IPE Flashcards
What are alpha blockers used in?
BPH and HTN
What are some examples of alpha blockers?
doxazosin and tamsulosin
What are some side effects of alpha blockers?
Postural hypotension
drowsiness
dyspnoea
cough
What are the side effects of calcuim channel blockers?
headache flushing ankle oedema hypotension constipation
What are the side effects of bendroflumethiazide?
Gout
Hypokalaemia
Hyponatraemia
Impaired glucose tolerance
Name some inducers of the P450 system?
Phenytoin Carbemazepine Barbiturates Rifampicin Alcohol acute sulphonylurea and St johns wort
What are some inhibitors of the P450 system
Omeprazole Disulfiram Ethanol Valproate Isonazid Cimetidine Erythromycin Sulfonamides
What are some side effects for ciclosporin?
Everything increased
- fluid retention
- hypertrophy of the gums
- tremor
- increased BP
- increased hair
- high K
- hepatotoxic
Name three drugs that can cause lung fibrosis
Amiodarone Methotrexate Cytotoxic drugs - bleomycin Dopamine receptor antagonists- bromocriptime Nitrofuratoin
What are the side effects of B blockers?
Bronchospasm
fatigue
cold peripheries
sleep disturbances
What are the side effects of nicorandil?
headache
flushing
anal ulceration
What are the side effects of nitrates?
Headache
postural hypotension
tachycardia
What are the features of lithium toxicity?
coarse tremor (a fine tremor is seen in therapeutic levels) hyperreflexia acute confusion seizure coma
What may precipitate lithium toxicity?
dehydration renal failure duiretics ACEi Metrondiazole NSAIDs
What monitoring is required with a patient on lithium?
TFT, U&E prior to treatment
Lithium levels weekly until stabilised then every 3 months
TFT, U&E every 6 months
What monitoring is required for amiodarone?
TFT, LFT, U&E, CXR prior to treatment
TFT, LFT every 6 months
What is given along side isonazid and why?
Pyrodixine
Reduce the risk of peripheral neuropathy
When is lithium monitoring done?
12 hours post dose
When is ciclosporin monitoring done?
Immediately before dose
When are digoxin levels done?
6 hours post dose
What Abx should be avoided when a patient is on statins and why?
Macrolides eg erythromycin due to the increased risk of myopathy and rhabdomyolysis due to inhibition of the P450 system
What are the adverse effects of gentamicin?
Ototoxicity - irreversible due to auditory or vestibular nerve damage
Nephrotoxicity - accumulates in renal failure
What antibiotic should be prescribed in caution in those with epilepsy and why?
Quinolones such as ciprofloxacin
lower seizure threshold
Why should we be careful with quinolones in athletes?
Tendon damage and rupture
What is the treatment for legionella pnuemonia?
Erythromycin
What is the bacteria in bacterial vaginosis?
Gardnerella vaginalis
What are some differentials for lymphadenopathy?
EBV virus HIV rubella Toxoplamosis, CMV , TB Leukaemia and lymphoma SLE and RA Sarcoidosis
What is the most common organism found in central line infections?
Staph epidermidis
What electrolyte imbalances can precipitate digoxin toxicity?
Hypokalaemia
hypomagnesaemia, hypercalcaemia, hypernatraemia, acidosis
When is diclofenac contraindicated?
ischaemic heart disease
peripheral arterial disease
cerebrovascular disease
congestive heart failure (New York Heart Association classification II-IV)
What may indicate a paracetamol over dose on liver function tests?
Transaminitis (elevated ALT and AST) in the 10,000s
What is the problem with rapid correction of chronic hypernatraemia?
How should this be avoided?
predisposes to cerebral oedema
Replace fluids slowly and U&Es should be monitored- aim for a reduction <12mmol/day
What is sick euthyroid disease?
Caused by systemic illness
low total and free T4/T3
Normal or low TSH
Methotrexate and which other drug is a never prescribe together?
Trimethoprim
What are the SEs of ivabravine?
visual effects, particular luminous phenomena, are common. Headache. Bradycardia, due to the mechanism of action, may also be seen
