Specific drugs

Question 1

SSRIs.

Answer 1

Fluoxetine.
Sertraline.
Citalopram.

Question 2

TCAs.

Answer 2

Amitriptyline.

Amoxapine.

Question 3

First line medication in depression.

Answer 3

SSRI – sertraline.

Question 4

First line medication in anxiety disorders.

Answer 4

SSRI – sertraline.

Question 5

First generation anti-psychotics.

Answer 5

Haloperidol.

Chlorpromazine.

Question 6

Second generation anti-psychotics.

Answer 6

Aripiprazole.
Olanzapine.
Risperidone.
Clozapine.

Question 7

Important side effect of risperidone.

Answer 7

Reduced libido.

Question 8

Useful feature of aripiprazole.

Answer 8

Good choice in patients who are concerned about weight gain.

Question 9

Clozapine monitoring.

Answer 9

Weekly FBC for 18 weeks, then fortnightly till one year, then monthly.
Affected by smoking.

Question 10

Antipsychotic side effects.

Answer 10

Sedation.
EPSE.
Hyperprolactinaemia.
Reduced seizure threshold.
Metabolic syndrome.
Anti-cholinergic SE.
Postural hypotension.

Question 11

Acute bipolar medications.

Answer 11

Benzodiazepines – diazepam.

Antipsychotics – quetiapine.

Question 12

Long-term bipolar medications.

Answer 12

Mood stabilisers:
Carbamazepine.
Lithium.
Valproate.
Lamotrigine.

Question 13

Hypnotics.

Answer 13

Benzodiazepines – diazepam.

Z drugs – zopiclone.

Question 14

Anxiolytics.

Answer 14

Benzodiazepines – diazepam, lorazepam.

Other – buspirone, pregabalins.

Question 15

Uses of Azathioprine.

Answer 15

Crohn’s – severe acute and maintenance of remission.
UC – maintenance of remission.
RA – unresponsive to other DMARDs.
Suppression of transplant rejection.

Question 16

Metabolised product of Azathioprine.

Answer 16

Mercaptopurine.

Question 17

Monitoring of Azathioprine.

Answer 17

Pre: TPMT enzyme levels.
During: weekly FBC (8 weeks) then 3 monthly.
Toxicity.

Question 18

What should be given with Methotrexate to reduce the risk of toxicity?

Answer 18

Folic acid.

Given weekly on a different day to methotrexate.

Question 19

Important risk of corticosteroid treatment (in relation to immune suppression).

Answer 19

May suppress an immune response to infection so that it presents late at an advanced stage.

Question 20

Where is information on immunosuppressants found in the BNF?

Answer 20

Treatment summary: immune response.

Question 21

Conditions methotrexate is used in.

Answer 21

Severe crohn’s – maintenance and remission.

Rheumatoid arthritis.

Question 22

Methotrexate and contraception.

Answer 22

Effective contraception needed in men and women during treatment and for 3 months after finishing.

Question 23

Pretreatment tests for methotrexate.

Answer 23

Pregnancy.

Liver and renal function.

Question 24

Monitoring in methotrexate.

Answer 24

FBC, renal and liver function weekly until therapy stabilised, then every 2-3 months.
Report any signs of infection, particularly sore throat, immediately.

Question 25

Uses of PPIs.

Answer 25

Gastric and duodenal ulcers.
Prevention and treatment of NSAID related ulcers.
Dyspepsia or GORD.
Reduced risk of bleeding following surgery for severe peptic ulcer bleed.

Question 26

PPIs.

Answer 26

Omeprazole.

Lansoprazole.