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MBChB - Full Clinical Topics > Drugs > Flashcards

Drugs Flashcards

1
Q

What dose of adrenaline is given to a < 6 month old having an anaphylaxis reaction?

A

150mcg (0.15ml of 1:1000)

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2
Q

What dose of adrenaline is given to a 6 month- 6yrs old having an anaphylaxis reaction?

A

150mcg (0.15ml of 1:1000)

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3
Q

What dose of adrenaline is given to a 6-12year old having an anaphylaxis reaction?

A

300mcg (0.3ml of 1:1000)

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4
Q

What dose of adrenaline is given to an adult (>12yrs) having an anaphylaxis reaction?

A

500mcg (0.5ml of 1:1000)

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5
Q

In addition to adrenaline what other two drugs should be given for an anapylactic reaction?

A

Hydrocortisone

Chlorphenamine

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6
Q

What is the most common electrolyte imbalance associated with Bisoprolol?

A

Hyponatremia

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7
Q

You are in a GP clinic and change a dose of Ramipril from 5mg to 10mg OD. What action must be taken?

A

Book U+E’s to be monitored in 14 days time

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8
Q

A patient is switched from furosemide to bumetanide, what is the strength relationship between the two drugs?

A

1mg Bumetanide = 40mg Furosemide

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9
Q

An elderly lady in your practice has just been started on Aspirin, what additional medication should be prescribed?

A

Omeprazole

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10
Q

You are prescribing naproxen to a patient for the first time (for pain). What 2 key things must you ask about in the history?

A

Allergies

History of stomach ulcers etc

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11
Q

You are prescribing labetalol to a pregnant patient to control her blood pressure, what must you ask about in the history before starting this drug? (2)

A

Allergies

History of asthma

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12
Q

What are the most common side effects of anti-cholinergic medicines?

A

Dry mouth, dry eyes, constipation and blurred vision

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13
Q

Name three common medicines which cause hyperprolactinaemia?

A

Verapamil
Tramadol
Thioxanthenes (Zuclopenthixol, Flupenthixol - anti-pyschoctics)

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14
Q

A 57 year old man is admitted to hospital with a 3 day history of LRTI and one day history of rash. He was started on antibiotics 3 days ago. What is the most likely drug responsible for his rash?

A

Amoxicillin

used for LRTI’s - note rashes are a common side effect of all penicillin medications

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15
Q

What is first line drug management for shingles (Herpes Zoster) for an adult?

A

Aciclovir 800mg 5x/day for 7 days

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16
Q

A 45 year old caucasian male presents with a BP of 170/110. What is the most appropriate drug/ dose to start him on?

A

Ramiprill 2.5mg

White <55

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17
Q

What is the most important information that should be communicated to a patient about taking Gliclazide?

A

Can cause hypo’s (know symptoms)
Take with breakfast
Can cause weight gain

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18
Q

You are starting a patient on carbimazole for hyperthyroidism, what is the main SE you should counsel them on?

A

Agranulocytosis (immediate help if sore throat, mouth ulcers, brusing, fever, malaise)

19
Q

A patient with UC presents for his 3 month review after being started on mesalazine, what monitoring should patients on mesalazine recieve?

A

Renal function (start, 3 months, yearly)

20
Q

What blood test should be conducted when starting steroids in a 60 year old man? What additional medications should be prescribed?

A

Glucose (can worsen diabetes)

Also prescribe PPI

21
Q

Name 2 common side effects of denosumab?

A

Hypocalcaemia (can be used to treat hypercalcemia)

Osteonecrosis of the jaw

22
Q

The chemotherapy agent Vinblastine is most commonly associated with which side effect?

A

Peripheral neuropathy

23
Q

How long after a prescription is dated can it be picked up?

A

6 months

24
Q

How long can the contraceptive pill be prescribed for on a single prescription?

A

6 months

25
Q

Which opiates can come in a patch?

A

Fentanyl

Buprenorphine

26
Q

How do you find the opiate conversion tables in the electronic BNF?

A

Guidance tab at the bottom

Prescribing in paliative care

27
Q

You are writing a prescription for a fentanyl patch (a 75 microgram patch) which should be given one every 72 hours. How do you write this prescription?

A 
FENTANYL 75 (SEVENTY-FIVE) MICROGRAM PATCH
Replace ONE (1) patch every 72 (SEVENTY-TWO) hours 
Supply FIVE (5) patches
28
Q

When replacing opiate patches what is the guidance around replacing the patches?

A

Replace at a different site!
When starting take last dose of other opiates (i.e. oral MR) then immediately put patch on (as it takes a bit of time to work)

29
Q

A patient under the paliative care team is using fentanyl patches (equivalent to 180mg morphine daily) however needs extra support for breakthrough pain, what should she be prescribed?

A

Oromorph

1/6 to 1/10 of daily dose (18 to 30mg)

30
Q

When increasing opiates what is the maximum change you should make?

A

Do not increase more than 50% of current dose

i.e. if on 100mg/ day don’t go to more than 150mg/day

31
Q

When counselling for Warfarin vs. NOAC what are the main points which should be covered?

A

Warfarin - individualised treatment and INR is monitored

  • Diet has to be monitored more in warfarin
  • Much more monitoring requirement for warfarin
  • Reversible with vit K

NOACS

  • Less monitoring and less lifestyle impact
  • Note Dabigatran can be reversed, others can’t initially (so if high fall risk should Wafarin be considered?)
32
Q

What surface area should one fingertip unit of steroid cream cover?

A

Approx size of face or both palms

33
Q

Name three drugs which could help a patient trying to come off alcohol?

A

Naltrexone/ Baclofen- Make alcohol use less rewarding
Acamprosate- Reduces craving
Disulfiram- Causes sickness when alcohol ingested (v.low adherence)

34
Q

Name three side effects/ increased risks when taking the COC pill? When should this pill be taken?

A

Each day at same time for 21days, 7 day break
Small risk of blood clots
Very small risk of heart attacks and strokes
Increased risk of breast cancer and cervical cancer

35
Q

What are bisphosphonates used for and what is the most common side effect of them?
E.g Alendronic acid

A

Used to strengthen bones
- Most common SE is inflammaton/ ulceration/ irritation of the oesophagus
(So take 30min before food and don’t lie down for 30min after)

36
Q

What is the most important side effect of rispiridone?

A

Hyperprolactinaemia

Change in periods, galactorrhea, painful intercourse, acne and hirsutism

37
Q

You are about to start a patient on ramiprill and are reviewing some bloods they have just had done, what key areas must you look at? (3)

A 
Baseline potassium (ACEI can cause hyperkalaemia) 
Baseline renal function (ACEI cause decreased renal function, up to 25% increase in urea/creatinine is acceptable) 
- Px to return in 7-10days to have renal function monitored
38
Q

A patient is about to be started on treatment for their newly diagnosed pulmonary TB infection, what agents are started?
- What must be checked before starting

A 
Isoniazid - 6months
Rifampicin- 6months
Pyrazinamide- 2months
Ethambutol- 2months 
All causes liver toxicity so check LFTs, also check kidney function and caution starting ethambutol if kidney pathology
39
Q

You are about to start a patient on Metronidazole, what is the single most important lifestyle factor you must council on?

A

ALCOHOL MUST BE AVOIDED

  • There is a very severe reaction
  • All AB’s may have some small reaction but the reaction between alcohol and metronidazole is very severe
40
Q

Name 3 drugs which can cause lung fibrosis?

A

Amiodarone, methotrexate, nitrofurantoin (used for UTI) , bleomycin

41
Q

Name 6 common side effects of iron supplementation?

A 
Constipation
Black stools
Diarrhoea
Heartburn
Nausea
Abdominal/epigastric pain
42
Q

A patient is diagnosed with impertigo, what is the best treatment?

A

Fucidic acid

Flucloxacillin if very severe

43
Q

A patient on antibiotics complains of orange tears and orange urine, what is the most likely antibiotic they are taking?

A

Rifampicin

44
Q

Where does metoclopramide act and what are some of it’s most important side effects?

A

Acts on the gut (so good for gastroenteritis, or other motility problems)
- Can cause tardive dyskinesia and extra pyramidal problems

MBChB - Full Clinical Topics (23 decks)

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