S13 Flashcards
(17 cards)
Mr J, who is 77-years-old, was recently started on a new drug. Three weeks following initiation, Mr J was admitted into hospital and is found to have an abrupt decline in his glomerular filtration rate. He is otherwise well.
Amlodipine
Atenolol
Bendroflumethiazide
Bumetanide
Doxazosin
Lisinopril
Methyldopa
Verapamil
Lisinopril
Renal impairment may occur in patients with bilateral renal artery stenosis who have been initiated on an ACEI. Such patients rely on angiotensin II to maintain glomerular capillary pressure via vasoconstriction on the efferent arteriole. This is blocked by the ACEI, lisinopril, causing an abrupt decline in the glomerular filtration rate.
Mrs D, a 58-year-old nurse, is reporting cold hands and feet following the addition of a new drug.
Amlodipine
Atenolol
Bendroflumethiazide
Bumetanide
Doxazosin
Lisinopril
Methyldopa
Verapamil
Beta-blockers such as atenolol cause coldness of the extremities.
Mr A, a 53-year-old mechanic, reports a strong headache and swelling of his ankles a few days after starting a new drug.
Amlodipine
Atenolol
Bendroflumethiazide
Bumetanide
Doxazosin
Lisinopril
Methyldopa
Verapamil
Amlodipine
The dihydropyridine calcium channel blockers (e.g. nifedipine, amlodipine) cause peripheral vasodilation which leads to swollen ankles, headaches and flushing. Verapamil is another type of calcium channel blocker which is more selective to the heart.
Mrs R, a 73-year-old retired teacher, has reported extreme lethargy and dizziness 7 days after starting a second antihypertensive. She has already been taking atenolol for 10 years. Her heart rate was reported to be 45 bpm and her blood pressure as 75/40 mmHg.
Amlodipine
Atenolol
Bendroflumethiazide
Bumetanide
Doxazosin
Lisinopril
Methyldopa
Verapamil
Both verapamil and atenolol can increase the risk of bradycardia. This is a severe interaction
Mrs Y is a 49-year-old house wife. She has type 2 diabetes mellitus and hypertension. Her doctor has recently initiated her on a drug which she suspects is raising her blood glucose levels.
Amlodipine
Atenolol
Bendroflumethiazide
Bumetanide
Doxazosin
Lisinoppril
Methyldopa
Verapamil
Hyperglycaemia is an adverse effects of thiazide diuretics
Mr K, a 36-year-old shop assistant, was admitted into hospital after collapsing during a marathon. He was reported to have hypokalaemia, hyponatraemia and he was severely dehydrated.
Amlodipine
Atenolol
Bendroflumethiazide
Chloroquine
Doxazosin
Lisinopril
Methyldopa
Verapamil
Bendroflumethiazide
Thiazide diuretics can cause electrolyte imbalance such as a decline in the levels of potassium, sodium, magnesium and chloride.
Mrs J is a 26-year-old shop assistant who has been admitted into hospital after screaming hysterically in a public area. Upon questioning, her doctor finds out that she has frequent recurrent 20 minute episodes where she feels that she is going to die, her heart rate increases, she has chest pain and difficulty breathing. She is not on any medications and is otherwise well.
Acute stress disorder
Agoraphobia
Depression
Epilepsy
Generalised anxiety disorder
Panic disorder
Post-traumatic stress disorder
Social phobia
Panic disorder presents with physical and psychological signs and symptoms. It is characterised by recurrent, severe panic attacks and behavioural changes associated with these.
Mrs J is a 39-year-old bank assistant who has overwhelming worries about everyday aspects and is unable to relax. She reports periods where her fears worsen and she feels dizzy, gets palpitations, shortness of breath and flushes. She has had these signs and symptoms for the past 9 months.
Acute stress disorder
Agoraphobia
Depression
Epilepsy
Generalised anxiety disorder
Panic disorder
Post-traumatic stress disorder
Social phobia
Generalised anxiety disorder is characterised by persistent excessive and inappropriate anxiety on most days for at least 6 months. The anxiety is not restricted to a specific situation.
Mr K is a 31-year-old gate keeper who becomes very anxious in closed spaces such as an elevator and on the train.
Acute stress disorder
Agoraphobia
Depression
Epilepsy
Generalised anxiety disorder
Panic disorder
Post-traumatic stress disorder
Social phobia
Agoraphobia is where a person becomes afraid of places or situations from which escape might be difficult.
Mr L is a 37-year-old soldier who is unable to relax since returning from a conflict zone 3 months ago. He is irritable, has difficulty concentrating and falling asleep and feels helpless. He vividly recalls a traumatic experience where he witnessed a close friend’s death in a forest. He now avoids visits to the park.
Acute stress disorder
Agoraphobia
Depression
Epilepsy
Generalised anxiety disorder
Panic disorder
Post-traumatic stress disorder
Social phobia
Post-traumatic stress disorder
Post-traumatic stress disorder usually occurs after exposure to a traumatic event which involved actual or threatened death, or serious injury or threats to the physical integrity of self or others. The person responds with intense fear, helplessness or horror. Sufferers can re-experience symptoms (flashbacks) and avoid situations associated with the trauma. This condition usually occurs within 6 months of the traumatic event.
Miss G is a 26-year-old student who is quiet, has few friends and avoids social gatherings especially dining out as she feels that people will laugh at the way she eats.
Acute stress disorder
Agoraphobia
Depression
Epilepsy
Generalised anxiety disorder
Panic disorder
Post-traumatic stress disorder
Social phobia
Social phobia is where a person experiences a marked, persistent and unreasonable fear of being observed, embarrassed or humiliated in a social or performance situation (e.g. public speaking or eating in front of others).
An NHS prescription for atenolol dated 30/09/24.
30/06/24
28/07/24
30/09/24
30/03/25
30/06/25
30/09/25
Repeats are not allowed
There is no legally defined final dispensing date, it is based on clinical judgement
30/03/25
Prescriptions are valid for 6 months from the appropriate date.
A private prescription for atenolol dated 30/09/24.
30/06/24
28/07/24
1/10/24
30/03/25
30/06/26
30/09/25
Repeats are not allowed
There is no legally defined final dispensing date, it is based on clinical judgement
30/03/25
Prescriptions are valid for 6 months from the appropriate date.
The last repeat on a private prescription for candesartan signed and first dispensed on 30/06/24 and repeated on 30/07/24 and 30/08/24. The prescription requested 3 repeats.
30/06/24
28/07/24
1/10/24
30/03/25
30/06/25
30/09/25
Repeats are not allowed
There is no legally defined final dispensing date, it is based on clinical judgement
There is no legally defined final dispensing date, it is based on clinical judgement
There is no legal time limit on the dispensing of private repeat prescriptions if the first dispensing took place within 6 months of the appropriate date. It should be based on clinical judgement.
The first repeat on a private prescription for vardenafil signed on 30/06/24 and first dispensed on 01/01/25.
30/06/24
28/07/24
1/10/24
30/03/25
30/06/25
30/09/25
Repeats are not allowed
There is no legally defined final dispensing date, it is based on clinical judgement
Repeats are not allowed
The first dispensing should be within 6 months of the appropriate date. The first dispensing was incorrectly carried out a day after this time and the mistake must not be carried on.
A private prescription for a Schedule 2 CD signed on 03/09/24.
30/06/24
28/07/24
1/10/24
30/03/25
30/06/25
30/09/25
Repeats are not allowed
There is no legally defined final dispensing date, it is based on clinical judgement
1/10/24
Prescriptions for Schedule 2 CDS are valid for 28 days from the appropriate date, which in the case of a private prescription is the date of signing.
A final repeat on a private prescription requesting 3 repeats for a schedule 4 CD. The prescription was signed and first dispensed on 02/09/24.
30/06/24
28/07/24
1/10/24
30/03/25
30/06/25
30/09/25
Repeats are not allowed
There is no legally defined final dispensing date, it is based on clinical judgement
There is no legally defined final dispensing date, it is based on clinical judgement
There is no legal time limit on the dispensing of private repeat prescriptions for schedule 4 CDs if the first dispensing took place within 28 days of the appropriate date. It should be based on clinical judgement.
