Common drug SEs etc

Question 1

How do you monitor furosemide efficacy?

Answer 1

Weight daily

Question 2

What blood to monitor furosemide?

Answer 2

U+Es (hypokal)

Question 3

If oral furosemide isn’t working what can you try?

Answer 3

IV better bioavailability

Question 4

If furosemide is given BD what timings?

Answer 4

morn and lunch (at night- nocturia)

Question 5

Do you worry about first dose hypotension in diuretics?

Answer 5

Not so much

Question 6

When in the day should you give nitrates?

Answer 6

morn and lunch- need a nitrate free period as get tolerance

Question 7

When should you give first dose of ramipril?

Answer 7

Night (first dose hypotension)

Question 8

Monitoring bloods for ACEi?

Answer 8

U&Es and LFTs (pro drug so needs good liver function)

Question 9

Does someone need to omit ACEi if D&V

Answer 9

Yes possibly- sick day rules- to call doc

Question 10

Timings of parkinsons meds?

Answer 10

Same time each day

Question 11

What if parkinson medicated pt is NBM?

Answer 11

Convert to rotigotine patch (use website)

Question 12

When should you take statins? why

Answer 12

Night as that is when the enzyme works

Question 13

Which statin does timing not matter in?

Answer 13

Atorvostatin

Question 14

Any action need to be taken if someone on statin is given amlodipine?

Answer 14

Reduce dose of statin

Question 15

What drink should statin patients avoid?

Answer 15

Grapefruit juice

Question 16

Counselling re SEs for statin?

Answer 16

Rhabdomyolysis

Question 17

Common metformin SE?

Answer 17

GI

Question 18

Why is metformin MR?

Answer 18

So plasma drug level stable for SEs

Question 19

What if metformin patient has decline in eGFR?

Answer 19

Stop the metformin and monitor BMs

Question 20

Digoxin + hypokalaemia =?

Answer 20

risk toxicity

Question 21

If converting digoxin or phenytoin from tablet to liquid form what needs to be done

Answer 21

reduce dose

Question 22

Vancomycin loading dose is based on?

Answer 22

weight

Question 23

Vancomycin maintenance dose is based on?

Answer 23

Creatinine clearance

Question 24

Methotrexate patients should avoid which drugs? why?

Answer 24

NSAIDs and penicillins as they reduce clearance of MTX

Question 25

How is MTX given?

Answer 25

Weekly with folic acid on the other days

Question 26

When do you give a reduced dose of paracet?

Answer 26

Pt <45kg (max dose is 15mg/kg)

Question 27

How do you give paracet in liver impairment?

Answer 27

max 3g/day

Question 28

What does the number mean in an insulin name e.g. humalog mix 25

Answer 28

The amount of short acting in it

Question 29

Do they still need long acting insulin if on a sliding scale?

Answer 29

Yes but at 80% dose

Question 30

What insulin will the sliding scale be?

Answer 30

Actrapid

Question 31

What is the route of insulins? Except?

Answer 31

All SC except fast acting in a sliding scale (Actrapid/novorapid) which are IVI

Question 32

Are oral antibiotics ever used in neut sepsis?

Answer 32

No not enough- IV probably tazocin and gent

Question 33

Which antiemetic is fine to use in parkinsons as it doesn't cross the BBB?

Answer 33

Domperidone

Question 34

What must always be tried before giving IV GTN in ACS?

Answer 34

Sublingual

Question 35

Name three LMW heparins

Answer 35

Enoxaparin, tinzaparin, dalteparin

Question 36

Can ACEi be used in pregnancy?

Answer 36

No - labetalol instead

Question 37

Do sulfonylureas carry a risk of hypoglycaemia?

Answer 37

Yes

Question 38

What do you need to test before starting a statin?

Answer 38

ALT

Question 39

What drug is given in acute dystonic reaction to antipsychotics? When is it NOT given?

Answer 39

procyclidine Tardive dyskinesia

Question 40

Which antihypertensives are contraindicated in PVD?

Answer 40

β blockers can cause peripheral vasoconstriction and worsen ischaemia in PVD ACEi cautioned in severe

Question 41

What can't you use verapamil with?

Answer 41

beta blockers (bradycardia)

Question 42

Can you give CCBs in heart failure?

Answer 42

Should avoid except amlodipine

Question 43

What drug can increase risk of rhabdo on a statin?

Answer 43

Gemfibrozil

Question 44

What route might be avoided in anticoagulated pt?

Answer 44

IM

Question 45

What do you do if statin causes Cr to be 5x normal range?

Answer 45

Stop it and if symptoms resolve re-start and lower dose