PSA

Question 1

What drugs are enzyme inducers

Answer 1

Carbamazepine
Rifampicin
Alcohol (chronic)
Barbiturates
Sulphonylureas
Phenytoin

Question 2

What are the enzyme inhibitors?

Answer 2

Omeprazole
Allopurinol
Disulfarim
Ethanol (acute)
Valproate
Isoniazid
Ciprofloxacin
Erythromycin
Sulphonamide

Question 3

What Drugs are to be stopped before surgery?

Answer 3

Insulin

Lithium
Ace inhibitors
CCP/HRT
K sparing diuretics

Anticoaualnts
Hypoglyceamics

Question 4

When are the indications for each of the commonly prescribed anti-emetic medications?

Answer 4

Cyclizine- First line except in cardiac or urinary impairment

Metoclopramide- Contraindicated in GI obstruction and Pheochromacytoma

Ondansetron- Chemotherapy nausea

Question 5

When are the doses administered for each of the commonly prescribed anti-emetic medications?

Answer 5

Cyclizine- 50mg, TDS, IV/IM/PO

Metoclopramide- 10mg, TDS, ORAL/IM/Slow IV

Ondansetron- 4mg IM/IV/PO- Post op

Question 6

Explain the Pain Ladder for a patient with no co-morbidities?

Answer 6

Paracetamol
Weak opiod- e.g. dihydrocodeine, tramadol (+paracetamol)
Strong opiod- Morphine Sulphate (+paracetamol)

Question 7

What is the opioid of choice in hepatorenal syndrome?

Answer 7

Buprenorphine

Question 8

Name three commonly prescribed neuropathic painkillers and the initial dosing of choice in patients with no co-morbidities

Answer 8

Amitriptyline 10mg, nightly

Duloxetine 60mg, oral daily

Pregabalin 75mg, BD

Question 9

If you have rheumatoid arthritis and a UTI what two medications commonly interact to cause harm

Answer 9

Methotrexate and Trimethoprim

Question 10

What class of drugs commonly causes peripheral oedema?

Answer 10

CCB’s

Question 11

Describe the corresponding changes that are made to levothyroxine based on T4 levels?

Answer 11

<0.5, Increase
0.5-5 Gucci
>5- Reduce

Question 12

What ECG changes does digoxin induce?

Answer 12

Salvador Dali sign (ST downsloping)

Question 13

How should a raised INR be managed in patients taking warfarin?

Answer 13

<5 - Sound
5-8 - Bleeding- IV Vitamin K
5-8 No bleeding- Omit Warfarin
Over 8- No bleeding- PO Vitamin K
Over 8- Bleeding- IV Vitamin K

Question 14

Explain the Hypertension Pathway

Answer 14

Under 55 or T2DM- Ace Inhibitors

Over 55 or Black- CCB

Step 2: Add whichever one hasn’t been started

Step 3: Add Bendroflumethiazide

Step 4: Spironolactone if Potassium <4.5mmol/l
Alpha or Beta Blocker if potassium>4.5mmol/l
Refer

Question 15

What two classes of medication are first line for heart failure?

Answer 15

Ace inhibitors and Beta blockers

Question 16

Why is bisoprolol favoured over digoxin in AF

Answer 16

Bisoprolol is a rate limiter on exertion as well as at rest

Digoxin is a rate limiter only at rest

Question 17

Why do you check before starting azathioprine

Answer 17

Thiopurine s-methyl Transferase

Question 18

What does 1% mean in the clinical context for calculations

Answer 18

1g in 100ml or 10mg in 1ml

Question 19

What rare but damaging side effect do statins have?

Answer 19

Cirrhosis.

Monitor liver function tests

Question 20

What antipsychotic can cause reduced glucose tolerance?

Answer 20

Olanzapine

Question 21

What common allergen does Tazocin contain

Answer 21

Penicillin