Patient information

Question 1

What HTN med is teratogenic in pregnancy?

Answer 1

Ramipril is teratogenic in the first trimester, it is advised to convert to labetalol (first line) before
conception.

Question 2

Side effects of tamoxifen

Answer 2

Tamoxifen increases the efficacy of warfarin and therefore increases susceptibility to high INR readings.

VTE risk!

Increases endometrial cancer risk!

Question 3

Risks with sulphonylureas (Gliclazide) ?

Answer 3

Hypoglycaemia

Question 4

Risk with metformin?

Answer 4

Lactic Acidosis

Question 5

When should gliclazide be taken?

Answer 5

Gliclazide should be taken in the morning with breakfast. Taking at bedtime will increase the risk of nocturnal
hypoglycaemia. If a daily dose of greater than 160 mg is required, then the total daily dose should be divided,
but doses should still be given with meals

Question 6

When is renal function monitored post initiation of ACE-I?

Answer 6

It is important to monitor renal function (and potassium) following initiation of ACE-inhibitors, particularly in
those with CKD. This should be done 1–2 weeks following initiation

Question 7

When should you take extra precautions with ACE-Inhibitors?

Answer 7

caution should be taken, particularly in the elderly who are unwell when on ACE-inhibitors, as it
increases the risk of acute kidney injury.

Question 8

What should an elderly patient take alongside steroid if treatment is >3 months?

Answer 8

steroids increase the risk of osteoporosis, particularly in the elderly. If a patient is predicted to take
steroid therapy for greater than 3 months (as is typical in polymyalgia rheumatica), prophylactic treatment with a
bisphosphonate (e.g. alendronic acid) is an option

Question 9

How to take alendronic acid?

Answer 9

Once weekly
don’t take at same time as bisphosphonates
Avoid food 2 hours after taking alendronic acid
take them upright with water to avoid gastric side effects