Random 3 Flashcards
Drug used to relieve obstructive symptoms of BPH:
- name
- class
- MoA
- side effects
Tamsulosin , Alfuzosin
Class: alpha1 antagonist (L1-antagonist)
MoA: it will induce smooth muscle relaxation in the prostate and the bladder -> better urinary flow
SEs__: dizziness, postural hypertension, dry mouth, depression
Drug used to relieve symptoms of BPH- shrink prostate size
- name
- class
- MoA
- side effects
Finasteride
Class: 5-alpha reductase inhibitor
MoA: inhibit conversion of testosterone -> DHT (this is responsible for increased size of prostate
Side effects: gynecomastia, reduced libido, erectile problems
*effects seen after 6 months
* may decrease PSA up to 50%
Which ones are live-attenuated vaccines?
- BCG
- MMR
- oral Polio
- oral rotavirus
- yellow fever
- oral typhoid
Antibiotics used for the treatment of pneumonia
- the most common
- IV in hospital
- atypical pneumonia
- doxycycline
- amoxicillin 500 mg x3 a day
- Tazocin (Piperacillin/tazobactam) -> used in IV hospital admission
- Clarithromycin/ erythromycin - atypical pneumonia (but also against gram +ive and gram -ve)
What CURB score would indicate the need for IV antibiotic?
3 or more
What’s the maximum dosage of Paracetamol?
Max dose of Paracetamol over 24 hours:
- 8 x 500 mg
OR
- 4 x 1 g
Is there a difference in effect between Clarithromycin given orally or IV?
Same effect if clarithromycin 500 mg bd oral or IV -> so oral route will be preferred
Is there a difference between effect of the same dose of anti-epileptic when given IV or orally?
No difference, therefore give same dose IV as you would give orally (and vice versa)
How long is the standard treatment for lower UTI for?
3 days
Most common antibiotics used for UTI
- trimethoprim
- nitrofurantoin -> makes urine darker in colour/ be careful if impaired kidney funtion
- ciprofloxacin -> may cause cholestasis
- amoxicillin -> safe in renal function
- cephalaxin
- pivmecillinam
Why do we need to be careful about eGFR of the patient in prescribing any drug? (two general considerations)
- for the treatment to be effective
- if the function is impaired -> potential drug toxicity/overdose due to problems with elimination/metabolism
- What’s the method to estimate eGFR and renal function?
- Write down the formula
- when do we need to worry
Cockcroft Gault equation
*worry if eGFR is <50 ml/min
Two most common bacteria that cause cellulitis
Staphylococcus
Streptococcus
How does Pseudomonas caused cellulitis differ in appearance from Strep/Staph one?
The wound oozes and smells
Antibiotics commonly used for cellulitis
- Flucloxacillin
- Erythromycin
*IV Flucloxacillin for severe infection
What antibiotics may cause jaundice?
Drug-induced jaundice with:
- Flucloxacillin
- Co-amoxiclav
These may cause cholestasis jaundice (post-hepatic due to stasis)
*it is reversible - will clear out
Organisms commonly causing fungal infections (2)
- Aspergillus
- Candida albicans *patients on chemo
Common anti-fungal drugs (2)
*name of anti- fungal prescribed for severe infections
- Fluconazole
- Nystatin (oral drops: 1 ml drop x4 a day)
* Amphotericin (IV for severe infections)
- Name 2 common drugs that are given once weekly
- OSCE tip - in terms of prescription chart
- Alendronic acid (for osteoporosis)
- Methotrexate (for RA)
These drugs to be taken once a week
Cross all other days in the prescription chart out!
Mode of action of:
- Nystatin
- Fluconazole
- Nystatin: cell wall synthesis (ergosterol breakdown -> less plasma membrane)
- Fluconazole - cell wall synthesis (14 alpha-demethylase enzyme)
what does it mean: modified release drug?
Drug is released over period of time -> prolonged time of absorption
Why while taking anti-fungals monitoring is required?
They are p450 enzyme inhibitors -> therefore less liver metbolism -> increased concentration of other drugs
Can we give anti-fungal to a patient that is on methotrexate?
Better not as both of these drugs cause liver damage
*if a patient is on methotrexate and fluconazole is needed -> stop methotrexate temporarily
Side effects of amiodarone
Amiodarone - class III anti-arrhythmic
- pulmonary fibrosis
- thyroid disturbances
- slate-grey appearance of the skin
- further arrhythmias
What two antibiotics may cause drug-induced jaundice?
- Amoxicillin/clavulanic acid, also known as co-amoxiclav
- Flucloxacillin
