Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Past Paper Mistakes > Notebook > Flashcards

Notebook Flashcards

1
Q

Clozapine traffic light system

A

Result of last blood test:
Red- needs to be reviewed by Dr
Amber- depends on Dr’s judgement
Green- can take

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Missing clozapine doses

A

Patients who have missed clozapine doses for more than 48 hours will need to have the medicine re-titrated. They cannot continue taking their usual maintenance dose. If they miss more than three days of clozapine their blood testing frequency may need to change.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

TRS

A

Treatment resistant schizophrenia (had 1 or 2 other antipsychotics and experienced EPSEs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Carbamazepine-clozapine

A

Increase the risk of myelosuppression when given with clozapine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Clozapine- smoking

A

Smoking decreases dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Clozapine- caffeine

A

Caffeine increases the dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Essential services

A

Dispensing medicines (required to keep copy of all supply)
Dispensing appliances e.g. cathetar, incontinence and stoma appliances
Repeat dispensing
Disposal of unwanted medicines
Clinical governance
Public health (promotion of healthy lifestyles)
Signposting
Support for self care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Drug Tariff

A

What is paid to community pharmacies for the NHS services provided

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How many public health campaigns are community pharmacies required to take part in?

A

6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Authorising witness for destruction of CDs

A

Not a requirement to have authorising witness for patient-returned CDs. Record still needs to be made in the register.

For expired pharmacy stock, it is a legal requirement to have a witness for obsolete, expired and unwanted Schedule 1 and 2 CDs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Advanced services

A 
Community pharmacy consultation service
MURs (decommissioned at end of 03/21)
NMS
Flu vaccination service
Appliance use reviews
Stoma appliance customisation
Hepatitis C testing service
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Enhanced services

A

Smoking cessation
Provision of hormonal contraception
Supervised methadone consumption
Needle exchange service

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

NMS categories

A

Asthma/COPD
Diabetes (type 2)
Antiplatelets/anticoagulants
Hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Stages of NMS

A

1) Patient engagement (Day 1)
2) Intervention (Day 7-14)
3) Follow-up (Day 21-28)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Categories eligible for flu vaccine

A

Aged 65+
Have certain health conditions
Pregnant
In long-stay residential care
Receive carer’s allowance/main carer for an older or disabled person at risk
Lives with someone who is at high risk of coronavirus
Front line health workers and social care workers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the sodium content of Gaviscon Advance suspension?

A

2.3 mmol of sodium per 5ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which pain relief meds are not on the Dentists Formulary?

A

Codeine

Co-codamol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Maximum codeine sale

A

32

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Highest codeine strength P med

A

12.8mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Max ibuprofen sale

A

96 (3 boxes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Topical decongestants

A

Oxymetazoline
Xylometazoline
Ephedrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Oral decongestants

A

Phenylephrine

Pseudoephedrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Duration of use of topical decongestants

A

Do not use for longer than 7 days- rebound congestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Patients to avoid decongestants in

A

High BP
Diabetes
Hyperthyroidism
Heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Cough suppressants for dry coughs

A

Codeine
Pholcodeine
Dextromethorphan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Expectorants for productive coughs

A 
Guaifenesin
Squill
Ipecacuanha
Sodium citrate
Ammonium chloride
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Soothing agents for dry, tickly coughs

A

Glycerin
Honey
Simple linctus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Codeine age

A

12 years and over- associated with risk of respiratory side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Potassium citrate/sodium citrate for cystitis

A

Use for max 2 days before seeing GP

Sodium citrate- caution in heart disease, hypertension or renal impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Symptoms of cystitis (inflammation of the bladder)

A

Wanting to urinate more frequently and urgently
Pain/burning while peeing
Dark/cloudy/strong-smelling urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Symptoms of thrush (Candida)

A

Pain during urination
Soreness around outer vaginal area
Thick, cottage-cheese like vaginal discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Treatment of thrush

A

Antifungals- clotrimazole, fluconazole
Max OTC age 60
If patient is diabetic- refer (sign of uncontrolled diabetes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Treatment of period pain

A

NSAIDs (due to the increase in prostaglandins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

When is it best to do pregnancy testing?

A

HCG levels are the highest in the morning so it is best to do them in the morning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Teething gel containing salicylates

A

Not recommended in under 16- Reyes syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Head lice treatment

A

Non-insecticides: cyclomethicone or dimethicone (so can be used in pregnancy and breast-feeding)
Insecticides: malathion or permethrin (alternate to prevent resistance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Meningitis

A

Inflammation of the lining of the brain and spinal cord

Bacterial meningitis is more dangerous than viral and can cause septicaemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Define constipation

A

Fewer than 3 bowel movements per week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How long do laxatives take to work?

A

Stimulant laxatives: 6-12 hours [Glycerin suppositories work in about 15-30 minutes. They are mildly irritant so should be moistened with water before insertion]

Bulk forming: 1-2 days
Osmotic: 2-3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Haemorrhoids (piles)

A

Swollen veins in the back passage (internal) or around the anus (external) that can be painful, itchy and can bleed

Docusate is licensed for the prevention and treatment of piles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Preferred group of laxatives in IBS

A

Bulk forming

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Symptoms of meningitis

A 
Fever
Vomiting
Severe headache
Stiff neck
Dislike of bright lights
Very sleepy
Confusion
Non-blanching rash
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Treating dandruff

A

Shampoos containing selenium sulphide (mild), salicylic acid, coal tar or zinc pyrithione
Ketoconazole can treat and prevent dandrugg and seborrhoeic dermatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Psoriasis

A

Red inflamed skin with silvery scales
Usually localised to knees and elbows
Treat with coal tar and salicylic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Sale of Dovonex

A

Contains calcipotriol (Vitamin D analogue)
Can be sold for 18 years and over
Max 12 weeks treatment for Dr-diagnosed psoriasis, then must see Dr for ongoing treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Treatment for male pattern baldness and certain types of hair loss

A

Minodixil (2%/5%)
Needs 4 months continued use
Max age for use 65 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

OTC treatments for acne

A 
Salicylic acid
Benzoyl peroxide (Bleaches skin + increases sensitivity to light)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Cold sores

A

Caused by herpes simplex type 1 virus

Treat with aciclovir cream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Warts

A

Mostly on the hands (if on the feet then veruccas)
Caused by HPV
Salicylic acid and lactic acid e.g. Bazuka, Salactol
Can take months-years to work

No OTC products to be used on the face or in the anal/genital areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

OTC hydrocortisone

A 
Over the age of 10
Can't be used by pregnant/breast-feeding women
Not for the face or anal/genital area
Apply thinly
Max 7 days use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

OTC clobetasone butyrate

A

Over the age of 12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Permethrin for scabies

A

Apply 5% preparation over whole body including face, neck, scalp and ears then wash off after 8–12 hours. If hands are washed with soap within 8 hours of application, they should be treated again with cream.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Scabies on treatment

A

Malathion: left on for 24 hours
Permethrin: left on for 8-12 hours

Repeat after a week
Treat whole family
Refer pregnant women and children under 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Corns and calluses (caused by ill-fitting shoes)

A

Corns: in between the toes- where it’s moist
Calluses: on the ball or heel of the foot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Onychomycosis (fungal nail infections)

A

Amorolfine hydrochloride 5% nail lacquer
18 years and over
Not suitable for pregnant or breastfeeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Athletes foot

A

Imidazole antifungals: miconazole, clotrimazole
Non-imidazole antifungal: terbinafine

If the foot is inflamed- treat with hydrocortisone and antifungal till the rash is cleared, and continue for further 2 weeks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Tamsulosin for BPH age restrictions

A

45-75

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Bacterial and viral conjunctivitis

A

Conjunctivitis usually causes a pink or red, gritty feeling in the eye and may cause the eyelids to stick together in the morning.
Often starts in one eye, usually spreading to the other.

Bacterial conjunctivitis normally causes a yellow or green sticky discharge
Viral conjunctivitis normally causes a watery discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Allergic conjunctivitis

A

Allergic conjunctivitis usually causes pink or red itchy eyes. The eyes are normally watery and other allergy symptoms such as sneezing and a runny nose may be present.

Sodium cromoglicate can be used in over 2 years of age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Chloramphenicol for bacterial conjunctivitis

A

Over the age of 2. Not suitable for pregnant or breastfeeding women.

Eye drops: every 2 hours for the first 48 hours, then every 4 hours
Continue treatment for 48 hours after the eye appears normal
Max licensed duration: 5 days
Cannot be given if they have had laser eye surgery less than 6 months ago

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Caution with naphazoline and xylometazoline

A

Work by shrinking blood vessels- check if they have HTN, diabetes, overactive thyroid or raised cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Arachis oil can be used for ear wax

A

Check peanut allergy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Miconazole oral gel age

A

4 months and over

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Brown staining of teeth

A

Chlorhexidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Antibiotics that cause intrinsic staining

A

Tetracyclines (4th month in utero to 12 years) so contraindicated in under 12 years and during pregnancy and breastfeeding.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Osteonecrosis of the jaw

A

Greater risk for those taking IV bisphosphonates for cancer than oral for osteoporosis or Paget’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Which drugs can cause gingival hyperplasia (overgrowth)?

A

Phenytoin
Ciclosporin
Nifedipine (and other CCBs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What drugs can cause xerostomia (dry mouth)?

A 
Excessive diuretic use
Antihistamines
Antimuscarinics
Alpha blockers
Baclofen
TCAs
SSRIs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Increased saliva production

A

Clozapine

Neostigmine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Hypoalbuminaemia

A

Can occur in severe liver disease

Reduced protein binding= increased toxicity of highly protein bound drugs e.g. phenytoin and prednisolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Dexamethasone for nerve compression pain

A

Anti-inflammatory properties

Reduces oedema around tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

When is CrCl used?

A

DOACs and renally excreted drugs

Not for periods of rapidly changing renal function and AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is the eGFR for Stage 1 CKD?

A

≥90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What is the eGFR for Stage 2 CKD?

A

60-89

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is the eGFR for Stage 3a CKD?

A

45-59

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is the eGFR for Stage 3b CKD?

A

30-44

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What is the eGFR for Stage 4 CKD?

A

15-29

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What is the eGFR for Stage 5 CKD?

A

<15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What is the INR target range for valvular AF?

A

3-4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What is the INR target range for non-valvular AF?

A

2-3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

CHADVASC and HASBLED

A

Women already have a score of 1 in CHADVASC

Score of 2 in both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Which DOACs can be crushed?

A

Apixaban
Rivaroxaban
Edoxaban

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

CrCl>95

A

Should not take edoxaban as it would be cleared too quickly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What are the weight limitations for DOACs?

A

<50kg

>120kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Treating PE/DVT with apixaban

A

10mg BD for 7 days, then 5mg BD thereafter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Off label use of metformin

A

PCOS

87
Q

Off-label vs unlicensed

A

Off label: Medicine being used in a way that is different to that described in the licence.
E.g. used for a disease that is not in the license, used for an age group outside the licensed range, using medicine at a higher dose than stated

Unlicensed: Medicine may have MA in other countries, but not the UK so has to be imported. May also need to be made up to be taken as unlicensed preparation. Some medicines have no license at all.

88
Q

Keeping private Rx

A

2 years

89
Q

Keeping Vet Rx

A

5 years

90
Q

Legal requirement for vet CDs

A

Valid for 28 days
Include a declaration that these items are “prescribed for the treatment of an animal or herd under his care”
Maximum of 28 days treatment should be prescribed unless situations of long term ongoing medication (e.g. treatment of epilepsy in dogs)
Standardised form is not required

91
Q

Schedule 1,2,3,4 Rxs are valid for how long

A

28 days

92
Q

Schedule 5 Rxs are valid for how long

A

6 months

93
Q

Record keeping of POM-V supplies

A

Name of medicine
Date of receipt or supply
Batch number
Quantity
Name and address of the supplier or recipient
If there is a written prescription, record the name and address of the prescriber and keep a copy of the prescription.

94
Q

Additional details that must be added to Vet Prescriptions

A

Name and telephone number of the prescriber
Qualification of the prescriber
Name and address of the owner of the animal (and where the animal is kept, if different)
Identification and species of the animal(s)
Withdrawal period (if relevant)
Any necessary warnings
If necessary, a declaration that it is “for administration under the cascade” (see below)
If the prescription is repeatable, the number of times it can be repeated.

95
Q

EEA doctors

A

Cant prescribe unlicensed meds and CD schedules 1, 2 and 3

Also can’t supply phenobarbital as emergency supply

96
Q

RP record

A

Should be treated as CD register so put * for amendments
Writing reason for absence is good practice, not legally required
Must record when and by whom changes were made

97
Q

In the absence of the responsible
pharmacist, pharmacy staff, as outlined in the
pharmacy procedures…

A
  • CANNOT supply GSL medicines against a prescription unless there is a second pharmacist present
  • CANNOT sell P medicines unless there is a second pharmacist present
  • CANNOT hand out pre-bagged and checked medicines to patients or delivery drivers unless there is a second pharmacist present
  • CANNOT sell or supply any medicines, including GSL medicines, if the responsible pharmacist is absent for more than two hours unless another responsible pharmacist is appointed.
98
Q

Schedule 3 CDs

A

Temazepam, gabapentin, pregabalin and tramadol are all Schedule 3 Controlled Drugs. Emergency supplies of these medicines are not allowed and so they cannot be supplied.

99
Q

Schedule 4 CDs

A

Medicines such as benzodiazepines (apart from temazepam, which is Schedule 3), zopiclone, and zolpidem are Schedule 4 Controlled Drugs. Up to five days’ treatment may be supplied, if it is clinically appropriate and after an assessment.

100
Q

Schedule 5 CDs

A

Medicines such as dihydrocodeine and codeine containing products (including co-codamol 30mg/500mg) are Schedule 5 Controlled Drugs. Up to five days’ treatment may be supplied if it is clinically appropriate and after an assessment.

101
Q

Labelling of emergency supply

A

Must state ‘For emergency supply’

102
Q

CD requirements: total quantity in words and figures

A

Schedule 2 and 3

103
Q

CD repeats permitted

A

Schedule 4 and 5

104
Q

When is the UK prescriber address required for CDs?

A

Schedule 2 and 3

105
Q

Sativex

A 
Licensed medicine containing cannabis
Schedule 4 Part 1
Doesn't need to be locked away
To be kept in the fridge
Do not need to keep record of stock in and out
Not required for safe custody
106
Q

Dentists prescribing

A

Can prescribe anything in the BNF privately and as an emergency but must following Dentists formulary in normal instances

107
Q

Community Practitioner Nurse

A

Cannot prescribe phenobarbital- not on their formulary

108
Q

Private scripts for CDs

A

Must be on standardised prescription form (FP10CD)

109
Q

Methadone for addiction

A

Can be prescribed by Independent Pharmacy Prescribers- but not other meds for addiction e.g. diamorphine, dipiprenone and cocaine

110
Q

CD requirements

A

Must be recorded if proof of identity was requested

111
Q

Patient returns of CDs

A

Are not added to the CD register

112
Q

Signed orders for salbutamol/adrenaline auto-injectors

A

Needs to be supplied from the Head Teacher including:

1) Name of the school
2) Purpose of the product
3) Total quantity required

The signed order is kept for 2 years. Good practice to put in the POM register.
Only one brand of AAIs should be supplied.

113
Q

Audit cycle

A

1) Identify problem/issue
2) Set criteria + standards
3) Observe practice/ data collection
4) Compare performance with criteria and standards
5) Implementing change

114
Q

Cough symptom differentiation

A

TB: night sweats, fever, weight loss
HF: shortness of breath
Pneumonia: non-productive initially but progresses to productive
Chronic Bronchitis: closely associated with Hx of smoking
Cystic fibrosis: recurrent infections, wheeze [Picked up with heel-prick test in babies]
Laryngotracheobronchitis (croup): usually presents at night
Pertussis (whooping cough): cold-like symptoms before whooping cough

115
Q

Right lower quadrant pain

A

Appendicitis

Refer to hospital

116
Q

Right upper quandrant pain

A

Peptic ulcer- just off the midline

Liver is also in this region so it could be gall stones

117
Q

Left lower quadrant pain

A

Likely to be IBS- around the small intestine area

118
Q

Signs of measles

A

Small blueish-white spots lined with a red ring along the palate in the mouth

119
Q

Febrile neutropenia

A

Tazocin + Ciprofloxacin

Temp ≥ 38°C or signs of sepsis
+
Neutrophil count <0.5x10^9/L

120
Q

Pirinase (fluticasone nasal spray)

A

POM>4 years

P>18 years

121
Q

Clobetasone cream

A

P>12 years

122
Q

Tranexamic acid

A

Not suitable for those with irregular periods

123
Q

Sumatriptan 50mg OTC

A

<65 years

124
Q

Naproxen 250mg OTC

A

15-50 years

125
Q

Max licensed duration of prochlorperazine

A

2 days

126
Q

Max licensed duration of co-codamol (8/500)

A

3 days

127
Q

Max licensed duration of Naproxen 250mg

A

3 days

128
Q

Max licensed duration of omeprazole

A

14 days

129
Q

Ibuprofen-bendroflumethiazide

A

Reduced diuretic and anti-hypertensive effect

130
Q

Rennies-ciprofloxacin

A

Reduced plasma concs (space doses as far apart as possible)

131
Q

Sodium citrate-lithium

A

Reduced lithium concentrations

132
Q

Maloff Protect

A

Combinaton of atovaquone and proguanil hydrochloride
Can take antacids with aluminium with 2hr gap

Avoid supply if on metoclopramide, rifampicin or tetracycline as decreases their concentration.

133
Q

Which drugs have reduced absorption due to antacids?

A 
Warfarin
Tetracyclines
Digoxin
Rifampicin
Iron (2hr gap)
Chlorpromazine
Ciprofloxacin + norfloxacin
134
Q

Fexofenadine

A

Now GSL
Over the age of 12
One tablet OD

135
Q

BMI

A

<18.5 underweight
18.5-25 normal
25-30 overweight
>30 obese

136
Q

Pernicious anaemia (B12 deficiency)

A

Hydroxocobalamin (retained longer than cyanocobalamin) for up to 3 months

137
Q

Megaloblastic anaemia (due to poor nutrition, pregnancy or antiepileptics)

A

Folic acid for 4 months

138
Q

SSRIs

A

Initially risk of suicidal thoughts
Hyponatraemia
Risk of serotonin syndrome

139
Q

Recommendation for physical activity per week

A

150 mins of moderate intensity

Weight loss target of 10-15%

140
Q

Mechanism of action of biguanides

A

Reduces gluconeogenesis of glucose in the liver

Increases the intestinal absorption of glucose and increases the glucose uptake and utilisation in the cells

141
Q

Advantages of using metformin

A

Doesn’t cause weight gain

Doesn’t cause hypoglycaemia (as it does not stimulate insulin secretion)

142
Q

Most common adverse effect of metformin

A

Diarrhoea

143
Q

HbA1c for treatment with metformin/diet + lifestyle alone

A

48mmol/l

144
Q

Sulfonylureas (glibenclamide, gliclazide, glimepiride, glipizide, tolbutamide)

A

May cause hypoglycaemia (more likely with long-acting sulfonylureas such as glibenclamide).

Associated with modest weight gain, probably due to increased plasma-insulin concentrations.

145
Q

Acarbose

A

has a poorer anti-hyperglycaemic effect than many other antidiabetic drugs, including the sulfonylureas, metformin hydrochloride, and pioglitazone.

146
Q

The meglitinides, nateglinide and repaglinide

A

have a rapid onset of action and short duration of activity. These drugs can be used flexibly around mealtimes and adjusted to fit around individual eating habits which may be beneficial for some patients, but generally are a less preferred option than the sulfonylureas.

147
Q

The thiazolidinedione (pioglitazone)

A

Pioglitazone should not be used in patients with heart failure or a history of heart failure.
Incidence of heart failure is increased when pioglitazone is combined with insulin especially in patients with predisposing factors e.g. previous myocardial infarction.
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.

148
Q

Sitagliptin dose reduction

A

Manufacturer advises reduce dose to 50 mg once daily if eGFR 30–45 mL/minute/1.73 m2.
Manufacturer advises reduce dose to 25 mg once daily if eGFR less than 30 mL/minute/1.73 m2.

149
Q

The dipeptidylpeptidase-4 inhibitors (gliptins), alogliptin, linagliptin, sitagliptin, saxagliptin, and vildagliptin

A

do not appear to be associated with weight gain and have less incidence of hypoglycaemia than the sulfonylureas.

150
Q

Mechanism of DPP4-inhibitors

A

increase incretin levels (GLP-1 and GIP), which inhibit glucagon release, which in turn increases insulin secretion, decreases gastric emptying, and decreases blood glucose levels.

151
Q

The sodium glucose co-transporter 2 inhibitors (canagliflozin, dapagliflozin, and empagliflozin)

A

may be suitable for some patients when first-line options are not appropriate.
Canagliflozin and empagliflozin can be beneficial in patients with type 2 diabetes and established cardiovascular disease.

Sodium glucose co-transporter 2 inhibitors are associated with a risk of diabetic ketoacidosis.

152
Q

SGLT2 inhibitors mode of action

A

Sodium-glucose co-transporter-2 inhibitors work by inhibiting SGLT2 in the PCT, to prevent reabsorption of glucose and facilitate its excretion in urine. As glucose is excreted, its plasma levels fall leading to an improvement in all glycemic parameters.

153
Q

GLP1 agonists

A

The glucagon-like peptide-1 receptor agonists, dulaglutide, exenatide, liraglutide and lixisenatide, should be reserved for combination therapy when other treatment options have failed.

154
Q

Liraglutide

A

Proven cardiovascular benefit and should be considered in patients with type 2 diabetes and established cardiovascular disease.

155
Q

HbA1c target for adults prescribed a single drug associated with hypoglycaemia (such as a sulphonylurea), or two or more antidiabetic drugs in combination

A

Aim for an HbA1c concentration of 53 mmol/mol

156
Q

‘Poorly controlled’ diabetes

A

Rise of HbA1c to 58 mmol/mol (7.5%) or higher)

Drug treatment should be intensified, alongside reinforcement of advice regarding diet, lifestyle, and adherence to drug treatment.

157
Q

STEMI

A

Complete blockage of the artery

158
Q

NSTEMI

A

Partial blockage of the artery

159
Q

AF ECG

A

Absence of the P wave

160
Q

What medicines would you typically see for a patient who has undergone a renal transplant?

A 
Mycophenolate
Tacrolimus
Prednisolone
Cimetidine
Atorvastatin
Aspirin
161
Q

Carbapenems

A

Avoid if severe penicillin allergy
Seizure risk at high doses or in renal failure
Interaction: valproate (diminishes valproate levels)

162
Q

Generations of cephalosporins

A

1st- Cefalexin, cefradine
2nd- Cefuroxime
3rd- Cetriaxone, ceftazidime

163
Q

Tetracyclines

A 
Avoid in pregnancy and in children
Avoid milk/dairy with tetracycline/oxytetracycline
Avoid antacids (iron and zinc preparations) may reduce the absorption as it chelates
164
Q

Macrolides

A

QT interval prolongation
Erythromycin is useful as prokinetic
Common enzyme inhibitor- interacts with warfarin, carbamazepine, etc.

165
Q

Clindamycin

A

A lincosamide

High risk of C.difficile- can cause colitis so be wary of diarrhoea (streaked with bright red blood)

166
Q

Trimethoprim

A

Can affect the folate pathway- risk of severe bone marrow suppression with methotrexate
Can cause hyperkalaemia and hyponatraemia

167
Q

Trimethoprim-warfarin

A

Increases the anticoagulant effect of warfarin

168
Q

Trimethoprim- phenytoin

A

Increases the concentration of phenytoin

169
Q

Aminoglycosides

A

Dosing based on weight and renal function

Risk of nephrotoxicity and ototoxicity

170
Q

Glycopeptides e.g. teicoplanin, vancomycin

A

Dosing based on weight and renal function

Mainly gram positive/MRSA infections

171
Q

Quinolones

A 
Caution in under 12s
QT prolongation
May induce convulsions- esp with NSAIDs
Enzyme inhibitors- interactions!!
Risk of tendon damage
Iron, zinc, antacids and calcium reduce absorption
172
Q

Nitrofurantoin eGFR

A

Avoid <45

173
Q

TB treatment

A

INITIAL (12 months)
Rifampicin, Isoniazid, Pyrazinamide, Ethambutol

CONTINUATION (4 months)
Rifampicin, Isoniazid

174
Q

Rifampicin

A

Strong enzyme inducer- interacts with COC, ciclosporin, rivaroxaban
Discolouration to teeth, urine, sweat, phlegm, discolours contact lenses
Monitor renal, hepatic and FBC

175
Q

When to take rifampicin

A

On an empty stomach (1hr before food/2hrs after)

176
Q

Ethambutol

A

Reversible ocular toxicity

177
Q

When to take isoniazid

A

On an empty stomach (1hr before food/2hrs after)

178
Q

Monitoring isoniazid

A

Renal + hepatic bloods

179
Q

What bacterium can cause the infective exacerbation of COPD?

A

Streptococcus pneumoniae

180
Q

Azoles e.g. fluconazole, itraconazoles

A

Prophylaxis + treatment of fungal infections

181
Q

Imidazoles e.g. clotrimazole, miconazole, ketoconazole

A

Local treatment of vaginal thrush and dermatophytes

182
Q

Shingles treatment

A

Aciclovir 800mg five times a day for 7 days

183
Q

Threadworm treatment

A

<2 years refer to GP

Repeat treatment 2 weeks after

184
Q

Amphotericin B

A

Not interchangeable preparations- must be brand specified
Used for severe systemic fungal infections
Can cause nephrotoxicity

185
Q

Vancomycin

A

Loading dose: 25-30mg/kg irrespective of renal function
Trough conc: 10-20mg/L
Risk of red man syndrome with vancomycin- slow IV infusion- do not exceed 10mg/min
Oral vancomycin isn’t systemically absorbed- used for C diff

186
Q

Bridging with DOACs

A

Not needed due to their fast onset of action

187
Q

Childbearing age to consider for valproate

A

12-49

188
Q

Indications for sodium valproate

A

Epilepsy
Bipolar disorder
(Off-license) Migraines

189
Q

Fentanyl patches

A

Contraindicated in opioid-naive patients
Avoid head exposure- causes fentanyl to be released quicker
Use for longer than 3 months results in dependence

190
Q

Monitoring for lithium

A

Assess renal, cardiac, and thyroid function before treatment initiation.
An ECG is recommended in patients with cardiovascular disease or risk factors for it. Body-weight or BMI, serum electrolytes, and a full blood count should also be measured before treatment initiation.

Monitor body-weight or BMI, serum electrolytes, eGFR, and thyroid function every 6 months during treatment, and more often if there is evidence of impaired renal or thyroid function, or raised calcium levels.

Lithium levels should be measured 3 monthly for the first 12 months, then 6 monthly. Unless the patient is deemed high risk. If dose changes are made, measure 1 week after.

191
Q

Lithium counselling advice

A

Carry Purple book
Avoid dietary changes that affect sodium intake (low sodium= increased conc)
Seek medical attention if diarrhoea or vomiting- leads to sodium depletion that increases plasma lithium concentration
Avoid OTC NSAIDs

192
Q

Lithium drug interactions

A

The plasma concentration of lithium is increased by ACE inhibitors, angiotenin II receptor antagonists, diuretics and NSAIDs resulting in increased plasma levels and toxicity
Interacts with amiodarone- both prolong QT interval

193
Q

Lithium causes hypothyroidism

A

Prevents the secretion of thyroid hormones

194
Q

Lithium-naproxen

A

Naproxen increases lithium levels

195
Q

Target lithium concentrations

A

Maintenance: 0.4-1mmol/l
Elderly: lower end of the range
Acute episode of mania: 0.8-1mmol/l

196
Q

Pre-renal causes of AKI

A

Hypovolaemia
Reduced cardiac output
Drugs that reduce blood pressure and circulating volume e.g. ACEs, ARBs, loop diuretics, NSAIDs

197
Q

Renal causes of AKI

A 
Toxins and drugs (antibiotics, contrast media, chemo)
Vascular- thrombosis
Glomerular
Tubular
Interstitial
198
Q

Post-renal causes of AKI

A

Obstruction- renal stones, blocked cathetar

199
Q

If patient with history of stroke is on citalopram (prolongs QT)

A

Switch to sertraline

200
Q

Venlafaxine

A

can increase BP

201
Q

First line for gout

A

NSAIDs (excluding aspirin)/colchicine (can be given if on anticoags)

202
Q

Long term gout therapy

A

Xanthine-oxidase inhibitors: allopurinol or febuxostat.

Allopurinol is recommended as first-line urate-lowering therapy where renal function allows. Febuxostat can be used as an alternative when allopurinol is contra-indicated or not tolerated.

203
Q

Thiazide and thiazide-like diuretics e.g. indapamide, bendroflumethiazide

A

Can cause hyperglycaemia and can antagonise oral antidiabetic meds
Can exacerbate gout
Can cause hypokalaemia- dangerous in severe CV disease and in patients who are taking cardiac glycosides (hypokalaemia= digoxin toxicity; in patients with hepatic impairment hypokalaemia may precipitate encephalopathy)

204
Q

ACE inhibitors in pregnancy

A

Teratogenic risk- avoid

205
Q

Mineralocorticoid

A

Used for hypotension- sodium and water retention, potassium loss
High mineralocorticoid and low glucocorticoid effect- fludrocortisone

206
Q

Glucocorticoid

A

Used for diabetes, osteoporosis, peptic ulceration, muscle wasting, psychiatric reactions (sleep or mood disturbances)
High glucocorticoid effect- betamethasone, dexamethasone

207
Q

NICE recommendation for smoking cessation

A

Use of long acting (patches) for constant nicotine and supplement with short acting form (lozenges, nasal spray or gum)

208
Q

Vareniciline

A

Reduces seizure threshold

209
Q

Bupropion

A

Increased risk of serotonin syndrome

210
Q

> 10 cigarettes daily

A

High strength patch daily for 6-8 weeks, then medium strength for 2 weeks, then low strength for final 2 weeks

211
Q

<10 cigarettes daily

A

Medium strength patch for 6-8 weeks, then low strength for 2-4 weeks

212
Q

Theophylline

A

Can cause hypokalaemia- monitor if using concomitant salbutamol
Concentration increased in heart failure, liver impairment and viral infections
Decreased by smoking and alcohol consumption

213
Q

Side effect of SGLT-2 inhibitors

A

Gangrene- would result in amputation

Past Paper Mistakes (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions