Medicines 4 Flashcards
Why would diazepam be given before surgery?
Sedation for interventional procedures if general anaesthesia is not good
Why would sodium citrate be given before surgery.
To neutralise acidity of fluid in the stomach
Which diabetic medication should promptly report any symptoms indicative of bladder cancer such as haematuria, dysuria, or urinary urgency during treatment.
Pioglitazone
MHRA alert: Pioglitazone: risk of bladder cancer (July 2011)
The European Medicines Agency has advised that there is a small increased risk of bladder cancer associated with pioglitazone use. However, in patients who respond adequately to treatment, the benefits of pioglitazone continue to outweigh the risks.
Pioglitazone should not be used in patients with active bladder cancer or a past history of bladder cancer, or in those who have uninvestigated macroscopic haematuria. Pioglitazone should be used with caution in elderly patients as the risk of bladder cancer increases with age.
Before initiating treatment with pioglitazone, patients should be assessed for risk factors of bladder cancer (including age, smoking status, exposure to certain occupational or chemotherapy agents, or previous radiation therapy to the pelvic region) and any macroscopic haematuria should be investigated. The safety and efficacy of pioglitazone should be reviewed after 3–6 months and pioglitazone should be stopped in patients who do not respond adequately to treatment.
Patients already receiving treatment with pioglitazone should be assessed for risk factors of bladder cancer and treatment should be reviewed after 3–6 months, as above.
WHich antidiabetic medication can cause pancreatitis ?
Gliptins/dipeptidyl peptidase-4 (DPP-4) inhibitors - Sitagliptin, Alogliptin, Linagliptin, Saxagliptin can cause acute pancreatitis
GLP-1 receptor agonists
What are cracks in the corner of the lips known as ?
Angular chelitis
What is xerostomia? and give an example of a medication that causes it
Dry mouth - Antihistamines, antimuscarinic, tricyclic antidepressants (amitriptyline,Clomipramine) and some diuretics
What medications can cause cause corneal oedema with contact lenses
(e.g. oral contraceptives–particularly those with a higher oestrogen content)
Which drugs cause drugs which reduce eye movement and blink reflex with contact lenses
drugs which reduce eye movement and blink reflex (e.g. anxiolytics, sedative hypnotics, antihistamines, and muscle relaxants)
Which drugs reduce lacrimation with contact lenses?
drugs which reduce lacrimation (e.g. older generation antihistamines, phenothiazines and related drugs, some beta-blockers, diuretics, and tricyclic antidepressants)
Which drugs increase lacrimation with contact lenses?
drugs which increase lacrimation (including ephedrine hydrochloride and hydralazine hydrochloride).
Other drugs that may affect contact lens wear
Isotretinoin (can decrease tolerance to contact lens)
which medications can discolour contact lenses?
rifampicin and sulfasalazine (can discolour lenses).
how can aspirin affect contact lenses?
aspirin (can cause irritation)
what antacid that may cause diarrhoea.
Magnesium containing antacids cause laxative effect
How can cancer drugs be ranked based off their emetogenicity (A more emetogenic drug is one that has a higher likelihood of causing nausea and vomiting)
Drugs may be divided according to their emetogenic potential and some examples are given below, but the symptoms vary according to the dose, to other drugs administered and to the individual’s susceptibility to emetogenic stimuli.
Mildly emetogenic treatment—fluorouracil, etoposide, methotrexate (less than 100 mg/m2, low dose in children), the vinca alkaloids, and abdominal radiotherapy.
Moderately emetogenic treatment—the taxanes, doxorubicin hydrochloride, intermediate and low doses of cyclophosphamide, mitoxantrone, and high doses of methotrexate (0.1– 1.2 g/m2).
Highly emetogenic treatment—cisplatin, dacarbazine, and high doses of cyclophosphamide.
What is the most effective form of contraception?
Copper IUD is the most effective and can be inserted up to 5 days after UPSI
What contraception needs to be stopped before surgery
CHC use should be discontinued at least 4 weeks prior to major elective surgery, any surgery to the legs or pelvis, or surgery that involves prolonged immobilisation of a lower limb. An alternative method of contraception should be used to prevent unintentional pregnancy, and CHC may be recommenced 2 weeks after full remobilisation. When discontinuation is not possible, e.g. after trauma or if a patient admitted for an elective procedure is still on CHC, thromboprophylaxis should be considered.
Which oral bisphosphonate can be taken ONCE monthly?
Ibandronic Acid
What TOPICAL steroids are least and most potent?
Mild
Hydrocortisone
Moderate
Alclometasone dipropionate
Clobetasone butyrate
Hydrocortisone butyrate
Potent
Beclometasone dipropionate
Betamethasone
Fludroxycortide
Fluocinolone acetonide
Fluocinonide
Fluticasone
Mometasone furoate
Very potent
Clobetasol propionate
Which corticosteroids cause mineralcorticoid effect and what is this effect
Mineralocorticoid side effects
hypertension
sodium retention
water retention
potassium loss
calcium loss
Mineralocorticoid side effects are most marked with fludrocortisone, but are significant with hydrocortisone, corticotropin, and tetracosactide. Mineralocorticoid actions are negligible with the high potency glucocorticoids, betamethasone and dexamethasone, and occur only slightly with methylprednisolone, prednisolone, and triamcinolone.
What is yellow fever, how many vaccines are required and what certification is often required when travelling abroad with it?
Yellow fever is a serious viral disease transmitted to humans primarily through the bites of infected Aedes or Haemagogus mosquitoes.
A single dose of yellow fever vaccine confers life-long immunity against yellow fever disease. Immunisation should be performed at least 10 days before travelling to an endemic area to allow protective immunity to develop and for the International Certificate of Vaccination or Prophylaxis - ICVP (if required) to become valid
When is a rabies vaccination given?
Post-Exposure Prophylaxis (PEP):
Indication: After potential exposure to rabies (e.g., animal bite, scratch, or saliva exposure to broken skin or mucous membranes).
Schedule for Previously Unvaccinated Individuals:
Day 0 (as soon as possible after exposure).
Day 3.
Day 7.
Day 14.
Immunocompromised individuals: Add a fifth dose on Day 28.
Rabies Immunoglobulin (RIG): Administer on Day 0 for category III exposures, infiltrating the wound and injecting any remaining dose intramuscularly.
Previously Vaccinated Individuals:
Two booster doses of rabies vaccine on Day 0 and Day 3.
RIG is not needed.
Name inhalers containing a combination of fluticasone and salmeterol.
Seretide Accuhaler / Seretide Evohaler
Name inhalers that can be used for MART therapy
Symbicort (budesonide + formoterol)
Commonly used in MART regimens.
Rapid onset of action due to formoterol.
Fostair (beclometasone + formoterol)
Suitable for maintenance and reliever therapy in asthma.
Available in metered-dose inhaler (MDI) or dry powder inhaler (DPI) formulations.
DuoResp Spiromax (budesonide + formoterol)
Equivalent to Symbicort in some regions.
Used as a MART inhaler.
Which inhalers are only licensed for COPD
Triple Therapy Inhalers (ICS + LABA + LAMA):
Trelegy Ellipta (fluticasone + umeclidinium + vilanterol)
Trimbow (beclometasone + formoterol + glycopyrronium)
Trixeo Aerosphere (budesonide + formoterol + glycopyrronium)
some dual therapy:
Anoro Ellipta (umeclidinium + vilanterol)
