MANAGEMENT RESP

Question 1

What is important to remember about rifampicin (TB treatment)?

Answer 1

1. potent CYP450 enzyme inducer so can increase metabolism of a number of medications including the combined oral contraceptives therefore reducing the efficacy/how well the treatment works
2. NEED TO CHANGE contraception to intra-uterine device or parenteral progestogen
3. hepatitis is a complication so LFT monitoring needed

Question 2

What are ASF of ethambutol (TB drug)?

Answer 2

optic neuritis, photosensitivity

Question 3

What is management for acute/severe hypercalcaemia (e.g. secondary to squamous lung ca/excess PTHrP)

Answer 3

rehydration with fluids (0.9% sodium chloride IV 1L over 6 hours) then

IV bisphosponates (pamidronate is an IV bisphosphonate e.g. IV 30mg infusion)