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MCQ > List of 15 Drugs for MCQ > Flashcards

List of 15 Drugs for MCQ Flashcards

1
Q

What is Ceftazidime?

A
  • cephalosporin antibiotic
  • given IV
  • used for pseudomonas lung infections in CF
  • used for complicated UTIs
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2
Q

What is the initial dose and frequency for a patient with an eGFR of 40mL/min for Ceftazidime?

A

reduce if the creatinine clearance is 50mL/,om pr ;ess

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3
Q

What are the directions for giving Ceftazidime?

A

IV infusions - intermittently or via drip

  • Glucose 5% or 10%
  • NaCL 0.9%
  • dissolve 2mg in 10mL
  • single doses over 1g via IV route only
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4
Q

What two patients groups can Ceftazidime not be given to?

A
  • contraindicated in those with a cephalosporin OR cautioned in those to penicillin OR other β-lactam hypersensitivity
  • cautioned in those with renal impairment as it is really excreted
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5
Q

What are four adverse effects of Ceftazidime and how can they be monitored?

A
  • abdominal pain/diarrhoea/vomiting /pseudomembranous enterocolitis
  • thrombocytosis/thrombocytopeinia (monitor platelets)
  • anaphylactic reaction/angio-oedema (monitor reaction, avoid in those with Hx of sensitivity)
  • nephritis/acute kidney injury - RARE
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6
Q

Can Ceftazidime be used in pregnancy or when breastfeeding?

A
  • not harmful if pregnant

- present in low concentrations in breastmilk, but appropriate for use

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7
Q

What is Gentamicin?

A
  • IV antibiotic
  • aminoglycoside
  • can be used for meningitis, endocarditis, pneumonia, sepsis
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8
Q

What is the initial dose and frequency for a patient with an eGFR of 40mL/min for Gentamicin?

A

once daily, high dose regimen of ahminoglycosides should be AVOIDED in those with CrCL less than 20mL/min

those with renal impairment - serum concentrations HAVE to be monitored

those with renal impairment - the interval between doses might need to be increased and/or a reduction in dose

NEPHROTOXICITY common with this drug

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9
Q

What are the directions for giving Gentamicin?

A

IV infusion - intermittently of via drip

  • Glucose 5%
  • NaCl 0.9%
  • 50-100mL given over 20-30 minutes
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10
Q

What two patients groups can Gentamicin not be given to?

A

contraindicated:
- myasthenia gravis
- those with ear problems

cautioned:
- auditory disorders
- muscular weakness
- renally impaired

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11
Q

What are four adverse effects of Gentamicin and how can they be monitored?

A

MAIN for Aminoglycosides

  • OTOTOXICITY
  • NEPHROTOXICITY
  • skin reactions
  • tinnitus (ears!) OTOTOXICITY
  • nausea/vomiting
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12
Q

Can Gentamicin be used in pregnancy or when breastfeeding?

A

2nd/3rd Trimester

  • risk of auditory/vestibular nerve damage
  • avoided unless essential
  • IF given, serum conc monitoring essential
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13
Q

What is Sodium Valproate?

A
  • used in epilepsy (anti-epileptic)
  • teratogenic
  • C/I for women of childbearing age unless on the PPP
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14
Q

What is the initial dose and frequency for a patient with an eGFR of 40mL/min for Sodium Valproate?

A
  • reduce dose
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15
Q

What are the directions for giving Sodium Valproate?

A

IV injection - give over 3-5 mins

IV infusion

  • Glucose 5%
  • NaCl 0.9%
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16
Q

What two patients groups can Sodium Valproate not be given to?

A

C/I

  • acute porphyrias (liver)
  • hepatic dysfunction
  • urea cycle disorders (hyperammonaemia)
  • pregnant women

Caution
- Liver Toxicity (monitor liver enzymes, LFTs)

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17
Q

What are four adverse effects of Sodium Valproate and how can they be monitored?

A

pancreatitis - abdominal pain, nausea & vomiting

blood dyscrasias/disorders

  • bruising, bleeding
  • thrombocytopeinia,

liver function/disorders

  • hepatic disorders
  • encephalopathy
  • jaundice
  • malaise
  • drowsiness
  • anorexia
  • oedema
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18
Q

Can Sodium Valproate be used in pregnancy or when breastfeeding?

A

NOPE
- not used for epilepsy unless there’s NO OTHER suitable treatment

breastfeeding
- risk of haematological disorders in breast-fed newborns and infants

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19
Q

What is Hydrocortisone?

A
  • a steroid with glucocorticoid and mineralocorticoid activity
  • given orally for asthma, eczema, inflammation
  • given IV for hypersensitivity reactions, adrenocortical insufficiency, severe IBD
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20
Q

What is the initial dose and frequency for a patient with an eGFR of 40mL/min for Hydrocortisone?

A

undertaken with caution

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21
Q

What are the directions for giving Hydrocortisone?

A

for IV use:

  • Glucose 5%
  • NaCl 0.9%
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22
Q

What two patients groups can Hydrocortisone not be given to?

A

C/I

  • live virus vaccines for those receiving immunosuppressive doses of hydrocortisone
  • systemic infection
  • AVOID THOSE WITH CHICKENPOX/MEASLES, severe risk

Cautions - extensive, match the side effects

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23
Q

What are four adverse effects of Hydrocortisone and how can they be monitored?

A

electrolyte imbalance

  • POTASSIUM
  • fluid retention

osteoporosis/fractures

dyslipidaemia/diabetes

adrenal suppression

  • eye exams, cataracts
  • fatigue

psychiatric reactions (systemic, high dose)

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24
Q

Can Hydrocortisone be used in pregnancy or when breastfeeding?

A

benefit of treatment outweighs the risk in pregnancy & when breast feeding

longer-term treatment more problematic than shorter term

fluid retention should be monitored closely

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25
Q

What is Amiodarone?

A

Class III Anti-dysrhythmic Drug

- used for both supra ventricular and ventricular arrhythmias

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26
Q

What are the directions for giving Amiodarone?

A

IV

  • Glucose 5%
  • 250mL over 20-120 mins
  • not diluted to less than 600mcg/mL
  • NOT NaCL
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27
Q

What two patients groups can Amiodarone not be given to?

A

C/Is

  • severe conduction disturbances
  • heart-block
  • sinus bradycardia
  • injection for cardiomyopathy
  • bolus in congestive heart failure
  • avoid in severe resp. failure

Cautions

  • heart failure
  • hypokalaemia - check potassium
  • bradycardia
  • acute porphyrias
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28
Q

What are four adverse effects of Amiodarone and how can they be monitored?

A
  • arrhythmias
  • hepatic disorders (test transaminases)
  • hyper/hypo-thyroidism (check thyroid)
  • respiratory disorders (pulmonary toxicity)
  • skin reaction (phytotoxicity), avoid sunlight unless wearing high factor sunscreen
  • corneal micro deposits, blurred vision
  • hypokalaemia
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29
Q

Can Amiodarone be used in pregnancy or when breastfeeding?

A

Pregnancy - ONLY use if no alternative, possible risk of neonatal goitre (thyroid)

Breastfeeding - AVOID, risk of neonatal hypothyroidism from release of iodine

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30
Q

What is Salbutamol?

A

B2 Agonist

used in Asthma & COPD

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31
Q

What are the directions for giving Salbutamol?

A

IV

  • Glucose 5%
  • NaCl 0.9%

Nebulisation
- NaCl 0.9%

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32
Q

What two patients groups can Salbutamol not be given to?

A

C/Is

  • pre-eclampsia
  • Hx of cardiac disease/myocardial ischaemia

Cautions

  • hypokalaemia (serious side effect of Β2 agonist therapy)
  • IV use in pre-eclampsia
  • arrhythmias
  • diabetes - risk of hyperglycaemia and ketoacidosis
  • QT-interval prolongation
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33
Q

What are four adverse effects of Salbutamol and how can they be monitored?

A
  • arrhythmia
  • palpitations
  • headache
  • tremor
  • hypokalaemia
  • nausea
  • hyperglycaemia
  • muscle cramps
34
Q

Can Salbutamol be used in pregnancy or when breastfeeding?

A

take as normal if pregnant OR breastfeeding

35
Q

What is Parecoxib?

A

selective COX-2 inhibitor
NSAID
IV used for acute post-op pain - injectable

36
Q

What is the initial dose and frequency for a patient with an eGFR of 40mL/min for Parecoxib?

A

AVOID if possible or use with caution

lowest effective dose should be used for the shortest possible duration

those with Cr CL <30mL/min or particularly susceptible to water retention - lowest possible dose 20mg

mild-moderate renal impairment, no dose reduction necessary

37
Q

What two patients groups can Parecoxib not be given to?

A

C/Is

  • active GI bleeding/ulceration
  • IBD
  • ischaemic heart disease
  • heart failure

Cautions

  • allergic disorders
  • any type of cardiac impairment/risk of
  • dehydration
  • elderly
  • history of cardiac failure
  • history of GI disorders
  • hypertension
  • oedema
38
Q

What are four adverse effects of Parecoxib and how can they be monitored?

A
  • constipation, GI discomfort, nausea (less so because IV)
  • dyspepsia & ulceration
  • hypokalaemia
  • serious skin reactions - Steven Johnson’s Syndrome
  • renal function
39
Q

Can Parecoxib be used in pregnancy or when breastfeeding?

A

AVOID in the 3rd Trimester - contraindicated
- 1st & 2nd Trimester avoid unless absolutely necessary

AVOID in those breast-feeding

40
Q

What are the directions for giving Parecoxib?

A

only injected with

  • NaCl 0.9%
  • Glucose 5%
  • NaCl 0.45% + Glucose 5%
41
Q

What is Omeprazole?

A

a PPI

  • used for prevention of GI ulcers
  • used for GORD
42
Q

What are the directions for giving Omeprazole?

A

for IV use reconstitute with 100mL of

  • Glucose 5%
  • NaCl 0.9%

intermittent infusion - 40mg over 20-30 mins
stable infusion - 6 hrs in Glucose 5% or 12 hrs in NaCl 0.9%

43
Q

What two patients groups can Omeprazole not be given to?

A

Cautions

  • those at high risk of osteoporosis
  • elderly (osteoporosis)
44
Q

What are four adverse effects of Omeprazole and how can they be monitored?

A
  • can increase the risk of fractures
  • can increase the risk of a C diff infection
  • MHRA - low risk of SCLE (monitor skin for lesions)
  • can mask the symptoms of gastric cancer
  • abdominal pain, constipation, diarrhoea, nausea & vomiting
  • bone fractures
  • hypomagnesaemia - monitor magnesium
  • SCLE (skin)
45
Q

Can Omeprazole be used in pregnancy or when breastfeeding?

A

NOT known to be harmful in pregnancy

Present in milk but NOT known to be harmful when breastfeeding

46
Q

What is Infliximab?

A

IV Infusion Drug for Inflammatory related conditions

  • Crohn’s disease
  • Arthritis
  • Ulcerative Colitis
  • Plaque Psoriasis

Tumour Necrosis Factor Alpha (TNF-a) inhibitors (monoclonal antibodies)

47
Q

What two patients groups can Infliximab not be given to?

A

C/I

  • moderate or severe heart failure
  • severe infections (dampens down the immune system)

Cautions

  • patients to be up-to-date with immunisation schedule
  • check for active & latent TB before treatment
  • mild heart failure
  • development of malignancy
48
Q

What are the directions for giving Infliximab?

A
  • Give intermittently in NaCl 0.9%
  • start infusion within 3 hours of reconstitution
  • 100mg in 10mL water for injection first, then to final volume of 250mL
  • give through low protein-binding filter
49
Q

What are four adverse effects of Infliximab and how can they be monitored?

A
  • hypersensitivity reactions within 1-2 hrs after infusion
  • monitor for Hep B infections
  • monitor for signs of TB - cough, weight loss, fever
  • blood disorders - monitor for fever, sore throat, bruising or bleeding
  • increased risk of dizziness
  • monitor skin for non-melanoma skin cancer
50
Q

Can Infliximab be used in pregnancy or when breastfeeding?

A

use only if essential in pregnancy

amount present in breastmilk to small to be harmful

51
Q

What is Metformin?

A

1st line pharmacological treatment in Type 2 Diabetes

52
Q

What is the initial dose and frequency for a patient with an eGFR of 40mL/min for Metformin?

A

avoid if eGFR less than 30mL/min

dose reduction in moderate renal impairment

renal function monitoring needed

53
Q

What two patients groups can Metformin not be given to?

A

C/Is

  • acute metabolic acidosis (lactic & diabetic ketoacidosis)
  • avoid if eGFR less than 30mL/min

Cautions - risk factors for acidosis

  • chronic stable heart failure
  • drugs that can impair renal function
  • stop treatment if dehydration occurs
54
Q

What are four adverse effects of Metformin and how can they be monitored?

A
  • abdominal pain, diarrhoea, GI disorders, nausea, vomiting (can divide doses/start slow/take with meals)
  • hepatitis
  • lactic acidosis
  • vitamin B12 absorption decreased
55
Q

Can Metformin be used in pregnancy or when breastfeeding?

A

can be used in pregnancy (and used for gestational diabetes)

can be used during breast-feeding

56
Q

What is Pioglitazone?

A

used as add-in treatment for Type 2 Diabetes

57
Q

What two patients groups can Pioglitazone not be given to?

A

C/I

  • those with/history of heart failure
  • active/past history of bladder cancer (assess for risk before treatment, particularly in the elderly)
  • uninvestigated haematuria

Cautions
- increased risk factors for heart failure or bladder cancer

58
Q

What are four adverse effects of Pioglitazone and how can they be monitored?

A
  • MHRA: closely monitor for signs of heart failure
  • haematuria, dysuria, urinary urgency should be reported immediately (bladder cancer)
  • bone fractures
  • visual impairment
  • increased weight
  • hepatic impairment - monitor liver function and symptoms of liver toxicity (abdominal pain, fatigue, dark urine)
59
Q

Can Pioglitazone be used in pregnancy or when breastfeeding?

A

AVOID in pregnancy, toxic in animal studies

AVOID in breastfeeding, present in milk

60
Q

What is Zoledronic Acid?

A

an IV bisphosphonate - used for Osteoporosis and other skeletal disorders

61
Q

What are the directions for giving Zoledronic Acid?

A

osteoporosis

- IV infusion over at least 15 minutes

62
Q

What is the initial dose and frequency for a patient with an eGFR of 40mL/min for Zoledronic Acid?

A

avoid in Paget’s disease, treatment of post-menopausal osteoporosis and osteoporosis in men if eGFR less than 35mL/min

avoid in treatment of tumour-induced hypercalcaemia if serum creatinine above 400mmol/L

dose adjustments needed in malignancies of the bone - if eGFR 30-40 mL/min 3mg

63
Q

What two patients groups can Zoledronic Acid not be given to?

A

cautions

  • elderly (especially those with GI disease or bleeding)
  • atypical femoral fractures
  • cardiac disease
  • those taking other drugs that affect renal function
64
Q

What are four adverse effects of Zoledronic Acid and how can they be monitored?

A

MHRA: atypical femoral fractures

  • patients to report thigh, hip or groin pain during treatment
  • re-evaluate need after 5 years or more

MHRA: osteonecrosis of the jaw (particularly with IV) ]

  • dental check ups needed
  • maintain good oral hygiene
  • report any symptoms, pain swelling, non-healing sores

MHRA: osteonecrosis of the external auditory canal
- ear symptoms, chronic ear infections to be reported

65
Q

Can Zoledronic Acid be used in pregnancy or when breastfeeding?

A

Avoid in pregnancy, toxic in animal studies

Avoid - no information available

66
Q

What is Granisetron?

A

seretonin receptor antagonist

- used for IV chemo/post-op nausea and vomiting

67
Q

What are the directions for giving Granisetron?

A 
Intravenous Infusion, give intermittently 
- Sodium Chloride 0.9% 
- Glucose 5%
dilute up to 3mL in 20-50mL
give over 5 mins
68
Q

What two patients groups can Granisetron not be given to?

A

Cautions

  • subacute intestinal obstruction
  • susceptibility to QT prolongation (including electrolyte disturbances)
69
Q

What are four adverse effects of Granisetron and how can they be monitored?

A
  • constipation
  • headache
  • diarrhoea
  • insomnia
  • QT interval prolongation
  • extrapyramidal symptoms
70
Q

Can Granisetron be used in pregnancy or when breastfeeding?

A

Avoid in pregnancy

Avoid - no info available

71
Q

What is Ciprofloxacin?

A

Quinolone Antibiotic

72
Q

What is the initial dose and frequency for a patient with an eGFR of 40mL/min for Ciprofloxacin?

A

dose reductions needed if eGFR between 30-60mL/min

73
Q

What two patients groups can Ciprofloxacin not be given to?

A

C/Is

  • patients with history of tendon disorders
  • patients over 60 years of age are more prone to tendon damage

Cautions

  • prolongs the QT interval
  • conditions that predispose to seizures (epilepsy)
  • conditions of the heart
74
Q

What are four adverse effects of Ciprofloxacin and how can they be monitored?

A
  • CONVULSIONS may occur with IV use (and taking NSAIDs at the same time)
  • TENDON DAMAGE may occur with IV use
  • AORTIC ANEURYSM AND DISSECTION small risk with IV use
  • QT interval prolongation
75
Q

Can Ciprofloxacin be used in pregnancy or when breastfeeding?

A

Avoid in pregnancy - shown to cause arthropathy

Manufacturer advises to avoid in breastfeeding

76
Q

What is Furosemide?

A

Loop Diuretic

  • inhibits reabsorption from the ascending limb of the loop of Henle
  • used for oedema/hypertension
77
Q

What are the directions for giving Furosemide?

A

IV should not exceed 4mg/min

  • single doses of up to 80mg may be administered
  • lower rate needed in renal impairment
78
Q

What is the initial dose and frequency for a patient with an eGFR of 40mL/min for Furosemide?

A
  • high doses/rapid intravenous administration can cause tinnitus and deafness
  • high doses of loop diuretics can occasionally be needed in renal impairment
79
Q

What two patients groups can Furosemide not be given to?

A

C/Is

  • renal failure due to nephrotoxic/hepatotoxic drugs
  • severe hypokalaemia
  • severe hyponatraemia

Cautions

  • can exacerbate diabetes
  • hypotension/hypovolaemia
  • hypokalaemia - use potassium-sparing diuretics
  • urinary retention due to enlarged prostate
80
Q

What are four adverse effects of Furosemide and how can they be monitored?

A
  • dizziness
  • electrolyte imbalance
  • auditory disorder & tinnitus with rapid IV infusion
  • acute kidney injury
  • diabetes
81
Q

Can Furosemide be used in pregnancy or when breastfeeding?

A

Not to be used to treat gestational hypertension

Amount too small to be harmful. May inhibit lactation.

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