pharmacology

Question 1

HRT of choice in perimenopausal women

Answer 1

systemic cyclical combined

Question 2

adverse effects of quinilones - ciprofloxacin

Answer 2

lower seizure threshold
tendon damage
lengthens QT interval

Question 3

contraindications in pt for quinilones

Answer 3

avoid in breastfeeding and G6PDH

Question 4

ectasy poisoning fx

Answer 4

neurological: agitation, anxiety, confusion, ataxia
cardiovascular: tachycardia, hypertension
hyponatraemia
this may result from either syndrome of inappropriate ADH secretion or excessive water consumption whilst taking MDMA
hyperthermia
rhabdomyolysi

Question 5

drugs that cause lung fibrosis

Answer 5

amiodarone
bleomycin
DMARDS - metho and sulfa
Ergots - bromocriptine, cabergoline
Furantoin

Question 6

side effects metformin

Answer 6

GI
lactic acidosis

Question 7

SE sulfonylurea

Answer 7

hypoglycemia
increased appetite + weight gain
SIADH
liver dysfunction

Question 8

SE glitazones

Answer 8

weight gain
fluid retention -> worsen HF
fracture
liver dysfunc

Question 9

SE gliptins

Answer 9

pancreatitis

Question 10

adverse effects of macrolides

Answer 10

prolong QTc
GI SE
cholestatic jaundice
P450 inhibitor
azith - tinnitus and HL

Question 11

gentamicin adverse effects

Answer 11

ototoxicity
nephrotoxicity -> ATN

CI in myasthenia gravis

Question 12

digoxin toxicity fx and mx

Answer 12

fx
- N+V
- confusion
- yellow-green vision
- arrhythmias
- gynecomastia

mx
- digibind
- monitor K
- correct arrhythmias

Question 13

toxic digoxin level

Answer 13

likelihood increases from 1.5to 3mcg/L

Question 14

digoxin monitoring

Answer 14

measure only if suspected toxicity between 8-12 hours after last dose

Question 15

treatment for low magnesium

Answer 15

if <0.4 or tetany, arrhthymias, seizure then give IV magnesium sulphate

Question 16

what factors can precipitate digoxin toxicity

Answer 16

hypokalaemia - potassium also binds to the ATPase pump so if there is less potassium then more digoxin can bind and cause toxicity
renal failure
MI
hypothyroidism
amiodarone
quinidine
verapamil
diltazem
thiazides, loops, spironolactone

Question 17

adverse effects of heparin

Answer 17

bleeding
thrombocytopenia
osteoporosis
hyperkalaemia
heparin induced thrombocytopenia

Question 18

metformin ad CT scans

Answer 18

discontinue its use for 48 hours after scan due to renal impairment

Metformin should also be stopped in chronic kidney disease if the creatinine is > 150 mmol/l (or eGFR < 30 ml/min).

Question 19

oragnophosphate insecticide poisoning px

Answer 19

D: defaecation & diaphoresis.
U: urinary incontinence.
M: miosis (pupil constriction).
B: bradycardia
E: emesis.
L: lacrimation.
S: salivation.

Question 20

diclofenac is contraindicated wirth?

Answer 20

any form of CVD

Question 21

LMWH has greatest inhib effect on which protein the coag cascade

Answer 21

factor Xa

Question 22

most important monitoring test for amiodarone

Answer 22

TFT

Question 23

drug that induce urinary retention

Answer 23

tricyclic antidepressants e.g. amitriptyline
anticholinergics e.g. antipsychotics, antihistamines
opioids
NSAIDs
disopyramide

Question 24

what type of ABX is gentamicin

Answer 24

aminoglycoside

Question 25

common electrolyte abn with PPI

Answer 25

hypomagnesia