PPT

Question 1

Discuss common side effects of amitriptyline

Answer 1

Anticholinergic syndrome (dry mouth, arrhythmia, blurred vision,urinary retention, constipation) drowsiness; QT interval prolongation and QRS widening

Question 2

Mechanism of action and clinical use of metoclopramide

Answer 2

Dopamine antagonist

Antiemetic and prokinetic effects however patient can suffer dystonic reactions

Question 3

Treatment for dystonic reactions

Answer 3

Procyclidine (anticholinergic)

Question 4

What assessments/investigations should be made in clinic for a patient with a new hypertension diagnosis

Answer 4

Test urine - albumin:creatinine ratio and haematuria
Measure plasma glucose, electrolytes, creatinine, eGFR, serum total cholesterol and HDL
Examine fundi for presence of hypertensive retinopathy
Arrange for 12 lead ECG

Question 5

What risk score indicates need for commencing lipid lowering medication?

Answer 5

QRISK greater than 10%

Question 6

Mechanism of action of ciprofloxacin

Answer 6

DNA gyrase inhibitor -topoisomerase II (fluoroquinolone)

Question 7

Which antibiotics are commonly recognised as a cause of C. diff infection?

Answer 7

Clindamycin
(Fluroquinolones) ciprofloxacin
Cephalosporins

Question 8

Treatment for acute C. Difficle infection

Answer 8

Cessation is causative antibiotic

• metronidazole for mild disease
• vancomycin for severe

Question 9

Antiemetic of choice for renal colic

Answer 9

Metoclopramide, prokinetic effects aid stone expulsion

Question 10

Suggest differentials for a child presenting with bruises, fatigue and flu like symptoms

Answer 10

• child abuse
• acute lymphoblastic leukaemia
• Idiopathic thrombocytopenia pupura
• Genetic clotting disorder
• Vitamin deficiency

Question 11

Suggest a typical chemotherapy regime for a a child with Acute lymphoblastic leukaemia

Answer 11

Cyclophosphamide, Vincristine, Doxorubicin and dexamethasone

Question 12

Mechanism of action and serious side effects of doxorubicin

Answer 12

Topioisomerse II inhibitor

Dilated cardiomyopathy

Question 13

Discuss adverse effects of cyclophosphamide

Answer 13

Impaired fertility
bone marrow suppression and neutropenia
Haemorrhagic cystitis –> Bladder malignancy (this risk is reduced prophylactically by prescription of mercaptoethane sulphuric acid)

Question 14

Medications which can cause hypokalaemia

Answer 14

Diuretics 
Insulin 
Salbutamol and theophylline 
Laxatives 
B12 and folate

Question 15

Discuss unwanted effects of sulphonylureas

Answer 15

GI disturbances
Hypoglycaemia (particularly nocturnal)
Weight gain
Increased cardiovascular mortality

Question 16

What class of drug is Indapamide

Answer 16

Thiazide-like diuretic

Question 17

Which class of drug does indomethacin belong to?

Answer 17

NSAID

Question 18

Drugs that can cause QT prolongation

Answer 18

Sotalol
Amiodarone 
Ciprofloxacin, erythromycin, clarithroymcin 
Amitriptyline, venlafaxine, fluoxetine 
Haloperidol, quetiapine

Question 19

Drugs that cause ankle swelling

Answer 19

Amlodipine

Diltiazem

Question 20

Drugs that cause angioedema

Answer 20

ACEi
NSAIDs
ARBs

Question 21

Drugs that cause acute pancreatitis

Answer 21

Azathioprine 
Sulphasalazine 
Thiazides 
Sodium valproate 
DPP-4 inhibitors 
GLP-1 mimetics

Question 22

Drugs that can cause constipation

Answer 22

• antipsychotics
• tricyclic antidepressants
• verapamil
• opioids

Question 23

Drugs that cause agranulocytosis

Answer 23

Carbimazole 
Sulphasalazine 
Azothioprine 
Clozapine 
Olanzipine 
Methotrexate

Question 24

Discuss contraindications to the use of pioglitazone

Answer 24

Pioglitazone - thiozoladinedione

Heart failure; previous or active bladder cancer

Question 25

What class of drug is amlodipine

Answer 25

DHP calcium channel blocker

Question 26

Mechanism of action of spironolactone

Answer 26

Mineralocorticoid receptor antagonist