Extra

Question 1

Why is NAC a good idea in overdose?

Answer 1

PRECURSOR FOR LIVER TO MAKE GLUTATHIONE

Normally liver conjugates glucuronic acid with panadol.
In drug overdose, the system is saturated so the P450 oxidation system receives a load.
The panadol is oxidised to a toxic metabolite: N-acetyl-B-benzoquinine.
System for defense is glutathione which means non toxic mercaptopurine. If glutathione used up then the NA B benzo will bind intracellular proteins and cause acidosis and cell death

Question 2

Which is the only antibiotic that can precipitate lithium toxicity?

Answer 2

Metronidazole

also thiazides, ACEi, dehydration

Question 3

gliclazide side effect

Answer 3

weight gain
photosensitivity
SIADH
peripheral neuropathy
BM supression

Question 4

Which antibiotics cause G6PD crisis

Answer 4

cipro
sulfonamides (not trimeth!)
primaquine

penicillins, tetracyclines, macrolides thought ok

Question 5

During migraine….why does panadol not work?

Answer 5

Delayed gastric emptying during attacks

Hence often give metoclopramide too with panadol!

Question 6

MOA sildenafil

Answer 6

phosphodiesterase type 5 inhibitor

Question 7

Nicorandil is a…

Answer 7

K channel activator

Question 8

LFT picture valvroate and phenytoin

Answer 8

Hepatocellular

Question 9

MAO i picture

Answer 9

hepatocellular

Question 10

halothant picture

Answer 10

hepatocellular

Question 11

anti-TB med LFTs

Answer 11

hepatocellular

Question 12

statin LFT picture

Answer 12

hepatocellular

Question 13

Amiodarone LFT picture

Answer 13

hepatocellular

Question 14

methyldopa LFT picture

Answer 14

hepatocellular

Question 15

nitrofurantoin LFT picture

Answer 15

hepatocellular

Question 16

OCP LFT

Answer 16

obstructive

Question 17

fluclox picture

Answer 17

obstructivve

Question 18

augmentin picture

Answer 18

obstructibe

Question 19

prochlorperazine picture

Answer 19

obstructive

Question 20

sulfonylurea LFT pic

Answer 20

obstructiev

Question 21

fibrate LFT pic

Answer 21

obstructive

Question 22

statin LFT pic

Answer 22

hepatocellular

Question 23

causes of cirrhosis meds

Answer 23

methyldopa
amiodarone
methotrexate

Question 24

erythromycin LFT pic

Answer 24

obstructive

Question 25

Should you always give IVT in pre eclampsia?

Answer 25

No as cerebral oedema is a big issue

Question 26

Compare varenicline and buprenorphine

Answer 26

Varenicline probably better
Neither can be used in preg
Both start a week before quit date

Varenicline is a partial nicotinic receptor agonist
Main side effect is nausea, headache, abnomal dreams
Avoid in depression as increase suicide

Buprenorphine is a dopamine and noradrenaline reuptake inhibitor and nicotinic antagonist
Inrease risk seizures

Question 27

Increase dig toxic

Answer 27

age
hyperkalaemia
hypermagnesaemia
hypocalcaemia
hyponatraemia
low albumin
hypothyroidism 
acidosis 
amiodarone, spironolactone
diuretics that increase K

Question 28

Abx causes tendon snap

Answer 28

cipro

which also lowers seizure threshold