random 5 Flashcards
1
Q
What drug can be used to decrease the frequency of sickle cell anaemia crises?
A
Hydroxycarbamide
2
Q
What is G6PD deficiency?
A
Patients are susceptible to developing acute haemolytic anaemia when they take a number of common drugs (and fava beans). Risk and severity is almost always dose related.
3
Q
Name three drugs that should not be given to people with G6PD deficiency?
A
Dapsone, nitrofurantoin, quinolones, rasburicase, sulfonamides
4
Q
A patient with CKD may be given which one of the following to treat anaemia?
Darbopoetin
Folic acid
Hydroxycobalamin
A
Darbopoetin - EPO deficiency
May also be given iron
5
Q
MHRA important safety information r/e epoietins
A
Overcorrection of Hb conc. in patients with CKD may increase the risk of death and serious CVD. In patients with cancer may increase the risk of thrombosis. Only treat if symptomatic anaemia. Target range of 10-12 (or what relieves symptoms)
6
Q
Why might you advise against using epoietins in patients with a tumour?
A
There is a risk of tumour progression, blood transfusion may be the preferred treatment
7
Q
True/False - parental iron will correct Hb levels quicker than oral iron
A
False - parental iron does not produce a faster Hb response than oral iron, provided that oral iron is taken reliably.
8
Q
When Hb is within normal range, iron supplements should be continued for a further X months to replenish the patients stores
A
3 months
9
Q
What is pernicious anaemia?
A
Lack of gastric intrinsic factor resulting from an autoimmune gastritis causes malabsorption of vitamin B12
10
Q
Which of the following is preferred for treating B12 deficiency? Hydroxycobalamin or cyanobalamin
A
Hydroxycobalamin is vitamin B12 of choice - patient is loaded then it is given at intervals of 3months usually for life
11
Q
Why should folic acid not be given in undiagnosed megaloblastic anaemia?
A
Should only be given in undiagnosed megaloblastic anaemia if vitamin B12 is given concurrently otherwise neuropathy may be precipitated.
12
Q
Why should folic acid NEVER be given alone for pernicious anaemia?
A
May precipitate subacute combined degeneration of the spinal cord
13
Q
How long should folate deficient anaemia be treated with folic acid supplements?
A
Give 5mg OD usually for 4 months - this will bring about remission and replenish stores
14
Q
Why must filgastrim be prescribed by brand?
A
It is a biosimilar medicine
15
Q
Idiopathic thrombocytopenia can be treated with what?
A
Corticosteroid
16
Q
Why might patients with renal artery stenosis require potassium supplementation?
A
Renal artery stenosis is associated with hypoaldosteronism and this can cause hypokalemia
17
Q
What are the 3 options for treating hyperkalemia?
A
Calcium gluconate 10%
IV soluble insulin (e.g. actrapid)
IV or neb salbutamol
18
Q
why must chronic hyponatremia be corrected slowly?
A
To avoid the risk of osmotic demyelination syndrome
19
Q
What can be used to treat severe hypocalcemia?
A
IV calcium gluconate
20
Q
How should severe hypercalcemia be managed?
A
Dehydration should be corrected first with NaCl
Drugs which promote hypercalcemia e.g. thiazides and vitamin D should be stopped
Bisphosphonates may be required (pamidronate is probably the most effective)
Could use corticosteroids if due to vitamin B toxicity but takes several days to achieve desired effect.
21
Q
What is the 1st line treatment for N+V in pregnancy, if lifestyle measures have failed?
A
Promethazine
OR prochlorperazine and metoclopramide are options
22
Q
Co-beneldopa can discolour the urine what colour?
A
Reddish
23
Q
Bisphosphonates are C/I in patients with what electrolyte disturbance?
A
Hypocalcemia
24
Q
If a patient is experiencing nightmares while taking bisoprolol what alterantive beta blocker could you switch them to?
A
Atenolol or nadaolol are very water soluble as so less likely to pass the BBB.
(Sotalol is aswell but this shouldn’t be used often)
25
Nystatin can be used for the treatment of oral thrush, how long should you advise someone to use it for?
For 10 days
Until the thrush has cleared up
Until 24 hours after the thrush has cleared
Until 48 hours after the thrush has cleared
Nystatin should be continued until 48 hours after all the lesions have resolved.
26
Child has had a fever for the past couple of days and has now developed a rash all over the trunk and face of their body. The rash consists of small, raised red spots.
What does the child have? What advice do you give?
Chicken pox
If child has a fever can give paracetamol. Do not give ibuprofen
27
Gentleman explains that has a tingling or painful feeling on the right side of his body. There is a red blotchy rash going across his chest and tummy.
Shingles - refer to GP asap
28
Child has had cold like symptoms for the past couple of days and has since developed small white spots in his mouth. He also has a botchy rash that started at his hair line.
Measles
| Refer to GP
29
Patient has a red-pink skin rash and swollen glands. Glands have been swollen for a while now
Rubella - should always refer to GP
30
Child has a red prominent red rash on face.
Slapped cheek syndrome - normally fades within 2 weeks, do not need to stay off school and do not need to refer to GP as gets better on its own.
31
Child has a sore throat, temperature and has lost her appetite. She has also recently developed mouth ulers and as rash on her hands and feet.
Hand foot and mouth disease. No specific treatment, needs to run its course. Refer to GP if no improvement after 7-10 days
32
Baby has a temperature, being sick and cries when taken outside. Also has a blotchy-dark purple rash that is non blanching
Refer to A+E as meningitis
33
What is mirabegron used for?
Overactive bladder syndrome
34
How should nocturnal enuresis be treated?
If <5 years old treatment is not needed as it is likely to resolve.
Ideally use an alarm but can treat with oral or S/L desmopressin (not intranasal)
35
What is the first line treatment for urinary retention in men?
1st line is usually an alpha blocker
36
When might finasteride be used first line for urinary retention?
In patients with an enlarged prostate, a raised PSA and who are considered high risk of progression
37
What counselling must you provide a patient newly started on doxasozin?
Can cause first dose hypotension - lie down if feel dizzy
38
Tamulosin can be sold OTC for BPH. What age range can you sell it to? And for how long for?
Can be sold to men age 45-75 years for up to 6 weeks before they need to make an appointment
39
Finasteride MHRA alert
Reports of depression
40
Finasteride side effects
Breast enlargement, decreased libido and impotence
| Report any signs of male breast cancer
41
At what age is it recommended that COC are not continued and a more suitable alternative is offered?
50 years
42
How long before surgery should oestrogen containing contraceptives be stopped? When should they be restarted?
Stop 4 weeks before elective surgery
| Restart 2 weeks after full mobilisation
43
How to switch from COC to POP?
Start POP at the end of COC cycle without taking the 7 days break
44
Which oral antidiabetic drugs can be taken as normal during the peri-operative period?
Pioglitazone, DPP-4 inhibitors, and GLP-1 agonsits can be taken as normal during the whole peri-operative period.
45
Why should SGLT2 inhibitors not be given on the day of surgery?
Sodium glucose co-transporter 2 inhibitors should be omitted on the day of surgery and not restarted until the patient is stable; their use during periods of dehydration and acute illness is associated with an increased risk of developing diabetic ketoacidosis.
46
How should sulfonylureas be managed during surgery?
Sulfonylureas are associated with hypoglycaemia in the fasted state and therefore should always be omitted on the day of surgery until the patient is eating and drinking again
47
When can metformin be continued during surgery?
If only one meal will be missed during surgery, and the patient has an eGFR greater than 60 mL/minute/1.73m2 and a low risk of acute kidney injury (and the procedure does not involve administration of contrast media), it may be possible to continue metformin hydrochloride throughout the peri-operative period—just the lunchtime dose should be omitted if the usual dose is prescribed three times a day.
48
What is the risk of giving metformin during surgery?
Metformin hydrochloride is renally excreted; renal impairment may lead to accumulation and lactic acidosis during surgery.
49
True/False metformin should always be stopped after contrast medium
False - There is no need to stop metformin hydrochloride after contrast medium in patients missing only one meal or who have an eGFR greater than 60 mL/minute/1.73m2. If contrast medium is to be used, and eGFR is less than 60 mL/minute/1.73m2, metformin should be omitted on the day of the procedure and for the following 48 hours.
50
A patient taking canagliflozin, tells you they have got a stomach bug. What advice would you give them?
Sodium glucose co-transporter 2 inhibitors are associated with increased risk of developing diabetic ketoacidosis during periods of dehydration, stress, surgery, trauma, acute medical illness or any other catabolic state, and should be used with caution during these times. The MHRA has advised (2016) that these drugs should be temporarily stopped in patients who are hospitalised for acute serious illness until the patient is medically stable.
51
Ciprofloxacin warning labels
Do not take MILK, indigestion remedies, or medicines containing iron or zinc, 2 hours before or after you take this medicine
Space the doses evenly throughout the day. Keep taking this medicine until the course is finished, unless you are told to stop
Swallow this medicine whole. Do not chew or crush
52
Doxycyline warning labels
Do not take indigestion remedies, or medicines containing iron or zinc, 2 hours before or after you take this medicine
Protect your skin from sunlight—even on a bright but cloudy day. Do not use sunbeds
Take with a full glass of water
53
Sumatripan should not be sold OTC to patients who experience more than X number of attacks per month?
4 attacks per month - refer
54
What is seretide?
Combined ICS/LABA inhaler containing salmeterol and fluticasone
55
Which antiemetic should not be given after GI surgery?
Metoclopramide - is contraindicated in patients who have had GI surgery the previous 3-4 days
56
Patients taking a PPI OTC, should be referred to their GP if they see no improvement after how many days?
14 days
57
True/false - controlled drugs cannot be provided under a PGD
False - CDs can be considered in a PGD.
58
How is addisons disease treated?
Replace cortisol with hydrocortisone
| and mineralcorticoid with fludrocortisone
59
How should you manage a patient on prednisolone about to undergo minor surgery?
Advise they take their usual corticosteroid dose in the morning OR IV hydrocortisone at induction (no additional cover is needed)
60
How should you manage a patient on prednisolone about to undergo moderate surgery?
Usual dose of prednisolone on morning of surgery AND hydrocortisone IV at induction. Hydrocortisone TDS for 24 hours following moderate surgery
61
How should you manage a patient on prednisolone about to undergo major surgery?
Usual dose of prednisolone on morning of surgery AND hydrocortisone IV at induction. Hydrocortisone TDS for 48-72 hours following major surgery
62
What action should be taken if someone taking prednisolone is exposed to chicken pox for the first time?
Passive immunisation is needed
| corticosteroids should not be stopped, and dosage may need to be increased
63
When do steroids need to be withdrawn gradually?
>40mg prednisolone for more than one week
Pt has been given repeated doses in the evening
Received >3 weeks in treatment
Recent repeated courses
taken a short course within 1 year of stopping long term therapy
patient has other possible causes of adrenal suppression
64
How can cushings be treated?
Most types are treated surgically.
Metyrapone is helpful in controlling symptoms
ketoconazole
65
What level should BG be kept above while driving?
>5mmol/l
66
What action should a diabetic take if their BG level drops <4 while driving?
If <4 should have a snack and wait 45 minutes after BG has returned to normal
67
How often should diabetics be advised to measure their blood glucose while driving?
every 2 hours while driving
68
How often should HbA1c be monitored in T1DM?
every 3 -6 months
69
How often should HbA1c be monitored in T2DM?
Monitor every 3-6months, then 6 monthly once stable
70
Fasting BG target
4-7
71
BG target on waking
5-7
72
BG target after eating
5-9
73
What is the 1st line treatment regimen for patients with T1DM?
Twice daily insulin determir should be offered as long action basal.
Rapid acting insulin before meals (Avoid routine admin after meals)
74
When might metformin be given to patients with type 1 diabetes?
Patients with a BMI >25 (>23 and south asian)
75
What is the GOLD or CLARKE score used to assess?
Patient awareness of hypos. Should be assessed annually
76
When should drug treatment be intensified in type 2 diabetes?
If HbA1c is poorly controlled >58 then the drug treatment should be intensified
77
Shorter acting SU are preferred in elderly or renal impairment, such as....
Gliclazide, tolbutamide
78
GLP-1 agonists should only be prescribed when?
Should only be prescribed for patietns who have a BMI >35 and who have specific psychological or medical problems associated with diabetes
OR BMI <35 but whom insulin therapy would have significant implications
79
Recommended 1st line insulin regimen in type 1 diabetes?
Isophane insulin once or twice daily
80
What can be given for the treatment of painful diabetic neuropathy?
Duloxetine
81
How should diabetic ketoacidosis be managed?
Restore blood pressure with NaCl 0.9% fluid
Inc. potassium in fluid and adjust to plasma concentration
Start soluble insulin at a rate of 0.1U/kg/hr
Established therapy with long acting insulin should be continued during treatment
Once BG falls below 14mmol, glucose should be given IV
82
How should hypos be managed in patients taking acarbose?
For hypos need to carry glucose as acarbose interferes with sucrose absorption
83
Signs of lactic acidosis
Dysponea, abdominal pain, muscle cramps, asthenia (lack of energy), hypothermia
84
MHRA safety warnings with SGLT-2 inhibitors
Increased risk of lower limb amputations
| Risk of DKA
85
What type of insulin actrapid?
Rapid acting
86
What type of insulin is humulin s?
Rapid acting
87
What type of insulin is humulin I?
Intermediate
88
What type of insulin is insultard?
Intermediate
89
What type of insulin is Humulin M3?
Biphasic
90
What type of insulin is tresiba?
Long acting
91
What type of insulin is levemir?
Long acting
92
What type of insulin in abasalgar?
Long acting
93
What type of insulin is lantus?
Long acting
94
How should you advise a patient to treat a hypo?
Initially 10-20g of glucose orally
May need to repeat dose after 10-15 minutes
Following this a snack providing sustained availability of carbohydrate
95
What is diazoxide used for?
Chronic hypoglycemia in patients who suffer from excess endogenous insulin secretion
96
What action should be taken if a patient on warfarin has a major bleed?
Stop warfarin. Give phytomenadione IV and prothrombin complex
97
What action should be taken if a patient on warfarin has an INR >8 and a minor bleed?
Stop warfarin. Give phytomenadione IV. Repeat after 24 hours if INR is still high.
98
What action should be taken if a patient on warfarin has an INR >8 and no bleeding?
Stop warfarin. Give phytomenadione ORAL. Repeat after 24 hours if INR is still high
99
What action should be taken if a patient on warfarin has an INR 5-8 and is experiencing minor bleeding?
Stop warfarin. Give phytomenadione IV.
100
What action should be taken if a patient on warfarin has an INR 5-8 but has not bleeding?
Stop warfarin for the next 1 or 2 doses.
101
How are nasal polyps treated?
Intranasal corticosteroids
102
Propylthiouracil monitoring requirements
Monitor for hepatotoxicity.
103
How is round worm treated?
Mebenazole 100mg BD for 3 days. Cannot treat OTC
104
What electrolyte deficiency is often seen in severe asthmatics?
Magnesium
105
Give two examples of primary disease prevention strategies
Legislation e.g. smoking ban
Education campaigns
Immunisation
106
Give two examples of secondary disease prevention strategies
Mammograms, cervical screening, aspirin to prevent further heart attacks
107
Give two examples of tertiary disease prevention strategies
Cardiac, stroke rehabilitation
| Support groups
108
What are the 6 risk factors for VTE in patients taking the COC?
```
Family history of VTE (in persons <45 years)
Smoking
Obesity BMI >30
Long term immobilisation
Age >35 years
Previous thrombosis
```
109
Why are troponin levels taken immediately after a suspected MI and 10-12 hours later?
To see if the levels have increased, this would be indicative of a STEMI/NSTEMI
110
A patients would like advice on what has happened to their skin. Small patches of their skin has become scaly and discoloured. It is also itchy.
Pityriasis vesicolor
111
ACEi monitoring requirements
Renal function and electrolytes
112
Isoniazid monitoring requirements
Renal function should be checked before treatment.
Hepatic function should be checked before treatment. If there is no evidence of liver disease (and pre-treatment liver function is normal), further checks are only necessary if the patient develops fever, malaise, vomiting, jaundice or unexplained deterioration during treatment.
Those with alcohol dependence should have frequent checks of hepatic function, particularly in the first 2 months.
113
Pioglitazone monitoring requirements
Monitor liver function before treatment and periodically thereafter.
114
Calcium acetate is prescribed in CKD for what electrolyte deficiency?
Hyperphosphataemia
115
True/False hydrocortisone can be given OTC for dermatitis behind the ear?
True - just not face
116
A patient brings a prescription for propanolol for migraine prophylaxis to your pharmacy. After checking the PMR, you notice they also take amiodarone. What action do you take?
Propanolol and amiodarone should not be taken together - manufacturers state avoid. Contact prescriber and suggest an alternative for migraine prophylaxis
117
How should you treat hypoglycemia associated with unconsciousness?
Need to give a glucagon injection
118
what type of inhaler is an evohaler?
MDI
119
What type of inhaler is an accuhaler?
DPI
120
What antibiotic should be given to penicillin allergic patients, suspected of having meningitis?
Cefotaxime - cephalosporin but risks do not outweigh benefits
121
Recent MHRA warning in 2017 concerning corticosteroids
Rare risk of central serous choriotretinopathy with local and systemic administration
122
Isotretinoin monitoring
Liver function and serum lipid levels should be measured at baseline, after 1 month and then every 3 months
123
Which EHC can only be taken once in a menstrual cycle?
Ella ONE
124
How long do patients need to use additional protection following EHC?
Until next period
125
A patient has been experiencing attacks of gout regularly, the decision has been made to start allopurinol and preventative therapy. How and when should allopurinol be started considering the patients last attack was 2 days ago and was given naproxen to manage this.
Do NOT start allopurinol during an acute attack. Continue naproxen for one month after hyperuricaemia has been correct and start allopurinol 1-2 weeks after the acute attack has settled.
126
True/False: asthma is an absolute contraindication of NSAID therapy
False - only contraindicated in patients with a history of hypersensitivity
127
Which antibiotics need to be taken with food?
Metronidazole
Nitrofurantoin
Clarithromycin MR
128
Promethazine should be used with caution in which one of the following patient groups:
```
Glaucoma
Hypertension
Peptic ulceration
Diabetes
Parkinsons
```
Glaucoma
129
Prochlorperazine should be used with caution in which of the following patient groups:
```
Glaucoma
Hypertension
Peptic ulceration
Diabetes
Parkinsons
```
Glaucoma
| Parkinsons - dopamine antagonist so may exacerbate
130
A gentleman would like advice on a cough or cold product. He has hypertension. Which of the following drugs would be unsuitable:
```
Paracetamol
Dextremethorphan
Pseudoephedrine
Simple linctus
Ibuprofen
```
Pseudoephedrine - decongestants can cause blood pressure to rise.
131
Why should ibuprofen be avoided in the third trimester of pregnancy?
Avoid during the third trimester (risk of closure of fetal ductus arteriosus in utero and possibly persistent pulmonary hypertension of the newborn); onset of labour may be delayed and duration may be increased.
132
Lithium monitoring requirements
Monitor body-weight or BMI, serum electrolytes, eGFR, and thyroid function every 6 months during treatment, and more often if there is evidence of impaired renal or thyroid function, or raised calcium levels. Manufacturer also advises to monitor cardiac function regularly.
133
What is apomorphine?
Dopamine agonist
134
What three cytotoxic drugs commonly cause oral mucositis?
Fluorouracil, MTX and the anthracyclines
135
How can oral mucositis be treated?
It is best to prevent the complication with good oral hygiene. Once a sore mouth has developed, treatment is much less effective. Saline mouthwashes should be used but there is no evidence to support the use of antiseptic or anti-inflammatory mouthwashes
136
Bone-marrow suppression commonly occurs how many days after chemotherapy?
7 to 10 days. Delayed in carmustine, lomustine and melphalan.
137
Neutropenia is defined as what?
neutrophil count <1.06x10^9
138
Name the three highly emetogenic chemotherapy agents?
Cisplatin, dacarbazine and high doses of cyclophosphamide
139
Which chemo agents are associated with cytotoxicity?
The anthracycline cytotoxic drugs associated with dose-related, cumulative and potentially life-threatening cardiotoxic side effects.
140
Is St Johns Wort an enzyme inhibitor or enzyme inducer?
Enzyme inducer
141
Warfarin and fluconazole interaction
Anticoagulant effect enhanced by Fluconazole (can cause bleeding)
142
Warfarin and statin interaction
Anticoagulant effect enhanced by Statins (can cause bleeding)
143
Warfarin and SJW interaction
Anticoagulant effect reduced by St. John’s Wort
144
Pseudoephedrine and MAOI interaction
Hypertensive crisis
145
Colestyramine counselling
Other drugs should be taken at least 1 hour before or 4-6 hours after bile acid sequestrants to reduce possible interference with absorption
146
TB should be treated with what four drugs in the initial phase and for how long?
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
for 2 months
147
Following the initial phase, TB should then be treated with what drugs and for how long?
Treat with isoniazid and rifamipicin for a further 4 months
148
Clozapine monitoring
Monitor leucocyte and differential blood counts. Clozapine requires differential white blood cell monitoring weekly for 18 weeks, then fortnightly for up to one year, and then monthly as part of the clozapine patient monitoring service.
Close medical supervision during initiation (risk of collapse because of hypotension and convulsions).
Blood lipids and weight should be measured at baseline, at 3 months (weight should be measured at frequent intervals during the first 3 months), and then yearly with antipsychotics. Patients taking clozapine require more frequent monitoring of these parameters: every 3 months for the first year, then yearly.
Fasting blood glucose should be measured at baseline, at 4–6 months, and then yearly. Patients taking clozapine should have fasting blood glucose tested at baseline, after one months’ treatment, then every 4–6 months.
149
How do sulphonylureas work?
Work by increasing insulin secretion by beta cells
150
Does metformin cause hypos?
No Produces normoglycaemia rather than hypoglycaemia.
151
Does HRT provide contraception for patients going through the menopause?
No - HRT does not provide contraception and a woman is considered potentially fertile for 2 years after her last menstrual period if she is under 50 and for 1 year if she is over 50 years old.
152
Missed pill advice for POP
If a pill is forgotten, it should be taken as soon as remembered and carry on with the next one at the right time. If the pill was more than 3 hours overdue (12 hours for Cerazette =desogesterol) then a woman is not protected. Continue normal pill taking but other forms of contraception (barrier methods) should be used for the next 2 days.
153
ACE inhibitor side effects
Persistent dry cough, angiooedema, GI distrubances, altered LFTs, hyperkalemia, hypoglycemia, taste disturbances
154
Beta 2 agonists side effects
Fine tremor, Nervous tension, Headache, Muscle cramps, Palpitations, hypokalaemia.
155
Side effects associated with antihistamines?
Antimuscarinic side effects – urinary retention, dry mouth, blurred vision, constipation and sedation with the older generation.
156
Heparin can lead to what electrolyte disturbance?
Inhibition of aldosterone secretion by heparin (including low molecular weight heparins) can result in hyperkalaemia; patients with diabetes mellitus, chronic renal failure, acidosis, raised plasma potassium or those taking potassium-sparing drugs seem to be more susceptible. The risk appears to increase with duration of therapy and the CSM has recommended that plasma-potassium concentration should be measured in patients at risk of hyperkalaemia before starting heparin and monitored regularly thereafter,
157
Why should quinolones not be used in children?
Cause arthropathy (Joint disorders) in the weight bearing joints of immature animals. Therefore generally not recommended in children and growing adolescence. However, the significance of this effect in humans is uncertain and in some specific circumstances short term use of quinolones in children may be justified
158
Why should co-cyprindiol (dianette) only be used in women wtih severe acne who have not responded to oral abx?
VTE occurs more frequently than with other COC. It is contra-indicated in those with a personal or close family history of venous thromboembolism.
159
What has been reported in children after being given tacrolimus following transplantation?
Cardiomyopathy has been reported in children. Patients should be monitored by echocardiography for hypertrophic changes—consider dose reduction or discontinuation if these occur.
160
How can nitrate tolerance be avoided?
Reduction of blood-nitrate concentrations to low levels for 4 to 12 hours each day usually maintains effectiveness in such patients. If tolerance is suspected during the use of transdermal patches they should be left off for 8–12 hours (usually overnight) in each 24 hours; in the case of modified-release tablets of isosorbide dinitrate (and conventional formulations of isosorbide mononitrate), the second of the two daily doses should be given after about 8 hours rather than after 12 hours. Conventional formulations of isosorbide mononitrate should not usually be given more than twice daily unless small doses are used; modified-release formulations of isosorbide mononitrate should only be given once daily, and used in this way do not produce tolerance.
161
Penicillin V - take with or without food?
Should be taken on an empty stomach
162
Ampicillin - take with or without food
Should be taken on an empty stomach
163
Nitrofurantoin - take with or without food?
With food
164
Metronidazole -take with or without food?
With food
165
What drugs come with warning cards?
Lithium
Warfarin and DOACS
MAOIs
Steroids
166
What advice should you provide a patient that takes lithium before surgery?
Lithium should be stopped 24 hours before major surgery. Dose can be continued as normal in minor surgery
167
Can statins be given in pregnancy?
No should be avoided as a decreased synthesis of cholesterol possibly affects fetal development. Congenital abnormalities have been reported.
168
Target total cholesterol level
<5mmol/L
169
Target LDL cholestrol level
<3mmol/L
170
Ketoconazole (Nisoral) 2% OTC age
12 years
171
Azithromycin OTC age
16 years
172
Antibacterial therapy for acute bronchitis?
Amoxicillin or a tetracycline for 5 days
173
Abx for a low severity CAP
Amoxicillin
OR clarithromycin/doxycyline
7 days
174
Abx for a moderate severity CAP
Amoxicillin + clarithromycin
OR
doxycycline alone
treat for 7 days
175
Abx for a high severity CAP
Benzylpenicillin + clarithromycin
or benzylpen and doxycycline
treat for 7-10 days
176
Abx for HAP (early onset <5 days after admission)
Co-amoxiclav or cefuroxime
| 7 days
177
Abx for HAP (late onset >5 days after admission)
piptaz or ceftazadime
178
Which cephalosporin precipitates in the gall bladder?
Calcium ceftriaxone precipitates in gall bladder—consider discontinuation if symptomatic; calcium ceftriaxone precipitates in urine (particularly in very young, dehydrated or those who are immobilised)—consider discontinuation if symptomatic
179
Paracetamol dose for a 4 year old?
240mg
180
Paracetamol dose for a 2 year old?
180mg
181
Paracetamol dose in a 6month old baby?
120mg
182
Paracetamol dose in a 4month year old?
60mg
183
Paracetamol dose in 10 year old?
480-500mg
184
Paracetamol dose in a 12 year old?
480-750mg
185
Gentamicin trough and peak targets
5-10mg/L peak and <2mg/l
BUT if for endocarditis
3-5mg/l and <1mg/l
186
A women would like advice on what vitamins she should take and she is trying to conceive What would you tell her?
Folic acid 400mcg before and up until 12 weeks of pregnancy.
Should also consider taking a vitamin D supplement of 10mcg a day throughout.
187
During a anaphylatic reaction how would expect someones pulse to be?
Weak!
188
What are bacterial throat infections caused by?
Streptococcus pyogenes
189
What virus is glandular fever caused by?
Epstein barr virus
190
How would you advise a patient to take Fybogel?
Fill a glass with approximately 240ml cold water. Pour in the required amount (see dosage below). Stir
well and drink straight away, preferably after meals.
Do not take without water. This product should be taken should not be taken immediately before going to sleep.
191
How long is additional barrier protection required after taking levonelle?
Until next period
192
How long is additional barrier protection required after taking ella one?
14 days after
