Random4 Flashcards

1
Q

Side effects of calcium channel blockers (4)

A
  • Headache
  • Flushing
  • Ankle oedema
  • Constipation
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2
Q

Side effects of beta-blockers (4)

A
  • Bronchospasm (especially in asthmatics)
  • Fatigue
  • Cold peripheries
  • Sleep disturbances
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3
Q

Side effects of nitrates (3)

A
  • Headache
  • Postural hypotension
  • Tachycardia
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4
Q

Side effects of Nicorandil (3)

A
  • Headache
  • Flushing
  • Anal ulceration

Nicorandil - potassium channel activator -> known by its vasodilator properties

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5
Q

Site of action of Furosemide

A

Furosemide - inhibits the Na-K-Cl cotransporter in the thick ascending limb of the loop of Henle

  • hypotension
  • hyponatraemia
  • hypokalaemia, hypomagnesaemia
  • hypochloraemic alkalosis
  • ototoxicity
  • hypocalcaemia
  • renal impairment (from dehydration + direct toxic effect)
  • hyperglycaemia (less common than with thiazides)
  • gout
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6
Q

Cyclizine

  • class
  • use
  • caution
  • pregnancy use
A

Class: H1 receptor antagonist -> blocks histamine receptors in CTZ

Use: nausea, vomiting

Caution: may cause a drop in cardiac output and increase in HR - to be careful in HF

Safe to use in pregnancy

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7
Q

What is steroid psychosis?

A
  • A rare side effect related to steroid therapy
  • Steroid psychosis is unrelated to previous mental health history and can affect any age. Women are slightly more likely to be affected than men

*managed with lithium or typical anti-psychotics

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8
Q

Drug management of hepatic encephalopathy

A
  • treat any underlying precipitating cause
    • lactulose first-line, with the addition of rifaximin for the secondary prophylaxis of hepatic encephalopathy

*lactulose is thought to work by promoting the excretion of ammonia and increasing the metabolism of ammonia by gut bacteria

*antibiotics such as rifaximin are thought to modulate the gut flora resulting in decreased ammonia production

  • other options include embolisation of portosystemic shunts and liver transplantation in selected patients
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9
Q

(3) antibiotics that can be used in treatment of MRSA

A
  • vancomycin
  • teicoplanin
  • linezolid
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10
Q

Can Verapamil be given with B blockers?

A

NO as it is rate limiting - extreme brady

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11
Q

Can Diltiazem be given with B blocker?

A

Although Diltiazem is a rate-limiting CCB, it sometimes can be given with CCB (with caution!)

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12
Q

Carbimazole

Use

MoA

Side effects

A

Carbimazole

  • used in the management of thyrotoxicosis
  • given in high doses for 6 weeks until the patient becomes euthyroid before being reduced

Mechanism of action

  • blocks thyroid peroxidase from coupling and iodinating the tyrosine residues on thyroglobulin → reducing thyroid hormone production

Side effects: agranulocytosis, crosses the placenta (but may be used during pregnancy in low doses)

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13
Q

Folic acid as a supplementary treatment to methotrexate

  • dose
  • when to take
A

Dose: 5 mg folic acid a week (once a week)

When to take: at least 24 hours (or more) after last dose of methotrexate

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14
Q

How long do the men and women need to wait before they are advised to conceive after stopping methotrexate?

A

At least 6 months after treatment

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15
Q

What (3) medications we should avoid prescribing in a patient on methotrexate?

A
  • avoid prescribing trimethoprim or co-trimoxazole concurrently - increases risk of marrow aplasia
  • high-dose aspirin increases the risk of methotrexate toxicity secondary to reduced excretion
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16
Q

Contraindications to tetracyclines (2)

A
  • pregnancy
  • children under 12 y old
17
Q

At what levels of a) Hb and b) platelets the transfusion will be indicated?

A
18
Q
A
19
Q
  • St John’s Wort*
  • -* use
  • MoA
A
  • shown to be as effective as tricyclic antidepressants in the treatment of mild-moderate depression
  • mechanism: thought to be similar to SSRIs (although noradrenaline uptake inhibition has also been demonstrated)
20
Q

Is use of St John’s Wort advised?

A
  • NICE advise ‘may be of benefit in mild or moderate depression, but its use should not be prescribed or advised because of uncertainty about appropriate doses, variation in the nature of preparations, and potential serious interactions with other drugs’
21
Q

Adverse effects of St John’s Wort use

A
  • can cause serotonin syndrome
  • inducer of P450 system, therefore decreased levels of drugs such as warfarin, ciclosporin. The effectiveness of the combined oral contraceptive pill may also be reduced
22
Q

Common SE of Amoxicillin (1)

A

Rash with infectious mononucleosis

23
Q

Common SE of co-amoxiclav (1)

A

cholestasis

24
Q

Common SE of Flucloxacillin

A

Cholestasis (usually develops several weeks after use)

25
Q

Common SEs (2) of Erythromycin

A
  • Gastrointestinal upset
  • Prolongs QT interval
26
Q

Common SEs (2) of Ciprofloxacin

A
  • Lowers seizure threshold
  • Tendonitis
27
Q

Common SE (1) of Metronidazole

A

Reaction following alcohol ingestion

28
Q

Common SE (1) of Doxycycline

A

Photosensitivity

29
Q

Common SE of Trimethoprim

A
  • Rashes, including photosensitivity
  • Pruritus
  • Suppression of haematopoiesis