Medicines 46 Flashcards
(25 cards)
What are the effects of paracetamol overdose?
🛑 Main Risk:
Liver damage (hepatotoxicity) due to toxic metabolite NAPQI accumulation.
⚠️ Key Complications:
🧠 Encephalopathy (brain dysfunction from liver failure)
🍬 Hypoglycaemia (impaired gluconeogenesis)
😖 Right subcostal pain/tenderness (suggestive of liver inflammation)
📌 Additional Notes:
Symptoms may be delayed for up to 24 hours
N-acetylcysteine (NAC) is the antidote and most effective within 8–10 hours
What is Alteplase?
Alteplase is a thrombolytic drug, also known as a “clot-busting” drug
What is a key side effect to look out for with Nicorandil
Nicorandil can cause serious skin, mucosal, and eye ulceration; including gastrointestinal ulcers, which may progress to perforation, haemorrhage, fistula or abscess. Stop treatment if ulceration occurs and consider an alternative. (BNF)
What is key to know about the PPI dosing in H.Pylori?
Its Not excessively High
Esomeprazole: 20mg BD
Lansoprazole 30mg BD
Omeprazole 20-40mg BD
Pantoprazole 40mg BD
- BNF
Whats the most effective thiazide/thiazide like diuretic in renal impairment?
Metolazone is particularly effective when combined with a loop diuretic (even in renal failure); profound diuresis can occur and the patient should therefore be monitored carefully. BNF
Manufacturer advises metolazone remains effective if eGFR is less than 30 mL/minute/1.73 m2 but is associated with a risk of excessive diuresis. BNF
Indapamide - avoid in severe impairment (ineffective if creatinine clearance less than 30 mL/minute).
Which Anti emetic is favoured in the following:
management of Chemo-induced nausea and vomiting
management of Nausea and vomiting in patients recieving cytotoxics
Prevention of Chemo-induced nausea and vomiting
The 5HT3-receptor antagonists, granisetron, ondansetron, and palonosetron, are used in the management of nausea and vomiting in patients receiving cytotoxics. A combination of palonosetron with netupitant, a neurokinin 1-receptor antagonist, is also available.
Dexamethasone has antiemetic effects and is used in the management of chemotherapy-induced nausea and vomiting. It can be used alone or in combination with other antiemetics such as a 5HT3-receptor antagonist.
The neurokinin 1-receptor antagonists, aprepitant and fosaprepitant, are used to prevent nausea and vomiting associated with chemotherapy. They are usually given in combination with dexamethasone and a 5HT3-receptor antagonist.
What monitoring is required with Carbimazole ?
No Specific Monitoring requirements are outlined in the BNF
What is the usual dose for Colchicine for Gout flare ups
500 micrograms 2–4 times a day until symptoms relieved, total dose per course should not exceed 6 mg, do not repeat course within 3 days. as per BNF
Which TB treatment medication can cause visual disturbances?
Ethambutol is well-known for causing optic neuritis as a potential side effect, which can lead to:
Blurred vision
Reduced visual acuity
Red-green colour blindness
Visual field defects
These effects are dose-dependent and can be reversible if detected early and the drug is stopped promptly.
Leflunamide used for RA has teratogenic effects, how long should effective contraception be used in men and women after stopping the treatment
2 Years Women
3 months men
Effective contraception essential during treatment and for at least 2 years after treatment in women and at least 3 months after treatment in men (plasma concentration monitoring required; waiting time before conception may be reduced with washout procedure—consult product literature).
The concentration of the active metabolite after washout should be less than 20 micrograms/litre (measured on 2 occasions 14 days apart) in men or women before conception—consult product literature.
what antiepileptic drugs can be given once a day at bedtime?
LP3
- lamotrigine
- perampanel
- phenobarbital
- phenytoin
What is the treatment for COPD without asthma symptoms
Initial Management for All COPD Patients
Empirical treatment:
Use SABA (e.g., salbutamol) or SAMA (e.g., ipratropium) as needed for relief.
Step-Up Treatment – Without Asthmatic Features / Steroid Responsiveness
Persistent breathlessness/exacerbations:
Offer LABA + LAMA.
Stop SAMA if LAMA started.
Continue SABA as needed.
Frequent or severe exacerbations:
Add ICS for triple therapy (LABA + LAMA + ICS).
Review annually and document ICS use.
Persistent symptoms despite LABA + LAMA:
Trial ICS for 3 months.
If improved → continue triple therapy.
If no benefit → step back down to LABA + LAMA.
WHat is the treatment for COPD with asthma symptoms
Initial Management for All COPD Patients
Empirical treatment:
Use SABA (e.g., salbutamol) or SAMA (e.g., ipratropium) as needed for relief.
Step-Up Treatment – With Asthmatic Features / Steroid Responsiveness
Persistent symptoms/exacerbations:
Start LABA + ICS.
Review annually, document ICS use.
Frequent/severe exacerbations or persistent symptoms:
Add LAMA → triple therapy.
Stop SAMA if LAMA given.
SABA can still be used as needed.
WHat antibiotics can be used prophylactically for COPD exaccerbations ?
Consider azithromycin (unlicensed) if:
Patient is a non-smoker, all other treatments optimised.
Has frequent/prolonged exacerbations (≥4/year with sputum) or hospitalisations.
Before starting:
Perform sputum C&S, CT thorax, baseline ECG (QT), LFTs.
Monitoring: Review at 3 months, then every 6 months. Continue only if benefits outweigh risks.
how long should a nitrate free period be?
between 8 and 12 hours
Which non Antidiabetic medication can lower blood glucose
ACE inhibitors
Non selective beta blockers
Which antibiotic can cause Bone marrow suppression?
Linezolid
Which medications cause Antiepiletic hypersensitivity syndrome
CP3 and rufinamide, lamotrigine, lacosamide
Symptoms: Fever, rash, liver dysfunction, renal+ pulmonary abnormalities and multi organ failure
Stop immediately
What are the drug used to treat Postural hypotension in Parkinsons disease
Rv drug treatment to address any pharmacological cause
Midodrine is first line
Fludrocortisone is an alternative
Which medications can cause Bezoar formation
Sucralfate
A bezoar is a tightly packed collection of partially or undigested material that can become lodged in the digestive tract, often the stomach
Why should the following be monitored with Methylphenidate?
Pulse, blood pressure, psychiatric symptoms, appetite, weight and height
Pulse, blood pressure, psychiatric symptoms, appetite, weight and height should be recorded at initiation of therapy, following each dose adjustment, and at least every 6 months thereafter.
Pulse & BP: Risk of tachycardia and hypertension
Psychiatric Symptoms: Can worsen anxiety, agitation, or trigger psychosis
Appetite: Suppressed appetite is common
Weight & Height: Risk of growth suppression in children
📝 Monitor regularly—especially in children—every 6 months or as clinically needed.
What is the MHRA alert with febuxostat
These alerts highlight the risk of serious hypersensitivity reactions, including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).
Immediate discontinuation
What is the STOPP criteria for donepezil ?
Bradycardia
Less than 60beats per minute
