Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DrFeelGood Stuffs > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What is the only lipid modifying drug that may be considered in pregnancy (and what is the risk)?

A

Bile acid sequestrants or resins e.g. colesevelam (can cause fat solube vitamin deficiency on prolonged use)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the NICE advice regarding lipid modifying therapy in pregnancy?

A

pregnant women/ women planning to conceive must not use lipid modifying therapy due to potential for fetal abnormality + should be stopped 3 months before trying to conceive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is meloxicam?

A

NSAID used short term for OA, long term for RA/ ankylosing spondylitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are 6 complications of ACE inhibitors?

A
  1. Dry cough
  2. First-dose hypotension
  3. Hyperkalaemia
  4. Urticaria
  5. Altered taste
  6. renal impairment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the conversion between oral morphine and subcutaneous morphine?

A

Oral morphine is twice the dose of subcutaneous morphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a good starting regime of oral morphine for someone without other comorbidities?

A

Total 20-30mg MR morphine and 5mg oramorph as breakthrough; e.g. 15mg MR morphine BD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is preferred to morphine in palliative patients with renal impairment?

A
  • Oxycodone if mild/moderate
  • if severe, alfentanil, buprenorphine, fentanyl
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are 4 things that may be useful for metastatic bony pain?

A

1 opioids
2 bisphosphonates
3 radiotherapy
4 denosumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do you get from oral codeine / tramadol dose to oral morphine?

A

Divide by 10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When is activated charcoal offered in paracetamol overdose?

A

If present within 1 hour of ingestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are 4 indications for NAC in paracetamol overdose?

A
  1. Paracetamol level on or above treatment line which joins >100mg/kg at 4 hours and >15mg/kg at 15 hours
  2. Staggered overdose / timing uncertain
  3. Patients presented 8-24h after ingestion if dose >150mg/kg
  4. Patients presenting >24h if jaundiced / hepatic tenderness / raised ALT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Over what time frame is N-acetylcysteine now recommended to be infused over and why?

A

1 hour (rather than 15 minutes) due to risk of anaphylactoid reaction (non Ig-E mediated mast cell release)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the management of anaphylactoid reaction to NAC?

A

stop infusion then restart at slow rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the name of the criteria for liver transpant in acute liver failure in paracetamol overdose + what are they?

A

King’s College Criteria
pH <7.3, 24h after ingestion
or all of:
* prothrombin time > 100
* creatinine >300
* grade 3 or 4 encephalopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the definition of a staggered overdose?

A

not taken within 1 hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are 8 examples of live attenuated vaccinations?

A
  1. BCG
  2. MMR
  3. intranasal influenza
  4. rotavirus
  5. polio
  6. yellow fever
  7. oral typhoid
  8. chickenpox / shingles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

3 inactivated vaccination preparations?

A
  • IM influenza
  • rabies
  • hepatitis A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are 3 toxoid (inactivated toxin) vaccinations?

A
  • tetanus
  • diphtheria
  • pertussis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a multivalent vs monovalent vaccination?

A

Multivalent - protect against multiple strains or subtypes of a pathogen
Monovalent - confer immunity against one strain of a pathogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the advice if a women misses 2 or more COCPs?

A
  • take the last pill (even if it means taking 2 pills in one day)
  • use condoms/abstain for 7 days
  • if missed pill in week 1: use emergency contraception if had unprotected sex in pill free week/week 1
  • if week 2: after 7 consecutive days of taking pill no need for EC
  • if week 3: finish pills in current pack and omit pill-free period
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What anti-TB drugs can affect INR in patients on warfarin and how?

A
  • Rifampicin - P450 enzyme INDUCER - increases warfarin metabolism so DECREASES INR
  • Isoniazid - P450 INHIBITOR reduces warfarin metabolism so INCREASES INR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the effect of P450 enzyme inducers on the COCP?

A

Will reduce its effectiveness - as metabolised more quickly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are 8 examples of P450 enzyme inducers?

A
  • rifampicin
  • carbamazepine
  • phenytoin
  • phenobarbitone
  • smoking
  • chronic alcohol use
  • St John’s Wort
  • griseofulvin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are 13 examples of P450 inhibitors?

A
  • ciprofloxacin
  • erythromycin
  • isoniazid
  • cimetidine
  • omeprazole
  • amiodarone
  • allopurinol
  • ketoconazole, fluconszole
  • sertraline, fluoxetine
  • ritonavir
  • sodium valproate
  • acute alcohol intake
  • quinupristin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the treatment of major bleeding (e.g. intracerebral haemorrhage) with warfarin?

A

stop warfarin, give 5mg vitamin K IV and give prothrombin complex concentrate IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is prothrombin complex concentrate (PCC)?

A

solution containing coagulation factors II, VII, IX and X - designed to reverse warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Following raised INR at what INR can warfarin be restarted?

A

INR <5.0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the management of INR >8, minor bleeding?

A

stop warfarin, give IV vitamin K 1-3mg
repeat vit K if INR still too high after 24h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the management of INR <8.0, no bleeding?

A

stop warfarin ,give PO vitamin K 1-5mg (use IV preparation orally)
repeat dose if still too high after 24h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the maangement of INR 5.0-8.0 with minor bleeding?

A

stop warfarin, give IV vitamin K 1-3mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the management of INR 5.0-8.0 with no bleeding?

A

Withold 1 or 2 doses of warfarin, reduce subsequent maintenance dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the risk of of using ACEis with aortic stenosis?

A

May result in hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is a key drug interaction of ACEis?

A

Diuretics when high dose E.g >80mg furosemide per day; high risk of hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are considered acceptable rises in creatinine and potassium when starting ACEi?

A

Increase in serum creatinine up to 30%, K+ up to 5.5 acceptable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Which emergency contraception should you exercise caution for patients with asthma?

A

Ulipristal (EllaOne)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How long after intercourse can Ulipristal (EllaOne) be used for UPSI?

A

120 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How long after intercourse can levonorgestrel (levonelle) be used after UPSI?

A

72 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

When can hormonal contraception be started after use of Ulipristal (EllaOne) vs levonorgestrel (levonelle)?

A

EllaOne - 5 days after
Levonelle - straight away

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Can EllaOne / levonelle be used within the same menstrual cycle more than one?

A

Yes, both can

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the guidance for breastfeeding and EllaOne/ levonelle?

A

Levonelle (levonorgestrel) - can continue breastfeeding
EllaOne (Ulipristal) - breastfeeding should be delayed for one week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

When can copper IUD be used for UPSI?

A

Up to 5 days after UPSI or 5 days after ovulation date (day 14)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

If a patient wants the copper coil removed after insertion for UPSI when should it be done?

A

Wait at least until after next period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

If a patient wants the copper coil removed after insertion for UPSI when should it be done?

A

Wait at least until after next period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the mechanism of ulipristal acetate (EllaOne)?

A

selective progesterone receptor modulator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is agomelatine?

A

used in treatment of depression - agonist at melatonin receptors - improves sleep quality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the commonest side effect of SSRIs?

A

gastrointestinal symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Which SSRI is the best post-myocardial infarction?

A

sertraline - more evidence for safe use than other antidepressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What could prompt you to prescribe another drug alongside SSRIs and why?

A

if also on NSAID - PPI as can increase risk of GI bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Should SSRIs be given in combination with warfarin / heparin?

A

no - avoid, consider mirtazapine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is the interaction between SSRIs and triptans?

A

increased risk of serotonin syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

After what time period should patients be reviewed after starting SSRIs?

A

2 weeks; 1 week if age 25 or at risk of suicide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What are 4 types of drugs whihc can cause staining of the teeth?

A
  1. tetracyclines - intrinsic staining
  2. chlorhexidine mouthwash - removable with polishing
  3. iron salts in liquid form
  4. co-amoxiclav suspension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

For how long should patients be continued on an SSRI if they have a good response to antidepressant therapy?

A

at least 6 months after remission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What drug group is most commonly implicated in intrinsic staining of the teeth?

A

tetracyclines - if given in utero until 12 years of age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Over what time period should SSRIs be stopped?

A

over 4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Which SSRI doesn’t need tapering over 4 weeks when stopped?

A

fluoxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What is the guidance re SSRIs and pregnancy?

A

weigh up beneits and risks when deciding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

How does atropine work to treat symptomatic bradycardia?

A

increases firing of the sinoatrial node (SA) and conduction through the AV node, opposes action of vagus nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is the risk with SSRIs in pregnancy?

A

first trimester - increased risk of congenital heart defects
third trimester - persistent pulmonary hypertension of the newborn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What are 4 causes of gingival hyperplasia?

A
  1. Phenytoin
  2. Ciclosporin
  3. Calcium channel blockers (esp nifedipine)
  4. AML
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Which antibiotic have ruptured Achilles tendon / tendinopathy as a side effect?

A

fluoroquinolones e.g. ciprofloxacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What are 5 risk factors for Achilles tendinopathy with fluoroquinolones?

A
  1. Age >60 years
  2. Corticosteroid therapy
  3. Renal failure
  4. Diabetes mellitus
  5. History of MSK disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What is the treatment of symptomatic bradycardia?

A

atropine - 0.5-1mg IV; may repeat every 3-5 minutes up to maximum 3mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What drug should be given immediately after thrombolysis is given for MI?

A

heparin (UFH or LMWH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What should be done in patients taking AEDs who need an antidepressant medication?

A

seek specialist advice - as all antidepressants lower seizure threshold. SSRIs / sertraline are preferred option

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Which antidepressants should be avoided in patients taking triptans for migraine?

A

SSRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Which antidepressants interact with MAOIs?

A

SSRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What is meant by a live attenuated vaccination?

A

virus / bacteria has been weakened via genetic modification of the pathogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Which antidepressants may be sedating and what is the DVLA advice?

A

mirtazapine, trazodone, lofepramine; DVLA advises people should not drive during this time if affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is a key adverse effect of carbamazepine?

A

aplastic anaemia - needs FBC monitoring (also drug interactions - CYP450 inducer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What is a key side effect of cabergoline?

A

Pulmonary fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What 2 drugs can affect the absorption of levothyroxine?

A
  • calcium carbonate
  • iron
    (Take at least 4h apart)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What are 7 adverse effects of loop diuretics?

A
  1. Hypotension
  2. Ototoxicity
  3. Hyponatraemia, hypokalaemia, hypomagnesaemia, hypocalcaemia
  4. Hypochloraemic acidosis
  5. Renal impairment
  6. Hyperglycaemia
  7. Gout
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What is the mechanism of action of loop diuretics?

A

Inhibit Na-K-Cl cotransporter in thick ascending loop of Henle, reducing absorption of NaCl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What are the 2 most common drug causes of drug induced lupus erythematosus (DILE)?

A
  • procainamide
  • hydralazine
    (Also isoniazid, minocycline, phenytoin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What pattern of antibodies are seen in DILE? (4 key features)

A
  1. ANA positive 100%
  2. dsDNA negative
  3. Anti-histone antibodies in 80-90%
  4. anti-Ro, anti-Smith +ve in 5%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What are the key features of drug-induced lupus erythematosus?

A
  • malar rash
  • pulmonary involvement E.g. pleurisy
  • myalgia
  • arthralgia
    Renal and neuro involvement rare
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What are 3 types of drugs which can cause purpura in adults?

A
  1. Quinine
  2. Antiepileptics
  3. Anti thrombotics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What are 11 causes of drug-induced seizures?

A
  1. bupropion
  2. antidepressants e.g. TCAs, venlafaxine
  3. dyphenhydramine
  4. tramadol
  5. amphetamine
  6. isoniazid
  7. cocaine, lidocaine
  8. MDMA
  9. lithium
  10. antipsychotics e.g. clozapine, barbiturate withdrawal
  11. benzodiazepines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What electrolyte abnormality is most likely to occur with furosemide and prednisolone taken together?

A

hypokalaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What are 3 types of influenza vaccination?

A
  1. whole inactivated virus
  2. split virion (virus particles disrupted by detergent treatment)
  3. subunit (mainly haemagglutinin and neuraminidase)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What does the cholera immunisation involve?

A

inactivated Inaba and Ogawa strains of Vibrio cholerae with recombinant B-subunit of the cholera toxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What are 7 indications for BCG vaccination?

A
  1. infants in UK where incidence >40/100 000
  2. infants w parent/grandparents born in country where incidence >40 /100 000
  3. unvaccinated contacts of respiratory TB (tuberculin neg)
  4. unvaccinated new entrants <16y born/lived in country with incidence <40 /100 000
  5. healthcare workers
  6. prison staff
  7. staff of care home for elderly
  8. working with homeless people
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What other disease does the BCG also offer limited protection against?

A

leprosy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What is the only exception to performing a tuberculin skin test prior to performing the BCG?

A

children <6 yeras old with no contact with TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

When can other vaccinations be given in relation to BCG?

A

can be given at same time, but if not administered simultaneously there should be a 4 week interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

What are 5 contraindications to BCG?

A
  1. previous BCG vaccination
  2. past history of tuberculosis
  3. HIV
  4. pregnancy
  5. positive tuberculin test (Heaf or Mantoux)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What is the cut off age for BCG?

A

not given to anyone over age of 35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What is the management of beta blocker overdose?

A
  • atropine if bradycardic
  • glucagon if severe
    Haemodialysis not effective
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What can be an early sign of aspirin (salicylate) overdose?

A

Tinnitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What metabolic derangement may be seen with aspirin (/ salicylate) overdose?

A

Initially respiratory alkalosis then metabolic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What is the treatment of salicylates (e.g. aspirin) overdose?

A
  • General - ABC, charcoal
  • urinary alkalinisation with IV sodium bicarbonate (increases urinary excretion)
  • haemodialysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

What are 6 indications for harmodialysis in aspirin (/salicylate) overdose?

A
  1. Serum concentration > 700mg/L
  2. Metabolic acidosis resistant to treatment
  3. Acute renal failure
  4. Pulmonary oedema
  5. Seizures
  6. Coma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Why does salicylate overdose (e.g. aspirin) cause sweating and pyrexia?

A

salicylates cause the uncoupling of oxidative phosphorylation leading to decreased adenosine triphosphate production, increased oxygen consumption and increased carbon dioxide and heat production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

What are 11 drugs which can cause a hepatocellular picture of DILI?

A
  1. paracetamol
  2. sodium valproate
  3. phenytoin
  4. MAOIs
  5. halothane
  6. anti-TB: isoniazid, rifampicin, pyrazinamide
  7. statins
  8. alcohol
  9. amiodarone
  10. methyldopa
  11. nitrofurantoin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

What are 11 drugs which can cause a cholestatic picture of DILI?

A
  1. COCP
  2. flucloxacillin
  3. co-amoxiclav
  4. erythromycin
  5. anabolic steroids
  6. testosterone
  7. chlorpromazine
  8. prochlorperazine
  9. sulphonylureas
  10. fibrates
  11. nifedipine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

What are 3 types of drugs which can cause liver cirrhosis?

A
  1. methotrexate
  2. methyldopa
  3. amiodarone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What is the mechanism of action of sildenafil?

A

aka viagra - phosphodiesterase V inhibitor. cause vasodilation via increase in cGMP leading to smooth muscle relaxation in blood vessels supplying corpus cavernosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

When should sildenafil be taken for its use in erectile dysfunction?

A

approx 1 hour before sexual activity (short acting)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

What are 3 contraindications to PDE5 inhibitors?

A
  1. nitrates + nicorandil
  2. hypotension
  3. recent stroke or MI (wait 6 months)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

What are 6 side effects of phosphodiesterase type 5 inhibitors?

A
  1. visual disturbances - blue discoloration; also NAION
  2. nasal congestion
  3. flushing
  4. GI side effects
  5. headache
  6. priapism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

What are 3 common side effects of dihydropyridine CCBs (amlodipine, nifedipine, felodipine)?

A

headache, flushing ankle swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Which calcium channel blockers can cause tachycardia?

A

short acting dihydropyridines e.g. nifedipine - cause peripheral vasodilation which can cause reflex tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

What are 5 common side effects of verapamil?

A
  1. heart failure
  2. constipation
  3. hypotension
  4. bradycardia
  5. flushing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

What are 4 common side effects of diltiazem?

A
  1. hypotension
  2. bradycardia
  3. heart failure
  4. ankle swelling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

What is the most common side effect of sildenafil?

A

headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

What are 4 situations when diclofenac is contraindicated?

A
  1. ischaemic heart disease
  2. peripheral arterial disease
  3. cerebrovascular disease
  4. congestive heart failure (NYHA 2-4)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Is St. John’s Wort an inducer or inhibitor of P450?

A

Inducer - effectiveness of warfarin / COCP reduced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

What drug monitoring is required for statins?

A

LFTs - baseline, 3 months, 12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

What drug monitoring is required for amiodarone?

A

TFT, LFT, U&Es CXR at baseline
TFT & LFT every 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

What drug monitoring is required for methotrexate?

A

FBC, LFT, U&Es before treatment then weekly until stabilised, then every 2-3 months

112
Q

What is the recommended monitoring for azathioprine?

A

FBC and LFT before treatment; FBC weekly for first 4 weeks; then FBC and LFT every 3 months

113
Q

What is the recommended monitoring for lithium?

A

TFT and U&E before starting
Lithium level weekly until stabilised then every 3 months
TFT and U&E every 6 months

114
Q

What is the recommended monitoring for sodium valproate?

A

LFT and FBC before starting treatment then LFT periodically during the first 6 months

115
Q

What is the recommended monitoring for glitazones?

A

LFT before treatment, then regularly during treatment

116
Q

What is the advice for switching between types of COCP with different progesterones?

A

BNF suggests omitting pill free period (FSRH advice contradicts)

117
Q

What are 5 types of cytotoxic agents?

A
  1. Alkylating agents
  2. Cytotoxic antibiotics
  3. Antimetabolites
  4. Acts on microtubules
  5. Topoisomerase inhibitors
    + other
118
Q

What is the mechanism of action of cyclophosphamide?

A

Alkylating agent - causes cross-linking in DNA

119
Q

What is an example of an alkylating cytotoxic agent?

A

Cyclophosphamide

120
Q

What are 3 side effects of cyclophosphamide?

A
  1. Haemorrhagic cystitis
  2. Myelosuppression
  3. Transitional cell carcinoma
121
Q

What are 2 examples of cytotoxic antibiotics?

A
  1. Bleomycin
  2. Anthracyclines e.g. doxorubicin
122
Q

What is the mechanism of action if bleomycin?

A

Degrades preformed DNA

123
Q

What is a key side effect of bleomycin?

A

Pulmonary fibrosis

124
Q

What is the mechanism of action of anthracyclines e.g. doxorubicin?

A

Stabilises DNA-topoisomerase II complex, inhibits DNA and RNA synthesis

125
Q

What is a key adverse effect of anthracyclines e.g doxorubicin?

A

Cardiomyopathy

126
Q

What are 4 examples of antimetabolite cytotoxic drugs?

A
  1. Methotrexate
  2. Fluorouracil
  3. 6-mercaptopurine
  4. Cytarabine
127
Q

What are 4 adverse effects of methotrexate?

A
  1. Myelosuppression
  2. Pulmonary fibrosis
  3. Liver fibrosis
  4. Mucositis
128
Q

What are 3 side effects of fluorouracil?

A
  1. Myelosuppression
  2. Mucositis
  3. Dermatitis
129
Q

What are 3 side effects of 5 fluorouracil?

A
  1. Myelosuppression
  2. Mucositis
  3. Dermatitis
130
Q

What is a key side effect of 6-mercaptopurine?

A

myelosuppression

131
Q

What are 2 key side effects of cytarabine?

A

myelosuppression, ataxia

132
Q

What are 2 examples of cytotoxic drugs that act on microtubules?

A
  1. vincristine/vinblastine
  2. docetaxel
133
Q

What are 2 key side effects of vincristine?

A
  1. peripheral neuropathy
  2. paralytic ileus
134
Q

What is a key side effect of vinblastine?

A

myelosuppression

135
Q

What is a key side effect of docetaxel?

A

neutropenia

136
Q

What is a key example of a topoisomerase inhibitor-type cytotoxic drug?

A

irinotecan

137
Q

What is a key side effect of irinotecan?

A

myelosuppression

138
Q

What are 3 key side effects of cisplatin?

A
  1. ototoxicity
  2. peripheral neuropathy
  3. hypomagnesaemia
139
Q

What is a key side effect of hydroxyurea?

A

myelosuppression

140
Q

What is the mechanism of action of quinolone antibiotics?

A

inhibit DNA synthesis by inhibiting topoisomerase II (DNA gyrase) and topoisomerase IV - bactericidal

141
Q

What are 4 adverse effects of quinolones?

A
  1. lower seizure threshold in patients with epilepsy
  2. tendon damage (including rupture)
  3. cartilage damage
  4. lengthens QT interval
142
Q

What drug used in concurrence with quinolones increases the risk of tendon damage?

A

steroids

143
Q

What are 3 contraindications to quinolones?

A
  1. pregnancy
  2. breastfeeding
  3. G6PD
144
Q

What is the mechanism of organophosphate (e.g. pesticide) poisoning?

A

inhibition of acetylcholinesterase leading to upregulation of nicotinic + muscarinic cholinergic neurotransmission

sarin gas = used in warfare, similar

145
Q

What are 7 features of organophosphate insecticide poisoning?

A
  1. salivation
  2. lacrimation
  3. urination
  4. defecation/diarrhoea
  5. cardiovascular: hypotension, bradycardia
  6. small pupils
  7. muscle fasciculation
146
Q

What are 2 aspects of the management of organophosphate poisoning?

A
  1. atropine
  2. pralidoxime - unclear role
147
Q

What is the mechanism of action of metformin?

A
  • activation of AMP-activated protein kinase (AMPK)
  • increases insulin sensitivity
  • reduces hepatic gluconeogenesis
  • reduce GI absorption of carbohydrates
148
Q

What are 3 key side effects of metformin?

A
  1. GI upset - nausea, anorexia, diarrhoea
  2. reduced B12 absorption
  3. lactic acidosis with severe liver disease or renal failure
149
Q

What are 4 contraindications to metformin?

A
  1. chronic kidney disease
  2. recent myocardial infarction, sepsis, AKI, severe dehydration - tissue hypoxia (causes lactic acidosis)
  3. iodine-containing x-ray contrast media
  4. alcohol abuse (relative)
150
Q

What are the rules regarding metformin use in chronic kidney disease?

A
  • review if creatinine >130 umol/L (eGFR <45)
  • stop if creatinine >150 (eGFR <30)
151
Q

What should happen to a patient’s metformin if they are having imaging involving iodine-containing contrast?

A

stop on day of procedure and for 48h afterwards

152
Q

What is the mechanism of action of macrolides?

A
  • inhibit bacterial protein synthesis by blocking translocation
  • bacteriostatic
153
Q

What are 5 adverse effects of macrolides?

A
  1. prolongation of QT interval
  2. GI side effects - nausea (less with clari)
  3. cholestatic jaundice
  4. P450 inhibitor
  5. azithromycin - hearing loss + tinnitus
154
Q

What is a key drug interaction of macrolides?

A

statins - macrolides inhibit cythochrome P450 isoenzyme CYP3A4 that metabolises statins; concurrent use significantly increases risk of myopathy / rhabdomyolysis

155
Q

What is the difference in P450 enzyme inhibitors and inducers in terms of speed of onset?

A

inhibitors have rapid effects, whereas induction usually requires prolonged exposure to the inducing drug

156
Q

What are the options for migraine prophylaxis and when should specific ones be avoided?

A
  1. propranolol
  2. topiramate - avoid in women of childbearing age
  3. amitriptyline
157
Q

Which anti-TB drug causes a peripheral neuropathy and how?

A

isoniazid - vitamin B6 deficiency

158
Q

What is another name for vitamin B6?

A

pyridoxine

159
Q

How can vitamin B6 deficiency caused by isoniazid be prevented?

A

prophylactic pyridoxine should be prescribed at the same time as isoniazid

160
Q

What are 2 consequences of vitamin B6 deficiency?

A
  1. peripheral neuropathy
  2. sideroblastic anaemia
161
Q

What is the mechanism of action of tamoxifen?

A

selective oestrogen receptor modulator (SERM) - acts as oestrogen receptor antagonist + partial agonist

162
Q

What are 4 side effects of tamoxifen?

A
  1. hot flushes (commonest)
  2. menstrual disturbance - vaginal bleeding, amenorrhoea
  3. VTE
  4. endometrial cancer
163
Q

How long is tamoxifen used for?

A

5 years following removal of tumour

164
Q

What is an alternative SERM to tamoxifen and how does its side effect profile differ?

A

raloxifene - lower risk of endometrial cancer

165
Q

What is the main indication for digoxin?

A

rate control in management of AF; also has positive inotropic properties so sometimes used for improving symptoms (not mortality) in HF

166
Q

What is the mechanism of action of digoxin?

A
  • decreases conduction through AV node, slows ventricular rate in AF and flutter
  • increases force of cardiac muscle contraction due to inhibition of Na+/K+ ATPase pump. also stimluated vagus nerve
167
Q

When is digoxin monitoring recommended and how?

A

if toxicity suspected only - concentration should be measured within 8-12h of last dose

168
Q

What are 7 features of digoxin toxicity?

A
  1. lethargy
  2. nausea + vomiting
  3. anorexia
  4. confusion
  5. yellow-green vision
  6. arrhythmias (AV block, bradycardia)
  7. gynaecomastia
169
Q

Which electrolyte abnormality classically precipitates digoxin toxicity?

A

hypokalaemia (digoxin binds to ATPase pump on same site as potassium; hypokalaemia means dig binds more easily, increasing its inhibitory effects)

170
Q

What are 8 drugs that can precipitate digoxin toxicity?

A
  1. amiodarone
  2. quinine
  3. verapamil
  4. diltiazem
  5. spironolactone
  6. ciclosporin
  7. thiazides
  8. loop diuretics
171
Q

What is the management of digoxin toxicity?

A

digibind, correct arrhythmias, monitorin K+

172
Q

What should be done in patients on long term oral prednisolone who develop intercurrent illness?

A

double steroid dose

173
Q

What are 2 key adverse effects of aminoglycosides e.g. gentamicin?

A
  1. ototoxicity - auditory/vestibular nerve damage
  2. nephrotoxicity - acute tubular necrosis
174
Q

Is ototoxicity due to aminoglycosides reversible?

A

no - irreversible

175
Q

What causes nephrotoxicity from gentamicin / aminoglycosides?

A

acute tubular necrosis

176
Q

Concomitant use of which drug with aminoglycosides increases the risk of acute tubular necrosis?

A

furosemide

177
Q

What is a contraindication to using aminoglycosides?

A

myasthenia gravis

178
Q

When should aminoglycoside levels be measured and how should doses be adjusted?

A
  • peak (1 hour after administration) - if too high, decrease dose
  • trough - if too high, increase interval
179
Q

What is the conversion from oral morphine to oral oxycodone?

A

divide by 1.5-2 to get oxycodone dose

180
Q

How does transdermal fentanyl equate to oral morphine?

A

fentanyl 12mcg patch = morphine 30mg PO

181
Q

Which opioid side effects tend to be transient vs persistent?

A
  • transient: nausea, sedation
  • persistent: constipation
182
Q

What is the guidance for statins and pregnancy?

A

contraindicated in pregnancy (IUGR, fetal death)

183
Q

What are 3 groups of adverse effects of statins?

A
  1. myopathy - myalgia, myositis, rhabdomyolysis, raised CK
  2. liver impairment - discontinue if serum transaminases persistently > 3 x ULN
  3. increase risk of intracerebral haemorrhage
  4. GI disturbances - very rarely pancreatitis
  5. interstitial lung disease - rarely
184
Q

What are 5 risk factors for myopathy in a patient taking statins?

A
  1. advanced age
  2. female sex
  3. low BMI
  4. multisystem disease e.g. DM
  5. lipophilic statins > hydrophilic
185
Q

What are 4 groups of patients who should take statins?

A
  1. established CVD - stroke, TIA, IHD, PAD
  2. QRISK >10%
  3. T2DM - use QRISK
  4. T1DM diagnosed > 10 years ago, or age > 40 or established nephropathy
186
Q

What is he mechanism of action of statins?

A

decrease intrinsic cholesterol synthesis via inhibiting enzyme HMG-CoA reductase (rate limiting

187
Q

Why does grapefruit juice have key drug interactions e.g. statins?

A

inhibits action of intestinal CYP3A4 which normally metabolises many drugs - increases their action

188
Q

What are 4 important side effects of ACE inhibitors?

A
  1. hyperkalaemia
  2. first-dose hypotension
  3. dry cough
  4. aniogoedema - may occur up to 1 year after starting
189
Q

What is the mechanism of action of benzodiazepines?

A

enhance effect of inhibitory neurotransmitter GABA by increasing frequency of chloride channels

190
Q

What is NICE guidance on withdrawing a benzo?

A
  • withdraw in steps of about 1/8 (range 1/10 to 1/4) of the daily dose every fortnight
  • if difficulty - switch patients to the equivalent dose of diazepam
  • reduce dose of diazepam every 2-3 weeks in steps of 2 or 2.5 mg
191
Q

How long can it take to withdraw from benzodiazepines?

A

from 4 weeks to a year or more

192
Q

What are 9 features of benzodiazepine withdrawal syndrome?

A
  1. insomnia
  2. irritability
  3. anxiety
  4. tremor
  5. loss of appetite
  6. tinnitus
  7. perspiration
  8. perceptual disturbances
  9. seizures
193
Q

For how long can benzodiazepine withdrawal symptosm occur after withdrawal?

A

up to 3 weeks after stopping long-acting drug

194
Q

What advice should be given when commencing patients on mefloquine for malaria prophylaxis?

A
  • nightmares or anxiety may be prodromal of more serious neuropsychiatric event
  • suicide and DSH can occur
  • can continue for several months due to long-half life
195
Q

Which patients is mefloquine contraindicated in?

A

anxiety, depression, schizophrenia, other psychiatric disorders

196
Q

What is the most important counselling to give to a patient taking carbimazole?

A

attend for urgent medical review if develops symptoms of infection e.g. sore throat or fever

197
Q

What is a key adverse effect of carbimazole?

A
  • agranulocytosis
198
Q

How is carbimazole usually used to treat thyrotoxicosis?

A

given in high doses for 6 weeks until patient becomes euthyroid before being reduced

199
Q

What is the mechanism of action of carbimazole?

A

blocks thyroid peroxidase from coupling and iodinating the tyrosine residues on thyroglobulin, reducing thyroid hormone production

200
Q

What is the mechanism of action of propylthiouracil?

A
  • same as carbimazole: blocks thyroid peroxidase from coupling and iodinating tyrosine residuues on thyroglobulin, reducing thyroid hormone production
  • peripheral action: inhibits 5’-deiodinase which reduces peripheral conversion of T4 to T3
201
Q

What is the guidance about carbimazole in pregnancy?

A

crosses placenta but may be used in low doses during pregnancy

202
Q

What are 2 first line options to treat hiccups in palliative care?

A
  1. chlorpromazine
  2. haloperidol

gabapentin and dexamethasone also work

203
Q

What is the treatment of local anaesthetic toxicity?

A

IV lipid emulsion

204
Q

What is the maximum dose of lidocaine if given a) alone and b) with adrenaline?

A

a) 3mg / kg
b) 7 mg / kg

205
Q

What are 2 things that increase the risk of lidocaine toxicity?

A
  1. liver dysfunction
  2. low protein states
206
Q

What are 3 lidocaine drug interactions?

A
  1. beta blockers
  2. ciprofloxacin
  3. phenytoin
207
Q

What are the features of lidocaine toxicity?

A

Initial CNS over activity then depression as lidocaine initially blocks inhibitory pathways then blocks both inhibitory and activating pathways. Cardiac arrhythmias.

208
Q

How does the action of bupivacaine differ from lidocaine?

A

much longer duration of action - may be used for topical wound infiltration at end of surgery with long duration of analgesic effect

209
Q

What local anaesthetic is used for IV regional anaesthesia e.g. Biers block?

A

prilocaine

210
Q

What are 2 situations when adding adrenaline to local anaesthetic is contraindicated?

A
  1. patients taking MAOIs
  2. Tricyclic antidepressants
211
Q

Which LA can’t be given in higher doses with adrenaline?

A

bupivacaine

212
Q

What are 2 teratogenic effects of ACE inhibitors?

A
  1. renal dysgenesis
  2. craniofacial abnormalities
213
Q

What is the teratogenic effect of alcohol?

A

craniofacial abnormalities

214
Q

What is the teratogenic effect of aminoglycosides?

A

ototoxicity

215
Q

What are 2 teratogenic effects of carbamazpine?

A
  1. neural tube defects
  2. craniofacial abnormalities
216
Q

What are 2 teratogenic effects of cocaine?

A
  1. intrauterine growth retardation
  2. preterm labour
217
Q

What are 2 teratogenic effects of smoking?

A
  1. intrauterine growth retardation
  2. preterm labour
218
Q

What are 2 teratogenic effects of valproate?

A
  1. neural tube defects
  2. craniofacial abnormalities
219
Q

What are 5 teratogenic effects of maternal diabetes mellitus?

A
  1. macrosomia
  2. neural tube defects
  3. polyhydramnios
  4. preterm labour
  5. caudal regression syndrome
220
Q

What is a teratogenic effect of chloramphenicol?

A

grey baby sydrome

221
Q

What is a teratogenic effect of diethylstilbesterol?

A

vaginal clear cell adenocarcinoma

222
Q

What is a teratogenic effect of tetracyclines?

A

discoloured teeth

223
Q

What is a teratogenic effect of thalidomide?

A

limb reduction defects

224
Q

What is a teratogenic effect of warfarin?

A

craniofacial abnormalities

225
Q

What is the mechanism of action of clopidogrel?

A

antagonist of the P2Y12 adenosine diphosphate (ADP) receptor, inhibiting the activation of platelets

226
Q

The concurrent advice of which drug with clopidogrel make it less effective?

A

PPIs (lansoprazole and pantoprazol OK - avoid omeprazole)

227
Q

What is a key investigation in an unwell person taking aminosalicylates?

A

FBC - agranulocytosis is a key side effect

228
Q

What are 6 side effects of sulfasalazine?

A
  1. rashes -> Stevens Johnson syndrome
  2. oligospermia
  3. headache
  4. Heinz body anaemia, megaloblastic anaemia
  5. may colour tears - stained contact lenses
  6. lung fibrosis
229
Q

What are 5 side effects of mesalazine?

A
  1. GI upset
  2. headache
  3. agranulocytosis
  4. pancreatitis
  5. interstitial nephritis
230
Q

What are the neurological features of ecstasy poisoning?

A
  • agitation
  • anxiety
  • confusion
  • ataxia
231
Q

What are the cardiovascular effects of ecstasy poisoning?

A

tachycardia, hypertension

232
Q

What is the key electrolyte seen in ecstasy poisoning and why?

A

hyponatraemia - SIADH or excessive water consumption whilst taking MDMA

233
Q

What are 5 effects of ecstasy poisoning?

A
  1. neurological
  2. cardiovascular - tachycardia, hypertension
  3. hyponatraemia
  4. hyperthermia
  5. rhabdomyolysis
234
Q

What is the management of ecstasy poisoning?

A
  • supportive
  • dantrolene for hyperthermia if simple measures fail
235
Q

Which antiepileptic can cause weight gain?

A

sodium valproate

236
Q

What effect does sodium valproate have on the P450 system?

A

inhibitor

237
Q

What are 8 side effects of sodium valproate?

A
  1. nausea
  2. increased appetite + weight gain
  3. alopecia - curly regrowth
  4. ataxia
  5. tremor
  6. hepatotoxicity
  7. pancreatitis
  8. hyperammonemic encephalopathy
238
Q

What are 3 abnormalities that may be seen on blood tests with sodium valproate?

A
  1. thrombocytopenia
  2. hyponatraemia
  3. hyperammonemic encephalopathy
239
Q

What treatment may be used if hyperammonemic encephalopathy develops secondary to sodium valproate?

A

L-carnitine

240
Q

What is the first line choice for palliative patients with confusion and agitation in whom reversible causes have been ruled out?

A

haloperidol (other options: chlorpromazine, levomepromazine)

241
Q

What can terminal agitation / restlessness be treated with?

A

midazolam

242
Q

What is the mechanism of sulphonylureas?

A
  • increase pancreatic insulin secretion (only effective if fuctional B-cells present
  • bind to ATP-dependent K+ channel on cell membrane of pancreatic beta cells
243
Q

What are 6 adverse effects of sulphonylureas?

A
  1. hypoglycaemic episodes
  2. weight gain
  3. hyponatraemia - SIADH
  4. bone marrow suppression
  5. hepatotoxicity (cholestatic)
  6. peripheral neuropathy
244
Q

What is the treatment of benzodiazepine overdose?

A
  • flumazenil
  • many cases managed with supportive care only - flumazenil has risk of seizures
245
Q

What is the management of tricyclic antidepressant poisonoing?

A
  • IV bicarbonate - reduce risk of seizures and arrhythmias
  • lots of antiarrhythmics and dialysis unsafe / ineffective
246
Q

What is the antidote to heparin poisoning?

A

protamine sulphate

247
Q

What is the management of beta blocker overdose?

A
  • atropine if bradycardic
  • glucagon in resistant cases
248
Q

What is the treatment for ethylene glycol poisoning?

A
  • fomepizole - first line
  • ethanol
  • haemodialysis - refractory cases
249
Q

What is the treatment of methanol poisoning?

A

fomepizole or ethanol
haemodialysis

250
Q

What is the management of organophosphate insecticide poisoning?

A

atropine

251
Q

What is the management of iron overdose?

A

desferrioxamine

252
Q

What is the management of lead overdose?

A

dimercaprol, calcium edetate

253
Q

What is the management of cyanide poisoning?

A
  • hydroxocobalamin
  • combination of amyl nitrite, sodium nitrite, sodium thiosulfate
254
Q

What are 2 key side effects of metronidazole?

A
  • disulfiram like reaction with alcohol
  • increases anticoagulant effect of warfarin
255
Q

What are 2 cardiovascular side effects of admiodarone?

A
  1. prolonged QT interval
  2. bradycardia
256
Q

What are 3 dermatological side effects of admiodarone?

A
  1. photosensitivity
  2. ‘slate-grey’ appearance
  3. thrombophlebitis and injection site reactions
257
Q

What is the effect of amiodarone on warfarin / INR?

A

decreases warfarin metabolism leading to raised INR

258
Q

Is sulfasalazine safe in pregnancy / breastfeeding?

A

yes - safe in both

259
Q

What are 4 side effects of PPIs?

A
  1. hyponatraemia, hypomagnesaemia
  2. osteoporosis + fragility fractures
  3. microscopic colitis
  4. increased risk of C diff infections
260
Q

What drugs can worsen symptoms of stress incontinence?

A

alpha blockers e.g. doxazosin - worsen stress incontinence by relaxing bladder outlet and urethra

261
Q

What are 7 drug causes of thrombocytopenia?

A
  1. Quinine
  2. Loop diuretics - furosemide
  3. NSAIDS
  4. Antibiotics: penicillins, sulphonamides, rifampicin
  5. Anticonvulsants: valproate, carbamazepine
  6. Heparin
  7. Abciximab
262
Q

What are 7 drugs associated with lichenoid ruptions?

A
  1. ACE inhibitors
  2. NSAIDs
  3. methyldopa
  4. chloroquine
  5. oral antidiabetics
  6. thiazide diuretics
  7. gold
263
Q

What are 3 types of vaccinations which people with egg allergy should avoid?

A
  1. influenza
  2. MMR
  3. yellow fever
264
Q

Which antihypertensive limits the maixmum dose of simvastatin to 20mg OD and why?

A

amlodipine - weak inhibitor of CYP3A4 therefore concurrent use results in raised blood levels of simvastatin - doubles its effect

265
Q

What are 5 examples of drugs which colchicine shouldn’t be co-prescribed with?

A
  1. clarithromycin
  2. erythromycin
  3. ritonavir
  4. verapamil
  5. itraconazole / ketoconazole
266
Q

What are 6 contraindications to colchicine?

A
  1. blood disorders
  2. eGFR < 10
  3. renal impairment
  4. severe hepatic impairment
  5. pregnant or breastfeeding
  6. P glycoprotein inhibitors or strong CYP 3A4 inhibitor drugs
267
Q

What are 5 side effects of cholestyramine?

A
  1. constipation
  2. tooth discolortion
  3. tooth enamel erosion
  4. premature tooth decay
  5. increased riks of gallstones
268
Q

What type of cholesterol are statins vs. fibrates effective at lowering?

A
  • statins: LDL
  • fibrates: triglyceride
269
Q

What is a key side effect of nicotinic acid to treat raised cholesterol?

A

vasodilatation - facial flushing

270
Q

What are 8 drug interactions of azathioprine?

A
  1. allopurinol
  2. febuxostat
  3. co-trimoxazole / trimoethoprim - haem toxicity
  4. warfarin
  5. clozapine
  6. ACE inhibitors
  7. aminosalicylates
  8. methotrexate
271
Q

What are 8 drugs which can cause erectile dysfunction?

A
  1. antihypertensives: thiazide diuretics, beta blockers, spironolactone
  2. Antidepressants: SSRIs, TCAs, benzos, antipsychotics, phenytoin
  3. 5-alpha reductase inhibitors e.g. finasteride
  4. Digoxin
  5. Opiates
  6. H2 blockers
  7. Anti-androgens e.g. bicalutamide
  8. Luteinising hormone releasing agonists/antagonists to treat prostate cancer
272
Q

What are 2 types of antihypertensives which can worsen glycaemic control in diabetics?

A

thiazides, beta blockers

273
Q

What are 2 cautions for prescribing sulfasalazine?

A
  1. G6PD deficiency
  2. aspirin allergy or sulphonamide allergy
274
Q

What is the hepatitis B vaccination made of?

A

HBsAg absorbed onto aluminium hydroxide adjuvant and is prepared from yeast cells using recombinant DNA technology

275
Q

What are 7 SSRI discontinuation symptoms?

A
  1. increased mood change
  2. restlessness
  3. difficulty sleeping
  4. unsteadiness
  5. sweating
  6. GI symptoms: pain, cramping, diarrhoea, vomiting
  7. paraesthesia + electric shock sensations
276
Q

What is the maximum daily dose of citalopram?

A
  • 40mg for adults
  • 20mg for patients >65 years
  • 20mg if hepatic impairment

DrFeelGood Stuffs (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions