Pharmacology

Question 1

What are the side effects of sodium valproate?

Answer 1

Teratogenic - Spina bifida
Liver damage and hep
Hair loss
Tremor

Question 2

What are the side effects of carbamazepine?

Answer 2

Agranulocytosis
Aplastic anaemia
Induces P450 so drug interactions

Question 3

Side effects of phenytoin?

Answer 3

Folate and Vit D deficiency
Megaloblastic anaemia
Osteomalacia

Question 4

Ethosuximide side effects?

Answer 4

Night terror

Rashes

Question 5

What are the side effects of Lamotrigine?

Answer 5

SJS

Leukopenia

Question 6

What are the features of opioid misuse?

Answer 6

Rhinorrhoea
Needle track marks
Pinpoint pupils
Drowsiness
Watering eyes

Question 7

What is the management of opioid overdose?

Answer 7

IV orIM naloxone

Question 8

What is the management of paracetamol overdose?

Answer 8

Within 1 hour: activated charcoal

Acetylcysteine after 4 hours infused over 1 hour by looking at graph

Question 9

What is the clinical features of paracetamol overdose?

Answer 9

Acute liver failure

Young person

Question 10

What are the teratogenic effects of anti-epileptic drugs in pregnancy?

Answer 10

Fetal hydantoin syndrome:
Microcephaly 
IUGR
Clef palate/lip
Mental retardation
Hypoplastic fingernails
Distal limb deformities

Question 11

What are the signs of opioid withdrawal?

Answer 11

Yawning
Dilated pupils
Rhinorrhea
Epiphora

Question 12

What are the side effects of the tuberculosis drugs?

Answer 12

Rifampicin - red/orange pee
Isoniazid - peripheral neuropathy
Pyrazinamide - hyperuricaemia (gout)
Ethambutol - colour blindness

All cause hepatotoxicity

Question 13

What is a non-sedating antihistamine?

Answer 13

Loratidine

Question 14

What are the side effects of the rheumatic drugs?

Answer 14

Methotrexate: pulmonary fibrosis

Leflunomide: HTN and peripheral neuropathy

Sulfasalazine: male infertility

Hydroxychloroquinine: nightmares and reduced visual acuity

Anti-TNF meds: reactivation of TB or Hep B

Rituximab: night sweats and thormbocytopenia

Question 15

Reversal of heparin?

Answer 15

Protamine

Question 16

Side effect of ACEi?

Answer 16

Dry cough
Lichen planus
Angioedema

Question 17

What is the side effect of statin?

Answer 17

High CK
Muscle cramps
Transaminitis

Question 18

What is the treatment for hypersalivation caused by clozapine?

Answer 18

Hycoscine

Question 19

What is the antidote for opioid toxicity?

Answer 19

400mcg naloxone boluses

Question 20

What is the dose for folic acid in well controlled type 1 diabetic mothers?

Answer 20

5mg pre conception until 12 week gestation

Question 21

What is the side effect of colchicine?

Answer 21

Diarrhoea

Question 22

Side effect of spironalactone?

Answer 22

Breast tenderness

Question 23

Features of metoclopromide overdose?

Answer 23

Oculogyric crisis

Question 24

What should you check before starting azathioprine?

Answer 24

Thiopurine methyl transferase activity (TPMT)

Question 25

What is the parkland formula?

Answer 25

4ml x %burns x weight(kg) Given half in the first 8 hours and the remaining half over the next 16 hours

Question 26

What is the treatment for a raised INR with a minor bleed?

Answer 26

Stop warfarin and 5mg phytomenadione (vitamin K) orally

Question 27

What is the treatment for a raised INR with a major bleed?

Answer 27

Stop warfarin Phytomenadione (Vitamin K) Fresh frozen plasma

Question 28

What are the main classes of laxatives and give examples

Answer 28

``` Softener and stimulant: Docusate sodium and Movicol Bulk forming agents: Psyllium husk Stool softener: Lactulose Stimulant: senna and bisacodyl Osmotic agents: lactulose Lubricants: mineral oil ```

Question 29

How to calculate the anion gap?

Answer 29

(Na+ + K+) - (HCO3- + Cl-)

Question 30

What are the symptoms of beta blocker overdose?

Answer 30

Hyoptension Bradycardia Seizures Hypoglycaemia

Question 31

What constitutes normal bag of 0.9% saline?

Answer 31

154 Sodium, 154 Chloride, 0 Potassium, 0 bicarbonate

Question 32

What is the medications adherence questionnaire?

Answer 32

Moriskeys scale

Question 33

What is the treatment for delirium tremens/alcohol withdrawal?

Answer 33

Oral chloradiazepoxide

Question 34

What is the medical management of breast cancer?

Answer 34

ER+: Tamoxifen - premenopausal Anaztrazole - post menopausal HER2+: Traztazumab (herceptin)

Question 35

What is the medical treatment for peripheral arterial disease?

Answer 35

Clopidogrel and atorvastatin

Question 36

Treatment for high INR and emergency surgery

Answer 36

Prothrombinex

Question 37

Management of bowel obstruction during end of life care

Answer 37

loperamide hydrochloride

Question 38

Which medication can increase warfarin in blood if used together?

Answer 38

Antibiotics (clarithromycin) SSRI Sodium valproate Ozaloes e.g. metronidazole, omeprazole etc ASS OZALES

Question 39

Which drugs cannot be given with methotrexate and why?

Answer 39

Trimethoprim because it causes pancytopaenia. Co-trimoxazole as it contains trimethoprim.

Question 40

Which electrolyte disturbance can PPIs cause?

Answer 40

Hyponatraemia

Question 41

What needs to be prescribed in addition to SSRIs and NSAIDs?

Answer 41

PPIs due to increased GI bleeding risk

Question 42

What is the reversal agent for rivaroxiban and apixaban?

Answer 42

Andexanet alfa

Question 43

Which drug causes a contraindication to chest drain?

Answer 43

INR >1.5

Question 44

What is the maintenance fluid measurement for kids?

Answer 44

0-10kg: 100ml/kg 11-20kg: 50ml/kg >20kg: 20ml/kg

Question 45

What is the codeine to morphine conversion?

Answer 45

10mg codeine to 1mg of morphine

Question 46

What is the ABG of salicylate poisoning immediately and 12 hours afterwards?

Answer 46

t0: Respiratory alkalosis t12: metabolic acidosis

Question 47

First line treatment for diabetic neuropathy?

Answer 47

Pregabalin, gabapentin, amitriptyline or duloxetine

Question 48

Which drug increases azathioprine toxicity?

Answer 48

Allopurinol

Question 49

Which medication needs to be started alongside allopurinol?

Answer 49

NSAIDs or colchicine "cover"

Question 50

What is a side effect of SSRIs?

Answer 50

SIADH