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PSA Part 2 Flashcards

1
Q

What are tocolytic agents?

A

Drugs designed to inhibit contractions of myometrial smooth muscle cells

Used in premature labour

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2
Q

Trimethoprim is contraindicated in patients taking which drug, and why?

A

Methotrexate

Trimethoprim is a folate antagonist, and so is methotrexate, so combined usage can lead to toxicity and causes bone marrow suppression, pancytopenia, and neutropenia

Folate is used in DNA synthesis

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3
Q

What are common side-effects of Bisoprolol use?

A

Headache and dizziness

Bradycardia

Fatigue

Insomnia

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4
Q

When correcting Hypokalaemia under the normal range (3.5-5) of 2.5-3.5, what infusion at what rate do you give?

A

IV 1L of 0.9% NaCl with 40mmol KCl over 4 hours

Standard infusion rate for potassium is 10mmol KCl per hour

Only in extreme cases where potassium is below 2.5mmol/L, should the KCl rate be increased to 20mmol/hr

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5
Q

What is the fluids you give as maintenance if they also need potassium?

A

IV 1L of 0.9% NaCl with 40mmol KCl over 8 hours

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6
Q

Is Erythromycin safe to use in breastfeeding mothers?

A

It is safe

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7
Q

What is the name of the antidote drug used for reversal of anticoagulation from Apixaban and Rivaroxaban?

A

Andexanet alfa

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8
Q

What is the name of the antidote drug used for reversal of anticoagulation from Dabigatran?

A

Idarucizumab

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9
Q

What other class of drugs are people who are allergic to penicillin at risk of also reacting to?

A

Cephalosporins

Other beta-lactam antibacterials

Carbapenems (Meropenem)

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10
Q

What are the doses you give of the anti-histamine Chlorphenamine after when you have initiated the adrenaline in an anaphylaxis situation?

A

Adult and over 12yo - 10mg

Child 6-12 - 5mg

Child 6m-6y - 2.5mg

Child less than 6m 250micrograms/kg

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11
Q

What are the doses you give of hydrocortisone, after when you have initiated the adrenaline in an anaphylaxis situation?

A

Adult and child over 12yo - 200mg

6yo-12yo - 100mg

6m-6yo - 50mg

<6m - 25mg

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12
Q

What are side effects of GTN spray?

A

Headaches

Hypotension

Dizziness

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13
Q

What are some pharmacological risk factors associated with c.difficile infection?

A

Clindamycin

Acid suppressing drugs (PPIs)

Cephalosporins (especially third and fourth generation)

Fluoroquinolones

Broad-spectrum penicillins

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14
Q

What drug do you give prophylactically in children with sickle cell anaemia, to reduce the risk of pneumococcal infection?

A

PHENOXYMETHYLPENICILLIN

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15
Q

Do diabetic lorry, bus, and coach drivers need to tell the DVLA if they are being treated with insulin, non-insulin injections, or tablets? Do they need to tell the DVLA if their diabetes is diet controlled?

A

Yes if insulin, non-insulin injections or tablets

No if diet controlled

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16
Q

What electrolyte disturbances can loop diuretics, like furosemide, cause?

A

Hypokalaemia

Hyponatraemia

Hypocalcaemia

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17
Q

What drugs can lead to gynaecomastia as an adverse effect?

A

Spironolactone - potassium sparing diuretic

Finasteride - 5 alpha-reductase inhibitor

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18
Q

What is the first line management for digoxin toxicity?

A

Digibind

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19
Q

What is the first line management for digoxin toxicity?

A

Digibind

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20
Q

What common drug is a common cause of urticaria?

A

Aspirin

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21
Q

What are common side effects of amlodipine?

A

peripheral oedema, constipation and diarrhoea

22
Q

What are common side effects of bisoprolol?

A

dizziness, headache, diarrhoea, nausea and vomiting

23
Q

What are common side effects of losartan?

A

abdominal pain, diarrhoea and dizziness

24
Q

What are common side effects of metformin?

A

Constipation, diarrhoea
Nausea and vomiting
Lactic acidosis

25
What two groups can potassium sparing diuretics be grouped into, and what are two examples for each group?
Epithelial sodium channel blockers - amiloride and triamterene Aldosterone antagonists - spironolactone and eplerenone
26
What are 2 examples of drugs should you try to avoid in elderly people?
Hypoglycaemics - hypoglycaemic events Antipsychotics - vascular events
27
What T2DM drugs is it best to avoid in AKI?
Metformin Sitagliptin
28
What T2DM drugs is is ok to use in AKI?
Sulfonylureas Insulin
29
What is a drug that is contraindicated in liver disease?
Statins
30
What are the fluid requirements for routine maintenance in adults?
25-30ml/kg/day of water 1mmol/kg/day of K+, Na+ and Cl- 50-100g/day of glucose - limit starvation ketosis
31
What are the primary toxicities of aminoglycosides like gentamicin?
Nephrotoxicity and ototoxicity
32
This patient has evidence of transaminitis, having recently started a new medication. He, therefore, has a drug-induced liver injury (DILI). As most medications are metabolised in the liver, it is a common site for toxicity. DILI is categorised as hepatocellular, cholestatic or a mixed pattern of injury, depending on the ALT : ALP ratio:

ALT : ALP > 5 (ie significantly raised ALT, normal ALP): hepatocellular picture. Common causative agents include paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), statins and amiodarone
  • ALT : ALP < 2 (ie significantly raised ALP, normal ALT): cholestatic picture. Common causative agents include co-amoxiclav, erythromycin, chlorpromazine and hormonal contraception
  • ALT : ALP 2–5 (ie ALT and ALP raised): mixed picture. Common causative agents include phenytoin, sulfonamides and carbamazepine.
    • 33
    What drugs have been reported to cause erythema multiforme?
    ``` Penicillins NSAIDs Anticonvulsants Nitrofurantoin Sulfonamides ```
    34
    In DKA what rate do you give the insulin mixed with saline per kg?
    0.1 unit/kg/hour
    35
    In DKA, what insulin do you start?
    Fixed-dose insulin via an infusion pump 50 units human soluble insulin e.g. Actrapid or Humulin S Can make it up to 50ml with 0.9% sodium chloride solution
    36
    Do you offer prophylaxis to patients with valvular heart disease against infective endocarditis to people undergoing dental operations?
    No you don't offer antibiotic prophylaxis
    37
    What is first line treatment for idiopathic or viral pericarditis?
    NSAIDs and colchicine
    38
    What is Diclofenac contraindicated in?
    Diclofenac is now contraindicated with any form of cardiovascular disease Diclofenac appears to be associated with a significantly increased risk of cardiovascular events compared with other NSAIDs Patients should be switched from diclofenac to other NSAIDs such as naproxen or ibuprofen This advice does not apply to topical diclofenac
    39
    What 5 classes of drugs are common causes of urinary retention?
    The following drugs may cause urinary retention: 1. tricyclic antidepressants e.g. amitriptyline 2. anticholinergics - antipsychotics, antidepressants, anticholinergic respiratory agents, detrusor relaxants 3. Opioids 4. NSAIDs 5. Benzos 6. CCBs 7. Antihistamines 8. Alcohol
    40
    What is the appropriate time to take blood samples for therapeutic monitoring of drug levels of Lithium, Digoxin, Phenytoin, Ciclosporin?
    L12hium = 12 hours lithium 6igoxin = 6 hours Digoxin ciclosp0rin = trough, because levels lowest and closest to 0 (immediately before next dose) phenyt0in = trough, for same reason (immediately before next dose)
    41
    Why do you need to be cautious of using cyclizine in patients with HF?
    Cyclizine is an anti-histamine Histamine is a vasodilator (like its role in anaphylaxis +asthma) anti-histamine prevents vasodilation, which increases systemic vascular resistance heart failure patients have defective ability to overcome to pump, so cardiac output may reduce, which could decompensate their heart failure
    42
    What class of drug is Tamsulosin, and what is its effect?
    Alpha blockers Smooth muscle relaxation
    43
    In hypotensive DKA patients, what should the systolic BP have to to initiate fluid resuscitation, and what do you give over how long?
    Systolic BP <90mmHg 500ml of 0.9% Sodium Chloride over 15 minutes
    44
    Clarithromycin is a CYP3A4 inhibitor, that should not be used in conjunction with a statin, what are other examples of CYP3A4 inhibitors?
    Erythromycin '-azole' antifungals Verapamil Diltiazem Grapefruit juice
    45
    When should simvastatin and atorvastatin be taken?
    Simvastatin - only in evening/at night, because most cholesterol metabolism happens at night Atorvastatin - can be taken in the morning or evening, but should be taken at SAME TIME everyday
    46
    What is the first line anti-emetic in pregnancy unless contraindicated?
    1st line - Cyclizine Other 1st line drugs - Prochlorperazine, Chlorpromazine, Promethazine
    47
    Do Sepsis 6
    48
    What age and under in paeds is it advised that you shouldn't use paracetamol and ibuprofen?
    Can be used by infants, but recommended that neither be taken by infants under the age of THREE MONTHS, unless recommended by a doctor
    49
    What is the most appropriate observations to measure a year after starting the COCP to monitor for adverse side effects?
    Body mass index BP
    50
    What is diclofenac CI in?
    Any form of cardiovascular disease
    51
    What is the secondary prevention anti-platelets regime for MI and strokes?
    Secondary prevention anti-platelets: MI: life-long aspirin + 12 month ticagrelor Stroke: lifelong clopidogrel (if can't have clopidogrel: aspirin + dipyridamole)
    52
    What antibiotics are women safe to have whilst breastfeeding?
    antibiotics: penicillins, cephalosporins, trimethoprim

    PSA (8 decks)

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