JAE quizzed

Question 1

Ciprofloxacin

Answer 1

Quinolone
* Bactericidal - blocks bacteria DNA synthesis
1. [D]
2. [L3b] - 1 hour before food or 2 hours after
3. [L4a]
4. [L5]
5. [L8}
6. [L12]
7. Increased effect of caffeine
8. !Tendon damage/rupture (esp Achilles heel; avoid vigorous exercise
9. !Tingling in hands and feet - peripheral neuropahty
10.

Question 2

Isotretinoin (Oratane)

Answer 2

Retinoid
* modulates cell proliferationa and differentiation which leads to reduced sebum excretion, less acne, less inflammation and less cyst formation.
* Category X - contraindicated
* 10-20% of patients relapse and may require repeat courses
* Allow at least 2 months after finishing course to see whether further treatment is needed as improvement may continue for several months after stopping
* papulopustular rosacea often relapses after stopping isotretinoin; repeat courses or long-term treatment may be needed
1. [A] - swallow whole
2. [B] - Take with or soon after food
3. [L8] - SPF30 or SPF50+, avoid sunlamps or tanning beds
4. Avoid waxing and dermabrasion during and 6 months after stopping treatment as it could scar or irritate your skin.
5. Avoid using anti-acne preparations as local irritation may increase
6. Contraception before, during, and 1 month after treatment
7. Do not donate blood and for 8 weeks after stopping treatment
8. Avoid Vitamin A supplements
9. Often cause dry eyes, lips, and mouth
10. [L13] - special disposal
11. !Report if any nausea, headaches, or visual changes
12. !Report if any changes in mood
13. LFTs and Lipids at baseline, then 1st month of treatment, then prn.

Question 3

Carbamazepine (Tegretol)

Answer 3

Antiepileptic
* Prevents repetitive neuronal discharges by blocking voltage-dependent and use-dependent sodium channels.
* Indicated for Epilepsy, neuralgias, Bipolar
* Category D - monitoring required
* Steady state around 2-4 weeks
1. [A]
2. [B]
3. [L5]
4. [L9]
5. [L12] - drowsiness, dizziness, blurred vision, esp when starting or increasing dose
6. [L13]
7. [L18]
8. [L21] - Special disposal
9. Report rashes (Severe skin reactions)
10. Report sore throat, fever, mouth ulcers, brusing or bleeding (multi-organ hypersensitivity syndrome)
10. May increase the effects of alcohol
11. FBC prior, then periodically

Question 4

Topiramate (Topamax)

Answer 4

Antiepileptic
* Stablises presynaptic neuronal membrane by blcoking voltage-dependant sodium channels. Enchances activity of GABA on postsynaptic chloride channels
* Doses of 50mg or more should be taken in 2 doses

1. [L1] - esp when start or dose increase
2. [L9]
3. [L12]
4. [L21] - special handling and disposal required
   SE: confusion, nervousness/agitation, hallucination, paraesthsia
5. Avoid alcohol as it can worsen side effects

Ensure effective contraception during and 1 month after - category D
6. Drink enough water every day (esp if you had kidney stones in past
7. !May reduce or prevent sweating and may affect your body’s ability to cool down - Hyperthermia
8. !Stop treatment as quickly as possible if decreased vision or eye pain
9. meausre serum [bicarbonate] at baseline and periodically thereafter; metabolic acidosis if low -> lead to kidney stones, osteoporosis, rickets in children

Question 5

Sodium valproate (Epilim, Valpro)

Answer 5

Antiepileptic
Prevents repetative neuronal discharge by blocking sodium channels.
Also use in bipolar
EC tablets mat reduce GI upset
!hepatic impairment
1. SW with it soon after food
1. [L9]
2. [L10a]
3. [L12] - drowsy
4. [L13]
5. [L21]
6. May increase effects of alcohol
7. Increase appetite - watch diet to avoid weight gain
8. Effective contraception during and 1 month after - category D
9. !Report any symptoms of fever, rash, abdominal pain, vomiting, jaundice (hepatitis or pancreatitis)
10. !Repoet signs of bruising or bleeding (thrombocytopenia or hepatotoxicity from clotting factors
11. May reduce BMD with longterm treatment, ensure adequate vitamin D and calcium intake
12. TDM may be useful to confirm toxicity or compliance

Question 6

Phenytoin (Dilantin)

Answer 6

Antiepileptic
*

1. [L5]
2. [L9]
3. [L12]
4. [L13]- do not remove from original packaging until dose required
5. [L21]

Question 7

Levothyroxine (Eutroxsig, Oroxine, Levoxine, Eltroxin)

Answer 7

Thyroxine or T4
* For Hypothyroid
* Not interchangable with Eltroxin

1. [?L3b]
2. [L4am] - remove dairy
3. [L6] - Eutroxsig, Oroxine

Question 8

Lithium carbonate

Answer 8

1. [L5]
2. [L13]
3. [L21]
4. [LA,B]

Question 9

Warfarin

Answer 9

Blood
1. [L5]
2. [L10b]
3. [L21]

Question 10

Cyclosporine

Question 11

Phentermine

Question 12

Mesalazine (Pentasa)