Chapter 2 Qs Flashcards Preview

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Flashcards in Chapter 2 Qs Deck (23):

Q2.1 Give an example of 2 drugs that should be stopped in a pt with haemoptysis

Antiplatelets: Aspirin

Anticoagulants: LMWH


Q2.1 Give an example of 2 pescriptions that should be stopped in a hyperkalaemic patient 

ACEi (ramipril) 

IV fluid with added potassium 


Q2.2 What affect do these drugs have on K+ 

1. Bendroflumethiazide

2. Lisinopril

1. Bendroflumethiazide, thiazide diuretic, hypokalaemia 

2. Lisinopril, ACEi, hyperkalaemia


Q2.2 What is the mechanism of action of the following antiemetics: 

1. Metoclopramide:

2. Domperidone: 

3. Cyclizine:

1. Metoclopramide: dopamine antagonist, crosses BBB, exacerbated parkinsonian symproms

2. Domperidone: dopamine antagonist Doesn't cross BBB, safe in PD

3. Cyclizine: antihistamine anti-emetic



Q2.3 Name one drug which results in a dry cough as a SE 

ACE-I cause dry cough through accumulation of bradykinin via reduced degradation by ACE.


Q2.3 What affects do the following drugs have on electrolytes: 

1. Lisinopril

2. Bendroflumethiazide

1. Lisinopril, ACE-i cause hyperkalaemia via reduced aldosterone production, and reduced K+ excretion in kidneys (aldosterone antagonists do this too).

2. Bendroflumethiazide, is a thiazide diuretic which causes hypokalaemia (loop diuretics do this too) 


Q2.4. How do the following two drugs cause 'stomach upset': 

1. Ibuprofen

2. Prednisolone

1. Ibuprofen, NSAID, inhibits prostaglandin synthesis needed for gastric mucosal protection.

2. Prednisolone, Oral steroids inhibit gastric epithelial renewal.

Both → indigestion/dyspepsia.



Q2.4. How do the following two drugs cause renal falure: 

1. Ibuprofen

2. Ramipril

1. Ibuprofen, NSAID inhibits prostaglandin synthesis → reduced renal artery diameter → reduced kidney perfusion + function.

2. Ramipril, ACEi, reduces angiotensin II profuction req for preserving glomerular filtration when blood flow is reduced


Q2.5. Give an example of a drug type that should be stopped if patient is constipated

STOP opioids e.g. co-codamol, codeine


Q2.6 Common PMHx contra-indication for Ibuprofen 

Asthma: NSAIDs (e.g. ibuprofen) cause bronchoconstriction, so avoid unless strictly necessary + under supervision (not at home).


Q2.6 Important to remember regarding PRN medications

For prescription to be valid, must write maximum PRN frequency – can’t just write “as required” on its own.


Q2.6 CI for trimethoprim in a pt with RA on methotrexate 

Trimethoprim = folate antagonist, so CI with methotrexate (also folate antagonist) as risk of BM toxicity → pancytopenia + neutropenic sepsis.


Q2.6 Important to remember in a septic pt on methotrexate

If on methotrexate + septic, must stop it pending exclusion of neutropenic sepsis.


Q2.7 Important side effect on CCB

CCBs (e.g. amlodipine) cause ankle swelling. Do not use in HF.


Q2.7 How long after an ischaemic stroke should we wait to start LMWH?

Stop LMWH (e.g.enoxaparin) for 2 months (duration varies throughout UK) following an ischaemic stroke


Q.2.8 How to check how to manage warfarin and INR on the BNF 

Check BNF for this by typing in “warfarin INR”/Oral anticoagulants in search bar.

If patient has high warfarin (INR 5-8), withhold a few doses.

If patient on warfarin with INR >2 (i.e. therapeutic), then do not give prophylactic heparin as increases risk of bleeding unnecessarily.


Q2.9 Important trivia re asthma

1.Beta Blockers


3. Apsirin (NSAID) 

  1. Beta-blockers; strictly CI (can precipitate bronchospasm)
  2. NSAIDs; use with caution (can precipitate bronchospasm)
    • If asthmatic already on NSAID without problem, may continue.
  3. Aspirin, although an NSAID, very rarely worsens asthma – so commonly (but cautiously) used.


Q2.9 What is the maximum dose of aspirin?



Q2.9 What is Co-amoxiclav

= amoxicillin + clavulanic acid.


Q2.10 Common CI to microgynon

Microgynon ED is COCP – CI in migraine with aura, as significantly increases risk of stroke.


Q2.10 Max dose of Bisoprolol (&important drug to NOT co-prescribe)

 20 mg per day


Do NOT use with verapamil


Q2.10 Rout for Insulin?

All insulin is SC e.g. Novomix

except sliding scales using short-acting insulin (e.g. Actrapid or Novorapid) given by IV infusion.