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!VIVA/PACES/PSA > PSA > Flashcards

PSA Flashcards

1
Q

Gentamicin SEs

A

Ototoxicity and nephrotoxicity

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2
Q

Vancomycin SEs

A

Ototoxicity and nephrotoxicity

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3
Q

Digoxin toxicity SEs

A

Confusion, arrhythmias, nausea, visual halos

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4
Q

Lithium toxicity SEs

A

Early: fine tremor
Intermediate: tiredness
Late: arrhythmias, diabetes insipidus, seizures, coma, renal failure

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5
Q

Phenytoin toxicity SEs

A

Gum hypertrophy, ataxia, nystagmus, peripheral neuropathy, teratogenicity

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6
Q

Beta-blockers

A

Bronchospasm -> wheeze?
Bradycardia
Hypotension
Erectile dysfunction

CI in acute HF
CI with CCB

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7
Q

DMARD SEs

A

Myelosuppression

Liver cirrhosis

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8
Q

Test pre-biological DMARD therapy

A

CXR as anti-TNF-alpha Abs can restart pul TB

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9
Q

Common reaction to statins

A

Myalgia
Abdo pain/ GI SEs
Increased ALT/AST

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10
Q

Dangerous reaction to statins

A

Rhabdomyalysis

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11
Q

Common causes of C difficile infection

A

Cephalosporins
Ciprofloxacin
Clindamycin

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12
Q

ACEI SEs

A 
Hypotension
Electrolyte abnormalities
AKI
Dry cough
angioedema - delayed reaction
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13
Q

CCBs SEs

A

Hypotension
Bradycardia
Peripheral oedema
Flushing

CI with beta blocker

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14
Q

Diuretic SEs

A

Hypotension
Electrolyte abnormalities
AKI

Sub-class effects

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15
Q

Potassium sparing diuretics examples

A

Spironolactone

Amiloride

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16
Q

Heparin SEs

A

Haemorrhage
Heparin-induced thrombocytopenia
Dalteparins etc -> hyperkalaemia

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17
Q

Aspirin SEs

A

Haemorrhage
Peptic ulcers and gastritis
Tinnitus in large doses

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18
Q

Digoxin SEs

A 
Nausea
Vomiting
Diarrhoea
Confusion
Drowsiness 
Blurred vision 
Xanthopsia - halo vision
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19
Q

Amiodarone

A

Interstitial lung disease eg pul fibrosis
Thyroid dysfunction eg hypo/hyper
Skin greying
Corneal deposits

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20
Q

Haloperidol SEs

A

Dyskinesia eg acute dystonia, Parkinsonism (CI in Parkinson’s disease), tardive dyskinesia

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21
Q

Clozapine SE

A

Agranulocytosis

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22
Q

Steroid SEs

A 
Stomach Ulcers
Thin skin
Edema
Right and left heart failure
Osteoporosis
Infections eg candida
Diabetes
Syndrome Cushings
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23
Q

NSAIDs SEs

A 
No urine - renal failure
Systolic dysfunction eg HF
Asthma
Indigestion and ulceration
Dyscrasia
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24
Q

Drugs with narrow therapeutic index

A

Warfarin
Phenytoin
Digoxin
Theophylline

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25
Q

Enzyme inducers

A 
PC BRAS
Phenytoin
Carbamazepine
Barbituates
Rifampicin
Alcohol (chronic)
Sulphonyureas
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26
Q

Enzyme inhibitors

A 
AODEVICES
Allopurinol
Omeprazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloaxcin
Ethanol (acute)
Sulphonamides
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27
Q

Drugs which require careful dosage control

A

Antihypertensives

Antidiabetics

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28
Q

An alpha blocker used in hypertension?

A

Doxazocin

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29
Q

A dopamine agonist used for patients with a prolactinoma?

A

Cabergoline or bromocriptine

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30
Q

A dopamine antagonist that can be used for psychotic disorders or nausea?

A

Metoclopromide

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31
Q

Causes of gingival hyperplasia?

A

Phenytoin,
Ciclopsporin
CCBs
AML

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32
Q

Drug causes of tinnitus

A

Aspirin
Aminoglycosides eg gentamicin, tobramycin
Loop diuretics
Etoh

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33
Q

Drug causes of vertigo

A

Gentamicin
Loop diuretics
Metronidazole
Co-trimoxazole

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34
Q

Ototoxic drugs

A 
Aspirin
Aminoglycosides
Loop diuretics 
Quinines
Chemotherapy
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35
Q

Ankle oedema causes

A

Naproxen

CCBs

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36
Q

Bradycardia

A

B blockers
B blocker + diltiazem/verapamil
Digoxin if wrong dose

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37
Q

How long to treat thrush for in pregnancy and what route?

A

PV, 7 days

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38
Q

First and second line therapy for C difficile

A

Vancomycin

Fidaxomicin

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39
Q

Second line therapy for C diff or where 1st failed or not tolerated

A

Vancomycin

Fidaxomicin

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40
Q

NSAID SEs esp in elderly

A

GI

Renal impairment

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41
Q

Opioid SEs

A

anticholinergic
constipation
nausea
drowsiness

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42
Q

How should loperamide be taken?

A

After each loose stool

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43
Q

What monitoring should be done for cyclosporin?

A

U&Es for hyperkalaemia

Serum creatinine/renal function before starting, every 2wks for first 3mths, then monthly

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44
Q

Common SE of GLP-1 agonists eg liraglutide

A

nausea/vomiting

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45
Q

Precipitators of serotonin syndrome

A 
SSRI + TCA eg amitriptyline
\+ tramadol (serotonin inducing)  
lithium
metoclopromide
triptans
SNRIs
46
Q

What should be monitored in first month with COCP and why?

A

BP, if >160/95 then need to stop

47
Q

Opioid of choice in renal impairment

A

oxycodone - metabolites processed and broken down in liver so won’t accumulate

morphine - most broken down in liver but produces 1 v active metabolite which is renally excreted in the process and will accumulate in renal impairment

48
Q

Profuse haemorrhage mx in pt on warfarin

A

IV vit K + PCC + hold warfarin

49
Q

Management of amiodarone induced thyroid dysfunction

A

hyperthyroidism - hold until controlled

hypo - can not withdraw if replacement thyroid therapy given + supervision etc

50
Q

Cyclophosphamide SEs

A

myelosuppression
haemorrhagic cystitis
transitional cell carcinoma

51
Q

Vincristine SEs

A

peripheral neuropathy
urinary hesitancy (2 to bladder atony)
paralytic ileus

52
Q

Bleomycin SE

A

Lung fibrosis

53
Q

Doxorubicin SE

A

cardiomyopathy

54
Q

Methotrexate SE

A

Myelosuppression, mucositis, liver fibrosis, lung fibrosis

55
Q

Cisplatin SEs

A

ototoxicity
peripheral neuropathy
low Mg

56
Q

ACE-I SEs

A

Cough
Hyperkalaemia
Angioedema (delayed onset)

57
Q

Loop diuretics SEs

A

Tinnitus
Hypokalaemia
Postural hypotension

58
Q

Thiazide diuretics SEs

A 
Hypercalaemia
Hypokalaemia 
Hyponatraemia
Dehydration
Postural hypotension
Gout
Impaired glucose tolerance
Impotence

Rarely - pancreatitis

59
Q

Gliclazide SEs

A

Hypoglycaemia

Hyponatraemia

60
Q

When should levothyroxine be taken?

A

30mins before food - absorption may be affected by food, caffeine, other meds

61
Q

Side effects of levothyroxine

A

hyperthyroidism
reduced mineral bone density
worsening of angina
AF

62
Q

Contraindicated drugs in HF

A 
Thiazolidinediones
Verapamil
NSAIDs (fluid retention + CV SEs)
Glucocorticoids (fluid retention)
Flecainide (negative inotrope, arrhythmogenic)
63
Q

Cardiovascular effects of Tacrolimus and Cyclosporin

A

HTN
Hyperglycaemia

Tacro - hyperlipidaemia

64
Q

What drug should be stopped as it accumulates in renal dysfunction?

A

Allopurinol

  • either hold it or give max dose of 100mg OD until improves
65
Q

When should anti-plts be held pre-surgery?

66
Q

Drugs causing hyponatraemia

A 
Thiazide diuretics
Loop diuretics
Gliclazide 
SSRIs
Carbamazepine
Anti-psychotics
PPIs
67
Q

What should be prescribed if pt on warfarin has INR of >1.5 on day of surgery?

68
Q

How should rivaroxaban be taken?

69
Q

What should be done in a female of child-bearing potential on topiramate?

A

Contraception that is NOT COCP - reduces efficacy and they have to continue it until 4wks finished topiramate therapy

70
Q

Pt turns yellow on ABx, what is likely drug?

A

Co-amoxiclav causing cholestatic jaundice

More common in men>65

71
Q

What drug can increase bleeding events if given with Dabigatran?

A

Citalopram

72
Q

What rise in creatinine is acceptable when starting ACEI? What should be monitored?

A

<20%

Repeat U&Es after 1 week

73
Q

Side effects of cyclosporin? What should be monitored on this therapy?

A

Nephrotoxicity
Hypertension

Monitor BP regularly
Renal function tests at start and then every two weeks until stable

74
Q

Na/K/Cl requirement per day for adult

A

1mmol/kg/L

75
Q

Max rate of K+ infusion

76
Q

Drugs CI/cautioned in PVD

A

Beta-blockers

ACE-I

77
Q

Tests to be done before starting treatment with amiodarone

A

Serum potassium
LFTs
TFTs
CXR

78
Q

What to do if patient presents with raised CK/muscle pain and is on statin?

A

Hold statin

Reintroduce at lower dose if CK goes back to normal

79
Q

What opiate is preferable in renal impairment?

A

Fentanyl or Oxycodone

80
Q

Azathioprine SEs

A

Nausea/vomiting
Myelosuppression - do FBC if bleeding or infection occurs
Pancreatitis

81
Q

What is long term PPI use a risk factor for?

A

Osteoporosis

82
Q

A TB patient on treatment develops a malar rash, arthralgia and myalgia - what drug is responsible? What antibodies might indicate a drug induced cause?

A

Isoniazid

Ant-histone Abs POSITIVE
dsDNA NEGATIVE

83
Q

Drugs causing lupus

A

Procainamide
Hydralazine
Isoniazid

84
Q

Side effects of isoniazid

A

Hepatitis
Drug-induced lupus
Peripheral neuropathy

85
Q

What should be checked before starting a patient on ethambutol and why?

A

Eye test

Optic neuritis risk

86
Q

What drug should be given to patients on isoniazid and why?

A

Pyridoxine (vit B6)

due to risk of peripheral neuropathy

87
Q

Is azathioprine safe in pregnancy?

88
Q

What drug can azathioprine react with dangerously?

A

Allopurinol

89
Q

What screening is needed for patients taken hydroxychloroquine?

A

Bull’s Eye Retinopathy before starting

Annual screening

90
Q

Sulfasalazine SE for men

A

Oligospermia

91
Q

Drug appropriate for HTN with gout

92
Q

Main SE of colchicine?

93
Q

What anti-HTNive should not be given with beta blockers in diabetes and why?

A

Thiazides as can cause insulin resistance

94
Q

SE of PPIs

A 
hyponatraemia
hypoMg
increased risk of C diff
osteoporosis
loose stools
95
Q

SE of cisplatin

A

Peripheral neuropathy
Ototoxicity
Hypomagnesaemia

96
Q

Bleomycin SE

A

Lung fibrosis

97
Q

Doxorubicin SE

A

Cardiomyopathy

98
Q

Side effects of alendronate

A

Diarrhoea

GI SEs eg dyspepsia

99
Q

Constipation drugs

A

1) Bulk forming - bran/isphagula husk
2) Osmotic - macrogol, lactulose
3) Stimulant - Senna, bisacodyl, docusate

100
Q

Drugs indicated for opioid induced constipation

A

osmotic + stimulant

101
Q

How fluid depleted are each of the following

1) decreased UO <30ml/h
2) decreased UO + tachy
3) decreased UO + shocked

A

1) 500ml
2) 1L
3) 2L

102
Q

What fluid to initially give for resuscitation and how much can you give?

A

500ml 0.9% over 15mins, can give up to 2L
reassess after each bolus

If elderly or extensive co-morbidities eg HF+renal failure - 250ml boluses

103
Q

What are the normal fluid requirements for an adult per day?

A

25-30ml/kg/day water
1mmol/kg/day K/Na/Cl
50-100g/day glucose

104
Q

What anti-emetic causes fluid retention?

105
Q

What anti-emetic is CI in young people?

A

Metoclopromide

106
Q

What drug may be used for diabetic neuropathy?

A

Duloxetine

107
Q

What drugs should be avoided in asthmatics?

A

Beta-blockers

NSAIDs

108
Q

Possibilities of early early parkinsons treatment

A

Dopamine antagonist eg Ropinirole

MAO-I inhibitor eg rasagiline

109
Q

Pityriasis versicolour Mx

A

Ketoconazole shampoo 5%

110
Q

When should montelukast be taken?

!VIVA/PACES/PSA (5 decks)

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