1. MSRA Passmed > Meds > Flashcards

Meds Flashcards

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1
Q

Describe the mechanism of action of Domperidone.

A

Domperidone works by blocking dopamine receptors in the chemoreceptor trigger zone (CTZ) of the brain, providing anti-emetic effects without crossing the blood-brain barrier.

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2
Q

Explain the side effects associated with calcium channel blockers.

A

Calcium channel blockers can cause side effects such as headache, flushing, and ankle oedema.

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3
Q

Define the contraindication for Pioglitazone.

A

Pioglitazone is contraindicated in patients with heart failure.

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4
Q

How do beta-blockers affect patients with erectile dysfunction?

A

Beta-blockers, such as bisoprolol, can cause erectile dysfunction as a side effect.

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5
Q

What is the recommendation for thiazide use in patients with poorly controlled hypertension?

A

In patients with poorly controlled hypertension already taking an ACE inhibitor and a calcium channel blocker, a thiazide-like diuretic should be added.

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6
Q

Explain the use of pirfenidone and nintedanib in idiopathic pulmonary fibrosis (IPF).

A

Pirfenidone and nintedanib are used in the management of IPF as they may decrease functional decline, prolong survival, and potentially reduce acute exacerbations.

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7
Q

Describe the precautions for using ulipristal acetate in women with asthma.

A

FSRH guidance advises that ulipristal acetate should be used with caution in women with severe asthma controlled with oral glucocorticoids.

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8
Q

What is the effect of iron and calcium carbonate tablets on levothyroxine absorption?

A

Iron and calcium carbonate tablets can reduce the absorption of levothyroxine and should be taken 4 hours apart.

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9
Q

How does erythromycin affect the QT interval?

A

Erythromycin can cause a prolonged QT interval and is associated with cardiotoxicity, including ventricular arrhythmias.

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10
Q

List the side effects of Amiodarone.

A

Amiodarone side effects include pulmonary fibrosis, thyroid disturbances, a slate-grey appearance of the skin, and further arrhythmias.

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11
Q

What monitoring is required for Ramipril and Candesartan?

A

Both Ramipril (an ACE inhibitor) and Candesartan (an angiotensin 2 receptor blocker) require regular monitoring of renal function and electrolytes.

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12
Q

Describe the specific indication for Nimodipine.

A

Nimodipine is specifically indicated for the prevention of cerebral vasospasm following subarachnoid haemorrhage (SAH) and is administered to patients for 21 days after the initial bleed.

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13
Q

What is the role of Spironolactone in diuretic therapy?

A

Spironolactone is a potassium-sparing diuretic that acts as an aldosterone antagonist and has anti-androgen effects, which can lead to gynaecomastia.

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14
Q

What is the recommended treatment for acne vulgaris in pregnancy?

A

Oral erythromycin is recommended for the treatment of acne vulgaris in pregnancy if treatment is needed.

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15
Q

Identify the potential ototoxicity associated with loop diuretics.

A

Loop diuretics, such as bumetanide and furosemide, may cause ototoxicity.

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16
Q

What SSRIs are preferred for breastfeeding women?

A

Sertraline and paroxetine are the SSRIs of choice for breastfeeding women.

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17
Q

Describe the mechanism by which spironolactone can lead to gynaecomastia.

A

Spironolactone inhibits androgen receptors, causing an imbalance between oestrogen and testosterone levels, which can lead to gynaecomastia.

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18
Q

Identify the drugs that impair wound healing.

A

Non-steroidal anti-inflammatory drugs, steroids, immunosuppressive agents, and anti-neoplastic drugs impair wound healing.

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19
Q

Explain the most common causes of drug-induced lupus erythematosus.

A

The most common causes of drug-induced lupus erythematosus are procainamide and hydralazine.

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20
Q

List less common causes of drug-induced lupus erythematosus.

A

Less common causes include isoniazid, minocycline, and phenytoin.

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21
Q

How can lithium toxicity be precipitated?

A

Lithium toxicity can be precipitated by factors that reduce renal clearance, such as dehydration, renal failure, and certain drugs like thiazide diuretics, ACE inhibitors, NSAIDs, and metronidazole.

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22
Q

Describe the action of bendroflumethiazide in relation to lithium.

A

Bendroflumethiazide is a thiazide diuretic that inhibits sodium reabsorption in the distal convoluted tubule, leading to increased water excretion but also decreases lithium excretion, raising the risk of lithium toxicity.

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23
Q

What are the symptoms of severe lithium toxicity?

A

Symptoms of severe lithium toxicity may include confusion, ataxia, seizures, and coma.

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24
Q

Identify a medication useful for managing tremor in drug-induced parkinsonism.

A

Procyclidine is useful for managing tremor in drug-induced parkinsonism.

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25
What side effects are associated with beta blockers?
Side effects of beta blockers include bronchospasm, cold peripheries, fatigue, sleep disturbances (including nightmares), and erectile dysfunction.
26
List contraindications for prescribing beta blockers.
Contraindications for beta blockers include uncontrolled heart failure, asthma, sick sinus syndrome, and concurrent use of verapamil.
27
Explain the impact of thiazolidinediones on heart failure.
Thiazolidinediones, such as pioglitazone, are contraindicated in heart failure as they cause fluid retention.
28
What medications should be used with caution in patients with heart failure?
Medications that should be used with caution in heart failure include NSAIDs, glucocorticoids, and class I antiarrhythmics like flecainide.
29
Describe the drugs that can cause cholestasis or hepatitis.
Drugs that can cause cholestasis or hepatitis include the combined oral contraceptive pill, certain antibiotics (like flucloxacillin and erythromycin), anabolic steroids, phenothiazines, sulphonylureas, and fibrates.
30
Identify drugs associated with liver cirrhosis.
Drugs associated with liver cirrhosis include methotrexate, methyldopa, and amiodarone.
31
What is the recommended medication regimen for angina management?
All patients with angina should receive aspirin and a statin, along with sublingual glyceryl trinitrate to abort attacks.
32
How should beta-blockers and calcium channel blockers be used in angina treatment?
Beta-blockers or calcium channel blockers should be used first-line based on comorbidities, contraindications, and patient preference; rate-limiting calcium channel blockers like verapamil or diltiazem should be used as monotherapy.
33
What is the recommendation for calcium channel blockers used in combination with beta-blockers?
When used in combination with beta-blockers, a longer-acting dihydropyridine calcium channel blocker should be used.
34
Describe the risk associated with prescribing beta-blockers concurrently with verapamil.
There is a risk of complete heart block when beta-blockers are prescribed concurrently with verapamil.
35
Explain the approach to take if a patient has a poor response to initial treatment with a beta-blocker.
If there is a poor response to initial treatment, the medication should be increased to the maximum tolerated dose, for example, atenolol can be increased to 100mg once daily.
36
How should treatment be adjusted if a patient remains symptomatic after monotherapy with a beta-blocker?
If a patient is still symptomatic after monotherapy with a beta-blocker, a calcium channel blocker should be added, and vice versa.
37
What alternatives should be considered if a patient cannot tolerate the addition of a calcium channel blocker or a beta-blocker?
Consider using a long-acting nitrate, ivabradine, nicorandil, or ranolazine.
38
When is it appropriate to add a third drug for a patient on both a beta-blocker and a calcium-channel blocker?
A third drug should only be added while the patient is awaiting assessment for PCI or CABG.
39
List some drugs that can cause tinnitus.
Aspirin/NSAIDs, aminoglycosides, loop diuretics, and quinine can cause tinnitus.
40
Identify the drugs that may cause drug-induced photosensitivity.
Thiazides, tetracyclines, sulphonamides, ciprofloxacin, amiodarone, NSAIDs (e.g., piroxicam), psoralens, and sulphonylureas can cause photosensitivity.
41
What medications are known to cause urinary retention?
Tricyclic antidepressants (e.g., amitriptyline), anticholinergics (e.g., antipsychotics, antihistamines), opioids, NSAIDs, and disopyramide can cause urinary retention.
42
Describe the first-line therapy for a first episode of C. difficile infection.
The first-line therapy for a first episode of C. difficile infection is oral vancomycin for 10 days.
43
What is the second-line therapy for a first episode of C. difficile infection?
The second-line therapy is oral fidaxomicin.
44
Explain the treatment options for recurrent episodes of C. difficile infection within 12 weeks of symptom resolution.
Within 12 weeks of symptom resolution, the treatment option is oral fidaxomicin.
45
What should be done after 12 weeks of symptom resolution for recurrent C. difficile infection?
After 12 weeks of symptom resolution, either oral vancomycin or fidaxomicin can be used.
46
What is the treatment for life-threatening C. difficile infection?
The treatment for life-threatening C. difficile infection is oral vancomycin and IV metronidazole, with specialist advice for possible surgery.
47
Identify drugs that can cause hyponatraemia by affecting antidiuretic hormone (ADH).
Diuretics (especially thiazides), SSRIs, antipsychotics (e.g., haloperidol), NSAIDs, and carbamazepine can cause hyponatraemia.
48
List the side effects associated with Methotrexate.
Methotrexate can cause myelosuppression, liver cirrhosis, and pneumonitis.
49
What side effects are associated with Sulfasalazine?
Sulfasalazine can cause rashes, oligospermia, Heinz body anaemia, and interstitial lung disease.
50
Describe the side effects of Leflunomide.
Leflunomide can cause liver impairment, interstitial lung disease, and hypertension.
51
What are the side effects of Hydroxychloroquine?
Hydroxychloroquine can cause retinopathy and corneal deposits.
52
List the side effects of Prednisolone.
Prednisolone can cause Cushingoid features, osteoporosis, impaired glucose tolerance, hypertension, and cataracts.
53
What side effects are associated with Gold therapy?
Gold therapy can cause proteinuria.
54
Identify the side effects of Penicillamine.
Penicillamine can cause proteinuria and exacerbation of myasthenia gravis.
55
What are the common side effects of Etanercept?
Etanercept can cause demyelination and reactivation of tuberculosis.
56
List the side effects of Infliximab.
Infliximab can cause reactivation of tuberculosis.
57
What side effects are associated with Adalimumab?
Adalimumab can cause reactivation of tuberculosis.
58
Describe the common reactions associated with Rituximab.
Infusion reactions are common with Rituximab.
59
What side effects can NSAIDs cause in asthmatics?
NSAIDs can cause bronchospasm in asthmatics.
60
List the antibiotics that can be safely given to breastfeeding mothers.
Safe antibiotics for breastfeeding mothers include penicillins, cephalosporins, and trimethoprim.
61
What endocrine medications are safe for breastfeeding mothers?
Glucocorticoids (at low doses) and levothyroxine are safe for breastfeeding mothers.
62
Identify the epilepsy medications that can be given to breastfeeding mothers.
Sodium valproate and carbamazepine can be given to breastfeeding mothers.
63
What asthma medications are safe for breastfeeding mothers?
Salbutamol and theophyllines are safe for breastfeeding mothers.
64
List the psychiatric drugs that can be safely used by breastfeeding mothers.
Tricyclic antidepressants and antipsychotics can be safely used by breastfeeding mothers.
65
What antihypertensive medications are safe for breastfeeding mothers?
Beta-blockers and hydralazine are safe for breastfeeding mothers.
66
Identify the anticoagulants that can be used during breastfeeding.
Warfarin and heparin can be used during breastfeeding.
67
What drugs should be avoided during breastfeeding?
Drugs to avoid during breastfeeding include ciprofloxacin, tetracycline, chloramphenicol, sulphonamides, lithium, benzodiazepines, aspirin, carbimazole, methotrexate, sulfonylureas, cytotoxic drugs, and amiodarone.
68
What is the recommended treatment for exacerbations of chronic bronchitis?
The recommended treatment for exacerbations of chronic bronchitis is amoxicillin, tetracycline, or clarithromycin.
69
Describe the treatment for uncomplicated community-acquired pneumonia.
The treatment for uncomplicated community-acquired pneumonia is amoxicillin, with doxycycline or clarithromycin for those allergic to penicillin, and flucloxacillin if staphylococci are suspected.
70
Describe the recommended treatment for lower urinary tract infections.
Trimethoprim or nitrofurantoin. Alternatives include amoxicillin or cephalosporin.
71
Explain the treatment options for acute pyelonephritis.
Broad-spectrum cephalosporin or quinolone.
72
Define the treatment for acute prostatitis.
Quinolone or trimethoprim.
73
How is impetigo treated?
Topical hydrogen peroxide, or oral flucloxacillin or erythromycin if widespread.
74
What is the recommended treatment for cellulitis?
Flucloxacillin; clarithromycin, erythromycin, or doxycycline if penicillin-allergic.
75
Describe the treatment for cellulitis near the eyes or nose.
Co-amoxiclav; clarithromycin plus metronidazole if penicillin-allergic.
76
Explain the treatment for erysipelas.
Flucloxacillin; clarithromycin, erythromycin, or doxycycline if penicillin-allergic.
77
What is the recommended treatment for animal or human bites?
Co-amoxiclav; doxycycline plus metronidazole if penicillin-allergic.
78
How is mastitis during breastfeeding treated?
Flucloxacillin.
79
Define the treatment for throat infections.
Phenoxymethylpenicillin; erythromycin alone if penicillin-allergic.
80
What is the recommended treatment for sinusitis?
Phenoxymethylpenicillin.
81
Explain the treatment for otitis media.
Amoxicillin; erythromycin if penicillin-allergic.
82
Describe the treatment for otitis externa.
Flucloxacillin; erythromycin if penicillin-allergic.
83
What is the recommended treatment for periapical or periodontal abscess?
Amoxicillin.
84
How is acute necrotising ulcerative gingivitis treated?
Metronidazole.
85
Define the treatment for gonorrhoea.
Intramuscular ceftriaxone.
86
What is the recommended treatment for chlamydia?
Doxycycline or azithromycin.
87
Explain the treatment for pelvic inflammatory disease.
Oral ofloxacin plus oral metronidazole or intramuscular ceftriaxone plus oral doxycycline plus oral metronidazole.
88
Describe the treatment for syphilis.
Benzathine benzylpenicillin or doxycycline or erythromycin.
89
What is the recommended treatment for bacterial vaginosis?
Oral or topical metronidazole or topical clindamycin.
90
How is Clostridioides difficile infection treated for the first episode?
Oral vancomycin.
91
Explain the treatment for second or subsequent episodes of Clostridioides difficile infection.
Oral fidaxomicin.
92
Define the treatment for Campylobacter enteritis.
Clarithromycin.
93
What is the recommended treatment for non-typhoid Salmonella?
Ciprofloxacin.
94
Describe the treatment for shigellosis.
Ciprofloxacin.
95
Explain the mechanism of action of Suxamethonium.
It is a depolarising neuromuscular blocker that inhibits the action of acetylcholine at the neuromuscular junction.
96
What are the characteristics of Suxamethonium?
Fastest onset and shortest duration of action among muscle relaxants; produces generalized muscular contraction prior to paralysis.
97
Describe the adverse effects of Suxamethonium.
Includes hyperkalaemia, malignant hyperthermia, and lack of acetylcholinesterase.
98
Define the characteristics of Atracurium.
A non-depolarising neuromuscular blocking drug with a duration of action of 30-45 minutes, causing histamine release.
99
What is the mechanism of action of Vecuronium?
It is a non-depolarising neuromuscular blocking drug with a duration of action of approximately 30-40 minutes.
100
Explain how Pancuronium works as a muscle relaxant.
It is a non-depolarising neuromuscular blocker with an onset of action of 2-3 minutes and a duration of up to 2 hours.
101
Describe the effects of Amlodipine on the vascular system.
It causes arteriolar vasodilation without venodilation, leading to increased capillary hydrostatic pressure and ankle oedema.
102
Describe the mechanism of action of Bendroflumethiazide.
Bendroflumethiazide blocks sodium and chloride reabsorption in the distal tubule, leading to sodium loss greater than water loss, which can result in hyponatraemia, while also increasing calcium reabsorption.
103
Explain the side effects associated with Bendroflumethiazide.
The side effects of Bendroflumethiazide include gout, hypokalaemia, hyponatraemia, and impaired glucose tolerance.
104
Define the primary effects of Atenolol on the cardiovascular system.
Atenolol decreases cardiac output and causes peripheral vasoconstriction through beta-2 blockade and unopposed alpha activity, which can lead to cold peripheries.
105
List the common side effects of ACE inhibitors.
Common side effects of ACE inhibitors include cough and hyperkalaemia.
106
How do calcium channel blockers affect patients?
Calcium channel blockers can cause side effects such as headache, flushing, and ankle oedema.
107
Explain the potential side effects of beta-blockers.
Beta-blockers may cause bronchospasm (especially in asthmatics), fatigue, and cold peripheries.
108
Describe the side effects of Doxazosin.
Doxazosin can lead to postural hypotension as a side effect.
109
What is the time frame for starting Atovaquone + proguanil (Malarone) before travel?
Atovaquone + proguanil (Malarone) should be started 1 to 2 days before travel.
110
How long should Atovaquone + proguanil (Malarone) be continued after travel?
Atovaquone + proguanil (Malarone) should be continued for 7 days after travel.
111
Define the side effects of Chloroquine.
Chloroquine can cause headache and is contraindicated in patients with epilepsy.
112
What is the recommended duration for taking Chloroquine before and after travel?
Chloroquine should be taken 1 week before travel and continued for 4 weeks after travel.
113
Explain the side effects associated with Doxycycline.
Doxycycline can cause photosensitivity and oesophagitis.
114
What is the time frame for starting Doxycycline before travel?
Doxycycline should be started 1 to 2 days before travel.
115
How long should Doxycycline be taken after travel?
Doxycycline should be taken for 4 weeks after travel.
116
Describe the side effects of Mefloquine (Lariam).
Mefloquine can cause dizziness and neuropsychiatric disturbances, and it is contraindicated in epilepsy.
117
What is the recommended time to start Mefloquine before travel?
Mefloquine should be started 2 to 3 weeks before travel.
118
How long should Mefloquine be continued after travel?
Mefloquine should be continued for 4 weeks after travel.
119
Explain the duration for taking Proguanil (Paludrine) before and after travel.
Proguanil (Paludrine) should be taken 1 week before travel and continued for 4 weeks after travel.
120
What is the combination treatment of Proguanil + chloroquine and its timing?
Proguanil + chloroquine should be started 1 week before travel and continued for 4 weeks after travel.
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