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PSA > Communicating information > Flashcards

Communicating information Flashcards

1
Q

Indications for allopurinol

A

As ULT to ALL Patients following FIRST ATTACK of gout

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2
Q

Adverse effects of Allopurinol

A

Severe cutaneous adverse reaction (SCAR)
Drug reaction w/ eosinophillia
SJS

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3
Q

Patients should stop allopurinol immediately if they develop:

A

RASH

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4
Q

Allopurinol interactions (3):

A

Azathioprine

(NOT LISTED IN BNF)
Cyclophosphamide - reduces renal clearance = marrow toxicity
Theophylline - inhibits breakdown leading to increase in concentration

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5
Q

Drug used first line in ischaemic heart disease

A

ASPIRIN

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6
Q

Drugs which Aspirin potentiates:

A

Oral hypoglycaemics
Warfarin
Steroids

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7
Q

CCB NEVER to be given with Beta-blocker

A

Verapamil

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8
Q

Which CCB may cause constipation

A

Verapamil

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9
Q

Verapamil effect on cardiac function

A

Negatively inotropic

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10
Q

CCB which can cause flushing

A

Dihydropyridines

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11
Q

Where do dihydropyridines (amlodipine, Nifedipine etc.) act

A

PERIPHERAL vascular smooth muscle more than myocardium thus do not worsen heart failure but may cause ankle swelling

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12
Q

Adverse effect of this drug cause an increase in ‘everything’

A

Ciclosporin

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13
Q

the ‘everything’ increased with Ciclosporin

A

Fluid, BP, K+, Hair, gums, glucose

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14
Q

Digoxin - when is monitoring required

A

Only when toxicity is suspected - within 8-12 hours of last dose

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15
Q

Symptoms of digoxin toxicity

A

Generally unwell, lethargy, nausea & vomitting, anorexia, confusion
Yellow-green vision
gynaecomastia
Arrhythmias

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16
Q

Precipitants to Digoxin toxicity

A

HYPOKALAEMIA - digoxin binds to ATPase pump at same site as K, thus without K+, digoxin binds more easily
Renal failure
Hypomagnesaemia, hypercalcaemia, hypernatreamia
Drugs which cause hypokalaemia

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17
Q

Which common antibiotic is contraindicated in Myasthenia Gravis

A

Gentamicin

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18
Q

Monitoring of Gentamicin

A

Both peak (1 hour after administration) and trough levels (just before the next dose) are measured

If trough dose is high the INTERVAL between doses should be increased

If the peak level is high, the DOSE should be decreased

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19
Q

Unfractionated heparin mechanism

A

Forms a complex which inhibits thrombin, factors Xa, IXa, XI, XII.

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20
Q

LMWH mechanism

A

Increases the action of antithrombin III on factor Xa

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21
Q

Electrolyte disturbance with Heparin

A

HYPERKALAEMIA
(by reversible aldosterone inhibition)

22
Q

Heparin and LMWH monitoring

A

Heparin: aPTT
LMWH: Anti-factor Xa (although routine monitoring not required)

23
Q

Lithium toxicity - therapeutic range

A

0.4-1.0
Toxicity generally occurs at >1.5

24
Q

Features of lithium toxicity

A

Coarse tremor
Hyperreflexia
Acute confusion
polyuria
seizure
coma

25
Q

Drug precipitants of Lithium toxicity

A

DIURETICS (esp. Thiazides)
ACE inhibitors
NSAIDS
Metronidazole

26
Q

Macrolide adverse effects (MACRO

A

Motility issues
Arrhythmia
Cholestatic jaundice
Rash
Ototoxicity/eOsinophillia

27
Q

Which drugs should be stopped while taking macrolide

A

STATINS - increased risk of myopathy and rhabdomyolysis due to P450 inhibition

28
Q

Adverse effects of metformin

A

GI upset V common - intolerable in 20%
Reduced B12 absorption
Lactic acidosis with severe liver disease or renal failure

29
Q

Which drug should be stopped if there is tissue hypoxia (MI, sepsis, AKI, severe dehydration)

A

Metformin

30
Q

When should metformin be stopped in the context of CKD

A

eGFR < 30 ml/min
Dose reviewed at eGFR < 45 ml/min

31
Q

How long should metformin be stopped for following administration of iodine containing x-ray media

A

On the day of the procedure and for subsequent 48 hours

32
Q

Paracetamol overdose: Mx. if <1 hour

A

<1 hour = activated charcoal
NAC

33
Q

Salicylate poisoning

A

Urinary alkalinization w/ IV bicarbonate

34
Q

Opiate overdose

A

Naloxone

35
Q

Benzodiazepine overdose mx.

A

Flumazenil

36
Q

TCA overdose mx.

A

IV bicarbonate (may reduce risk of seizures and arrhythmias in severe toxicity)

37
Q

As well as those on Nitrates and nicornadil and those experiencing hypotension, in whom else is PDE-5i contraindicated in

A

Pts. w/ recent stroke or myocardial infarction - wait 6 months

38
Q

Viagra (the blue pill) causes what visual disturbance

A

Blue vision

39
Q

Drugs to be used in caution for pts. w/ obstructive lung diseases

A

NSAIDs
B-blockers
Adenosine (use verapamil as alternative)

40
Q

Drugs which may exacerbate heart failure (4)

A

Thiazolidinediones - pioglitazone absolute CI = fluid retention

Verapamil - negative inotropic effects

NSAIDs/glucocorticoids - cause fluid retention (low dose aspirin is exception as benefits outweigh risks)

Class I antiarrhythmics - flecainide = negative inotropic and pro-arrhythmic effect

41
Q

Drugs to avoid in renal failure

A

Antibiotics: Tetracycline, nitrofurantoin
NSAIDs
Lithium
Metformin

42
Q

Antibiotics likely to accumulate in CKD - need dose adjustment:

A

Most incl. penicillins, cephalosporins, vancomycin, gentamicin, streptomycin

43
Q

Prescribing in pregnancy: harmful antibiotics

A

Tetracyclines
Aminoglycosides - gentamicin etc.
Sulphonamides and trimethoprim
Quinolones

44
Q

Drugs to avoid in pregnancy:
2 X Antihypertensives:
1 X cholesterol drugs
1 X diabetic drug

A

ACEIs/ARBS
Statins
Sulfonylureas
Warfarin

45
Q

Adverse effects of QUINOLONES - Ciprofloxacin, Levofloxacin

A

Lower seizure threshold
TENDON damage - incl. rupture
Cartilage damage
Lengthens QT interval

46
Q

Which two classes of antibiotic prolong the QT interval

A

Macrolides and Quinolones

47
Q

What is Tamoxifen

A

Selective oestrogen receptor modulator (SERM)

48
Q

What is Tamoxifen used in:

A

Management of oestrogen receptor positive breast cancer

49
Q

Side effects of tamoxifen

A

Menstrual disturbance: vaginal bleeding, amenorrhoea
Hot flushes
VTE
Endometrial cancer

50
Q

Trastuzumab - used in?
Side effects:
Flu-like symptoms and diarrhoea common
Cardiotoxicity

A

HER2 positive breast cancer

51
Q

Drugs likely to accumulate in CKD

A

Most antibiotcs
Digoxin
MTX
Sulphonylureas
Furosemide
Opioids

PSA (10 decks)

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