high risk meds

Question 1

what signs/symptoms should all patients taking methotrexate report

Answer 1

should report all signs/symptoms that suggest an infection e.g sore throat, mouth ulcers

Full blood count, renal + liver function tests should be carried out

Question 2

which drugs cause QT prolongation

Answer 2

• Antiarrythmics: Amiodarone, Flecanide, Sotalol
• Antibiotics: Macrolides, Chloroquine, Mefloquine
• Anticychotics: Quetiapine, Haloperidol
• Antidepressants: SSRIs, TCAs, Venlafaxine
• Antiemetics: Domperidone, Ondansteron
• Antifungals: Fluconazole, Ketoconazole

Question 3

what should you do if the PRE-dose trough concentration of gentamicin is too high

Answer 3

increase the interval between doses

Question 4

what should you do if the POST-dose ‘peak’ concentration of gentamicin is too high

Answer 4

reduce the dose

Question 5

which oral combined contraceptive medication should be avoided in severe stage 4 kidney disease?

Answer 5

yasmin

Question 6

what is the therapeutic range of lithium

Answer 6

0.4 -1 mmol/L

Question 7

how long should patients taking methotrexate be on contraception for

Answer 7

need effective contraception during and for at least 6 months after treatment in men and women.

Question 8

name the common enzyme INDUCERS

CRAP GPS

Answer 8

Carbamazepines
Rifampicin
Alcohol
Phenytoin
Griseofulvin
Phenobarbitone
Sulphonylureas

Question 9

name the common enzymes INHIBITORS

SICK FACES. COM

Answer 9

Sodium valproate
Isoniazid
Cimetidine
Ketoconazole

Fluconazole
Alcohol & Grapefruit juice
Chloramphenicol
Erythromycin
Sulfonamides

Ciprofloxacin
Omeprazole
Metronidazole

Question 10

which electrolyte changes increase risk of digoxin toxicity

Answer 10

• Hypercalcaemia
• hypokalaemia
• hypomagnesaemia
• hypoxia

Question 11

which diuretics increase risk of digoxin toxicity

Answer 11

• loop diuretics (e.g furosemide, bumetanide)

- thiazide-like diuretics ( bendroflumethiazide, indapamide, metolazone)