Prescribing

Question 1

Give an example of a beneficial side effect

Answer 1

Antihistamines have a side effect of drowsiness so can therefore be used as a sleep medication sometimes

Question 2

What are the adverse drug reactions in NSAIDs

Answer 2

GI bleeding
Renal impairment
Wheezing

Give a PPI to patients who are over 65, have a history of ulcers of H pylori infection

Question 3

What are the side effects of diuretics

Answer 3

Hypotension
Electrolyte disturbances- responsible for falls in older patients

Question 4

How are antibiotics associated with diarrhoea

Answer 4

GI tract has good and bad bacteria but pathogenic bacteria overload can lead to diarrhoea

Bloody diarrhoea could be a sign of C.diff infection

Question 5

Why are beta blockers contraindicated in asthma

Answer 5

As they block bronchial B2 adrenoceptors and cause bronchospasm

They are used with caution in COPD

Question 6

What types of drugs cannot be used in congestive heart failure

Answer 6

NSAIDs and corticosteroids worsen CHF

Rate limiting CCIs are contraindicated as they block calcium channels on the heart and block rate and force of contraction

High dose B blockers are also contraindicated

Glitazones (used in T2DM can worsen CHF)

Question 7

How can NSAIDs (esp Diclofenac and rofecoxib) increase CV events

Answer 7

NSAIDs may cause fluid retention
May exacerbate hypertension and CHF

Low dose aspirin is less of a problem

Question 8

How do NSAIDs lead to renal damage

Answer 8

Inhibit renal PGs
Reduce renal blood flow
Reduce GFR
May lead to acute renal failure
May also cause acute interstitial nephritis

Question 9

What are Erythematous eruptions

Answer 9

Reddening, may resemble measles or maculopapular

Question 10

Why are adverse drug reactions more common in drugs with a narrow therapeutic window

Answer 10

Small changes can be a difference between safety and toxicity