Drug Knowledge

Question 1

1. Why does ACE-I cause a dry cough?

2. What electrolyte disturbances do ACE-I cause?

Answer 1

1. Accumulation of bradykinin through reduced breakdown down of ACE-Enzyme.
2. Hyperkalemia (Reduced aldosterone production + Potassium excretion in kidneys)

Question 2

What side effects do Loop and thiazide diuretics cause on U+Es ?

Answer 2

Hypokalaemia (Increase K+ excretion in the kidneys)

Question 3

What type of antiemetic is cylizine?

Answer 3

Anti-histamine

Question 4

What anti-emetic should be avoided in Parkinson patients?

WHAT is a safer alternative [BONUS]

Answer 4

Metoclopramide - Crosses the BBB (Dopamine antagonists) further exacerbates the Parkinsonism symptoms acting on central dopamine receptors.

Bonus - Domperidone (Doesn’t cross the BBB + Dopamine antagonist + Increases contractions of the stomach and bowel).

Question 5

Why does Ibuprofen nephrotoxic?

Answer 5

Inhibits prostaglandin synthesis causing a reduction in renal artery diameter (and blood flow) reducing blood flow and perfusion.

Question 6

Why does ACE-I impair the kidneys?

Answer 6

Reduces AT2 production that helps to preserve GFR when renal blood flow is produced.

Question 7

How do oral steroids affect the GI System?

Answer 7

Inhibiting gastric epithelial renewal which predisposes to ulceration.

Question 8

Why should NSAIDs be avoided in Asthmatics (IBUPROFEN)?

Answer 8

Can cause broncoconstriction.

[Only used when necessary under close medical supervision]

Question 9

Which UTI ABx is ABSOLUTELY CONTRAINDICATED for those using methotrexate?

Answer 9

Trimethoprim (Also a folate antagonist) increased risk of bone marrow toxicity

Leads to PANCYTOPENIA AND NEUTROPENIC SEPSIS

Question 10

Any Px regularly on Methrotrexate that has an infection what important step must be taken?

Answer 10

Medication Withheld pending exclusion of neutropenic sepsis.

Question 11

Peripheral oedema can be a side effect of which class of anti-hypertensives?

Answer 11

CCB (Amlodopine)