Random 5

Question 1

Common SEs (2) of ACE inhibitors

Answer 1

• Cough
• Hyperkalaemia

Question 2

Common SEs (4) of bendroflumethiazide

Answer 2

• Gout
• Hypokalaemia
• Hyponatraemia
• Impaired glucose tolerance

Question 3

Common SEs (3) of Calcium Channel Blocker

Answer 3

• Headache
• Flushing
• Ankle oedema

Question 4

Common SEs (3) of beta-blockers

Answer 4

• Bronchospasm (especially in asthmatics)
• Fatigue
• Cold peripheries

*erectile dysfunction

Question 5

Common SE (1) of Doxazosin

Answer 5

Postural hypotension

*Doxazosin = alpha-blocker used for BPH or hypertension

Question 6

Drugs prolonging Q-T interval

Answer 6

• amiodarone, sotalol, class 1a antiarrhythmic drugs
• tricyclic antidepressants, selective serotonin reuptake inhibitors (especially citalopram)
• methadone
• chloroquine
• terfenadine
• erythromycin
• haloperidol
• ondanestron

Question 7

Drugs exacerbating psoriasis (5)

Answer 7

• Lithium
• B-blockers
• anti-malarials
• NSAIDs
• withdrawal of corticosteroids

Question 8

Which of these drugs have interaction with chloramphenicol eye drops?

• Gliclazide
• Metformin
• Methotrexate
• Aspirin

Answer 8

• Chloramphenicol should not be prescribed with any other potentially bone marrow suppressing drugs (especially with Methotrexate)
• Co-trimoxazole and trimethoprim should similarly be avoided due to the increased risk of methotrexate toxicity and potential pancytopenia

Question 9

Can we give nitrates in aortic stenosis?

Answer 9

Nitrates are contraindicated in aortic stenosis

• this is due to theoretical risk of profound hypotension
• GTN spray and isosorbide dinitrate are both nitrates

Question 10

What can Penicillamine cause in a patient with Wilson’s disease?

Answer 10

Membranous Glomerulonephritis

Question 11

What electrolyte abnormality can suxamethonium cause?

Answer 11

Suxamethonium - neuromuscular block

It may cause hyperkalaemia (especially in burns/trauma patients)

Question 12

Which disease is a contradiction to the use of diclofenac?

Answer 12

Any cardiovascular disease

• NSAIDs may be linked to an increased risk of cardiovascular events
• Diclofenac associated with a significantly increased risk of cardiovascular events compared with other NSAIDs

It is therefore advised that diclofenac is contraindicated in patients with the following:

• ischaemic heart disease
• peripheral arterial disease
• cerebrovascular disease
• congestive heart failure (New York Heart Association classification II-IV)

Patients should be switched from diclofenac to other NSAIDs such as naproxen or ibuprofen

This advice does not apply to topical diclofenac.

Question 13

What to check before starting Azathioprine?

Answer 13

• Thiopurine methyltransferase (TPMT) test → to look for individuals prone to azathioprine toxicity
• Deficiency of TPMT predisposes to pancytopenia

Extra info re to Azathioprine:

SEs

• bone marrow depression
• nausea/vomiting
• pancreatitis
• increased risk of non-melanoma skin cancer

A significant interaction may occur with allopurinol and hence lower doses of azathioprine should be used.