Prescribing section

Question 1

What is an enzyme inducer

Answer 1

Increase CYP450 activity
faster metabolism
decreased therapeutic effect

Question 2

Give examples of enzyme inducers

Answer 2

PC BRAS
Phenytoin
Carbamazepine
Barbituates
Rifampicin
Alcohol - chronic excess
Sulphonyureas
St Johns wart
Smoking
Topiramate

Question 3

What is an enzyme inhibitor

Answer 3

Decreases activity of enzyme
decreased metabolism
remains active for longer

Question 4

Give examples of enzyme inhibitors

Answer 4

AO DEVICES
Allopurinol / Amiodarone
Omeprazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin
Ethanol - Acute
Sulphonamides
Grapefruit juice
SSRI/SNRI

Question 5

What medications should be stopped prior to surgery

Answer 5

I LACK OP
Insulin
Lithium - day before
Anticoagulants/platelets
COCP / HRT - 4 weeks before
K+ sparing diuretics
Oral hypoglycaemics
Perindropil - And other ACEi

Question 6

What can carbamazepine cause

Answer 6

Hyponatraemia

Question 7

when should steroid be prescribed

Answer 7

Morning - prevent sleep

Question 8

when should brand names of drugs be used

Answer 8

Insulin
Anti-epilleptics

Question 9

What shoudl be prescribed for a patient in DKA

Answer 9

Fluids - 1L 0.9% NaCl over 1 hour
Stat if hypotensive

Insulin - Fixed rate
0.1units/kg/hr

Question 10

How does trimethorpim affect renal function

Answer 10

Falsely causes rise in Creatnine –> AKI

Question 11

What is gentamicin prescribing based on

Answer 11

Ideal body weight

Question 12

What is a risk of prescribing quinolones

Answer 12

tendon damage

Question 13

Name an adverse effect of co-amoxiclav

Answer 13

Increased risk of cholestasis

Question 14

Name 2 adverse reactions assosciated with ciclosporin

Answer 14

gungival hypetrophy
nephrotoxicity

Question 15

Name 2 adverse reactions associated with tacrolimus

Answer 15

Cardiomyopathy
peripheral neuropathy
DM
Pancytopenia

Question 16

Name 2 adverse reactions assosciated with Mycophenelate

Answer 16

GI upset
Myelosuppresion

Question 17

Name adverse effects of steroids

Answer 17

CORTIOSTEROID
Cushings syndrome
Osteoperosis
Retardation of growth
Thin skin / easy bruising
Immunosupression
Cataracts
Oedema
Stomach ulcers
Teratogenic
Emotional - psychosis
Rise in BP
Obesity
Increased hair growth
DM
Striae

Question 18

Name anticholinergic side effects

Answer 18

Cant shit, cant spit, cant see, cant pee
Blurred vision
cosntipation
dry mouth
urinary retention

Question 19

Name anti-muscarinic side effects

Answer 19

confusion
dialted pupil
loss of accommodation
dry mouth
tachycardia

Question 20

What drugs should be stopped in an AKI

Answer 20

DAMN
Diuretics
ACEi
Metformin
NSAIDs

Question 21

Describe the management of hypoglycaemia

Answer 21

Conscious - oral glucose

Unconscious
- IM glucagon

Unresponsive to IM or prolonged hypo
10% IV glucose infusion

Question 22

Name 2 thin emolients

Answer 22

E45
Aveeno
Diprobase cream
Oilatum

Question 23

Name 2 thick emolients

Answer 23

Diprobase ointment
Hydromol ointment
Cetraben ointment

Question 24

Describe the topical steroid ladder

Answer 24

Hydrocortisone
Eumovate
Betnovate
Dermovate

Question 25

When should prophylactic LMWH not be given to patients

Answer 25

Risk of bleeding Following acute ischaemic stroke

Question 26

What is a contraindication to compression stockings

Answer 26

PAD - absent limb pulses Can lead to critical limb ischaemia

Question 27

How many boluses can you give prior to escalation

Answer 27

6 - 2000mls

Question 28

Describe what happens if Methotrexate and NSAIDs are co-prescribed

Answer 28

Low platelet count

Question 29

Describe what happens if methotrexate and PPIs are co-prescribed

Answer 29

PPI - Enzyme inhibitor Increased level of methotrexate

Question 30

Name drugs most likely to cause ototoxicity

Answer 30

Gentamicin Vancomucin Furosemide Butenamide

Question 31

Name drugs most liekly to cause C.diff

Answer 31

Clindamycin Co-amox Cephalosporin Ciprofloxacin

Question 32

How often should you change a fentanyl patch

Answer 32

every 3 days

Question 33

when should an asthmatic patient seek medical help

Answer 33

The usual dose not preventing sx

Question 34

what are the symptoms of hypoglycaemia

Answer 34

Fast heartbeat. Shaking. Sweating. Nervousness or anxiety. Irritability or confusion. Dizziness. Hunger.

Question 35

What anti-depressants are licensed in anxiety

Answer 35

Escitalopram Sertraline Paroxetine 2nd line - Duloxetine - Venlafaxine

Question 36

What is the max dose of escitalopram in the elderly

Answer 36

10mg

Question 37

When are steroid prescribed

Answer 37

Morning

Question 38

When are statins prescribed

Answer 38

At night

Question 39

What medications cause diarrhoea

Answer 39

Antibiotics PPI Laxatives Antidepressants

Question 40

What medications cause oral thrush

Answer 40

Abx - Amoxicillin Inhaled ICS Immunosuppresant

Question 41

How does an Addisonian crisis present

Answer 41

Reduced consciousness Hypotension Hypoglycaemia hyponatraemia hyperkaemia