Chapter 9: random stuff

Question 1

what drugs pose a definite risk of haemolysis in most G6PD deficient patients?

Answer 1

• quinolones
• nitrofurantoin
• sulphonamides

Question 2

what drugs pose a possible risk of haemolysis in most G6PD deficient patients?

Answer 2

quinine
SU
aspirin dose of over 1g

Question 3

what is the MHRA/CHM advice with epoetins?

Answer 3

-risk of steven johnson’s syndrome and toxic epidermal necrolysis.
STOP IF RASH DEVELOPS.

• overcorrection of hb conc in CKD patients may increase their risk of death and CVD events.
• HB concs should be 10-12g/100ml

Question 4

prophylaxis with iron preparation can be used in…?

Answer 4

menorrhagia 
malabsorption 
pre-term neonates 
haemodialysis
pregnancy (iron + folic acid combo)

Question 5

what is the CHM/MHRA advice on IV iron?

Answer 5

serious hypersensitivity reaction

Question 6

can IV iron be given during pregnancy?

Answer 6

AVOID in the 1st trimester

risk and benefits ratio if given in the 2nd and 3rd trimester.

Question 7

what is the monitoring requirements of iron?

Answer 7

Hb concs should rise by 1-2g/L per day OR
20g/L over 3-4 weeks.

when Hb returns to normal, continue for a further 3 months to replenish iron stores.

Question 8

what are the 2 forms of megalobastic anaemia?

what are the causes?

Answer 8

1. pernicious (LOW VIT B12)- lack of gastric instrinsic factors resulting from autoimmune gastritis.
2. folate deficiency- caused by poor diet, pregnancy and antiepiletics.

Question 9

what is given in severe acute hypocalcamia?

Answer 9

inital slow IV injection of Ca gluconate 10%.

ECG and Ca conc monitoring- risk of arrhythmia when given too fast.

-Ca and vit D

Question 10

what is given in hypercalcamia?

Answer 10

phosphates
cinacalcet
calcintonin