Pharmacology

Question 1

What are accepted combination therapies for lowering BP?

Answer 1

ACEi plus either dihydropyradine CCB OR thiazide diuretic

Question 2

What are some considerations in prescribing beta blockers and thiazide diuretics for lowering BP?

Answer 2

Both increase risk of diabetes especially in metabolic syndrome.
B Blockers also CI in asthma.

Question 3

What is the consideration in prescribing Ramipril?

Answer 3

It is cleared by the liver

Question 4

What is the HAS-BLED score?

Answer 4

Predicts risk of bleeding in AF Rx w Warfarin;
H-HTN A-Abnormal renal/liver func S-Stroke Hx B- Bleeding Hx or predisposition L-Labile INRs E-Elderly (65+) D-Drugs(NSAIDS, antiplatelets, OR alcohol 8+ units/week)

Question 5

Which NOACs have shown lower risk of ICH compared to warfarin?

Answer 5

All of them

Apixaban, dabigatran, rivaroxaban

Question 6

Which NOACs show higher risk of GIT bleeding compared to warfarin?

Answer 6

Dabigatran and rivaroxiban

Question 7

Give examples of drugs with zero order kinetics

Answer 7

Aspirin (in overdose)
Alcohol
Phenytoin

Question 8

Name some inducers of CYP450 enzymes

Answer 8

Rifampicin
St Johns Wort
Alcohol

Question 9

How long to reach steady state concentration?

Answer 9

4-5 half lives.

SS is when rate of absorption equals rate of excretion

Question 10

Mx of Tinea skin infections (local and extensive)

Answer 10

local; topical imidazole or terbinefine cream 3-4 weeks BD

extensive; 4 weeks of either fluconazole, terbinefine, griseofulvin