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PSA passmed Flashcards

1
Q

which drugs in rheumatology are prescribed weekly?

A

bisphosphonates

methotrexate

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2
Q

Drugs to be avoided if pt has epilepsy

A 
alcohol, cocaine, amphetamines
ciprofloxacin, levofloxacin
aminophylline, theophylline
bupropion
methylphenidate (used in ADHD)
mefenamic acid
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3
Q

drugs that decr K

A

Thiazide diuretics
Loop diuretics
Acetazolamide

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4
Q

drugs that incr K

A 
ACE inhibitors
Angiotensin-2 receptor blockers
Spironolactone
Potassium sparing diuretics (amiloride, triamterene)
Potassium supplements (Sando-K, Slow-K)
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5
Q

meds to avoid in heart failure

A

thiazolidinediones*: pioglitazone is contraindicated as it causes fluid retention
verapamil: negative inotropic effect
NSAIDs**/glucocorticoids: should be used with caution as they cause fluid retention
class I antiarrhythmics; flecainide (negative inotropic and proarrhythmic effect)

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6
Q

labour induction medical no.1

A

Dinoprostone vaginal tablet

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7
Q

depression and stress incontinence

A

duloxetine

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8
Q

if pt’s eGFR is low, nitrofurantoin is unsuitable/ ineffective because of inadequate urine conc and risk of peripheral neuropathy.

A

can prescribe getamicin

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9
Q

pt with hx of epilepsy then depressive sx

Mx

A

not SSRIs or TCA= they incr risk of seizures by antagonising effect of valproate.

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10
Q

AKI drugs to alter: Metformin and Sitagliptin

A

if eGFR is <30 metformin should be avoided- incr risk of lactic acidosis
Sitagliptin i 1’ eliminated via renal route and requires dose reduction to 25mg OD if eGFR is <30.

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11
Q

Drugs that can cause CNS toxicity

A

Amitriptylline, citalopram and Tramadol

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12
Q

P450 inducer (reduced anticoag effect) e.g.

A

rifampicin

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13
Q

Drugs to avoid in the elderly

A

Glibenclamide- long acting sulfonylurea- higher risk of hypoglycaemia
Lorazepam- benzo- ince the risk of confusion and ataxia leading to falls
prochlorperazine (antipsychotic)- avoid in elderly its with dementia- incr risk of mortality/ stroke/ TIA

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14
Q

lithium toxicity can be aggravated by

A

hyponatraemia- body retains lithium which is an ion similar to sodium
Ace-i and loop diuretics increase the loss of NA- tf incr retention of Li.
NSAIDs can incr the risk of Li toxicity by reducing the exertion of Li due to fluid retention

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15
Q

folic acid in pregnancy duration

A

upto 12 weeks

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16
Q

sulfasalazine skin change

A

orange yellow discoloration

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17
Q

amiodarone skin change

A

slate grey appearance

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18
Q

medications that can cause sleep disturbance

A

B blockers esp lipid soluble ones can cause sleep disturbances with nightmares
Steroids can cause insomnia and nightmares. TCA can also cause sleep disturbance.

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19
Q

anti epileptic hypersensitivity syndrome cause

A

phenytoin

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20
Q

strontium ranelate can cause

A

severe allergic reactions- drug rash with eosinophilia and systemic sx

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21
Q

drugs with incr risk of toxicity due to hypoalbuminaemia

A

prednisone, omeprazole, phenytoin and letrozole are all bound to plasma albumin.

It is prednisone and phenytoin that can cause probs due to incr in the conc of a free drug

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22
Q

Medications that reduce anti platelet effect of clopidogrel

A

omeprazole and fluoxetine

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23
Q

Drugs that incr risk of simvastatin related myopathy- rhabdomyolysis

A

CCB- incr plasma conc

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24
Q

Drugs that should be used with caution in its with G6PD

A

aspirin <1g/day. gliclazide, nitrofurantoin and quinine

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25
Drugs that should be used with caution in its with G6PD
aspirin <1g/day. gliclazide, nitrofurantoin and quinine
26
drugs that cause ototoxicity
furosemide | vancomycin
27
drugs that cause constipation
buscopan | ferrous fumarate
28
Drugs to stop before surgery
``` Acei/ARB= 24 hours before Wafarin 5 dys before Clopidogrel 7 days before COCP 4-6wks before Lithium 2 days ```
29
Drugs to stop day of surgery
Metformin Insulin Gliclazide
30
with ileus avoid constipating drugs
e.g. Clozapine, hyoscine and amitriptyline
31
prolong QT interval
``` escitalopram domperidone odansetron Methadone quinolone ```
32
dry mouth
TCA | antipsychotics- risperidone
33
clozapine major SE
agranulocytosis
34
vigabatrin visual SE
visual field defect
35
isotretinoin SE visual
dryness of the eyes w/ blepharitis/ conjunctivitis
36
amiodarone visual SE
reversible corneal deposits present with night glare and may affect the pt's ability to drive in the dark
37
primary angle closure glaucoma precipitators
amitriptyline or chlorphenamine
38
primary angle closure glaucoma precipitators
amitriptyline or chlorphenamine
39
pioglitazone
rare reports of liver toxicity- discontinue if jaundice appears incr risk of HF when combined with insulin small risk of bladder ca= haematuria, dysuria or urgency
40
methotrexate to look out for
lung problems and liver problems
41
methotrexate to look out for
lung problems and liver problems
42
Creon how to take
best taken with food and should be taken immediately after it has been mixed with food
43
prostaglandin analogue e.g. latanoprost SE
brown pigmentation of eyes | causes thickening of the lashes
44
prostaglandin analogue e.g. latanoprost SE
brown pigmentation of eyes | causes thickening of the lashes
45
medications that may exacerbate heart failure
thiazolidinediones*: pioglitazone is contraindicated as it causes fluid retention verapamil: negative inotropic effect NSAIDs**/glucocorticoids: should be used with caution as they cause fluid retention class I antiarrhythmics; flecainide (negative inotropic and proarrhythmic effect)
46
medications that may exacerbate heart failure
thiazolidinediones*: pioglitazone is contraindicated as it causes fluid retention verapamil: negative inotropic effect NSAIDs**/glucocorticoids: should be used with caution as they cause fluid retention class I antiarrhythmics; flecainide (negative inotropic and proarrhythmic effect)
47
prednisolone LT SE
proximal muscle weakness
48
prednisolone LT SE
proximal muscle weakness
49
sodium valproate SE
weight gain & hair loss- top two liver toxicity Pancreatitis
50
drugs that cause renal impairment
ciclosporin (Neoral) | Contrast
51
SE of levodopa rx
postural hypotension | discolouration of urine
52
peripheral oedema drug causes
CCB | NSAIDs
53
Diazepine positing rx
flumazenil
54
opiod therapy SE
bradypnoea resp depression urinary retention
55
opiod therapy SE
bradypnoea resp depression urinary retention
56
sodium fusidate SE
hepatobiliary disorders
57
Digoxin toxicity
1) nausea and vomiting- early signs 2) yellow vision Amiodarone can incr the dose of digoxin
58
Digoxin toxicity
1) nausea and vomiting- early signs 2) yellow vision Amiodarone can incr the dose of digoxin
59
olanzapine and clozapine monitoring 6mnth
blood lipids and weight
60
Erythromycin affect on wafarin
inhibits the metabolism tf INR increases and risk of haemorrhage
61
erythromycin with simvastatin
inhibits the metabolism of simvastatin, incr risk of statin related myopathy. Good to withhold simvastatin during rx with erythromycin- this does not cause harm to the pt as this is a LT preventative measure.
62
SE of TB rx
ethambutol- eyes Isoniazid- peripheral neuropathy liver function should be checked before intiating
63
Labetalol and liver damage
severe hepatocellular damage has been reported with labetalol- reversible should be given alternative such as nifedipine
64
tumour lysis syndrome rx
rasburicase IV
65
tumour lysis syndrome rx
rasburicase IV
66
drugs that cause urinary retention
``` Anticholinergics (eg, antipsychotic drugs, antidepressant agents, anticholinergic respiratory agents, detrusor relaxants), General anaesthetics, Alpha-adrenoceptor agonists, Benzodiazepines (e.g. diazepam), Non-steroidal anti-inflammatory drugs (e.g. ibuprofen), Calcium-channel blockers, Antihistamines, Alcohol. ```
67
drugs that cause urinary retention
``` Anticholinergics (eg, antipsychotic drugs, antidepressant agents, anticholinergic respiratory agents, detrusor relaxants), General anaesthetics, Alpha-adrenoceptor agonists, Benzodiazepines (e.g. diazepam), Non-steroidal anti-inflammatory drugs (e.g. ibuprofen), Calcium-channel blockers, Antihistamines, Alcohol. ```
68
drugs that cause confusion
Anticholinergics (eg, antipsychotic drugs, antidepressant agents, anticholinergic respiratory agents, detrusor relaxants), Antipsychotics, Antidepressants, Anticonvulsants. Less common causes (Histamine H2 receptor antagonists, digoxin, beta-blockers, corticosteroids, non-steroidal anti-inflammatory agents and antibiotics.k
69
drugs that cause confusion
Anticholinergics (eg, antipsychotic drugs, antidepressant agents, anticholinergic respiratory agents, detrusor relaxants), Antipsychotics, Antidepressants, Anticonvulsants. Less common causes (Histamine H2 receptor antagonists, digoxin, beta-blockers, corticosteroids, non-steroidal anti-inflammatory agents and antibiotics.
70
alendronic acid SE
discomfort in the retrosternal area- alert damage to lower oesophagus and should be discontinued
71
alendronic acid SE
discomfort in the retrosternal area- alert damage to lower oesophagus and should be discontinued
72
methotrexate SE
pneumonitis | leucopenia
73
methotrexate SE
pneumonitis | leucopenia
74
peripheral vascular disease CI
B blockers | Ace-i
75
peripheral vascular disease CI
B blockers | Ace-i
76
gradual withdrawal of steroids if
- received more than 40mg prednisolone daily for more than one week - received more than 3 weeks treatment - recently received repeated courses
77
medications that worsen psoriasis
beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab
78
medications that worsen psoriasis
beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab
79
sotalol can prolong the Qt interval
Tricyclic antidepressants, selective serotonin uptake inhibitors and haloperidol are psychiatric drugs known to cause QTc prolongation.
80
sotalol can prolong the Qt interval
Tricyclic antidepressants, selective serotonin uptake inhibitors and haloperidol are psychiatric drugs known to cause QTc prolongation.
81
Drug causes of raised prolactin
metoclopramide, domperidone phenothiazines haloperidol very rare: SSRIs, opioids
82
drugs that prolong the QT interval
Quetiapine chlorpromazine -both antipsychotics Sotalol- antiarrythmic Carvedilol- BB
83
associated with bone loss
fureosemide | PPI- omeprozole
84
erythema multiforme SE
``` pheytoin carbamazepine valproate lamotrigine penicillinn sulphonamides aspirin allopurinol hydralazine cimetidine ```
85
pruitus due to biliary problems
colestyramine
86
methotrexate and trimethoprim together
toxicity and bone marrow suppression
87
to lower portal HTN
propanolol
88
abd ascites
spironolactone
89
drugs that can exacerbate hyponatraemia
carbamazepine citalopram lasoprazole
90
GTN SE
dizziness hypothension headache
91
GTN SE
dizziness hypothension headache
92
management of DKA
when K is between 3.5-5.5 to use 40mmol of K supplement

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