PSA

Question 1

Name enzyme inducers and how they affect Drug concentration

Answer 1

Will increase activity of P450 enzymes and will decrease activity of drug

PC BRAS:
P henytoin,
C arbamazepine ,
B arbiturates,
R ifampicin,
A lcohol (chronic excess),
S ulphonylureas

Question 2

Name enzyme inhibitors and how they affect Drug concentration

Answer 2

Will increase drug concentration

AODEVICES:
A llopurinol,
O meprazole,
D isulfiram,
E rythromycin,
V alproate,
I soniazid,
C iprofloxacin,
E thanol (acute intoxication),
S ulphonamides

Question 3

Which drugs should be stopped before surgery?

Answer 3

I LACK OP

Combined oral contraceptive pill (COCP) and hormone replacement therapy (HRT) 4 weeks before surgery
Lithium Day before
Potassium-sparing diuretics and angiotensin-converting enzyme (ACE) -inhibitors Day of surgery

Question 4

Which diuretic will cause hypokalaemia and which hyperkalaemia?

Answer 4

Bendroflumethiazide, a thiazide diuretic, causes hypokalaemia by increasing potassium excretion via the kidney. Lisinopril (an ACE-inhibitor) can cause hyperkalaemia.

Question 4

What should you do with methotrexate in an active infection?

Answer 4

Withold methotraxate

Question 5

What is the difference between metoclopramide and domperidone?

Answer 5

Metoclopramide and domperidone are both dopamine antagonists. Metoclopramide crosses the blood-brain barrier (BBB), and so exacerbates parkinsoninan symptoms by acting on central dopamine receptors. Domperidone does not cross the BBB, and so is safe to use in Parkinson’s disease

Question 6

What is the therapeutic value of INR?

Answer 6

INR = 2 (‘therapeutic’)

Question 7

What medication together with a beta blocker can cause bradycardia, hypotention and even heart block?

Answer 7

Verapamil- calcium channel blocker

Question 8

Statins combined with what other drug can result in raised CK?

Answer 8

Macrolides : clarythromycin, erythromycin
Will cause rhambomyolisis

Question 9

What can cause an increased neutrophil count (neutrophilia) and what a decreased one (neutropenia)

Answer 9

Neutrophelia: bacterial infection
Neutrophelia: Viral infection, clozipine

Question 10

What are the side effects of Gentamycin and Vancomycin?

Answer 10

Ototoxicity and Nephrotoxicity

Question 11

How do you calculate the dose for Gentamycin?

Answer 11

Most patients are treated with a high-dose regimen of 5–7 mg/kg once daily ; patients with severe renal failure (creatinine clearance <20 mL/min) or endocarditis may receive a divided daily dosing (1 mg/kg) 12 hourly (in renal failure) or 8 hourly (in endocarditis) depending on individual hospital policy.

Question 12

What is the INR?

Answer 12

Reflection of the patients PT when compared to matched group

Question 13

How do you manage INR different INR levels and bleeding?

Answer 13

Question 14

How do you administer acetylcysteine?

Answer 14

The first infusion of acetylcysteine should be 150mg/kg administered over 1 hour. Therefore, the correct initial dose is 150 x 51 = 7650mg.

the second infusion (50mg/kg) which is administered over 4 hours following the completion of the first infusion.

Question 15

Woman that got on a dual hormone pill developes HTN, what should you do?

Answer 15

Stop oestrogen contraceptive pill to avoid any stroke risks

Question 16

What medication can interact with SSRI and result in serotonin syndrome ?

Answer 16

Sumitriptan

Question 17

Reflax in child

Answer 17

Alginate acid/ Alginate

Question 18

Detrusor overeactivity

Answer 18

Oxybutin- immediate release
overeactive bladder

Question 19

Opoiod OD

Answer 19

400 MICROGRAM IV infusion once only

Question 20

Elderly 12 hour a bag
Younger; 8 hour a bag

Answer 20

dextrose 5 %

Question 21

Anti hypertensive that causes leg swelling?

Answer 21

Amlodipine

Question 22

Carbamezopine and COCP

Answer 22

(COCP) and would be contraindicated in this case as the patient is taking carbamazepine (a potent enzyme inducer) which may potentially reduce its efficacy.

Question 23

Stress Incotinence and drugs

Answer 23

stress incontinence (e.g. leakage of urine upon coughing and sneezing). Duloxetine is a serotonin-noradrenaline **reuptake inhibitor (SNRI) **which sphincter tone, resulting in a reduction in symptoms of stress incontinence

Question 24

Urge incotinence

Answer 24

Oxybutynin, tolterodine, and darifenacin are **anticholinergics** used in the management of urge incontinence. Mirabegron is a beta-3 adrenergic receptor agonist, used as second-line management of urge incontinence.