Pharmacology

Question 1

Causes of Digoxin toxicity

Answer 1

‘Low Potassium Can Hurt’

Low
- HypoK, HypoMg, Hypoalbumin, Hypothermia/thyroidism

Potassium
- Drugs which lower potassium eg. thiazides / loop diuretics

CAN
- hyperCa, high Acid (acidosis), hyperNa

Hurt/heart
- Common heart drugs eg. Amiodarone, diltiazem, verapmail, spirinolactone

Question 2

Digoxin toxicity can cause what unusual symptoms

Answer 2

yellow green vision
gynaecomastia

Question 3

what drug can cause corneal opacities and optic neuritis

Answer 3

amiodarone

Question 4

What antibiotic can cause long QT

Answer 4

macrolides (clary)

Question 5

What drug can cause blue tinge to vision

Answer 5

sildenafil

Question 6

contraindications to sildenafil

Answer 6

nitrates and nicorandil

recent stroke

Question 7

what is sildenafil used for in neonates

Answer 7

pulm htn

Question 8

When do you give cyclical vs continuous combined HRT

Answer 8

cyclical combined HRT if their LMP was less than 1 year ago

continuous combined HRT if they have:
-taken cyclical combined for at least 1 year
or
-it has been at least 1 year since their LMP/2 years if they had premature menopause

Question 9

Cocaine treatment

Answer 9

benzos

Question 10

2 side effects of tamoxifen

Answer 10

menstrual disturbance
hot flushes

Question 11

benzo OD rx

Answer 11

flumazenil

Question 12

methanol or ethylene glycol poisoning rx

Answer 12

ethanol or fomepizole

Question 13

Salicylate OD rx

Answer 13

urinary alkalinization with IV bicarbonate

haemodialysis

Question 14

TCA OD rx

Answer 14

IV bicarb to correct acidosis

Question 15

Lithium OD rx

Answer 15

IVI

haemodialysis

Question 16

Heparin toxicity rx

Answer 16

Protamine sulphate

Question 17

Beta blocker toxicity rx

Answer 17

atropine if brady
glucagon

Question 18

Organophosphate insecticides poisoning

Answer 18

atropine

Question 19

Iron toxicity rx

Answer 19

Desferrioxamine

Question 20

Lead poisoning rx

Answer 20

Dimercaprol

Calcium edetate

Question 21

Carbon monoxide poisoning rx

Answer 21

100% O2

Hyperbaric O2

Question 22

Cyanide posioning rx

Answer 22

Hydroxocobalamin

Also combination of amyl nitrite, sodium nitrite, and sodium thiosulfate

Question 23

Valproate bloods monitoring

Answer 23

LFT, FBC before treatment
LFT ‘periodically’ during first 6 months

Question 24

Glitazones blood monitoring

Answer 24

LFTs

Question 25

Azathioprine blood monitoring

Answer 25

FBC, LFT

Question 26

MTX blood monitoring

Answer 26

FBC, LFT, U&E

Question 27

Amiodarone blood monitoring

Answer 27

TFT, LFT

Question 28

What needs to be checked before starting TB treatment

Answer 28

LFTs

Question 29

side effects of amlodipine

Answer 29

headache, flushing, ankle oedema

Question 30

Which TB drug is associated with optic neuropathy

Answer 30

ethambutol

Question 31

TB drugs side effects

Answer 31

R - Rifampacin - 'R'ed/Organge Urine I - Isoniazid - 'I'nhibits liver, '(p)Ins' and needles P - Pyrazinamide - 'P'ainful joints + muscles E - Ethambutol - 'E'yes

Question 32

When is flumazenil contraindicated in benzo overdose?

Answer 32

Chronic benzo users as it can precipitate withdrawal seizures- supportive management

Question 33

when should NAC be given regardless of treatment line?

Answer 33

Staggered overdose If they present 8-24 hours later and have ingested more than 150 mg/kg Presenting >24 hours if they are clearly jaundiced or have hepatic tenderness, their ALT is above the upper limit of normal

Question 34

What NSAID is now contraindicated with any form of cardiovascular disease

Answer 34

diclofenac

Question 35

tinnitus can be a symptom of what overdose

Answer 35

aspirin

Question 36

What foetal issue can lithium cause

Answer 36

cardiac foetal abnormalities - Ebstein's anomaly

Question 37

Drugs that cause gynaecomastia

Answer 37

'Some Hormones Really Do Create Funny Knockers' S - spironolactone H - hormones (e.g. GnRH analgoues) R- ranitidine D - digoxin C - cimetidine F - finasteride K - ketoconazole

Question 38

ECG finding of TCA overdose

Answer 38

Sinus tachy, broad QRS, dominant R wave in aVR

Question 39

Drug that can't give at same time as levothyroxine

Answer 39

Ferrous sulphate Ca carbonate

Question 40

serious side effect of carbimazole

Answer 40

agranulocytosis

Question 41

Drugs c/i in breastfeeding

Answer 41

B- bromocryptine, benzodiazepine R- Radioactive drugs, rizatriptan E- ergotamine A- ACEi/ARB, aspirin, amiodaron, alcohol, S- sulphonamide, sulphonylurea, statin T- thiazide, tetracycline,( iso)tretinoin

Question 42

example of sulphonamide abx

Answer 42

co-trimoxazole