General

Question 1

Drugs prescribed in micrograms

Answer 1

Levothyroxine
Digoxin
Colchicine
Tamsulosin
Inhalers

Question 2

Drugs to avoid in renal impairment

Answer 2

NSAIDS
ACEi
ARB
Furosemide
Spironolactone

Question 3

Drugs prescribed once weekly

Answer 3

Methotrexate

Alendronate

Question 4

What drug do you hold when on antibiotics

Answer 4

PPI (risk of C. diff)

Question 5

What drugs don’t you give in PD

Answer 5

Haloperidol
Metoclopramide (domperidone is safe)

Question 6

When do you check U&E after starting ACEi

Answer 6

2 weeks

Question 7

What do you monitor when on COCP

Answer 7

BP and Weight at every visit

Question 8

Main drug co-prescription to avoid in asthma/COPD

Answer 8

Don’t give SAMA and LAMA together

Question 9

What is INR a measure of in Warfarin therapy

Answer 9

Short term control of coagulation

Question 10

Common nephrotoxic drugs

Answer 10

Diuretics, especially loop diuretics
ACEi/ARBs/mineralocorticoid antagonists
NSAIDs
Aspirin and paracetamol in overdose
Statins and fibrates (with rhabdomyolysis)

Anti-infectives (rarely when oral)
Aminoglycosides such as gentamicin
Vancomycin
Some penicillins and cephalosporins
Intravenous anti-fungals such as amphotericin B
Certain intravenous antivirals such as acyclovir

Radiocontrast agents
Lithium in overdose
Certain immunosupressants and chemotherapy

Question 11

Diabetes sick day rules

Answer 11

Check blood glucose more often (every 1-2h)
Check blood ketones irrespective of glucose

If appetite reduced can replace meals with carb rich drinks
Drink water/sugar-free fluids if glucose high
Seek medical attention if unable to tolerate oral feeding/fluids due to N+V

Question 12

Laxative types

Answer 12

Osmotic: Lactulose
Stimulant: Senna
Bulk-forming: Ispaghula husk
Stool softener

Question 13

Short term constipation (if stools hard)

Answer 13

1. Bulk-forming laxative

2. Osmotic laxative

Question 14

Short term constipation (if stools soft)

Answer 14

Senna

Question 15

Opioid induced constipation

Answer 15

Osmotic + stimulant laxatives

Question 16

Faecal impaction Mx

Answer 16

Osmotic laxative e.g. macrogol if hard stool

If soft stool, or stool still hard after macrogol: Add in stimulant laxative

Question 16

Chronic

Question 17

N+V in pregnancy

Answer 17

Cyclizine/promethazine (antihistamines)

Prochlorperazine (phenothiazines)

Question 18

Immediate relief of dyspepsia

Answer 18

Magnesium carbonate antacids

Question 19

Analgesia regular vs PRN

Answer 19

PRN if intermittent pain

Regular if constant pain

Question 20

Different statin doses

Answer 20

Lipid lowering = 10mg
Primary CV prevention (e.g. high QRISK) = 20mg
Secondary CV prevention = 80mg

Question 21

ACEi monitoring for renal function deterioration

Answer 21

○ >20% rise = remeasure renal function within 2 weeks
○ >30% rise = temporary dose reduction or withdrawal
○ >50% rise = Dose reduction or withdrawal
○ >100% rise = stop ACEi and specialist referral

Question 22

Opioid SEs

Answer 22

N+V
Constipation
Drowsiness
Resp depression