PSA Flashcards
(110 cards)
1
Q
Gentamicin SEs
A
Ototoxicity and nephrotoxicity
2
Q
Vancomycin SEs
A
Ototoxicity and nephrotoxicity
3
Q
Digoxin toxicity SEs
A
Confusion, arrhythmias, nausea, visual halos
4
Q
Lithium toxicity SEs
A
Early: fine tremor
Intermediate: tiredness
Late: arrhythmias, diabetes insipidus, seizures, coma, renal failure
5
Q
Phenytoin toxicity SEs
A
Gum hypertrophy, ataxia, nystagmus, peripheral neuropathy, teratogenicity
6
Q
Beta-blockers
A
Bronchospasm -> wheeze?
Bradycardia
Hypotension
Erectile dysfunction
CI in acute HF
CI with CCB
7
Q
DMARD SEs
A
Myelosuppression
Liver cirrhosis
8
Q
Test pre-biological DMARD therapy
A
CXR as anti-TNF-alpha Abs can restart pul TB
9
Q
Common reaction to statins
A
Myalgia
Abdo pain/ GI SEs
Increased ALT/AST
10
Q
Dangerous reaction to statins
A
Rhabdomyalysis
11
Q
Common causes of C difficile infection
A
Cephalosporins
Ciprofloxacin
Clindamycin
12
Q
ACEI SEs
A
Hypotension Electrolyte abnormalities AKI Dry cough angioedema - delayed reaction
13
Q
CCBs SEs
A
Hypotension
Bradycardia
Peripheral oedema
Flushing
CI with beta blocker
14
Q
Diuretic SEs
A
Hypotension
Electrolyte abnormalities
AKI
Sub-class effects
15
Q
Potassium sparing diuretics examples
A
Spironolactone
Amiloride
16
Q
Heparin SEs
A
Haemorrhage
Heparin-induced thrombocytopenia
Dalteparins etc -> hyperkalaemia
17
Q
Aspirin SEs
A
Haemorrhage
Peptic ulcers and gastritis
Tinnitus in large doses
18
Q
Digoxin SEs
A
Nausea Vomiting Diarrhoea Confusion Drowsiness Blurred vision Xanthopsia - halo vision
19
Q
Amiodarone
A
Interstitial lung disease eg pul fibrosis
Thyroid dysfunction eg hypo/hyper
Skin greying
Corneal deposits
20
Q
Haloperidol SEs
A
Dyskinesia eg acute dystonia, Parkinsonism (CI in Parkinson’s disease), tardive dyskinesia
21
Q
Clozapine SE
A
Agranulocytosis
22
Q
Steroid SEs
A
Stomach Ulcers Thin skin Edema Right and left heart failure Osteoporosis Infections eg candida Diabetes Syndrome Cushings
23
Q
NSAIDs SEs
A
No urine - renal failure Systolic dysfunction eg HF Asthma Indigestion and ulceration Dyscrasia
24
Q
Drugs with narrow therapeutic index
A
Warfarin
Phenytoin
Digoxin
Theophylline
25
Enzyme inducers
```
PC BRAS
Phenytoin
Carbamazepine
Barbituates
Rifampicin
Alcohol (chronic)
Sulphonyureas
```
26
Enzyme inhibitors
```
AODEVICES
Allopurinol
Omeprazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloaxcin
Ethanol (acute)
Sulphonamides
```
27
Drugs which require careful dosage control
Antihypertensives
| Antidiabetics
28
An alpha blocker used in hypertension?
Doxazocin
29
A dopamine agonist used for patients with a prolactinoma?
Cabergoline or bromocriptine
30
A dopamine antagonist that can be used for psychotic disorders or nausea?
Metoclopromide
31
Causes of gingival hyperplasia?
Phenytoin,
Ciclopsporin
CCBs
AML
32
Drug causes of tinnitus
Aspirin
Aminoglycosides eg gentamicin, tobramycin
Loop diuretics
Etoh
33
Drug causes of vertigo
Gentamicin
Loop diuretics
Metronidazole
Co-trimoxazole
34
Ototoxic drugs
```
Aspirin
Aminoglycosides
Loop diuretics
Quinines
Chemotherapy
```
35
Ankle oedema causes
Naproxen
| CCBs
36
Bradycardia
B blockers
B blocker + diltiazem/verapamil
Digoxin if wrong dose
37
How long to treat thrush for in pregnancy and what route?
PV, 7 days
38
First and second line therapy for C difficile
Vancomycin
| Fidaxomicin
39
Second line therapy for C diff or where 1st failed or not tolerated
Vancomycin
| Fidaxomicin
40
NSAID SEs esp in elderly
GI
| Renal impairment
41
Opioid SEs
anticholinergic
constipation
nausea
drowsiness
42
How should loperamide be taken?
After each loose stool
43
What monitoring should be done for cyclosporin?
U&Es for hyperkalaemia
| Serum creatinine/renal function before starting, every 2wks for first 3mths, then monthly
44
Common SE of GLP-1 agonists eg liraglutide
nausea/vomiting
45
Precipitators of serotonin syndrome
```
SSRI + TCA eg amitriptyline
+ tramadol (serotonin inducing)
lithium
metoclopromide
triptans
SNRIs
```
46
What should be monitored in first month with COCP and why?
BP, if >160/95 then need to stop
47
Opioid of choice in renal impairment
oxycodone - metabolites processed and broken down in liver so won't accumulate
morphine - most broken down in liver but produces 1 v active metabolite which is renally excreted in the process and will accumulate in renal impairment
48
Profuse haemorrhage mx in pt on warfarin
IV vit K + PCC + hold warfarin
49
Management of amiodarone induced thyroid dysfunction
hyperthyroidism - hold until controlled
| hypo - can not withdraw if replacement thyroid therapy given + supervision etc
50
Cyclophosphamide SEs
myelosuppression
haemorrhagic cystitis
transitional cell carcinoma
51
Vincristine SEs
peripheral neuropathy
urinary hesitancy (2 to bladder atony)
paralytic ileus
52
Bleomycin SE
Lung fibrosis
53
Doxorubicin SE
cardiomyopathy
54
Methotrexate SE
Myelosuppression, mucositis, liver fibrosis, lung fibrosis
55
Cisplatin SEs
ototoxicity
peripheral neuropathy
low Mg
56
ACE-I SEs
Cough
Hyperkalaemia
Angioedema (delayed onset)
57
Loop diuretics SEs
Tinnitus
Hypokalaemia
Postural hypotension
58
Thiazide diuretics SEs
```
Hypercalaemia
Hypokalaemia
Hyponatraemia
Dehydration
Postural hypotension
Gout
Impaired glucose tolerance
Impotence
```
Rarely - pancreatitis
59
Gliclazide SEs
Hypoglycaemia
| Hyponatraemia
60
When should levothyroxine be taken?
30mins before food - absorption may be affected by food, caffeine, other meds
61
Side effects of levothyroxine
hyperthyroidism
reduced mineral bone density
worsening of angina
AF
62
Contraindicated drugs in HF
```
Thiazolidinediones
Verapamil
NSAIDs (fluid retention + CV SEs)
Glucocorticoids (fluid retention)
Flecainide (negative inotrope, arrhythmogenic)
```
63
Cardiovascular effects of Tacrolimus and Cyclosporin
HTN
Hyperglycaemia
Tacro - hyperlipidaemia
64
What drug should be stopped as it accumulates in renal dysfunction?
Allopurinol
- either hold it or give max dose of 100mg OD until improves
65
When should anti-plts be held pre-surgery?
7 days
66
Drugs causing hyponatraemia
```
Thiazide diuretics
Loop diuretics
Gliclazide
SSRIs
Carbamazepine
Anti-psychotics
PPIs
```
67
What should be prescribed if pt on warfarin has INR of >1.5 on day of surgery?
Vit K
68
How should rivaroxaban be taken?
With food
69
What should be done in a female of child-bearing potential on topiramate?
Contraception that is NOT COCP - reduces efficacy and they have to continue it until 4wks finished topiramate therapy
70
Pt turns yellow on ABx, what is likely drug?
Co-amoxiclav causing cholestatic jaundice
More common in men>65
71
What drug can increase bleeding events if given with Dabigatran?
Citalopram
72
What rise in creatinine is acceptable when starting ACEI? What should be monitored?
<20%
| Repeat U&Es after 1 week
73
Side effects of cyclosporin? What should be monitored on this therapy?
Nephrotoxicity
Hypertension
Monitor BP regularly
Renal function tests at start and then every two weeks until stable
74
Na/K/Cl requirement per day for adult
1mmol/kg/L
75
Max rate of K+ infusion
20mmol/L
76
Drugs CI/cautioned in PVD
Beta-blockers
| ACE-I
77
Tests to be done before starting treatment with amiodarone
Serum potassium
LFTs
TFTs
CXR
78
What to do if patient presents with raised CK/muscle pain and is on statin?
Hold statin
| Reintroduce at lower dose if CK goes back to normal
79
What opiate is preferable in renal impairment?
Fentanyl or Oxycodone
80
Azathioprine SEs
Nausea/vomiting
Myelosuppression - do FBC if bleeding or infection occurs
Pancreatitis
81
What is long term PPI use a risk factor for?
Osteoporosis
82
A TB patient on treatment develops a malar rash, arthralgia and myalgia - what drug is responsible? What antibodies might indicate a drug induced cause?
Isoniazid
Ant-histone Abs POSITIVE
dsDNA NEGATIVE
83
Drugs causing lupus
Procainamide
Hydralazine
Isoniazid
84
Side effects of isoniazid
Hepatitis
Drug-induced lupus
Peripheral neuropathy
85
What should be checked before starting a patient on ethambutol and why?
Eye test
| Optic neuritis risk
86
What drug should be given to patients on isoniazid and why?
Pyridoxine (vit B6)
due to risk of peripheral neuropathy
87
Is azathioprine safe in pregnancy?
Yes
88
What drug can azathioprine react with dangerously?
Allopurinol
89
What screening is needed for patients taken hydroxychloroquine?
Bull's Eye Retinopathy before starting
| Annual screening
90
Sulfasalazine SE for men
Oligospermia
91
Drug appropriate for HTN with gout
Losartan
92
Main SE of colchicine?
Diarrhoea
93
What anti-HTNive should not be given with beta blockers in diabetes and why?
Thiazides as can cause insulin resistance
94
SE of PPIs
```
hyponatraemia
hypoMg
increased risk of C diff
osteoporosis
loose stools
```
95
SE of cisplatin
Peripheral neuropathy
Ototoxicity
Hypomagnesaemia
96
Bleomycin SE
Lung fibrosis
97
Doxorubicin SE
Cardiomyopathy
98
Side effects of alendronate
Diarrhoea
| GI SEs eg dyspepsia
99
Constipation drugs
1) Bulk forming - bran/isphagula husk
2) Osmotic - macrogol, lactulose
3) Stimulant - Senna, bisacodyl, docusate
100
Drugs indicated for opioid induced constipation
osmotic + stimulant
101
How fluid depleted are each of the following
1) decreased UO <30ml/h
2) decreased UO + tachy
3) decreased UO + shocked
1) 500ml
2) 1L
3) 2L
102
What fluid to initially give for resuscitation and how much can you give?
500ml 0.9% over 15mins, can give up to 2L
reassess after each bolus
If elderly or extensive co-morbidities eg HF+renal failure - 250ml boluses
103
What are the normal fluid requirements for an adult per day?
25-30ml/kg/day water
1mmol/kg/day K/Na/Cl
50-100g/day glucose
104
What anti-emetic causes fluid retention?
Cyclizine
105
What anti-emetic is CI in young people?
Metoclopromide
106
What drug may be used for diabetic neuropathy?
Duloxetine
107
What drugs should be avoided in asthmatics?
Beta-blockers
| NSAIDs
108
Possibilities of early early parkinsons treatment
Dopamine antagonist eg Ropinirole
| MAO-I inhibitor eg rasagiline
109
Pityriasis versicolour Mx
Ketoconazole shampoo 5%
110
When should montelukast be taken?
At night
