all drugs from MCQ list Flashcards by sophie hayton

which drugs are contraindicated in auditory disorders?

gentamycin

zoledronic acid: osteonecrosis of the jaw

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what interaction would amiodarone and an -ivir drug have?

a) severe bradycardia and heart block
b) reduced eGFR
c) QT-prolongation
d) AKI
e) hypermagnesemia
f) HF
g) Blood disorders
h) visual disturbances

severe bradycardia and heart block

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which drugs can cause visual disturbances

infliximab, pioglitazone and hydrocortisone

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which drug must you screen for TB before use

infliximab

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accidental card oops

hi x

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which drug can transiently raise LFTs?

sodium valproate

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what would be the most likely ADR for ceftazidime and gentamycin?

gentamycin- nephrotoxicity

reduce eGFR: AKI risk

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which drugs can cause skin reactions

gentamycin

omeprazole

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which drugs should NOT be given in renal impairment

furosemide
metformin (LA risk) if <30 
zoledronic acid if eGFR<30
parecoxib- avoid or use lowest dose/ time/ frequency
ceftazidime
gentamycin

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what do the drugs zoledronic acid

sodium valproate have in common?

cannot be given in children of child bearing potential

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monitoring requirements of: gentamycin (IV as well)

electrolytes 
renal before and during 
auditory and vestibular function 
measure peaks and troughs if IV
concentration after 3-4 doses in children

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monitoring requirements of: sodium valproate

LFTs- transient normally but monitor for 6m
FBC to ensure no bleeding risk
blood disorders
pancreatitis

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monitoring requirements of hydrocortisone

height and weight in children

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monitoring in amiodarone (IV as well)

LFTs before and every 6 months
potassium levels before
CRX before
thyroid before and every 6 months

IV: ECG and ensure resuscitation facilities.
liver transaminases closely

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monitoring in salbutamol

potassium levels (risk of hypokalaemia) and blood glucose if they have diabetes

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monitoring requirements of parecoxib

if renal impairment then monitor function and potassium/ water retention

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which drug must you monitor magnesium with? especially when….

omeprazole

if used with other drugs causing hypermagnesemia e.g. digoxin

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what is the likely interation between digoxin and omeprazole

a) severe bradycardia and heart block
b) reduced eGFR
c) QT-prolongation
d) AKI
e) hypermagnesemia
f) HF
g) Blood disorders
h) visual disturbances

hypermagnesemia

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monitoring requirements for metformin?

renal function before and annually thereafter (twice yearly if risk factors)

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monitoring requirements for infliximab (IV also)

infection- before, during and 6m after
periodic skin exam for non-melanoma skin cancer
blood disorders: fever, sore throat, bruising and bleeding
hypersensitivity reactions
TB before and 3 monthly thereafter

IV: 1-2 hours after w resuscitation equipment

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what should be done if someone has TB and infliximab must be prescribed?

treat for 2 months at least and then screen every 3 months month

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pioglitazone monitoring

liver function: if nausea, vomiting, abdopain, fatigue or dark urine
report haematurea

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when is the risk of hypersensitivity to infliximab highest?

first 2 infusions

if not received any for >16 weeks

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which patients must pioglitazone be avoided in?

bladder cancer
uninvestigated haematuria
HF or history of HF
hepatic impairment

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symptoms of hypersensitivity reaction? commonly occurs in which drug and when

infliximab, if not been given for >16 weeks | fever, chest pain, BP changes, dyspnoea, transient visual loss, pruritus

which drugs should be avoided in hepatic impairment

``` pioglitazone zoledronic acid furosemide parecoxib- 1/2 dose! sodium valproate ```

zoledronic acid monitoring requirements

renal function | liver function

what should patients look out for on zoledronic acid therapy?

hip, groin or thigh pain: atypical femoral fracture jaw pain, discharge, non-healing sores, dental mobility - osteonecrosis of the jaw ear pain, infections: osteonecrosis of the ear

risk factors for osteonecrosis of the ear and jaw? common with which drug

zoledronic acid jaw: potency of drug (more common at IV doses for cancer), smoking, dental disease ear: steroid use, chemotherapy, infections, ear operations, cotton bud use

monitoring requirements of furosemide?

electrolytes | potassium and sodium levels- can precipitate encephalopathy if liver impairment

4 severe safety considerations in ciprofloxacin use, what should you counsel for each?

1.tendon damage- can occur within 48 hours and up to 2 months after use 2. aortic aneurism and dissection- look out for severe sudden abdo, chest or back pain heart valve regurgitation 3. severe irreversible musculoskeletal or neurological side effects 4. heart valve regurgitation: rapid onset SOB when lying down, swelling on ankles, feet, abdomen and new heart palpitations

when should ciprofloxacin be discontinued?

neuro, psychiatric, tendon or hypersensitivity reactions occur

drugs to be cautioned in HF

pioglitazone: especially when given with insulin amiodarone hydrocortisone

which drug interacts with dairy and mineral fortified drinks

ciprofloxacin

drugs never to be used in HF

parecoxib- NSAID

which drug can impair skill based tasks such as driving?

ciprofloxacin

what is an interaction between pioglitazone and insulin? a) severe bradycardia and heart block b) reduced eGFR c) QT-prolongation d) AKI e) hypermagnesemia f) HF g) Blood disorders h) visual disturbances

HF risk is increased, especially if risk factors (past MI, stroke etc)

which patients can hydrocortisone not be used in?

CHF, diabetes, epilepsy, diverticulitis, | viral, fungal or bacterial legions,acne

drugs which can cause agranulocytosis?

sodium valproate | infliximab

which drug should be used in caution in lupus

omeprazole- omeprazole can cause | sodium valproate

risk of using amiodarone in pregnancy?

neonatal goitre, only use if no alternative

which drugs need to be used in caution in those who are susceptible to QT prolongation

salbutamol granisetron(n&v drug) ciprofloxacin

which drugs should be cautioned in those at risk of cardiac events?

amiodarone- last line for arrhythmia salbutamol parecoxib

2 drugs which should be used in caution in mitochondrial disorders and why?

sodium valproate- higher rate of acute liver failure and liver related deaths gentamycin- risk of deafness

which drugs need their electrolytes monitoring

furosemide- hypokalemia (careful in CVD and those being treated with cardiac glycosides), in hepatic impairment hypokalaemia can precipitate encephalopathy amiodarone (potassium levels before) parecoxib (sodium and water retention must be monitored= renal deterioration omeprazole- hypermagnesaemia granisetron: can have electrolyte disturbnaces- caution in patients with QT prolongation

most likely cause of ADE caused by granisetron and ciprofloxacin? a) severe bradycardia and heart block b) reduced eGFR c) QT-prolongation d) AKI e) hypermagnesemia f) HF g) Blood disorders h) visual disturbances

QT interval prolongation

sTF: salbutamol can be used in arrhythmias

false, it can cause arrhythmias, however can be used with caution

infliximab and sodium valproate could increase the risk of

blood disorders

infliximab and sodium valproate interaction would most likely cause: b) reduced eGFR c) QT-prolongation d) AKI e) hypermagnesemia f) HF g) Blood disorders h) visual disturbances

blood disorders

gentamicin use in patients with mitochondrial disorders increases the risk of

deafness

which drug is C/I in myasthenia gravis? and why?

gentamycin- impairs neuromuscular transmission

which of the drugs must be avoided in pregnancy (highlight if they can be used but only if no alternative)

yes if no alternative: amiodarone (risk of neonatal goitre only use if no alternative) parecoxib- avoid unless necessary, avoid in 3rd trimester infliximab- ensure effective contraception, only use if essential ciprofloxacin: a single dose may be used for meningococcal meningitis (eye only if benefits outweigh the risks) AVOID: pioglitazone zoledronic acid Granisetron

which of the drugs can you not abruptly withdraw

sodium valproate

which drug can transiently cause infertility?

parecoxib (long term use of several NSAID do this but stops after treatment is stopped)

patients in which furosemide is contraindicated

hypokalaemia hyponatraemia hypovolaemia hepatic impairment

which drug has a high risk of bladder cancer

pioglitazone

what can high doses or rapid IV administration of furosemide cause?

tinnitus and deafness

why must furosemide be used in caution in patients with liver impairment

can cause hypokalaemia and hyponatraemia which can precipitate encephalopathy

which drug must be stopped if dehydration occurs and why?

metformin- increased risk of AKI

which type of diuretic should be used to prevent hepatic encephalopathy

potassium sparing diuretic e.g. thiazide like

which type of diuretic should be used to prevent hepatic encephalopathy

potassium sparing diuretic e.g. thiazide like

``` most likely interaction between sodium valproate infliximab a) severe bradycardia and heart block b)reduced eGFR c) QT-prolongation d) AKI e)hypermagnesemia f)HF g) Blood disorders h) visual disturbances ```

blood disorders e.g. bruising, fever, bleeding, sore throat

interaction between pioglitazone and hydrocortisone would most likely cause? a) severe bradycardia and heart block b) reduced eGFR c) QT-prolongation d) AKI e) hypermagnesemia f) HF g) Blood disorders h) visual disturbances

visual disturbances

most likely interaction between salbutamol and infliximab a) severe bradycardia and heart block b) reduced eGFR c) QT-prolongation d) AKI e) arrhythmia f) hypermagnesemia g) HF h) Blood disorders i) visual disturbances

arrhythmia

theophylline and quinolones interaction?

increased risk of seizures

half life of amiodarone? drug loading dose?

200mg TDS for 7 days 200mg BD for 7 days 200mg OD as maintenance 50 days half life, so need a loading dose

what should be reported if on carbimazole?

sore throat, fever, malice, bleeding, ulcers

side effects of amiodarone

Nausea and vomitting and taste disurbance Thyroid function- Hypo and Hyperthyroidism through action of IODINE in the drug Phototoxic skin reactions: burning sensation, erythema, slate grey skin discolouration Pulmonary toxicity- persisitent SOB/ Cough Tremor- peripheral neuropathy- numbness in hands and feet Corneal microdepositis in eyes- dazzled by headlights- common SE: this is reversible once drug stopped

all drugs from MCQ list Flashcards

(68 cards)