Part _ communicating information

Question 1

information to communciate to a patient about tamoxifen

Answer 1

tamoxifen reduces the risk of endometrial cancer

tamoxifen reduces efficacy of warfarin

taking tamoxifen at night will reduce sx of hot flushes

Tamoxifen increases your risk of VTE need hosp

Question 2

what do you need to monitor witj patients taking methotrexate

Answer 2

measure FBC every 1-2 weeks untill stable

Question 3

what does alcohol do to warfarin

Answer 3

acute alcohol intoxication causes enzyme inhibition whreeas chronic excess causes enzyme induction

Question 4

if a pt is sick or has diarrhoea with ACEi what should you do

Answer 4

risk of AKI increased so need to communicate risk

Question 5

if a patient is predicted to be taking a steriod for more than 3 months what should you do

Answer 5

prescribe a bisphosphonate alongside

Question 6

pt prescribed citalopram what should you be aware of

Answer 6

can cause suicidal thoughts or thoughts of self harm
they can cause dry mouths
ssri can make you more photosensitive and precautions should be taken when in sunlight
it can take up to 6 weeks to see any improvements
it can cause low sodium levels

Question 7

how does ssri cause low sodium

Answer 7

block androgen receptors keeping levels high which in turn means aldosterone lowers sodium levels - moves more water and salt out of the body

Question 8

if unwell why does insulin need to be increased

Answer 8

when unwell blood glucose increases therofre higher basal doses are required, failing to do so will increases the risk of diabetic ketoacidosis

conversely if pt reduce their oral intake there is a risk of hypogylcaemia if the insulin intake is not decreased

Question 9

alendronic is given how often

Answer 9

once a week - needs to be taken upright

Question 10

should you eat with alendronic acid

Answer 10

no food should be avoided 2 hours after taking alendronic acid as it reduces its absorption

Question 11

BC risk on HRT higher fro combined or oestrogen only

Answer 11

combined especially conitnuous

risk of breast cancer related to dureation of use and not to the age at which it is started

Question 12

when should you take loperamide

Answer 12

after each loose stool

Question 13

methotrexate conception ban for men and women for how long

Answer 13

during taking and 6 months afterwards