OSCE drugs

Question 1

Acronym for drug counselling

Answer 1

ATHLETICS
Action
Timeline
How to take
Length of tx
Effects felt in
Tests
Important SE
Complications and CI
Supplementary advice

Question 2

warfarin

Answer 2

• thins blood = blocks vit K
• OD tablet
• INR testing = day 5 and 8 then every couple weeks
• SE = bleeding, diarrhoea, nausea
• CI = pregnancy, stroke, bleeding, caution falls
• avoid cranberry, spinach, alcohol binge
• no NSAIDs

Question 3

levothyroxine

Answer 3

• OD pre breakfast and caffeine = reduce absorption
• start then bloods 2-3w then 2-3m then yearly
• can make too high

Question 4

statins

Answer 4

• stop liver making cholesterol
• OD evening tablet
• review 4w then 6m
• LFTs pre start, 3m and 12m as alter, tft and u+e
• if LFT >3x limit stop statin
• SE = muscle pain, hair loss, itch, nausea
• CI = pregnancy
• avoid grapefruit
• macrolide abtibiotics = clarithromycin = bad

Question 5

metformin

Answer 5

• increases sensitivity of cells to insulin
• OD breakfast with or after meal
• U+E pre then annually
• nausea, diarrhoea, weight loss, abdo pain
• CI = renal impairment, ketoacidosis, low BMI
• Lactic acidosis
• miss dose = take asap unless close to next dose

Question 6

iron tablets

Answer 6

• replace iron
• 1-3 times a day depending on brand
• take 4m = 3-4w to normalise hb then 3m replenish stores
• test hb in 3-4w
• se = gi, contipation, balck stools

Question 7

bisphosphonates

Answer 7

• prevent bone from being broken down and help rebuild new bone
• once a week
• full glass water, 30m pre food, upright 30m
• se = headache, heartburn, GI, osteonecrosis jaw
• CI = pregnancy, ulcers, renal

Question 8

levodopa

Answer 8

• replace dopamine brain no longer able to make
• 3-4xd with food
• tablet
• can get wear off/on off
• se = psychosis, nausea, postural hypotension but other drugs to help with these
• ci = glaucoma

Question 9

methotrexate

Answer 9

• disease modifying = reduces inflammation and suppresses immune system
• once a week with folic acid
• tablet
• pre start = fbc, lft, u+e, then 2w then 2-3m
• se = alopecia, headaches, gi, myelosuppression (infection)
• careful with alcohol, myelosuppression, pulmonary toxicity
• CI = pregnancy, liver, breast feed, active infection

Question 10

SSRI

Answer 10

• alter balance of chemicals in breain = increase serotonin
• OD tablet
• GI, drowsy, headache
• suicide isk

Question 11

lithium

Answer 11

• mood stabiliser
• once or 2 daily
• lifelong
• pre start = fbc, u+e, TFT, ECG
• lithium after 5d then 4w then 3m, rest 6m
• SE = gi, metal, water
• toxic = gim neuromuscuar
• CI = pregnancy or breast, cardiac disease, renal

Question 12

omeprazole

Answer 12

• gord to prevent sx of indigestion
• PPI = inhibits acid secretion
• se = nausea, vomiting, stomach pain, constipation
• long term se = osteoporosis
• interact = SSRI, clopidogrel, methotrexate

Question 13

amlodipine

Answer 13

• cc = inhibit ca influx = reduce contraction and vasodilation
• se = flushing, dizzy, paliptations, leg swelling
• statin only max 20mg

Question 14

ramipril

Answer 14

• for htn, vasodialtion
• dry cough, hyperkalaemia, angiodema
• U+E and K
• Avoid nsaids

Question 15

bisoprolol

Answer 15

• reduce heart rate
• se = hypotn, sleep disturbance = nightmares and waking up, hypoglycaemia = mask sx
• no in asthma