Pharmacology

Question 1

tamoxifen indication

Answer 1

Decrease risk breast ca postmenopausal W/ osteoporosis or high risk,and rx breast ca.

Question 2

Tamoxifen moa

Answer 2

Oestrogen antagonist on breast + uterus.

Question 3

Tamoxifen contraindications (3)

Answer 3

Liver disease,
ovarian cysts,
endometrial carcinoma

Question 4

Crystalloid dose for resuscitation?

Answer 4

40 - 60 ml / kg

Question 5

Name the 5 WHO antenatal corticosteroid treatment criteria

Answer 5

• gestational age must be accurately determined
• Preterm birth considered imminent
• no evidence maternal infection
• adequate childbirth care available
• preterm newborn can receive adequate care if needed

Question 6

Indication antenatal corticosteroid treatment?

Answer 6

Women at risk preterm delivery 26 - 34 weeks where neonatal resus planned

Question 7

Drug and dose antenatal corticosteroid treatment? (2)

Answer 7

• Dexamethasone 8 mg 8 hourly for 24 hours (x3) (24 mg total) IM in deltoid or
• betamethasone 12 mg IM, repeat in 24h (x2) (24 mg total)

Question 8

Contraindications and extra precautions antenatal corticosteroid treatment? (8)

Answer 8

Contraindications

• overt/clinical chorioamnionitis
• pulmonary oedema
• active pulmonary Tb
• contraindications for steroids in general eg herpes keratitis,peptic ulcer disease

Extra precautions

• diabetes: receive in labour ward or high care
• pre-eclampsia: may develop pulmonary oedema
• don’t admin if rr > 24 / min
• increased incidence post partum sepsis - ensure adequate follow up and counsel about warning signs

Question 9

Indication repeat courses antenatal corticosteroid treatment?

Answer 9

Only if initial course > 10 weeks ago and renewed risk of imminent delivery <34 weeks