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PPE OSCE > Therapeutic Drugs > Flashcards

Therapeutic Drugs Flashcards

1
Q

How would you treat alcoholic liver disease?

A

Stop drinking alcohol
Low salt diet - may reduce oedema
Corticosteroids - hepatitis - reduce inflammation
Liver transplant
Disulfiram - creates unpleasant effects when alcohol is consumed so discourages drinking

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2
Q

How would you treat anaemia?

A

Iron deficiency anaemia = iron supplements and diet modification
Folic acid supplements
Vitamin B12 supplements
Blood transfusion
Kidney failure = erythropoeitin injections

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3
Q

How would you treat asthma?

A

Reliever inhaler - beta2 agonist - relax muscles to relax narrowed airways - salbutamol/terbutaline
Preventer inhaler - steroid - reduce inflammation and sensitivity in the airways - beclometasone/fluticasone
Long acting beta2 agonist - decreases need to take reliever - formoterol/salmeterol
Leukotriene receptor antagonist - block reaction causing inflammation
Methylxanthines - relax muscles around airways and are weak antiinflammatory agents - theophylline
Oral steroids - used in flare
Omalizumab - binds to protein involved in immune response and reduces blood levels

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4
Q

What are the side effects of beta2 agonist medications?

A

Tremor - headache - muscle cramps

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5
Q

How would you treat atrial fibrillation?

A

Restore normal rhythm - flecainide, beta blockers (sotolol), amiodarone
Restore heart rate - beta blockers (atenolol or bisoprolol) and calcium channel blockers (verapamil)

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6
Q

What are the side effects of flecainide?

A

Nausea, vomiting and heart rhythm disorders

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7
Q

What are the side effects of beta blockers?

A

Tiredness, coldness of hands and feet, low blood pressure, nightmares and impotence

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8
Q

What are the side effects of amiodarone?

A

Sensitivity to sunlight, lung problems, changes to liver function or thyroid function and deposits in the eye

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9
Q

What are the side effects of verapamil?

A

Constipation, low blood pressure, ankle swelling and heart failure

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10
Q

How would you treat ischaemic stroke?

A

Thrombolysis - alteplase - must be under 4 and a half hours
Antiplatelets - aspirin, clopidogrel
Anticoagulants - warferin - given in AF, Hx of clotting and DVT risk
Antihypertensives - beta blockers, ACEI, diuretics, calcium channel blockers, alpha blockers
Statin

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11
Q

How would you treat a haemorrhagic stroke?

A

Antihypertensives - beta blockers, ACEI, diuretics, calcium channel blockers, alpha blockers
Craniotomy

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12
Q

How would you treat COPD?

A

Smoking cessation
Beta2 agonist inhaler - relax airways - salbutamol, terbutaline
Muscarinic antagonist inhaler - ipratropium
Long acting relaxers - tiotropium, formetorol, salmeterol
Corticosteroid inhaler
Theophylline tablets - muscle relaxant in airways
Mucolytics - carbocisteine
Antibiotics - chest infection

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13
Q

How would you treat Type I Diabetes?

A

One, two, or three insulin injections per day regime — short or rapid-acting insulin analogue mixed with intermediate-acting insulin
Multiple daily injection regimen - short or rapid-acting insulin analogue before meals plus one daily injection of intermediate or long-acting insulin analogue (basal)
Continuous subcutaneous insulin infusion - programmable pump and insulin storage reservoir

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14
Q

How would you treat Type II Diabetes?

A

Lifestyle changes
Metformin - reduces glucose released by liver and increases insulin sensitivity
Sulphonylureas - increase insulin release from beta cells by binding ATP sensitive K channel
Glitazones - makes cells more sensitive to insulin - used in combination
Gliptins -prevent breakdown of GLP-1 which helps the body produce insulin
GLP1 agonists - boosts insulin production when there are high blood glucose levels - weight loss
Acarbose - slows down the rate at which your digestive system breaks carbohydrates down into glucose

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15
Q

What are the side effects of metformin?

A

Nausea - diarrhoea - kidney damage

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16
Q

What are the side effects of sulphonylureas?

A

Hypoglycaemia - nausea - diarrhoea - weight gain

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17
Q

What are the side effects of glitazones?

A

Weight gain - oedema

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18
Q

What are the side effects of acarbose?

A

Bloating - diarrhoea

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19
Q

How would you treat epilepsy?

A

Carbamazepine - VGSC blocker - tonic clonic and partial
Valproate Sodium - GABA inhibition - partial, tonic clonic and absence
Phenytoin - VGSC blocker - tonic clonic and partial
Lamotrigine - VGSC blocker - partial, tonic clonic and absence
Benzodiazepines - GABA Cl- inhibition - absence

20
Q

What are the side effects of benzodiazepines?

A

Sedation - Tolerance with chronic use - Confusion - Impaired co-ordination - Agression - Dependence/Withdrawal with chronic use - Abrupt withdrawal seizure trigger - Resp/CNS Depression

21
Q

What are the side effects of valproate?

A

CNS sedation ataxia tremor - weight gain - Increased transaminases

22
Q

What are the side effects of lamotrigine?

A

Less marked CNS Dizziness - Ataxia - Somnolence - Nausea - Skin rashes

23
Q

What are the side effects of phenytoin?

A

Dizziness - Ataxia - Headache - Nystagmus - Nervousness - Gingival Hyperplasia - Hypersensitivity

24
Q

What are the side effects of carbamazepine?

A

Dizziness - Drowsy - Ataxia - Motor disturbance - Numbness - Tingling - Vomiting - Variation in BP - Rashes - Hyponatraemia - Bone marrow depression - Neutropenia

25
Q

How would you treat gallstones?

A 
None 
Painkillers
Antibiotics
Ursodeoxycholic acid - may be given prophylactically for those at risk especially after weight loss 
Surgery
26
Q

How would you treat heart failure?

A

ACE inhibitors - cardioprotective and slow progression
Beta blockers - cardioprotective
Diuretics - ease fluid retention by increasing excretion of water
Mineralocorticoid/aldosterone receptor antagonists - spironolactone/eplenerone - increase excretion of water

27
Q

What are the side effects of spironolactone and eplenerone?

A

Breast tenderness and enlargement in men

28
Q

How would you treat hypertension?

A

ACE inhibitors - blood vessels relax and widen - ramipril/lisinopril
Angiotensin receptor blockers - blood vessels relax and widen - lorsartan
Calcium channel blockers - relaxes blood vessels - nifedipine/verapamil
Diuretics - increase excretion of water and salt
Beta blockers - slow heart rate and reduce FOC

29
Q

What are the side effects of ACE inhibitors?

A

Dry cough - Hyperkalaemia - Renal Failure - Hypotension

30
Q

What are the side effects of calcium channel blockers?

A

Dizziness - facial flushing - oedema - constipation

31
Q

What are the side effects of Diuretics?

A

Gout - impotence

32
Q

What are the side effects of beta blockers?

A

Cold peripheries - poor sleep - tiredness - impotence

33
Q

How would you treat Crohn’s disease?

A

Corticosteroids - antiinflammatory
Azathioprine and mercaptopurine - modify and suppress immune system
Infliximab - reduce TNF alpha so reduce inflammation
Aminosalicylates - interfere with inflammatory process
Antibiotics
Surgery

34
Q

What are the side effects of corticosteroids?

A

Osteoporosis - HT - diabetes - weight gain - cataracts and glaucoma - skin thinning - bruising - muscle weakness

35
Q

What are the side effects of theophylline?

A

Nausea - vomiting - tremor - palpitations

36
Q

What are the side effects of leukotriene receptor antagonists?

A

Abdo pain - headache

37
Q

How would you treat ulcerative colitis?

A

Corticosteroids - antiinflammatory
Azathioprine and mercaptopurine - modify and suppress immune system
Aminosalicylates - interfere with inflammatory process

38
Q

How would you treat an MI?

A

Aspirin - reduces stickiness of platelets
Heparin - prevents blood clots from forming
Painkillers
Streptokinase - clot buster (

39
Q

How would you treat angina?

A

GTN spray - relaxes blood vessels so reduces workload of heart
Statin - lower risk of atheroma formation
Aspirin - reduces stickiness of platelets
Beta blocker - reduce heart rate and FOC
ACE inhibitor - prevent build up fluid and cardioprotective
Calcium channel blockers - relax coronary arteries
Nitrates/K+ channel activators - same as GTN

40
Q

How would you treat peptic ulcer disease?

A

H2 antagonists - reduced production of acid - ranitidine
PPI - reduced acid secretion - omeprazole
Antibiotic - kill H pylori - amoxicillin and clarithromycin

41
Q

How would you treat DVT?

A

Anticoagulant - heparin/warferin - stop clot formation
Compression stockings
Streptokinase - break down clot

42
Q

How would you treat PE?

A

Anticoagulant - heparin/warferin - stop clot formation

Streptokinase - break down clot

43
Q

What are the side effects of warferin?

A

Bleeding - nausea and vomiting - fever - anorexia

44
Q

How would you treat hypothyroidism?

A

Levothyroxine - replaces deficient thyroxine

45
Q

How would you treat hyperthyroidism?

A

Carbimazole - reduces further production of thyroxine
Radioiodine - taken up by thyroid and detroys galnd from inside
Thyroid replacement therapy
Surgery then levothyroxine

PPE OSCE (2 decks)

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