PSA Flashcards
Which drugs impair glucose tolerance?
Thiazides, furosemide (less common)
Steroids
Tacrolimus, Ciclosporin
Interferon-alpha
Nicotinic acid
Antipsychotics
Beta blockers (slight impairment)- use in caution in diabetics as can interfere with the metabolic and automonic responses to hypoglycaemia
Drug induced glucose intolerance mneumonic?
TASTINg Sugar
Thiazide
Antipsychotic
Steroids
Tumour necrosis factor
Interferon alpha
Nicotinic acid
Drug-induced urinary retention?
Tricyclic antidepressants (amitriptyline)
Anticholinergics (antipsychotics, antihistamines)
Opiods
NSAIDs
Disopyramine
NOT A Drop
Drugs causing lung fibrosis?
Amiodarone
Cytotexic agents: busulphan, bleomycin
Anti-rheumatoid drugs- methotrexate, sulfasalazine
Nitrofurantoin
Ergot-derived dopamine receptor agonists (bromocriptime, cabergoline, pergolide)
A CANE
TB side effects and mechanism of action- Rifampicin
Inhibits bacterial DNA dependent RNA polymerase preventing transcription of DNA into mRNA
Potent liver enzyme inducer
Hepatitis, orange secretions (urine, tears)
Flu-like symptoms
TB side effects and mechanism of action- Isoniazid
Inhibits mycolic acid synthesis
Peripheral neuropathy- prevent with pyridoxine (Vit B6)
Hepatitis, agranulocytosis
Liver enzyme inhibitor
TB side effects and mechanism of action- Pyrazinamide
Converted by pyrazinamidase into pyrazinoic acid which in turn inhibits fatty acid synthase (FAS) I
Hyperuricaemia causing gout
Arthralgia, myalgia
Hepatitis
TB side effects and mechanism of action- Ethambutol
Inibits the enzyme arabinosyl transferase which polymerizes arabinose into arabinan
Optic neuritis: check visual acuity before and during treatment
Dose needs adjusting in patients with renal impairment
Summary of TB drugs?
RIPE - HOF HAP HAM
Rifampicin HOF: Hepatitis, Orange secretions, Flu-like symptoms
Isoniazid HAP: Hepatitis, Agranulocytosis, Peripheral neuropathy
Pyrazinamide HAM: Hyperuricaemia (gout), Arthralgia, Myalgia,
EYEthambutol - optic neuritis
Enzyme inducers?
PC BRAS- Phenytoin, Carbamazepine, Barbituates, Rifampicin, Alcohol (chronic excess), Sulphonylureas
Enzyme inhibitors?
AODEVICES:
Allopurinol, Omeprazole, Disulfiram, Erythromycin, Valproate, Isoniazid, Ciprofloxacin, Ethanol (acute intoxication), Sulphonamides
Diclofenac drug class?
NSAID
Indapamide class and a main side effect?
Thiazide like diuretic- hyperuricaemia which may exacerbate gout
Steroids strange side effect?
May alter mood and behaviour
Statin strange side effect?
Myalgia, myositis and myopathy
Carbimazole main adverse effects?
Agranulocytosis
(Crosses the placenta but may be used in low doses in pregnancy)
Rifampicin lowers the INR as it is an inducer, which antibiotic may enhance the effect of warfarin?
Metronidazole
General factors that may potentiate Warfarin?
Liver disease
P450 enzyme inhibitors
Cranberry juicec
NSAIDs
Drugs CI/ caution with asthma?
Beta-blockers- Best avoided
Adenosine- asthma/ COPD are contraindications
NSAIDs- mildly contraindicated
Medications normally taken at night?
Statins
Amitriptyline
General drug doses?
Paracetamol- 1g qds
Cyclizine- 50mg tds
Amoxicillin 500mg tds
Lansoprazole 15-30mg od
Aspirin- 75-30mg od
Levothyroxine 25-200 MCG od
Medications making heart failure worse?
Thiazolidinediones- pioglitazone
Verapamil
NSAIDs
Flecainide
Cardio drug monitoring?
Statins- LFTs- baseline, 3 months, 12 months
ACEi- U&E- prior to treatment, after increasing dose, at least annually
Amiodarone- TFT, LFT- TFT, LFT, U&E, CXR prior to treatment
TFT, LFT every 6 months
Important side effect of bisphosphonates?
Oesophageal reactions- why the guidance is to sit up after taking- get patients to report new oesophageal symptoms
Osteonecrosis of the jaw
Steroid side effects?
Learn
Can atenolol worsen hypoglycaemic awareness?
Yes
Is HRT contraindicated in heart disease?
Yes- ischaemic heart disease
Gentamicin questions?
I think
If trough levels too high- incrase time between doses
If peak levels too high- reduce dose
Always prescribe with opioid?
Anti-emetic (even if acute)
Laxative
When checking amlodipine side effects?
Instead of things like ankle swelling- type oedema
Statin monitoring?
In the BNF
LFTs x3 normal levels stop, if within that continue
LFTs measured before treatment
Creatine kinase measured before treatment
Be careful- if a solution says 0.05%, it is 0.05g per 100ml
/
Make sure to get the right drug- for example hydrocortisone not hydrocortisone butyrate
/
Remember U+E cover both electrolytes and renal function- they include creatinine and eGFR
/
Trimethoprim key interaction?
Methotrexate
Tricyclic antidepressant side effects?
Drowsiness
Dry mouth
Blurred vision
Constipation
Urinary retention
Postural hypotension
Lengthening of QT interval
Pioglitazone key contraindication?
Heart failure
Clozapine side effects?
Agranulocytosis, neutropenia
Reduced seizure threshold
Constipation
Myocarditis
Hypersalivation
When to stop COCP before surgery?
4 weeks before
Don’t give antiocoagulants etc to patients who are bleeding
x
Steroids side effects/contraindications?
Stomach ulcers
Thin skin
Oedema
Right and left heart failure
Osteoporosis
Infection
Diabetes
Cushing syndrome
NSAIDs cautions/contraindications?
Renal failure
Systolic dysfunction
Asthma
Indigestion
Dyscrasia- clotting abnormality
Aspirin not containdicated in renal, heart failure or asthma
What to search for instead of indigestion in the BNF?
Gastrointestinal discomfort
Gentamicin peak/trough doses?
Further down in the monitoring requirements
