Prescribing

Question 1

what should you give people with CVS risk >10%

Answer 1

atorvastatin 20mg

Question 2

amlodipine and simvastatin?

Answer 2

interact to increase effect of simvastatin side effects

switch to atorvastatin

Question 3

atorvastatin can be taken in the morning?

Answer 3

yes

Question 4

long term side effects of PPIs

Answer 4

hyponatraemia
osteoporosis
C.diff

Question 5

what is the triple whammy and what should you safety net about

Answer 5

NSAID
ACEI 
diuretic 
antiplatelet 
safety net about sick day rules

Question 6

what drugs should you avoid in asthma

Answer 6

B blocker

NSAIDs and aspirin

Question 7

drugs for 2ndary prevention of MI

Answer 7

antiplatelet
ACEI
B blocker
statin

Question 8

why do you give ACEI in CKD

Answer 8

slows progression on CKD

Question 9

side effects of quinine

Answer 9

QT prolongation

thrombocytopaenia

Question 10

indications for quinine

Answer 10

nocturnal muscle cramps

malaria

Question 11

what do you give someone with a CVS risk >10%

Answer 11

statin only

Question 12

considerations for use of NSAIDs e.g. diclofenac

Answer 12

1) is he in pain? 2) CKD - nsaids worsen this, 3) he has asthma - can induce bronchospasm, 4) contra-indicated in established cardiovascular disease, 5) risk of GI bleeding - on aspirin, and hx of erosive duodenitis, 6) high risk drug combo - triple whammy - nsaid + ACEI + diuretic - a particularly nephrotoxic combination!