Communicating info

Question 1

ACEi caution in what and what are risks

Answer 1

caution in pregnancy: teratogenic
risk - hyperkalaemia
extra caution with D&V (especially in elderly) as it can incr risk of AKI

Question 2

Tamoxifen SERM

Answer 2

incr risk of endometrial C
incr efficacy of warfarin –> HIGH INR
SEs: hot fluses, VTE risk

Question 3

SU eg gliclazide risk

Answer 3

HYPOS
- eat regular meals
NB. Glibenclamide is a long acting SU and so can cause LONG HYPOS

Question 4

Methotrexate

Answer 4

1-2 weekly blood test (neutropaenia)

dose: take ONCE A WEEK
interaction: folate ANTAGONISTS should never be co=prescribed eg trimethoprim

Question 5

Warfarin

Answer 5

SEs: BLEEDING
Alcohol interaction (acute = inhibitor, chronic = inducer)
Colour coded (white 0.5mg, brown 1mg blue 3mg, pink 5mg
MONITOR: Once WEEKLY –> once MONTHLY INR

Question 6

Steroids what to look out for and what to co-prescribe

Answer 6

need Regular BM monitoring
need Gastroprotection
>3m treatment –> BONE PROTECTION

Question 7

SSRIs

Answer 7

initial 1-2w period of incr ANXIETY/SUICIDAL IDEATION
takes up to 6 weeks to work
SEs: photosensitivity, dry mouth, SEROTONIN SYNDROME

Question 8

Insulin therapy

Answer 8

Higher requirements when UNWELL (higher BMs)
Lower requirements when not eating as much
LIPODYSTROPHY (if not rotating injection sites)

Question 9

Ciclosporin

Answer 9

regular U+Es required

Every 2 weeks for first 3 months –> MONTHLY

Question 10

Bisphosphonates

Answer 10

dose: take with a full glass of WATER , remain UPRIGHT for 30 minutes
EG-ONCE WEEKLY ALENDRONIC ACID
Interactions: Calcium salts (ie. Vit D3) reduce BISPHOSP absorption
FOOD reduces bisphosphonate absorption (AVOID FOR 2H)
SEs: Osteonecrosis (jaw, EAC), OESOPHAGEAL rtns

Question 11

HRT

Answer 11

excess risk of breast cancer persists for more than 10 years after stopping compared with women who have never used HRT