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A - Pre Reg COPY > BNF Preliminary Chapters > Flashcards

BNF Preliminary Chapters Flashcards

1
Q

How does Hepatic impairment affect the human body?

A 
Impaired metabolism (reduced metabolism) 
Hypoproteinaemia (low albumin) 
High INR, prothrombin 
Malabsorption of fat soluble vitamins 
Reduced bile excretion
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2
Q

What drugs are affected by hypoproteinaemia ?

A

NSAIDS
Warfarin
Phenytoin
Prednisolone

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3
Q

Which drugs can cause hepatic encephalopathy in severe liver disease?

A

Constipation: codeine, TCAs
Sedatives : antihistamines, Benzos, opioid
Hypokaelimic: diuretics

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4
Q

Which drugs are capable of causing oedema and ascites?

A

CCB
NSAIDs
Steroids

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5
Q

What are the signs and symptoms of hepatotoxicity?

A 
Weight loss
Abdominal pain
N and V
Dark urine 
Jaundice 
Itching 
Pale stools
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6
Q

Which drugs are enzyme inhibitors ?

A

Sodium Valproate
Isoniazid
Cimetidine
Ketoconazole

Fluconazole
Alcohol
Chloramphenicol 
Erythromycin 
Sulphonamide

Ciprofloxacin
Omeprazole
Metronidazole
Grapefruit

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7
Q

Which drugs are enzyme inducers?

A

Carbamazepine
St. John’s worst

Barbituates
Rifampicin
Alcohol
Phenytoin

Griseofulvin
Phenobarbitals
Sulfonylurea

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8
Q

Which drugs interact with grapefruit juice?

A

CNS: Quetiapine, setraline

CVS: Amiodarone , CCB

Immunosuppressants: tacrolimus, ciclosporin

Other: PDE5 inhibitors , colchicine

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9
Q

What liver results would you expect in hepatic impairment m?

A 
High ALT
High AST 
High ALP
High GGT
High bilirubin (jaundice) 
Low albumin 
High Prothrombin INR (low clotting factors)
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10
Q

What are the effects of renal impairment?

A

Reduced excretion (barrow therapeutics)

Reduced renal clearance

More sensitive to nephrotoxicity

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11
Q

What are the signs and symptoms of acute kidney injury?

A 
Dehydration 
Reduced urine 
High BP
Oedema 
Confusion 
Fatigue
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12
Q

What are the sick day rules and what is the reasoning behind them?

A

Dehydration is a major risk factor for AKI?

When N and V stop these:

Diuretics
ACE / ARB
Metformin
NSAIDs

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13
Q

When can DAMN drugs be restarted after sick day rulesv

A

24/48 hrs after normal eating

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14
Q

Which drug change urine colour to:

RED
BLUE
ORANGE 
YELLOW 
BROWN 
PINK/ORANGE
A

RED: co-danthramer, levodopa, doxorubicin, idebenone

BLUE: Triamterene

ORANGE: Rifampicin , sulfalazine l

YELLO: nitrofurantoin, senna

BROWN : prostaglandin analogues

Pink: phenidions

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15
Q

What strength morphine solution is CD5?

A

Below 13mg/5ml

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16
Q

When does breakthrough pain become an issue and pain management have to be reviewed?

A

If taking medicine for breakthrough pain twice daily or more

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17
Q

Between morphine and diamorphine, which is prefered parenterally due to increased solubility?

A

Diamorphine

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18
Q

What’s the dose conversion from oral morphine to parenteral morphine and diamorphine?

A

Morphine : 1/2

Diamorphine: 1/3

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19
Q

What’s the dose reduction when switching morphine to transdermal DUE TO HYPERALGESIA

A

25-50%

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20
Q

How is opioid induced constipation treated?

A

Senna + lactulose

Codanthramer

Methylnaltrexone

21
Q

How is anorexia treated in palliative care?

A

Prednisolone

Dexamethasone

22
Q

How are respiratory secretions treated in palliative care?

A

Hyoscine, glycopyrronium

23
Q

How is bowel colic treated in palliative care?

A

Loperamide

24
Q

How is capillary bleeding treated ?

A

Tranexamic acid

25
Q

How are convulsions treated in palliative care?

A

Phenytoin
Carbamazepine
Sc midazolam

26
Q

How is Dysphagia due to tumour treated in palliative care?

A

Dexamethasone

27
Q

How is dyspnea treated in palliative care ?

A

Oral morphine
Diazepam
Bronchospasms (corticosteroid)

28
Q

How are fungating tumours treated in palliative care?

A

Metronidazole

29
Q

How is gastric distension treated in palliative care?

A

Anti flatulents + antiacid + pro kinetic

30
Q

How are hiccups due to gastric distension treated?

A

Anti acid and anyiflatulent

31
Q

How is insomnia treated in palliative care?

A

Benzodiazepines

32
Q

How are muscle spasms treated in palliative care?

A

Baclofen Diazepam

33
Q

How is nausea and vomiting treated in palliative care?

A

Haloperidol
Levopromazine
Cyclizine
Metoclopramide

34
Q

How is pruiritis treated in palliative care?

A

Emollients

Obstructive Cholestid jaundice (colestyramine)

35
Q

How is raised intracranial pressure treated in palliative care?

A

Dexamethasone

36
Q

How is restlessness and confusion treated in palliative care

A

Levopromazine

Haloperidol

37
Q

Name 5 drugs that can cause mouth ulcers?

A 
Nicorandil 
NSAIDs
Pancreatin 
Cytotoxics 
Ace inhibitors
38
Q

Which drug can cause oral candidiasis ?

A

Corticosteroids (inhaled)

39
Q

Which drugs can cause teeth staining?

A

Chlorhexadine mouth wash

Tetracyclines

40
Q

Which drugs can cause osteonecrosis of the jaw?

A

Bisphosphonates

41
Q

Which drugs cause xerostomia?

A

Antimuscarinics
Opioids
Antidepressants
Antihistames

42
Q

Which drugs cause taste disturbance?

A 
Ace inhibitors 
Amiodarone 
Carbimazole 
Zopiclone 
Metformin
43
Q

Which drugs cause Mylosuppression?

A

DMDARDs: methotrexate, gold

Antiepileptic: carbamazepine

Antibiotics: chloramphenicol, linezolid, cotrimoxazole

Immunosuppressants: azathioprine

Anticipates: phenytoin , trimethoprim

Others : ASAs Carbimazole clozapine,

44
Q

What are the symptoms of Leucopenia, agranulocytosis and neutropenia ?

A

Malaise, sore throat, fever , cough, ulcers

45
Q

What are the symptoms of anaemia?

A

Fatigue, dizziness, fainting

46
Q

What are the symptoms of thrombocytopenia?

A

Bruising, bleeding

47
Q

Which drugs cause photosensitiveness?

A 
Voriconazole 
Doxycycline 
Demeclocycline 
Chloroquine 
Amiodarone
48
Q

Which drugs cause contact sensitisation?

A

Methotrexate

Chlorpromazine

49
Q

What are the rules on Biosimilars?

A

Clinically equivalent to originals

Licensed for same indications as original

Must be prescribed by brand

Black triangle

A - Pre Reg COPY (37 decks)

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