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Passmed PSA Revision Flashcards

1
Q

Drugs that cause impaired glucose tolerance

A
  • Thiazides, furosemide (less common)
  • Steroids
  • Tacrolimus, ciclosporin
  • Interferon-alpha
  • Nicotinic acid
  • Antipsychotics
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2
Q

Drugs causing urinary retention

A
  • Tricyclic antidepressants e.g. amitriptyline
  • Anticholinergics e.g. antipsychotics, antihistamines
  • Opioids
  • NSAIDs
  • Disopyramide
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3
Q

Drugs causing lung fibrosis

A
  • Amiodarone
  • Cytotoxic agents: busulphan, bleomycin
  • Anti-rheumatoid drugs: methotrexate, sulfasalazine
  • Nitrofurantoin
  • Ergot-derived dopamine receptor agonists (bromocriptine, cabergoline, pergolide)
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4
Q

Side-effects of Rifampicin

A
  • Hepatitis
  • Orange secretions
  • Flu like symptoms
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5
Q

Side-effects of Isoniazid

A
  • Peripheral neuropathy
  • Hepatitis
  • Agranulocytosis
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6
Q

Side-effects of pyrazinamide

A
  • Hyperuricaemia causing gout
  • Arthralgia
  • Myalgia
  • Hepatitis
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7
Q

Side-effects of ethambutol

A
  • Optic neuritis
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8
Q

Which tuberculosis medications do you stop if the patient develops hepatitis?

A
  • Pyrazinamide
  • Rifampicin
  • Isoniazid
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9
Q

How much paracetamol should a child have?

A

20mg/kg, every 6-8 hours

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10
Q

What is the initial dose of allopurinol and what should the uric acid levels aim to be?

A
  • Initial dose of 100 mg od
  • Aim for serum uric acid of <300 umol/l
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11
Q

Side effects of allopurinol?

A
  • Severe cutaneous adverse reaction
  • Drug reaction with eosinophilia and systemic symptoms
  • Stevens-Johnson syndrome
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12
Q

Drug interactions with allopurinol?

A
  • Azathiprine
  • Cyclophosphamide
  • Theophylline
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13
Q

Why shouldn’t children under 16 take aspirin?

A

Reye’s disease

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14
Q

If digoxin toxicity is suspected when do you measure concentration levels?

A

8-12 hours after last dose

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15
Q

Features of digoxin toxicity/

A
  • Generally unwell, lethargy, nausea & vomiting, anorexia, confusion, yellow-green vision
  • Arrhythmias e.g. AV block, bradycardia
  • Gynaecomastia
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16
Q

Drugs causing digoxin toxicity?

A
  • Amiodarone
  • Quinidine
  • Verapamil
  • Diltiazem
  • Spironolactone
  • Ciclosporin
  • Thiazide and loop diuretics
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17
Q

Treatment of digoxin toxicity?

A
  • Digibind
  • Correct arrhythmias
  • Monitor potassium
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18
Q

Gentamicin adverse effects?

A
  • Ototoxicity
    -Nephrotoxicity
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19
Q

Contraindications of gentamicin?

A

Myasthenia gravis

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20
Q

When should you measure gentamicin levels?
What should you do if trough (pre-dose) level is high?
What should you do if peak (post dose) level is high?

A
  • Measure peak (1 hour after administration) and trough (just before next dose)
  • If trough (pre-dose) is high the intervals between the doses should be increased
  • If peak (post-dose) is high the dose should be increased
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21
Q

Adverse effects of heparins?

A
  • Bleeding
  • Thrombocytopenia
  • Osteoporosis
  • Hyperkalaemia
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22
Q

How to reverse heparin overdose?

A

Protamine sulphate

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23
Q

Adverse effects of octreotide?

A

Gallstones

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24
Q

Uses of octreotide?

A
  • Acute treatment of variceal haemorrhage
  • Acromegaly
  • Carcinoid syndrome
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25
Q

What causes lithium toxicity?

A
  • Dehydration
  • Renal failure
  • Drugs- diuretics, ACE inhibitors, angiotensin II receptor blockers, NSAIDs and metronidazole
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26
Q

Features of lithium toxicity?

A
  • Coarse tremor
  • Hyperreflexia
  • Acute confusion
  • Polyuria
  • Seizure
  • Coma
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27
Q

Management of lithium toxicity?

A
  • Volume resuscitation with normal saline
  • Haemodialysis
  • Sodium bicarbonate
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28
Q

Adverse effects of macrolides?

A
  • Prolonged QT interval
  • GI side effects
  • Cholestatic jaundice
  • Azithromycin is associated with hearing loss and tinnitus
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29
Q

Interactions of macrolides?

A
  • Statins should be stopped whilst taking a course of macrolides - increases risk of myopathy and rhabdomyolsis
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30
Q

Does metformin cause hypoglycaemia?

A

No

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31
Q

Do sulphonylureas cause hypoglycaemia?

A

Yes

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32
Q

Adverse effects of metformin?

A
  • GI upset- nausea, anorexia, diarrhoea
  • Reduced vitamin B12 absorption
  • Lactic acidosis
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33
Q

Contraindications of metformin?

A
  • Chronic kidney disease
  • Periods of tissue hypoxia
  • Iodine containing X-ray contrast media
  • Alcohol abuse
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34
Q

Management of paracetamol overdose?

A
  • Activated charcoal if ingested <1 hour
  • N-acetylcysteine
  • Liver transplant
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35
Q

Opioid overdose treatment?

A
  • Naloxone
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36
Q

Tricyclic antidepressant overdose management?

A
  • IV bicarbonate
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37
Q

Warfarin overdose management?

A
  • Vitamin K
  • Prothrombin complex
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38
Q

Heparin overdose treatment?

A
  • Protamine sulphate
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39
Q

Contraindications of phosphodiesterase type V inhibitors e.g. sildenafil

A
  • Patients taking nitrates
  • Hypotension
  • Recent stroke or MI
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40
Q

Side effects of sildenafil?

A
  • Visual disturbances- blue discolouration
  • Nasal congestion
  • Flushing
  • GI Side effects
  • Headache
  • Priapism
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41
Q

Drugs used with caution in patients with asthma?

A
  • NSAIDs
  • Beta blockers
  • Adenosine- verapamil is used as an alternative
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42
Q

Drugs worsening seizure control in patients with epilepsy?

A
  • Alcohol, cocaine, amphetamines
  • Ciprofloxacin, levofloxacin
  • Aminophylline, theophylline
  • Bupropion
  • Methylphenidate
  • Mefenamic acid
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43
Q

Drugs exacerbating heart failure?

A
  • Thiazolidinediones
  • Verapamil
  • NSAIDs/ glucocorticoids
  • Class 1 antiarrhythmics
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44
Q

Which drugs should be used with caution in patients with ischaemic heart disease?

A
  • NSAIDs
  • Oestrogens
  • Varenicline
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45
Q

Drugs to avoid in renal failure?

A
  • Antibiotics - tetracycline, nitrofurantoin
  • NSAIDs
  • Lithium
  • Metformin
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46
Q

Antibiotics harmful in pregnancy?

A
  • Tetracyclines
  • Aminoglycosides
  • Sulphonamides and trimethoprim
  • Quinolones
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47
Q

Drugs (excluding antibiotics) that are harmful during pregnancy?

A
  • ACE inhibitors, angiotensin II receptor antagonists
  • Statins
  • Warfarin
  • Sulfonylureas
  • Retinoids
  • Cytotoxic agents
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48
Q

Adverse effects of quinolones?

A
  • Lower seizure threshold
  • Tendon damage
  • Cartilage damage
  • Lengthens QT
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49
Q

Contraindications of quinolones?

A
  • Pregnancy and breastfeeding
  • G6PD
50
Q

Adverse effects of tamoxifen?

A
  • Menstrual disturbance- vaginal bleeding, amenorrhoea
  • Hot flushes
  • Venous thromboembolism
  • Endometrial cancer
51
Q

How long is tamoxifen taken after removal of tumour?

52
Q

Adverse effects of trastuzumab?

A
  • Flu like symptoms and diarrhoea
  • Cardiotoxicity
53
Q

Examples of 5-HT3 antagonists and adverse effects?

A
  • Ondansetron
  • Polonosetron
  • Prolonged qt
  • Constipation
54
Q

Side effects of ACE Inhibitors?

A
  • Cough
  • Angioedema
  • Hyperkalaemia
  • First dose hypotension
55
Q

What is adenosine used for?

A

Terminate supraventricular tachycardias

56
Q

Adverse effects of adenosine?

A
  • Chest pain
  • Bronchospasm
  • Transient flushing
  • Increased ventricular rate e.g. WPW syndrome
57
Q

Adverse effects of aminosalicylate and adverse effects specifically with mesalazine?

A
  • Agranulocytosis
  • Pancreatitis is 7 times more common in patients taking mesalazine than sulfasalazine
58
Q

What is amiodarone used for and what is the mechanism of action?

A
  • Atrial, nodal and ventricular tachycardias
  • Blocking potassium channels
59
Q

Why should amiodarone be given into central veins?

A
  • Thrombophlebitis
60
Q

Monitoring of amiodarone prior to treatment and every 6 months?

A
  • TFT, LFT U&E, CXR prior to treatment
  • TFT, LFT every 6 months
61
Q

Community acquired pneumonia treatment?

A

Amoxicillin, add flucloxacillin if staphylococci is suspected

62
Q

Atypical pneumonia treatment?

A

Clarithromycin

63
Q

Hospital acquired pneumonia treatment

A

Co-amoxiclav

64
Q

Drugs for rate control of AF?

A
  • Beta clocker
  • Rate limiting calcium channel blocker e.g. diltiazem
65
Q

Adverse effects of azathioprine?

A
  • Bone marrow depression
  • Nausea/ vomiting
  • Pancreatitis
  • Increased risk of non-melanoma skin cancer
66
Q

Contraindications of beta-blockers?

A
  • Uncontrolled heart failure
  • Asthma
  • Sick sinus syndrome
  • Concurrent verapamil
67
Q

Side effects of beta-blockers?

A
  • Bronchospasm
  • Cold peripheries
  • Fatigue
  • Sleep disturbances, including nightmares
  • Erectile dysfunction
68
Q

Adverse effects of bisphosphonates?

A
  • Oesophageal reactions- oesophagitis
  • Osteonecrosis of jaw
  • Increased risk of atypical stress fracture
  • Acute phase response- fever, myalgia
  • Hypocalcaemia
69
Q

What is carbimazole used for and what are some adverse effects?

A
  • Agranulocytosis
  • Crosses placenta
70
Q

First line treatment for heart failure?

A
  • ACE inhibitor
  • Beta blocker
71
Q

What organism is Clostridioides difficile?

A
  • Gram positive rod
72
Q

Treatment for C. Diff?

A
  • Oral vancomycin for 10 days
  • Second line oral fidaxomicin
  • Third line oral vancomycin +/- metronidazole
73
Q

Adverse effects of cyclophosphamide?

A
  • Haemorrhagic cystitis
  • Myelosuppression
  • Transitional cell carcinoma
74
Q

Drugs which decrease serum potassium?

A
  • Thiazide diuretics
  • Loop diuretics
  • Acetazolamide
75
Q

Drugs which increase serum potassium?

A
  • ACE inhibitors
  • Angiotensin-2 receptor blockers
  • Spironolactone
  • Potassium sparing diuretics
  • Potassium supplements
76
Q

Drugs causing peripheral neuropathy?

A
  • Amiodarone
  • Isoniazid
  • Vincristine
  • Nitrofurantoin
  • Metronidazole
77
Q

Side effects of thyroxine therapy?

A
  • Hyperthyroidism
  • Reduced bone mineral density
  • Worsening of angina
  • AF
78
Q

Bacterial meningitis prophylaxis?

A

ciprofloxacin

79
Q

Methotrexate adverse effects?

A
  • Mucositis
  • Myelosuppression
  • Pneumonitis
  • Pulmonary fibrosis
  • Liver fibrosis
80
Q

STEMI acute management?

A
  • Aspirin
  • Ticagrelor
  • Unfractionated heparin if having a PCI
81
Q

Side effects of nitrates?

A
  • Hypotension
  • Tachycardia
  • Headaches
  • Flushing
82
Q

What pain drug is used in palliative care for patients with mild/ moderate renal impairment?

83
Q

Levodopa common adverse effects?

A
  • Dry mouth
  • Anorexia
  • Palpitations
  • Postural hypotension
  • Psychosis
84
Q

Why is phenytoin teratogenic?

A
  • Cleft palate and congenital heart disease
85
Q

PPI adverse effects?

A
  • Hyponatraemia
  • Hypomagnasaemia
  • Osteoporosis
  • Microscopic colitis
  • Increased risk of C. diff
86
Q

Why is sodium valproate teratogenic?

A
  • Neural tube defects
  • Neurodevelopmental delay
87
Q

Adverse effects of spironolactone?

A
  • Hyperkalaemia
  • Gynaecomastia
88
Q

Adverse effects of statins?

A
  • Myopathy
  • Liver impairment
89
Q

How do sulfonylureas work?

A

Increasing pancreatic insulin secretion and are only effective if functional B cells are present

90
Q

Adverse effects of sulfonyureas?

A
  • Hypoglycaemia
  • Weight gain
  • Hyponatraemia
  • Bone marrow suppression
  • Hepatotoxicity
  • Peripheral neuropathy
91
Q

Management of svt?

A
  • Vagal manoeuvres
  • IV adenosine
  • Electrical cardioversion
92
Q

Prevention of SVT?

A
  • Beta blockers
  • Radio frequency ablation
93
Q

How do thiazide diuretics work?

A
  • Inhibiting reabsorption at the beginning of the distal convoluted tubule by blocking the thiazide sensitive NA CL symporter
94
Q

Side effects of thiazide diuretics?

A
  • Dehydration
  • Postural hypotension
  • Hypokalaemia
  • Hyponatraemia
  • Hypercalcaemia
  • Gout
  • Impaired glucose tolerance
  • Impotence
  • Thrombocytopenia
  • Agranulocytosis
  • Photosensitivity rash
  • Pancreatitis
95
Q

Contraindications to thrombolysis?

A
  • Active internal bleeding
  • Recent haemorrhage, trauma, surgery
  • Coagulation and bleeding disorders
  • Intracranial neoplasm
  • Stroke <3 months
  • Aortic dissection
  • Recent head injury
  • Severe hypertension
96
Q

Treatment of trigeminal neuralgia?

A
  • Carbamazepine
97
Q

Treatment of variceal haemorrhage?

A
  • Terlipressin
  • Prophylactic antibiotics
98
Q

Prophylaxis of variceal haemorrhage?

A
  • Propanolol
99
Q

Side effects of warfarin?

A
  • Haemorrhage
  • Skin necrosis
  • Purple toes
100
Q

Drugs that decrease INR?

A
  • Phenytoin
  • Carbamazepine
  • Rifampicin
  • St Johns Wort
  • Chronic alcohol intake
  • Smoking
  • Barbiturates
102
Q

When should you measure lithium dose?

A

12 hours post dose

103
Q

When should you measure ciclosporin levels?

A

Trough levels immediately before dose

104
Q

When should you take digoxin levels?

A

At least 6 hours post dose

105
Q

First line treatment for acne?

A

Topical adapalene with topical benzoyl peroxide

106
Q

First step of pain ladder?

A
  • Paracetamol
  • NSAIDs, aspirin
107
Q

Step 2 pain ladder?

A
  • Codeine
  • Dihydrocodeine
108
Q

Step 3 pain ladder?

109
Q

Adverse effects of tamoxifen?

A
  • Menstrual disturbance
  • Hot flushes
  • VTE
  • Endometrial cancer
110
Q

Adverse effects of anastrozole?

A
  • Osteoporosis
  • Hot flushes
  • Arthralgia, myalgia
  • Insomnia
111
Q

Extrapyramidal side effects of typical psychotics?

A
  • Parkinsonism
  • Acute dystonia
  • Akathisia
  • Tardive dyskinesia
112
Q

How long is levonorgestrel licensed for emergency contraception?

113
Q

How long is ulipristal licensed for emergency contraception?

114
Q

How long is intrauterine device licensed for emergency contraception?

115
Q

Fungal nail infection treatment?

A
  • Amorolfine 5% nail lacquer
116
Q

ECG changed of lithium?

A

T wave flattening/ inversion

117
Q

Psoriasis exacerbating factors?

A
  • Trauma
  • Alcohol
  • Drugs- beta blockers, lithium, antimalarials, NSAIDs, ACE inhibitors, infliximab
  • Withdrawal of systemic steroids
118
Q

Adverse effects of retinoids?

A
  • Teratogenicity
  • Dry skin, eyes and lips
  • Low mood
  • Raised triglycerides
  • Hair thinning
  • Nose bleeds
  • Intracranial hypertension
  • Photosensitivity
119
Q

Treatment for predominant erythema/ flushing in rosacea?

A

Topical brimonidine gel

120
Q

Treatment for papules/ pustules in rosacea?

A

Topical ivermectin

121
Q

How is vasospasm treated in subarachnoid haemorrhage?

A

Oal nimodipine

122
Q

Patients who are allergic to penicillin are also allergic to…

A

Cephalosporins

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