Key Points

Question 1

Drugs that cause QT prolongation

Answer 1

‘Long Hearts Make Vampires Always Cry’

• Lithium, Loperamide
• Haloperidol
• Macrolides (azithromycin, clarithromycin)
• Venlafixine
• Amiodarone, Amitriptyline
• Citalopram

Hypokalaemia increase risk

Question 2

Drugs associated with C.diff

Answer 2

‘Crazy Chimps Buy Flourescent Poo’

• Clindamycin
• Cephalosporins
• Broad-spec penicillin
• Flouroquinolones (Ciprofloxacin)
• PPIs

Question 3

Smoking interactions

Answer 3

‘TACO’ - Tobacco Can Avoid Overdose

• Theophylline
• Aminophylline
• Clozapine
• Olanzapine
• Ropinirole

Question 4

Drugs that cause hypokalaemia

Answer 4

‘Don’t Cut Banannas’

• Diuretics
• Corticosteroids
• Beta - 2 agonists
• Macrolides

Question 5

What is chromaturia?

Answer 5

Harmless red brown colour of the urine caused by medication

Question 6

Nephrotoxic drugs

Answer 6

• Ciclosporin
• Tacrolimus
• Vancomycin
• Aminoglycosides

Question 7

Ototoxic drugs

Answer 7

• Aminoglycosides
• Loop diuretics
• Cisplatin
• Vancomycin
• macrolides

Question 8

Risk factors of QT prolongation

Answer 8

• HypOKalaemia
• HypOMagnesaemia
• Cardiac disease

Question 9

CP450 inhibitors

Answer 9

’SICKFACES.COM’ - increase drug concentration

Sodium valproate
Isonazid
Cimetidine
Ketoconazole
Fluconazole , Fluoxetine
Alcohol & grapefruit juice
Chloramphenicol
Erythromycin
Sulfonamides , Sertraline
Ciprofloxacin
Omeparazole
Metronidazole Macrolides

Rate limiting CCB

Question 10

CYP450 inducers

Answer 10

’CRAP GPS’ - decrease drug concentration

Carbemazepines
Rifampicin
Alcohol
Phenytoin
Griseofulvin
Phenobarbitone
Sulphonylureas, St Johns wort

Question 11

Drugs that cause photosensitivity

Answer 11

• Amiodarone
• Chlorpromazine
• NSAIDs
• Diuretics (furosemide, bendroflumethiazide)
• Tetracycline
• Quinolones
• Sulfonamides (co-trimoxazole)

Question 12

Pregnancy prevention programme

Answer 12

• 7 day prescription validity, 30 day supply
• Use highly effective contraception
• Fully informed of the risks and signed Risk Acknowledgment Form
• See specialist for annual review

User independent methods: IUD, POP implant, sterilisation
User dependent methods: two forms of contraceptive eg. COC + barrier method + regular pregnancy test

Question 13

Linezolide

Answer 13

• Cheese reaction
• Serotonin syndrome
• visual disturbances
• blood disorders
• not over 28 days

Question 14

Warning with tetracycline

Answer 14

Headache - STOP

Question 15

Two antibiotics with food or after

Answer 15

Metronidazole
Nitrofurantoin

Question 16

How long is treatment with Rifampicin and isoniazid in continuous phase

Answer 16

4 months

Question 17

What to consider with TB drugs

Answer 17

Liver

Question 18

Rifampicin SE

Answer 18

Urine discolouration
Stains contact

Question 19

Why would malarone be preferred over doxycycline

Answer 19

Doxy causes photosensitivity and most malaria countries are hot and sunny

Question 20

Prophylaxis for malaria

Question 21

Anti malaria and warfarin

Answer 21

Stop warfarin 2-3 weeks before and measure INR more frequently

Question 22

Where to find information

Answer 22

• Aseptics: yellow guide
• Manufacture and distribution: orange guide
• Interactions: Stockleys
• Immunisation against infectious disease + info about vaccinations: green book
• Martindale: reliable reference resource on drugs and medicines throughout the world
• BP: official standards for pharmaceutical substances and medicinal products

Question 23

Record keeping

Answer 23

• Private RX for POM = 2 Years
• Private RX for CD 2 and 3 = submitted to
  NHS agency
• POM register = 2 years
• Returned/ expired CD = 7 years
• RP record = 5 years
• NMS record = 2 years

Question 24

Treatment of gout

Answer 24

Cholchicine (first 48 hours)
Indomethacin & Naproxen

Question 25

Preventing gout

Answer 25

- Allopurinol & febuxostat - probenecid & sulfinpyrazone

Question 26

Nitrofurantoin CI

Answer 26

Long term COPD

Question 27

Which anntifungal interacts with warfarin

Answer 27

Oral - Miconazole Fluconazole

Question 28

What is CI in unstable angina

Answer 28

**CCB** - only used in stable

Question 29

Calcium carbonate + levothyroxine

Answer 29

Separate dose by atleast **4 hours** to reduce interaction

Question 30

Ferrous sulphate + levothyroxine

Answer 30

Separate dose by at least **2 hours**

Question 31

Side effect of gliptins (DDP)

Answer 31

**Acute pancreatitis**

Question 32

Mineralcorticoid steroid

Answer 32

**Fludrocortisone & Hydrocortisone** - Hyp**O** **K, Ca** - Hyp**ER** Na - **Eyes** - MHRA - **Psychiatric reaction** - STOP - Adrenal suppression - Infections (**immunosuppression**) **Warning with CHICKEN POX & MEASLES** - Cushing’s syndrome- moon face - skin thinning

Question 33

Side effects of glucocorticosteroid

Answer 33

- Diabetes - Osteoporosis - Muscle wasting - GI ulcers

Question 34

Pneumonic for mineralcorticosteroid

Answer 34

‘**ACHING BOSSOM**’

Question 35

Corticosteroids + Sertraline

Answer 35

**Bleeding** Hyponatraemia Give PPI

Question 36

Hypo in Sulphonylurea- Gliclazide, etc

Answer 36

**Refer to hospital** Yellow card - serious SE

Question 37

CPR

Answer 37

30 compressions (100 - 120 a minute) 2 breaths

Question 38

Hydoxychloroquine + macrolides

Answer 38

Increased risk of cardiovascular events

Question 39

Anti diabetic people preferred in renal impairment

Answer 39

‘Gliptins’

Question 40

Paracetamol dose under 6 (120/5ml)

Answer 40

3 - 6 months: **2.5mL** 6 - 24 months: **5mL** 2 - 4 years: **7.5mL** 4 - 6 years: **10mL** *up to 4 times a day*

Question 41

Paracetamol dose over 6 (250/5ml)

Answer 41

6 - 8 years: **5mL** 8 - 10 years: **7.5mL** 10 - 12 years: **10mL**

Question 42

MHRA warning with hydrocholothiazide

Answer 42

Non melanoma skin cancer Particularly in long term use

Question 43

Orlistat interactions

Answer 43

Warfarin Ciclosporin DOAC

Question 44

Antimuscaranic drugs

Answer 44

‘**DOTS**’ - **D**arifenacin - **O**xybutinin - **T**olterodine - **S**olifenacin

Question 45

Rosuvastatin + clopidogrel

Answer 45

Max 20mg

Question 46

Lansoprazole + methotrexate

Answer 46

Increased toxicity - reduce clearance

Question 47

Drugs that cause falls in elderly

Answer 47

- benzodiazepines - antihistamines - antiepileptics (remember lacosamide)

Question 48

Treatment of hyperkalaemia

Answer 48

Patiromer calcium

Question 49

Beta blocker in heart failure

Answer 49

**BVN** Bisoprolol Cervidolol Nebivolol

Question 50

Treatment for Bacterial vaginosis

Answer 50

Metronidazole 400mg BD 5-7 days

Question 51

Hypomagnesemia

Answer 51

Sotalol Digoxin PPI

Question 52

Liver toxicity

Question 53

Alcohol dependency

Answer 53

Choldiazepoxide

Question 54

How to treat torsade de pointes (prolonged QT prolongation)

Answer 54

IV magnesium sulfate

Question 55

Serotonin syndrome

Answer 55

- antidepressant - tramadol - methadone - Mirtazapine - Sertraline - lithium

Question 56

Neutropenia

Answer 56

Filgrastim