MCQ Flashcards
(115 cards)
what drug can mask hypoglycaemia (s/e caused by diabetic drugs)
beta blocker
what drug may increase blood glucose, list 3
prednisolone, thiazide, loop diuretics
which diabetic drug is the least likely to cause hypoglycaemia as a s/e
(DPPi ) sitagliptin,
why is prednisolone taken in the morning
to reduce chance of insomnia
which diabetic drug is the best with improving vascular complications as well as preventing hypoglycaemia?
SGLT-2
what is furosemide’s role in acute heart failure
direct effect on blood vessels: reduces preload and increase contractile function of the overstretched heart muscle
Can loop diuretic worsen gout
yes, for chronic use, as it inhibits excretion of uric acid
so does thiazide.
which diuretic increase toxicity of digoxin and why?
loop diuretic and its associated hypokalaemia
what diuretic increase blood glucose, LDL and triglycerides ?
Thiazides
which diuretic can cause impotence in men
thiazides
which diuretic’s effect may be reduced by anti-inflammotires
thiazides
what is the on/ off effect?
Levodopa- symptoms get worse towards end of dose interval. increase dose/ frequency to overcome but dyskinesia at beginning of the dosage interval. these happening tgt = on/ off effect
what is levodopa co-prescribed with and why?
carbidopa, a peripheral dopa-decarboxylase inhibitor to reduce dose required and reduce nausea
in acute ischaemic stroke, within ___hrs of the onset of stroke, should alteplase be administered to increase chance of living?
4.5 hrs
what kind of epilepsies/ seizures do gabapentin/ pregabalin treat? and in which kind should they be avoided?
they are used as add-on therapy for focal epilepsies where CBZ, lamotrigine, valporate are inadequate. They should be avoided in absence and myoclonic seizures
For gabapentin/ pregabalin- apart from focal epilepsies, what else are they indicated for
- neuropathic pain (inc diabetic neuropathy)
- pregabalin is an option for generalised anxiety disorder
gabapentin/ pregabalin- bind to voltage sensitive Ca2+ channel to inhibit release of GABA- reduce neuronal excitability
better tolerated than older antiepileptic drugs
also less interactions than CBZ. valporate and lamotrigine
gabapentin can cause false positive in what kind of test
detection of protein on urine dipstick test
H2 antagonist- Ranitidine, cannot completely suppress gastric acid production (unlike PPIs), but it has faster onset of action
Ranitidine, like PPI can also mask symptoms of gastro-oesophageal cancer
Fondaparinux (heparin) is very specific for which factor
Fondaparinux, a synthetic pentasaccharide that mimics the sequence of the binding site of heparin to antithrombin, is very specific for factor Xa. it also less lower bleeding risk than with LMWH, UFH
which two clotting factors are important for antithrombin to target
Ila and Xa
Heparin-induced thrombocytopenia is less likely to happen to LMWH or UFH ?
LMWH
(and does not occur to fondaparinux)
HIT is an autoimmune reaction to heparin, result in low platelet counts and thrombosis
in renal impairment, which ones accumulate? - LMWH, UFH, fondaparinux?
LMWH and fondaparinux accumulate so lower dose or UFH should be used instead.
LMWH (enoxaparin) is co-prescribed with warfarin in VTE, why?
LMWH provides bridging anticoagulation, it can be stopped once warfarin has established its effect. usually use for about 5 days