GP - Polypharmacy Flashcards
1
Q
Which medications are associated with drug-induced nephrotoxicity i.e. can cause deterioration in kidney function?
A
- NSAIDs
- Aminoglycosides (Abx) e.g. gentamicin, streptomycin, neomycin
- ACE-inhibitors & ARBs
- Diuretics
2
Q
What could a pt be at riks of if they take Metformin in renal impairment?
A
Lactic Acidosis
Avoid Metformin if eGFR < 30 mL/min/1.73m2
3
Q
Dr Murdock is reviewing Mrs Ade’s medicines list, to see which medications require monitoring. The list is below:
- Ramipril 10mg OD
- Bisoprolol 10mg OD
- Metformin 500mg TDS
- Bumetanide 1mg OD
- Atorvastatin 20mg nocte
Which of the following statements is incorrect:
- HBA1C should be checked after 3 months if the medications are altered
- She needs annual monitoring of her blood pressure when on Ramipril
- She needs annual monitoring of renal function for Ramipril and Bumetanide
- She needs regular monitoring of BMs to assess her Diabetic control
- She needs renal function checking after 1-2 weeks if the Bumetanide dose is increased
A
She needs regular monitoring of BMs
to assess her Diabetic control
- Regular BMs are not required as Metformin doesn’t cause hypos
4
Q
What are some common and some less common side-effects of Furosemide?
A
Common:
- mild GI disturbances e.g. diarrhoea, constipation etc.
- postural hypotension
-
electrolyte disturbances including:
- hyponatraemia
- hypokalaemia
- hypocalcaemia
- hypochloraemia
- hypomagnesaemia)
- hypersensitivity reactions (including rash, photosensitivity, and pruritus)
Less Common:
- pancreatitis
- hepatic encephalopathy
- temporary increase in serum-cholesterol and triglyceride concentration
- hyperglycaemia (less common than with thiazides)
- acute urinary retention
- metabolic alkalosis
- blood disorders (including bone-marrow depression, thrombocytopenia, and leucopenia)
- hyperuricaemia
- visual disturbances
- tinnitus
- deafness (usually with high parenteral doses and rapid administration, and in renal impairment)
