylline
H Warfarin
Hypothyroidism is a known side-effect of amiodarone, with a requirement for thyroid function test monitoring before treatment and then every 6 months
A 72-year-old man with a three day history of diarrhoea develops acute kidney injury
and hypokalaemia. He subsequently demonstrates symptoms of nausea, vomiting,
confusion and visual disturbances, including yellow vision.
Which of the following medicines has most likely caused the symptoms
A Amiodarone
B Ciclosporin
C Digoxin
D Gentamicin
E Methotrexate
F Phenytoin
G Theophylline
H Warfarin
Typical early symptoms of digoxin toxicity are nausea and vomiting with confusion, which can be exacerbated by hypokalaemia that can result from diarrhoea. A characteristic symptom is visual disturbances with yellow vision.
A patient has suspected unstable angina and a glyceryl trinitrate spray is ineffective.
Which of the following medicines is most suitable to manage the emergency situation
A Adrenaline injection
B Aspirin 300mg dispersible tablets
C Benzylpenicillin sodium injection
D Cefotaxime injection
E Flucloxacillin injection
F Hydrocortisone intravenous injection
G Prednisolone soluble tablets
H Salbutamol inhaler
B– Dispersible aspirin is used in addition to GTN spray for treatment of unstable angina
A patient has presented at their GP surgery with photosensitivity, a non-blanching rash
and a stiff neck. The patient has a documented skin rash allergy to amoxicillin.
Which of the following medicines is most suitable to manage the emergency situation?
A Adrenaline injection
B Aspirin 300mg dispersible tablets
C Benzylpenicillin sodium injection
D Cefotaxime injection
E Flucloxacillin injection
F Hydrocortisone intravenous injection
G Prednisolone soluble tablets
H Salbutamol inhaler
Signs of meningitis. 1stline is benzylpenicillin but unsuitable due to penicillin allergy. Cefotaxime can be used as no history of immediate anaphylactic reaction to penicillins.
A 45-year-old man has skin condition affecting his toes. The nail on two toes of his left
feet are discoloured and look a bit flaky. The surrounding skin is a little red. There is no
pain or itching. He is diabetic and takes metformin to manage his condition.
Which of the following skin conditions is the patient most likely to have
A Athlete’s foot
B Corn
C Dermatitis
D Foot ulcer
E Fungal nail infection
F Psoriasis
G Verruca
H Wart
They symptoms suggest a fungal nail infection. The nail will often lookabnormal and is discoloured. A single nail, several, or rarely all nails may be affected. The first and fifth toenails are most commonly involved. Fingernails can also be affected
An 18-year-old woman has a rash on her lower legs which has been for two days. The
rash is red, sore, itchy, and there appears to be small, raised bumps. She mentions
that she recently had hair removal treatment.
A Athlete’s foot
B Corn
C Dermatitis
D Foot ulcer
E Fungal nail infection
F Psoriasis
G Verruca
H Wart
The symptoms indicate dermatitis which is most likely to be associated with the hair removal treatment the patient has had. Acute contact dermatitis typically presents with erythema and vesiculation, dryness, scaling and bullae may also be present
A 35-year-old man has a growth on his right index finger. It appeared two weeks ago.
The growth is firm, raised and skin coloured. He is experiencing minor pain and itching
where the growth is.
A Athlete’s foot
B Corn
C Dermatitis
D Foot ulcer
E Fungal nail infection
F Psoriasis
G Verruca
H Wart
The symptoms suggest a wart. They can appear on palms, knuckles, knees, and fingers, and occur in clusters.Wartsarefirmto touch, have raised papules with a rough surface that resembles a cauliflower, and are usually skin coloured butmay appear darker on dark skin; they sometimes itch andcause minor pain. They willoften resolveontheir own but may take months or even years
An 89-year-old woman is under palliative care. She has been constipated for the past
few days due to receiving large doses of opioids in a syringe driver. The laxative
prescribed for the patient by the palliative care team is a stimulant laxative that is
potentially carcinogenic according to animal studies. It can also change the colour of
urine to red
A Bisacodyl
B Co-danthrusate
C Docusate
D Glycerol suppository
E Ispaghula husk
F Lactulose
G Senna
H Sodium picosulphate
Co-danthramer & co-danthrusateis indicated for constipation in palliative care. Rodent studies indicate potential carcinogenic risk. An adverse effect is that it can change the colour of urine to re
A 19-year-old woman has been advised by her GP to purchase a stimulant laxative
from a pharmacy. The GP mentioned the laxative has an onset of action of 8-12 hours
and also warned that it can change the colour of urine to yellow/red-brown
A Bisacodyl
B Co-danthrusate
C Docusate
D Glycerol suppository
E Ispaghula husk
F Lactulose
G Senna
H Sodium picosulphate
Senna has an onset of action 8–12 hours and can discolour urine. Senna available for general sale has been limited to a pack size of two short treatment courses (up to 20 standard-strength tablets, 10 maximum-strength tablets or 100ml solution/syrup). Stimulant laxatives on general sale (in shops and supermarkets) will be recommended for use only in people 18 years or older. Children aged 12 to 17 years can be supplied under the supervision of a pharmacist. Note the MHRA/CHM advice about Stimulant laxatives (bisacodyl, senna and sennosides, sodium picosulfate) available over the counter: new measures to support safe use (August 2020).Bisacodyl tablets act in 10–12 hours, suppositories work in 20–60 minutes. Docusate oral preparations act within 1–2 days,suppositories work in 20 minutes. Bulk forming laxatives have an onset of action of 72 hours
A 32-year-old woman who is 16 weeks pregnant and takes no regular medication has
developed hypertension.
Which of the following medicines is most suitable for this patient?
A Amlodipine
B Bendroflumethiazide
C Bisoprolol
D Doxazosin
E Furosemide
F Labetalol
G Ramipril
H Verapamil
Labetalol is the only medication listed that is recommended for hypertension in pregnancy
A 63-year-old Caucasian man with no previous medical history, who is newly
diagnosed with hypertension.
Which of the following medicines is most suitable for this patient
A Amlodipine
B Bendroflumethiazide
C Bisoprolol
D Doxazosin
E Furosemide
F Labetalol
G Ramipril
H Verapamil
Calcium channel blockers recommended in age > 55 years
A 64-year-old woman with diabetes needs blood pressure medication for the first time.
Which of the following medicines is most suitable for this patient?
A Amlodipine
B Bendroflumethiazide
C Bisoprolol
D Doxazosin
E Furosemide
F Labetalol
G Ramipril
H Verapamil
Ramipril (ACEI) recommend in diabetes
A 67-year-old man has been started on cisplatin for cancer.
The SmPC for cisplatin 1 mg/ml concentrate for solution for infusion is provided below:
https://www.medicines.org.uk/emc/product/6111/smpc#gref
Which of the following is a rare side effect of treatment with cisplatin?
A Allergic reaction
B Alopecia
C Anaemia
D Anorexia
E Convulsion
F Deafness
G Muscle spasms
H Sepsis
Section 4.8 of the SmPC states that convulsions are a rare side effect. Other rare side effects include acute leukaemia, peripheral neuropathy, leukoencephalopathy, reversible posterior leukoencephalopathy syndrome, myocardial infarction, and stomatitis.
A 71-year-old woman has been prescribed cisplatin for lung cancer.
The SmPC for cisplatin 1 mg/ml concentrate for solution for infusion is provided below:
https://www.medicines.org.uk/emc/product/6111/smpc#gref.
Which of the following is a rare side effect of the treatment of cisplatin
A Allergic reaction
B Alopecia
C Anaemia
D Anorexia
E Convulsion
F Deafness
G Muscle spasms
H Sepsis
Section 4.3 of the SmPC states that cisplatin may give allergic reactions in some patients. Therefore, use is contraindicated in those patients with a history of allergic reaction to cisplatin or other platinum containing compounds, or any component of the formulation.
A 34-year-old woman, with a BMI of 32, requests an over-the-counter medication. She
also takes levothyroxine 100 micrograms and desogestrel 75 micrograms. You advise
her that this medicine is not recommended because of potential interactions.
Which of the following medicines is most likely to interact with the patient’s
medicines?
A Atovaquone 250 mg/proguanil 100 mg tablets
B Chloramphenicol 0.5% eye drops
C Hydrocortisone 1% cream
D Nicotine 15 mg patch
E Omeprazole 10 mg tablets
F Orlistat 60 mg capsules
G Prochlorperazine 3 mg tablets
H Sildenafil 50 mg tablets
F-
See Alli 60mg SmPC, section 4.5:-Hypothyroidism and/or reduced control of hypothyroidism may occur when orlistat and levothyroxine are co-administered. Patients taking levothyroxine should consult a doctor before starting treatment with Alli, as orlistat and levothyroxine may need to be taken at different times and the dose of levothyroxine may need to be adjusted.-Orlistat may indirectly reduce the availability of oral contraceptives and lead to unexpected pregnancies in some individual cases. The use of an additional contraceptive method is recommended to prevent possible failure of oral contraception that could occur in case of severe diarrhoea.
A 65-year-old man requests an over the counter medicine. He also takes co-beneldopa
dispersible tablets for Parkinson’s disease. You advise him that this medicine is not
suitable for him because of his medical condition.
Which of the following medicines is most likely to be contraindicated for this
patient?
A Atovaquone 250 mg/proguanil 100 mg tablets
B Chloramphenicol 0.5% eye drops
C Hydrocortisone 1% cream
D Nicotine 15 mg patch
E Omeprazole 10 mg tablets
F Orlistat 60 mg capsules
G Prochlorperazine 3 mg tablets
H Sildenafil 50 mg tablets
Prochlorperazine 3 mg OTC is contraindicated in patients who have Parkinson’s Disease.Referencehttps://www.medicines.org.uk/emc/product/478
