Medicines 30 Flashcards
Which drugs have definite risk of haemolysis in most G6PD-deficient individuals
Fluoroquinolones (including ciprofloxacin, moxifloxacin, norfloxacin, and ofloxacin)
Nitrofurantoin
Primaquine
Quinolones
Sulfonamides (including co-trimoxazole)
What advice should be given to a patient with symptoms of mastitis ?
Symptoms:
* Swollen breast
* Hot to touch
* Painful to touch
* Red
* Lump or hard area on the breast
* Burning pain – can be constant or when
breastfeeding
* Nipple discharge – can be white in colour or
contain streaks of blood
* Flu like symptoms
Paracetamol + continue to breastfeed
or Ibuprofen
the patient has described the symptoms of Mastitis:
Mastitis is when usually one of the breasts become swollen, painful and hot. It can be
caused by blocked milk ducts and is very common in breastfeeding women and does not
usually need any urgent medical treatment.
What are the contraindications of GLP-1 receptor agonists?
❌ Do NOT prescribe in:
Ketoacidosis
Pancreatitis
Renal impairment:
Exenatide (standard) & Liraglutide: eGFR <30 mL/min/1.73m²
Exenatide (modified): eGFR <50 mL/min/1.73m²
Liraglutide & Semaglutide: End-stage renal disease
Severe hepatic impairment: Liraglutide
Severe GI disease: Exenatide, Liraglutide, Lixisenatide, Dulaglutide (e.g., gastroparesis, IBD)
What is the first line treatment for bacterial acute sore throat?
The choice of antibacterial depends on the bacteria causing the infection:
- Phenoxymethylpenicillin is first line in the treatment of sore throats as it treats and
covers Strep infections (e.g. strep throat). The suggested treatment duration is 5-10
days. - Alternative: clarithromycin or erythromycin (in penicillin allergic patients).
Duration: 5 days
What is the correct ratio of chest compressions to rescue breaths required for an adult who is unconscious and requires cardiopulmonary resuscitation (CPR)?
30:2
What are the reasons to stop HRT?
sudden severe chest pain (even if not radiating to left arm);
sudden breathlessness (or cough with blood-stained sputum);
unexplained swelling or severe pain in calf of one leg;
severe stomach pain;
serious neurological effects including unusual severe, prolonged headache especially if first time or getting progressively worse or sudden partial or complete loss of vision or sudden disturbance of hearing or other perceptual disorders or dysphasia or bad fainting attack or collapse or first unexplained epileptic seizure or weakness, motor disturbances, very marked numbness suddenly affecting one side or one part of body;
hepatitis, jaundice, liver enlargement;
blood pressure above systolic 160 mmHg or diastolic 95 mmHg;
prolonged immobility after surgery or leg injury;
detection of a risk factor which contra-indicates treatment.
What are the different Hba1C percentages at each level?
HbA1c Levels and Their Interpretations:
✅ Normal: < 42 mmol/mol (< 6.0%)
⚠️ Prediabetes (Increased risk): 42–47 mmol/mol (6.0–6.4%)
⚡ Diabetes (Diagnostic): ≥ 48 mmol/mol (≥ 6.5%)
For Diabetes Management:
🎯 Good control: < 48 mmol/mol (< 6.5%)
⚡ Target for most adults: ≤ 53 mmol/mol (≤ 7.0%)
⚠️ Less stringent target (if appropriate): ≤ 58 mmol/mol (≤ 7.5%)
What baseline monitoring requirements are there for amiodarone?
🫀 Cardiovascular:
ECG – Check heart rhythm and QT interval
Blood pressure and heart rate
🫁 Respiratory:
Chest X-ray – To detect pre-existing lung disease
🩺 Liver:
Liver function tests (LFTs) – Baseline liver assessment
🦋 Thyroid:
Thyroid function tests (TFTs): TSH, Free T4 – Amiodarone affects thyroid function
👁️ Ophthalmic:
Eye examination – Baseline if visual symptoms present (due to risk of optic neuropathy)
💧 Renal:
Electrolytes (K⁺, Mg²⁺) – Correct before starting to reduce arrhythmia risk
What are some factors that affect the dose of warfarin ?
Factors which necessitate
a dose reductions :
Warfarin:
* Weight loss
* Smoking cessation
* Acute illness
Factors which necessitate
a dose increase :
* Weight gain
* Diarrhoea
* Vomiting
Obviously changes to INR too
What is the max dose of the different migraleve Complete tablets in one day?
Children 12-15 years:
Adults and Children 16 years and over:
Children 12-15 years:
Swallow 1 Migraleve Pink tablet at the first sign of a
migraine attack. If the migraine persists, then take 1 Migraleve Yellow tablet 4 hours after the Pink dose and then every 4 hours.
Do not take more than 4 tablets (1 pink and 3 yellow) in a 24 hour period. If symptoms persist for more than 3 days, talk to your doctor.
Adults and Children 16 years and over:
Swallow 2 Migraleve Pink tablets at the first sign of a
migraine attack. If the migraine persists, then take 2 Migraleve Yellow tablets 4 hours after the Pink dose and then every 4 hours.
Do not take more than 8 tablets (2 pink and 6 yellow) in a 24 hour period. If symptoms persist for more than 3 days, talk to your doctor.
What are the different Water soluble and lipid soluble beta blockers?
Water soluble Beta-blockers
* Atenolol
* Celiprolol
* Nadolol
* Sotalol
Lipid soluble Beta-blockers
* Labetalol
* Metoprolol
* Pindolol
* Propranolol
Water soluble:
Less likely to enter
the brain = less
sleep disturbance
and nightmares.
Excreted by kidneys
and dose reductions
often needed in
renal impairment
What are the actions following a patient coming in with the following symptoms on carbimazole:
Patient should be counselled to look out for signs of early infections such as
mouth ulcers, bruising, malaise, sore throats and fevers
Stop Carbimazole
Speak to a doctor within 24 hours (depending on
when the patient presents to the pharmacy or asks
for advice this may mean sending them to A&E to
speak to a doctor)
WBC count – if WBC come back as normal
Carbimazole can be continued
* Although these symptoms are common for many
minor ailments = it is always safer to get a blood test
to ensure it is not caused by Carbimazole
What are the benefits of SGLT-2 inhibitors ?
💉 Glucose Control:
Lowers blood glucose by promoting urinary glucose excretion
Reduces HbA1c (~0.5–1%)
⚡ Cardiovascular Protection:
Lowers risk of heart failure hospitalization
Reduces major adverse cardiovascular events (MACE) in high-risk patients
💓 Heart Failure Management:
Proven benefit in heart failure with reduced ejection fraction (HFrEF), even without diabetes
🩺 Renal Protection:
Slows progression of chronic kidney disease (CKD)
Reduces albuminuria and preserves renal function
When are the different antimalarials contraindicated ?
(quick contraindications)
🚫 Malarone: Unsuitable in severe renal impairment
🚫 Doxycycline: Avoid in under 12s, pregnancy, or breastfeeding
🚫 Mefloquine: Unsuitable in epilepsy & psychiatric disorders (e.g., depression)
🚫 Proguanil: Avoid in renal impairment
🚫 Chloroquine: Unsuitable in epilepsy & severe renal impairment
🚫 Chloroquine + Proguanil: Avoid in epilepsy & renal impairment
When is the paracetamol dose given with the meningitis vaccine ?
You’ll need to give your baby 3 doses of paracetamol. Give them 1 dose as soon as possible after being vaccinated, give them a 2nd dose 4 to 6 hours later, and a 3rd dose 4 to 6 hours after that.
Make sure you leave at least 4 hours between each dose and do not give them more than 4 doses in 24 hours.
Why is pyridoxine given with Isoniazid?
⚡ Prevention of Peripheral Neuropathy
Isoniazid can cause peripheral neuropathy due to pyridoxine deficiency.
INH interferes with vitamin B6 metabolism, reducing its availability and leading to nerve damage.
Symptoms of neuropathy include tingling, numbness, and pain in the hands and feet.
When does redman syndrome occur with vancomycin?
The symptoms described are ‘red-man syndrome’ (RMS). Red man syndrome is a rate-dependent infusion reaction which can be caused by Vancomycin when the infusion rate is set too fast
What is the antidote to treat Loperamide overdose?
Naloxone
What are the antidotes/reversal agents for the following:
* Heparins
* Warfarin
* Paracetamol
* Digoxin
* Iron salts
* Benzodiazepines
* Opioids (& Loperamide)
* Dabigatran
* Dystonic reactions
* Amfetamines
* Cocaine
* Theophylline
- Heparins = For rapid reversal, Protamine
Sulfate (but only partially reverses the effects
of low molecular weight heparins) - Warfarin = Phytomenadione (Vitamin K1)
- Paracetamol = Acetylcysteine
- Digoxin = digoxin specific antibody antigen-
binding fragments - Iron salts= Deferoxamine
- Benzodiazepines = Activated charcoal (within
1 hour on ingestion) or Flumazenil
(unlicensed and also carries more risks) - Opioids (& Loperamide) = Naloxone
Hydrochlride - Dabigatran = Idarucizumab
- Dystonic reactions = Procyclidine or diazepam
- Amfetamines = Diazepam or Lorazepam
- Cocaine = diazepam
- Theophylline = lorazepam or Diazepam
What advice is given to people experiencing depressed mood, depression, suicidal thoughts with finasteride
Stop the finasteride and inform a healthcare professional.
What do the MHRA alerts for montelukast cover?
⚠ Key Risks:
Mood, sleep, or behaviour changes:
😴 Nightmares |
😠Aggression |
😟 Anxiety |
😔 Depression |
💭 Self-injury thoughts
🗣 Speech impairment
🔄 Obsessive-compulsive symptoms
📝 Advice for Healthcare Professionals:
2019 Guidance:
Stay alert for neuropsychiatric symptoms.
Advise patients to read the leaflet & seek immediate medical help if symptoms occur.
Updated 2024 Guidance:
Stronger warnings in product literature.
🔄 New Recommendation: Stop montelukast if new or worsening neuropsychiatric symptoms arise.
What is the advice regarding insomnia treatment post sleep hygiene advice?
🌙 Short-Acting Medications
✅ Useful for: Patients who struggle with falling asleep (sleep initiation).
Examples:
Z-Drugs: Zolpidem, Zopiclone
Benzodiazepines: Loprazolam, Temazepam, Lormetazepam
🌛 Long-Acting Medications
✅ Useful for: Patients who have trouble staying asleep (sleep maintenance) as they help maintain good sleep quality due to longer duration of action.
Examples:
Benzodiazepines: Diazepam, Nitrazepam, Flurazepam
📝 Key Tip:
Z-drugs are often preferred for short-term use due to fewer hangover effects.
Long-acting benzodiazepines may increase the risk of daytime drowsiness, especially in older adults.
What should blood glucose be whilst driving?
Blood-glucose
concentration should
be at least
5 mmol/litre while
driving. If blood-
glucose is
5 mmol/litre or
below, a snack should
be taken.
is codeine linctus a P, GSL medicine or POM?
MHRA reclassification: of codeine linctus from
P to POM to owing to the risk of dependence,
addiction, and overdose.
What are the medications that cause hypomagnesemia?
- PPI’s e.g. omeprazole
- Digoxin (increases the risk of
toxicity) - Diuretics
- Aminoglycosides
