Medicines 36 Flashcards
Can topical steroids be used for fungal skin infections?
No, topical steroids should not be used alone for fungal infections as they can worsen the condition. However, short-term use of combination antifungal + mild steroid (e.g., Daktacort®, Canesten HC®) may be appropriate for fungal infections with significant inflammation. 🌟
⚠️ Key points:
✔️ Use combination antifungal + mild steroid for up to 7 days, then continue with antifungal alone.
❌ Avoid using steroids alone—risk of tinea incognito (worsened fungal infection).
❌ Avoid strong steroids (e.g., betamethasone, clobetasol) in fungal infections.
What does the abbreviation P.C mean on a prescription?
p.c stands for ‘post cibum’ which means after food.
what is the difference between glucocorticoids and mineralcorticoids
🔹 Glucocorticoids (e.g., Prednisolone, Dexamethasone) – Think “Glucose & Inflammation”
Helps control inflammation (used for asthma, arthritis, allergies).
Affects metabolism by increasing blood sugar. 🍬
Long-term use can cause diabetes, osteoporosis, muscle loss, and mood changes.
🔹 Mineralocorticoids (e.g., Aldosterone, Fludrocortisone) – Think “Minerals & Blood Pressure”
Helps control salt & water balance in the body. 🧂💧
Affects blood pressure by increasing sodium & water retention and losing potassium.
Too much can cause high blood pressure & swelling; too little can lead to dehydration & low BP.
WHat is the interaction between fluroquinololnes and NSAIDs
Fluoroquinolones (e.g., ciprofloxacin, levofloxacin) and NSAIDs (e.g., ibuprofen, naproxen) can interact, leading to an increased risk of seizures.
🔹 Why?
Fluoroquinolones can lower the seizure threshold, making the brain more excitable. NSAIDs, particularly ibuprofen and fenbufen, can enhance this effect, increasing the risk of convulsions.
What travel health advice should be given to someone going to an area with poor sanitation and food hygiene?
🦠 Disease prevention: High risk of Hepatitis A, Typhoid, Cholera, and Traveller’s Diarrhoea
✅ Vaccinations:
💉 Consider Hepatitis A, Typhoid, and Cholera vaccines before travel
🍽️ Food & Drink Safety:
🚫 Avoid raw, unpeeled, or undercooked food
💧 Drink only bottled or boiled water – avoid ice cubes
🙌 Wash hands regularly or use hand sanitiser
🥄 Use clean utensils & avoid street food in risky areas
💊 Medical Kit:
💊 Carry oral rehydration salts (ORS) for dehydration
💊 Consider antidiarrheal medication (e.g., loperamide) for emergencies
What does the BCG vaccine help to protect from?
Immunisation against tuberculosis
Which beta-blockers have a longer duration of action and only need to be given once daily?
Atenolol, bisoprolol fumarate, celiprolol hydrochloride, and nadolol. (NICE)
What are the approximate equivalent doses of opioids?
Morphine 10mg - reference point
Codeine (PO): 100 mg
Diamorphine (IV, SC): 3.3 mg
Dihydrocodeine (PO): 100 mg
Hydromorphone (PO): 2 mg
Morphine (IV, SC): 5 mg
Oxycodone (PO): 6.6 mg
Oxycodone (IV, SC): 5 mg
Tramadol (PO): 100 mg
Morphine salt 12 mg daily ≡ Buprenorphine 5 micrograms/hour patch
Morphine 60 mg daily ≡ Fentanyl 25 micrograms/hour patch
Which drugs are associated with a risk of prolonged QT interval?
Antibiotics 🦠
Macrolides: Clarithromycin, Erythromycin, Azithromycin
Fluoroquinolones: Ciprofloxacin, Levofloxacin
Antifungals: Fluconazole, Voriconazole
Antipsychotics 🧠
Haloperidol
Chlorpromazine
Quetiapine
Risperidone
Antidepressants 💊
Citalopram
Escitalopram
Amitriptyline
Antiarrhythmics ❤️
Amiodarone
Sotalol
Other Drugs
Ondansetron (antiemetic)
Methadone (opioid)
Domperidone (prokinetic)
What drug interactions are associated with baclofen?
✅ Baclofen can interact with:
🔹 CNS depressants (alcohol, opiates, hypnotics, anxiolytics) → ⬆ drowsiness & respiratory depression
🔹 Tricyclic antidepressants (TCAs) → ⬆ muscle relaxation → profound hypotonia & drowsiness
🔹 Antihypertensives & diuretics → ⬆ risk of hypotension
🔹 Dopaminergics → hallucinations, confusion, nausea, headache (especially in Parkinson’s patients)
🔹 Lithium → worsening of hyperkinetic symptoms (e.g., in Huntington’s chorea)
🔹 NSAIDs → may reduce baclofen excretion, leading to increased drug levels
What is a common side effect of Ibenone?
Chromaturia is a side effect of idebenone - Orange brown Urine (BNF)
What are THREE common SEs of Nitrates?
flushing, headache, and postural hypotension
What advice should be given to patients and carers when using ulipristal acetate for emergency contraception?
✅ Key Points:
🔹 Vomiting within 3 hours? ➝ Take a replacement dose
🔹 Next period? ➝ May be early or late
🔹 Lower abdominal pain? ➝ Seek medical attention (risk of ectopic pregnancy)
⚠ Additional FSRH Advice:
🔸 Use a barrier method after taking ulipristal
🔸 Delayed period (>7 days), unusual bleeding, or pain? ➝ Take a pregnancy test
🔸 Starting hormonal contraception soon after? ➝ Take a pregnancy test (bleeding may not indicate menstruation)
What bacteria commonly causes impetigo?
Staphylococcus aureus.
What controlled drugs can podiatrists prescribe?
Podiatrists can prescribe diazepam, dihydrocodeine, lorazepam and temazepam only for oral administration.
Why shouldn’t pseudoephedrine be given in the following conditions:
🚫 Severe or uncontrolled hypertension .
🔹 Diabetes
🔹 Heart disease & ischaemic heart disease
🔹 Hyperthyroidism
🔹 Mild-moderate hypertension
🔹 Prostatic hypertrophy
🔹 Raised intra-ocular pressure / angle-closure glaucoma
🔴 Contraindications:
🚫 Severe or uncontrolled hypertension → Can further elevate blood pressure, increasing the risk of cardiovascular events.
⚠ Cautions:
🔹 Diabetes → May increase blood glucose levels.
🔹 Heart disease & ischaemic heart disease → Increased cardiac workload could lead to angina or arrhythmias.
🔹 Hyperthyroidism → Already elevated metabolic rate & heart rate may be further exacerbated.
🔹 Mild-moderate hypertension → Risk of worsening blood pressure control.
🔹 Prostatic hypertrophy → Can cause urinary retention.
🔹 Raised intra-ocular pressure / angle-closure glaucoma → Can worsen glaucoma by increasing intraocular pressure.
What are the symptoms of a wart and what virus causes them?
🦠 Cause: Warts are caused by the human papillomavirus (HPV), which infects the top layer of skin, leading to rapid skin cell growth.
Symptoms of Warts:
🔹 Common warts (verruca vulgaris) – Rough, raised, grainy growths, often on hands or fingers.
🔹 Plantar warts – Hard, flat warts on the soles of the feet, may have black dots (clotted blood vessels).
🔹 Flat warts – Small, smooth, flesh-colored lesions, often in clusters on the face, hands, or legs.
🔹 Filiform warts – Long, thread-like warts on the face, neck, or eyelids.
🔹 Genital warts – Soft, fleshy, cauliflower-like growths in the genital area.
Key Features:
✅ Skin-colored or brown
✅ Rough or smooth texture
✅ Painless (except plantar warts, which can be painful when walking)
✅ May appear singly or in clusters
Should QRISK be used in familial Hypercholesterolaemia?
CHD risk assessment tools should not be used to guide management of people with FH because they are already at a high risk of premature CHD. (NICE)
Name 3 secondary complications of diabetes
Cardiovascular disease, diabetic nephropathy and neuropathy are secondary complications of diabetes.
What schedule is lorazepam
Lorazepam, a schedule 4 CD, is allowed on repeats.
What age can Chloramphenicol be used
Some chloramphenicol preparations may be contraindicated in under 2s in the product literature. However, an MHRA review concluded that the benefits of chloramphenicol eye drops containing borax or boric acid outweigh the potential risk to children, including those aged 0 to 2 years.
OTC over 2 years
https://www.gov.uk/drug-safety-update/chloramphenicol-eye-drops-containing-borax-or-boric-acid-buffers-use-in-children-younger-than-2-years
Define Cytotoxic drugs
Cytotoxic drugs are medications that damage or kill cells by interfering with their growth or division. They are often used in cancer treatment (chemotherapy) to target and destroy rapidly dividing cancer cells, but they can also affect normal cells that divide quickly, leading to side effects.
Examples of Cytotoxic Drugs:
Alkylating agents (e.g., cyclophosphamide)
Antimetabolites (e.g., methotrexate)
Mitotic inhibitors (e.g., vincristine)
Topoisomerase inhibitors (e.g., etoposide)
What is Seborrhoeic dermatitis ?
Seborrhoeic dermatitis is a chronic inflammatory skin condition that primarily affects areas of the skin where sebaceous (oil) glands are most active. It is characterized by red, scaly, and flaky patches of skin, often accompanied by itching.
Common Symptoms of Seborrhoeic Dermatitis:
Scaly patches that may be yellowish or white
Redness and inflammation
Itching or burning sensation
Greasy appearance of the skin
Flaking similar to dandruff, especially on the scalp
Lesions may appear on the scalp, face (especially around the eyebrows, nose, and ears), chest, and back.
What is and What are the symptoms of discoid Eczema
Discoid Eczema (or nummular eczema) is a type of eczema characterized by round, itchy, inflamed patches of skin that are often dry, red, and scaly. These patches can appear anywhere but are common on the arms, legs, and torso. It is typically caused by a combination of genetic factors, environmental triggers, and infections.
Symptoms:
Well-defined, coin-shaped patches
Redness, dryness, scaling, and itching
Common on arms, legs, and torso - classically associated with lower extremities.
