PHARMACOLOGY

Question 1

Glucosamine

Answer 1

Trade name e.g. artho. Aid
Bisphosphonate for OA

Question 2

Pariet(trade) / rabeprazole (generic)

Answer 2

PPi for gastric ulcers, H. Pylori

Question 3

Digoxin

Answer 3

Cardiac glycoside
Used for congestive HF

Question 4

Frusemide

Answer 4

Loop diuretic
HF, hypertension

Question 5

Paroxetine

Answer 5

SSRI depression, anxiety

Question 6

Antibiotics

Answer 6

if no change after one course must include GP, always start with narrowest possible spectrum and educate pt of importance of finishing whole course.
Narrow spectrum:
• Flucloxacillin and dicloxacillin – indications are staph skin and nail infections, osteomyelitis and cellulitis.

Question 7

Antimycotics –

Answer 7

Topical: Azoles (Canesten and Daktarin)
• Inhibit fungal growth and are indicated in tinea pedis + cutaneous candidiasis.
• Apply thin layer to affected skin and surrounding area, pt must use it regularly and continue treatment for 2 weeks after symptoms gone.

Others for tinea:
• Nystain (2-3 times a day for at least 2 weeks)
• Terbinafine (once a day for a week) – more expensive. (Lamisil).
Onychomycosis
• Amorolfine, once weekly. Not to be used during pregnancy. (Loceryl).

Question 8

Oral: Terbinafine and Griseofulvin (Must notify GP to monitor pt systemicly)

Answer 8

• Indicated for deeper onychomycosis and dermatophyte infection of the skin where topical treatment is ineffective or inappropriate.
• Terbinafine – fungicidal MOA, contraindicated in hepatic disease.
• Griseofulvin – prevents fungal cell function and replication. Contraindicated in hepatic disease, men fathering children in near future and pregnant or breast feeding women.
• Full treatment must be taken until infected nail has grown out – up to 12 months.

Question 9

The “Triple Whammy”

Answer 9

The term “triple whammy” refers to the risk of acute kidney injury when an ACE inhibitor or Angiotension receptor blocker (usually used for hypertenision) is combined with a diuretic and NSAID. This combination might be seen in a patient with hypertension, congestive heart failure, or renal disease who has arthritis or other mild to moderate pain.

Need to be wary: woman of child bearing age, elderly, hx of GI bleed/ ulcer, HF,

Question 10

diabetic meds classes

Answer 10

Alpha-glucosidase inhibitors.
Biguanides.
Bile Acid Sequestrants.
Dopamine-2 Agonists.
DPP-4 inhibitors.
Meglitinides.
SGLT2 Inhibitors.
Sulfonylureas.

Question 11

cox 1

Answer 11

Paracetamol

Question 12

cox 2 drug

Answer 12

celecoxib

Question 13

cox 1 cox 1 drug

Answer 13

ibuprofen

Question 14

terbinafine moa

Answer 14

• Fungicidal, fungistatic, inhibits fungal ergosterol synthesis by inhibiting squalene epoxidase, leading to membrane disruption and cell death

• Adult: 250mg daily

Question 15

terbinafine precautions

Answer 15

o Renal
o Hepatic
o Pregnancy
o Breastfeeding
- Adult: 250mg daily
- Is expensive and authority required for PBS funding (nail must have 80% involvment)

Question 16

terbinafine practice points

Answer 16

• Treatment of choice for dermatophyte onychomycosis
• Obtain liver tests at baseline
• Monitor blood results
• May be used for other forms of tinea where griseofluvin is ineffective; treat for > 4-6 weeks
• Stop treatment if hepatotoxicity occurs or a rash worsens
• Fewer drug interactions than azole antifungals

Question 17

Tinea Pedis. rx

Answer 17

• Terbinafine (1/day for 1 week) more expensive
• Need to disinfect shoes, socks, bedding and wets areas to avoid re-infection
• Practice good foot hygiene

Question 18

trade names
coversyl argine
aspro clear
eliquis
cranial

Answer 18

a) perindopril
b) aspro clear
c) apixaban
d) loceryl