OSCE

Question 1

Counsel diltiazem, verapamil, amlodipine, lercanidipine

Answer 1

D-take xmg once daily, same time each day
U-for hypertension, reduce BP by stopping calcium from entering heart - dilation, blood flows more easily
M-BP if htn indicated and heart rate monthly
S-flushing, dizziness, ankle swelling
C-avoid grapefruit juice and NSAIDs such as ibuprofen, seek advice before OTC buy

Question 2

Counsel simvastatin, atorvastatin, pravastatin, rosuvastatin

Answer 2

D-take xmg once daily, take at night because this is when liver produces most cholesterol
U-for hyperlipidaemia-reduces amount of cholesterol made in liver therefore red body cholesterol
M-lipid profile, liver function test, renal, thyroid and creatinine kinase
S-report any muscle aches, pains, tenderness
C-avoid grapefruit juice

Question 3

Counsel GTN

Answer 3

D-1-2 sprays under tongue when you have pain or prior to exertion
U-dilates blood vessels which allows blood to flow more easily reducing anginal pain
M-none
S-headache, dizziness-take sitting down to help with this
C-retake dose after 5 mins if pain persists, if 5 mins after second pain remains, call for ambulance

Question 4

Counsel bisoprolol, atenolol, metaprolol,propranolol

Answer 4

D-xmg once daily, same time each day
U-works by making heart beat less forcefully with reduces work load and lowers heart rate
M-BP if indicated for htn
S-cold extremities and sleep disturbances
C-can cause bronchospasms in asthmatic patients, do not stop abruptly

Question 5

Counsel lisinopril, enalopril, perindopril

Answer 5

D-take xmg once daily, take first dose at night to avoid first dose hypotension
U-works by dilating blood vessels which reduces resistance, allows blood to flow more smoothly
M-renal function + electrolytes before, 1-2wks after and after dose change, BP monthly and month after dose change
S-headache dizziness, electrolyte disturbances, report any dry cough or lip/tongue swelling,
C-avoid NSAIDs (ibuprofen) seek advice OTC

Question 6

Counsel aspirin, ticagrelor, prasugrel, clopidogrel

Answer 6

D-xmg once daily, same time
U-thins blood which reduces likelihood of a clot forming
M-none
S-GI disturbances
C-avoid NSAIDs-seek otc advice

Question 7

Counsel losartan, candesartan

Answer 7

D-take xmg once daily, take first dose at night to avoid first dose hypotension
U-works by dilating blood vessels which reduces resistance, allows blood to flow more smoothly
M-renal function, serum electrolytes, blood pressure
S-headache dizziness, electrolyte disturbances
C-avoid NSAIDs (ibuprofen)