Pharmacology

Question 1

Patients with MI secondary to cocaine use should be given what additional drug as part of acute management?

Answer 1

Benzodiazepine IV

Question 2

When would nitrofurantoin be less effective and therefore not recommended to treat UTI?

Answer 2

Patients with CKD3b or worse (eGFR less than 45)

Question 3

What is the criteria for receiving a liver transplant post paracetamol overdose? (regarding bloods)

Answer 3

Criteria:

High-risk features mandating admission to a liver transplant centre are: INR >3.0 at 48 hours or >4.5 at any time. Oliguria or creatinine > 200 micromol/L. Acidosis with pH < 7.3 after resuscitation

Question 4

Which NSAID is contraindicated in any form of cardiovascular disease?

Answer 4

Diclofenac

Question 5

How is unfractionated heparin monitored?

Answer 5

APTT

Question 6

Which immunosuppressant if prescribed with allopurinol increases the risk of toxicity and excessive myelosuppresion?

Answer 6

Azathioprine and methotrexate

Question 7

PDE 5 inhibitors (e.g. sildenafil) are contraindicated in patients with recent what? And also on what type of cardiovascular drug?

Answer 7

Recent stroke
Contraindicated by nitrates and nicorandil

Question 8

When is transdermal HRT preferred?

Answer 8

If the woman is at risk of venous thromboembolism (VTE)

Question 9

At what creatinine should metformin be reviewed or stopped?

Answer 9

NICE recommend that the dose of metformin should be reviewed if the creatinine is > 130 micromol/l (or eGFR < 45 ml/min) and stopped if the creatinine is > 150 micromol/l (or eGFR < 30 ml/min)