Miscellaneous

Question 1

What type of drug is tamoxifen?

Answer 1

A selective oestrogen receptor modulator (it partially anatgonises and agonises oestrogen receptors)

Question 2

What is tamoxifen used for?

Answer 2

To treat oestrogen receptor positive breast cancer

Question 3

What are some of the side effects of tamoxifen?

Answer 3

Hot flushes (3%)
Increased DVT risk (1.2% per year)
Menstrual disturbances
Oesteoporosis

Question 4

Should metformin be stopped for surgery?

Answer 4

In minor surgery, no

In major surgery, yes and commence variable rate insulin

Question 5

Ciprofloxacin’s effect on warfarin?

Answer 5

It inhibits the P450 system causing an increase in INR

Question 6

How do we treat hyperhidrosis?

Answer 6

Aluminium chloride (applied via roll-ons at night-time)
Can eventually use botulinum toxin injections and topical glycopyrrolate if unresponsive

Question 7

What are the adverse effects of methotrexate?

Answer 7

Mucositis
Myelosuppression
Pneumonitis
Pulmonary fibrosis
Liver fibrosis

Question 8

Methotrexate and pregnancy

Answer 8

Stop at least 6 months before pregnancy for m/f

Question 9

Methotrexate and trimeothoprim

Answer 9

Both affect folate, can cause marrow aplasia

Avoid

Question 10

Methotrexate supplementation

Answer 10

Give with folic acid (5mg once weekly, 24 hours after methotrexate dose)

Question 11

Which medication to treat TB can have adverse effects on vision?

Answer 11

Ethambutol potentially causes optic neuritis

Question 12

Opioid misuse complications?

Answer 12

Viral infections secondary to sharing needles - HIV, Hep B and C
Bact. infection - Infective endocarditis, septic arthritis, septicaemia, necrotising fasciitis
VTE

Question 13

How do we treat opioid overdose?

Answer 13

IV/IM naloxone

Question 14

What can topical corticosteroids cause in patients with darker skin?

Answer 14

Patchy depigmentation