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Question 1
Correct
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You proceed to administer lorazepam intravenously to a 21-year-old patient with status epilepticus. Which of the following best describes lorazepam's action?
Your Answer: Potentiates effect of GABA
Explanation:Lorazepam is a type of benzodiazepine.
Benzodiazepines are gamma-aminobutyric acid (GABA) receptor agonists with sedative, hypnotic, anxiolytic, anticonvulsant, and muscle relaxant characteristics that promote inhibitory synaptic transmission across the central nervous system.
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This question is part of the following fields:
- Central Nervous System
- Pharmacology
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Question 2
Correct
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A 70-year-old woman presents with right-sided loss of pain and temperature sense on the body as well as left-sided loss of pain and temperature sense on the face. She also has complaints of vertigo, nausea, and tinnitus. Further examination of her cranial nerves suggest the presence of Horner's Syndrome. An MRI and CT scan was ordered and results showed that she is suffering from a left-sided stroke.
Branches of which of the following arteries are most likely implicated in the case?Your Answer: Posterior inferior cerebellar artery
Explanation:Wallenberg syndrome is also known as lateral medullary syndrome and posterior inferior cerebellar artery syndrome. It is the most common posterior circulation ischemic stroke syndrome. The primary pathology of Wallenberg syndrome is occlusion of the posterior inferior cerebellar artery (PICA) or one of its branches.
It is characterized by vertigo with nystagmus, nausea and vomiting, and sometimes hiccups, dysphonia, dysarthria, and dysphagia often present with ipsilateral loss of gag reflex, ipsilateral ataxia with a tendency to fall to the ipsilateral side, pain and numbness with impaired facial sensation on the face, impaired taste sensation, and impaired pain and temperature sensation in the arms and legs.
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This question is part of the following fields:
- Anatomy
- Central Nervous System
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Question 3
Correct
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A patient is found to be anaemic. Which one of the following blood results would favour a diagnosis of anaemia of chronic disease rather than iron deficiency:
Your Answer: Low total iron binding capacity (TIBC)
Explanation:Anaemia of chronic disease is one of the most common causes of normocytic anaemia. The anaemia is usually mild (Hb > 90 g/L) and non-progressive. Anaemia of chronic disease is usually associated with low serum iron, low transferrin saturation, and a low total iron binding capacity (TIBC) with normal or raised ferritin which differentiates it from iron deficiency anaemia.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 4
Correct
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A CT pulmonary angiography of a patient with a massive pulmonary embolus will most likely show which of the following signs?
Your Answer: Increased alveolar dead space
Explanation:A CT pulmonary angiogram is an angiogram of the blood vessels of the lungs. It is a diagnostic imaging test used to check for pulmonary embolism.
A pulmonary embolism is caused by a blood clot or thrombus that has become lodged in an artery in the lung and blocks blood flow to the lung. A patient with pulmonary embolism may feel an abrupt onset of pleuritic chest pain, shortness of breath, and hypoxia. Also, pulmonary embolism can result in alveolar dead space.
Dead space represents the volume of ventilated air that does not participate in gas exchange. The alveolar dead space is caused by ventilation/perfusion imbalances in the alveoli. It is defined as the sum of the volumes of alveoli that are ventilated but not perfused.
Aside from pulmonary embolism, smoking, bronchitis, emphysema, and asthma are among the other causes of alveolar dead space.
The other types of dead space are the following: Anatomical dead space is the portion of the airways that conducts gas to the alveoli. This is usually around 150 mL, and there is no possibility of gas exchange in these areas. Physiological dead space is the sum of anatomical and alveolar dead spaces.
Physiological dead space can account for up to 30% of the tidal volume.
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This question is part of the following fields:
- Physiology
- Respiratory Physiology
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Question 5
Correct
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What is the most common application of Nitrates?
Your Answer: Angina
Explanation:In patients with exertional stable angina, nitrates improve exercise tolerance, time to onset of angina, and ST-segment depression during exercise testing. In combination with beta-blockers or calcium channel blockers, nitrates produce greater anti-anginal and anti-ischemic effects.
While they act as vasodilators, coronary vasodilators, and modest arteriolar dilators, the primary anti ischemic effect of nitrates is to decrease myocardial oxygen demand by producing systemic vasodilation more than coronary vasodilation. This systemic vasodilation reduces left ventricular systolic wall stress. -
This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 6
Correct
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Regarding diuretics, which of the following statements is CORRECT:
Your Answer: Carbonic anhydrase inhibitors have their effect by inhibiting bicarbonate reabsorption.
Explanation:Carbonic anhydrase inhibitors e.g. acetazolamide block the reaction of carbon dioxide and water and so prevent Na+/H+exchange and bicarbonate reabsorption. The increased bicarbonate levels in the filtrate oppose water reabsorption. Proximal tubule sodium reabsorption is also reduced because it is partly dependent on bicarbonate reabsorption.
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This question is part of the following fields:
- Physiology
- Renal
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Question 7
Correct
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Which of the following medications may lessen warfarin's anticoagulant effect:
Your Answer: Phenytoin
Explanation:Phenytoin will decrease the level or effect of warfarin by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Metronidazole will increase the level or effect of warfarin by affecting hepatic enzyme CYP2C9/10 metabolism.
NSAIDs, when given with Warfarin, increase anticoagulation. -
This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 8
Correct
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A 32 year old man is brought to ED having been thrown off his motorbike. Following initial resuscitation and ruling out life-threatening injuries, you establish the patient has weakness of hip flexion. Which of the following nerves has most likely been injured:
Your Answer: Femoral nerve
Explanation:Flexion of the hip is produced by the iliacus, the psoas major, the sartorius, rectus femoris and the pectineus muscles. The femoral nerve innervates the iliacus, pectineus, sartorius and quadriceps femoris muscles, and supplies skin on the anterior thigh, anteromedial knee and medial leg.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 9
Correct
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Regarding the glomerular filtration barrier, which of the following statements is CORRECT:
Your Answer: The main factor determining whether a substance is filtered or not is molecular weight.
Explanation:Molecular weight is the main factor in determining whether a substance is filtered or not – molecules < 7 kDa in molecular weight are filtered freely e.g. glucose, amino acids, urea, ions but larger molecules are increasingly restricted up to 70 kDa, above which filtration is insignificant. Negatively charged molecules are further restricted, as they are repelled by negative charges, particularly in the basement membrane. Albumin has a molecular weight of 69 kDa and is negatively charged, thus only very small amounts are filtered (and all of the filtered albumin is reabsorbed in the proximal tubule), whereas small molecules such as ions, glucose, amino acids and urea pass the filter without hindrance. This means that ultrafiltrate is virtually protein free, but otherwise has an identical composition of that of plasma. The epithelial lining of the Bowman's capsule consists of a single layer of cells called podocytes. The glomerular capillary endothelium is perforated by pores (fenestrations) which allow plasma components with a molecular weight of < 70 kDa to pass freely.
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This question is part of the following fields:
- Physiology
- Renal
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Question 10
Correct
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A mother has serious concerns about vaccinating her child. She has read about many contraindications and risks in the papers and would like to discuss them with you.
One of these is a valid contraindication to vaccination.
Your Answer: None of the other options
Explanation:The options listed in this question are not true contraindications to vaccination. Therefore, the correct answer is ‘none of the other options’.
The contraindications to vaccination are:
Confirmed anaphylactic reaction to a previous dose of the vaccine or a vaccine containing the same antigens.
A confirmed anaphylactic reaction to another component in the vaccine. -
This question is part of the following fields:
- Microbiology
- Principles Of Microbiology
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Question 11
Correct
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How is filtered K+mainly reabsorbed in the thick ascending limb of the loop of Henle:
Your Answer: Secondary active transport via Na + /K + /2Cl - cotransporter
Explanation:Around 30% of filtered K+is reabsorbed in the thick ascending limb of the loop of Henle, primarily via the luminal Na+/K+/2Cl-cotransporter, but there is also significant paracellular reabsorption, encouraged by the positive potential in the tubular lumen.
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This question is part of the following fields:
- Physiology
- Renal
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Question 12
Correct
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A 30-year-old woman is transfused following a diagnosis of anaemia secondary to heavy vaginal bleeding. She complains of feeling hot and cold during transfusion of the second unit and her temperature is 38.5ºC. Prior to the transfusion, her temperature was 37ºC. She has no other symptoms.
Which of these transfusions reactions most likely occurred?Your Answer: Febrile transfusion reaction
Explanation:Febrile transfusion reactions presents with an unexpected temperature rise (≥ 38ºC or ≥ 1ºC above baseline, if baseline ≥ 37ºC) during or shortly after transfusion. It is usually an isolated finding and the fever is accompanied by chills and malaise occasionally.
Allergic reaction is commonly caused by foreign plasma proteins but may be due to anti-IgA. Allergic type reactions usually present with urticaria, pruritus, hives. Associations include laryngeal oedema or bronchospasm.
Acute haemolytic reaction aka immediate haemolytic transfusion reaction presents with fever, chills, pain at transfusion site, nausea, vomiting, dark urine and feeling of ‘impending doom’. Often, it occurs due to ABO incompatibility.
Transfusion-associated circulatory overload (TACO) presents as acute or worsening respiratory distress within 6 hours of transfusion of a large volume of blood. It is common in patients with diminished cardiac reserve or chronic anaemia. Elderly patients, infants and severely anaemic patients are particularly susceptible. Clinical features of TACO include: Acute respiratory distress, Tachycardia, Hypertension, Acute/worsening pulmonary oedema on chest X-ray. The BNP is usually raised to at least 1.5 times the pre-transfusion baseline.
Transfusion-related lung injury (TRALI) is a form of acute respiratory distress caused by the donor plasma containing antibodies against the patient’s leukocytes. It is defined as hypoxia and bilateral pulmonary oedema that occurs within 6 hours of a transfusion in the absence of other causes of acute lung injury. Clinical features include Breathlessness, cough, frothy sputum, hypertension or hypotension, hypoxia and fever. Chest X-ray shows multiple perihilar nodules with infiltration of the lower lung fields.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 13
Correct
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The neurotransmitter in the synaptic cleft is either eliminated or deactivated after the postsynaptic cell responds to the neurotransmitter.
Which of the following enzymes catalyses the breakdown of noradrenaline?Your Answer: Catechol-O-methyltransferase (COMT)
Explanation:The neurotransmitter in the synaptic cleft is either eliminated or deactivated after the post-synaptic cell responds to the neurotransmitter.
This can be accomplished in a variety of ways:
Re-uptake
Breakdown
DiffusionSerotonin is an example of a neurotransmitter that is uptake. Serotonin is absorbed back into the presynaptic neuron via the serotonin transporter (SERT), which is found in the presynaptic membrane. Re-uptake neurotransmitters are either recycled by repackaging into vesicles or broken down by enzymes.
Specific enzymes found in the synaptic cleft can also break down neurotransmitters. The following enzymes are examples of these enzymes:
Acetylcholinesterase (AChE) catalyses the acetylcholine breakdown (ACh)
The enzyme catechol-O-methyltransferase (COMT) catalyses the breakdown of catecholamines like adrenaline , dopamine and noradrenaline.The breakdown of catecholamines, as well as other monoamines like serotonin, tyramine, and tryptamine, is catalysed by monoamine oxidases (MOA).
Diffusion of neurotransmitters into nearby locations can also be used to eliminate them. -
This question is part of the following fields:
- Basic Cellular Physiology
- Physiology
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Question 14
Correct
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Which of the following is an example of discrete data:
Your Answer: Number of children
Explanation:Discrete data is quantitative data that can only take whole numerical values e.g. number of children, number of days missed from work.
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This question is part of the following fields:
- Evidence Based Medicine
- Statistics
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Question 15
Correct
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A tumour compresses the jugular foramen of a 50-year-old patient. Compression of several nerves in the jugular foramen will result in which of the following complications?
Your Answer: Loss of gag reflex
Explanation:The glossopharyngeal nerve, which is responsible for the afferent pathway of the gag reflex, the vagus nerve, which is responsible for the efferent pathway of the gag reflex, and the spinal accessory nerve all exit the skull through the jugular foramen. These nerves are most frequently affected if the jugular foramen is compressed. As a result, the patient’s gag reflex is impaired.
The vestibulocochlear nerve is primarily responsible for hearing. The trigeminal nerve provides sensation in the face. The facial nerve innervates the muscles of face expression (including those responsible for closing the eye). Tongue motions are controlled mostly by the hypoglossal nerve.
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This question is part of the following fields:
- Anatomy
- Cranial Nerve Lesions
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Question 16
Correct
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An ambulance transports a 37-year-old woman who is having a seizure. She is moved to resuscitation and given a benzodiazepine dose, which quickly ends the seizure. You later learn that she has epilepsy and is usually treated with carbamazepine to control her seizures.
What is carbamazepine's main mechanism of action?Your Answer: Sodium channel blocker
Explanation:Carbamazepine is primarily used to treat epilepsy, and it is effective for both focal and generalised seizures. It is not, however, effective in the treatment of absence or myoclonic seizures. It’s also commonly used to treat neuropathic pain, as well as a second-line treatment for bipolar disorder and as a supplement for acute alcohol withdrawal.
Carbamazepine works as a sodium channel blocker that preferentially binds to voltage-gated sodium channels in their inactive state. This prevents an action potential from firing repeatedly and continuously.
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This question is part of the following fields:
- CNS Pharmacology
- Pharmacology
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Question 17
Correct
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An X-ray of a 24-year-old female hockey player who arrives at the hospital with a left foot injury reveals an avulsion fracture of the fifth metatarsal tuberosity. Which of the following muscles is most likely responsible for the movement of the fractured fragment?
Your Answer: Fibularis brevis
Explanation:An avulsion fracture of the base of the fifth metatarsal happens when the ankle is twisted inwards.
When the ankle is twisted inwards a muscle called the fibularis brevis contracts to stop the movement and protect the ligaments of the ankle.
The base of the fifth metatarsal is where this muscle is attached. The group of lateral leg muscles that function to plantarflex the foot includes the fibularis brevis and the fibularis longus.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 18
Correct
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Which of the following is a contraindication to the use of opioid analgesics:
Your Answer: Raised intracranial pressure
Explanation:Opioids should be avoided in people who have:
A risk of paralytic ileus (opioids reduce gastric motility)
Acute respiratory depressionAn acute exacerbation of asthma (opioids can aggravate bronchoconstriction as a result of histamine release)
Conditions associated with increased intracranial pressure including head injury (opioids can interfere with pupillary response making neurological assessment difficult and may cause retention of carbon dioxide aggravating the increased intracranial pressure) -
This question is part of the following fields:
- Central Nervous System
- Pharmacology
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Question 19
Correct
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A 30-year-old male farmer presents to the Emergency Department due to a wound on his right forearm sustained two days ago while working on the farm. He cleaned the wound under a tap, but there was still some dirt and debris on examination.
Past medical history reveals that he never received a tetanus vaccine.
After cleaning the wound and prescribing antibiotics, which ONE of the following actions should be taken to manage his tetanus risk?Your Answer: Tetanus vaccination and 500 IU tetanus immunoglobulin
Explanation:If a patient presents with one of the following types of wounds, they are at risk of contracting tetanus and should be vaccinated immediately:
1) Contaminated puncture-type wounds from gardening and farming (as they may contain tetanus spores)
2) Wounds containing foreign bodies
3) Open (compound) fractures
4) Wounds or burns with sepsis
5) Animal bites and scratches (animal saliva does not contain tetanus spores unless the animal was routing in soil or lives in an agriculture setting)Extremely high-risk tetanus-prone wounds are any of the above wounds with one of the following:
1) Any wound contaminated by materials containing tetanus spores, e.g., soil, manure
2) Burns or wounds with extensive devitalised tissue
3) Wounds or burns with surgical intervention delayed for more than six hours even if the initial injury was not heavily contaminatedThe CDC recommends that adults who have never been vaccinated for tetanus receive a quick shot of the tetanus vaccine along with a booster dose ten years later. A tetanus-prone wound in an unvaccinated individual should also receive a high dose of tetanus immunoglobulin. The injected antibodies will prevent tetanus infection as the patient does not have any pre-existing antibodies against the disease.
In this case, the patient has a high risk, contaminated wound. He should receive a high dose of tetanus immunoglobulin along with the tetanus vaccine. (The preventative dose of tetanus immunoglobulin is 250 IU in most cases unless over 24 hours have passed since the injury or the wound is heavily contaminated, then 500 IU should be given.) His physician also needs to be contacted to arrange the remainder of the course as indicated in this case.
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This question is part of the following fields:
- Microbiology
- Specific Pathogen Groups
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Question 20
Correct
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All of the following statements are correct with regards to protection of the gastric mucosa except which of the following?
Your Answer: NSAIDs directly stimulate increased parietal cell acid production.
Explanation:Prostaglandin production, which usually inhibits acid secretion and increases mucus and bicarbonate secretion, is inhibited by NSAIDs.
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This question is part of the following fields:
- Gastrointestinal
- Physiology
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Question 21
Correct
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A 71-year-old woman presents with complaints of fatigue and worsening muscle weakness, and blood tests done shows a potassium level of 2.4 mmol/L.
Which is NOT a recognised cause of hypokalaemia?
Your Answer: Type 4 renal tubular acidosis
Explanation:A plasma potassium less than 3.5 mmol/L defines hypokalaemia.
Excessive liquorice ingestion causes hypermineralocorticoidism and leads to hypokalaemia.
Gitelman’s syndrome causes metabolic alkalosis with hypokalaemia and hypomagnesaemia. It is an inherited defect of the distal convoluted tubules.
Bartter’s syndrome causes hypokalaemic alkalosis. It is a rare inherited defect in the ascending limb of the loop of Henle.
Type 1 and 2 renal tubular acidosis both cause hypokalaemia
Type 4 renal tubular acidosis causes hyperkalaemia.
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This question is part of the following fields:
- Physiology
- Renal Physiology
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Question 22
Correct
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A 52-year-old patient requires procedural sedation for DC cardioversion of atrial fibrillation. You plan on using propofol as the sedative agent.
Propofol works as a result of action on what type of receptor? Select ONE answer only.Your Answer: Gamma-aminobutyric acid (GABA)
Explanation:Propofol (2,6-diisopropylphenol) is a short-acting phenol derivative that is primarily used for the induction of anaesthesia.
Its mechanism of action is unclear but is thought to act by potentiating the inhibitory neurotransmitters GABA and glycine, which enhances spinal inhibition during anaesthesia.
The dose for induction of anaesthesia is 1.5-2.5mg/kg. The dose for maintenance of anaesthesia is 4-12 mg/kg/hour. Following intravenous injection, propofol acts within 30 seconds and its duration of action is 5-10 minutes.
Propofol produces a 15-25% decrease in blood pressure and systemic vascular resistance without a compensatory increase in heart rate. It is negatively inotropic and decreases cardiac output by approximately 20%.
The main side effects of propofol are:
Pain on injection (in up to 30%)
Hypotension
Transient apnoea
Hyperventilation
Coughing and hiccough
Headache
Thrombosis and phlebitis -
This question is part of the following fields:
- Anaesthesia
- Pharmacology
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Question 23
Correct
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A 13-year-old male presents to the Emergency Department with a heavy nosebleed. His medical record shows that he was diagnosed with Haemophilia B as a child.
What is the mode of inheritance of this disease?Your Answer: X-linked recessive
Explanation:Deficiency of Factor IX causes Haemophilia B, and like the other Haemophilia’s, it has an X-linked recessive pattern of inheritance, affecting males born to carrier mothers.
Haemophilia B is the second commonest form of haemophilia and is rarer than haemophilia A. Haemophilia B is similar to haemophilia A but is less severe. You can distinguish the two disorders by specific coagulation factor assays.
The incidence of Haemophilia B is one-fifth of that of haemophilia A.
In laboratory findings, you get prolonged APTT, normal PT and low factor IX for Haemophilia B.
There is also a variation called Leyden, in which factor IX levels are below 1% until puberty, when they rise, potentially reaching as high as 40-60% of normal. This is thought to be due to the effects of testosterone at puberty.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 24
Correct
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Which cervical interspace is most likely injured if a patient presents with difficulty of shoulder abduction and elbow flexion, pain in the right shoulder and lateral arm, and decreased sensation over the deltoid and lateral arm?
Your Answer: C4-C5
Explanation:In the setting of cervical radiculopathy, because the nerve root of a spinal nerve is compressed or otherwise impaired, the pain and symptomatology can spread far from the neck and radiates to arm, neck, chest, upper back and/or shoulders. Often muscle weakness and impaired deep tendon reflexes are noted along the course of the spinal nerve.
Cervical radiculopathy is almost always unilateral, although, in rare cases, both nerves at a given level may be impacted. Those rare presentations can confound physical diagnosis and require acceleration to advanced imaging especially in cases of trauma. If there is nerve impingement, the affected side will be reduced relative to the unaffected side. Reduction in strength of muscles innervated by the affected nerve is also significant physical finding.
For a C4-C5 injury, the following symptoms may present:
Weakness in the deltoid muscle (front and side of the shoulder) and upper arm
Shoulder pain
Numbness along the outside of the upper arm -
This question is part of the following fields:
- Anatomy
- Head And Neck
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Question 25
Correct
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A 42-year-old man presented to the emergency room after an incident of slipping and falling onto his back and left hip. Upon physical examination, it was noted that he has pain on hip adduction, but normal hip flexion.
Which of the following muscles was most likely injured in this case?Your Answer: Pectineus
Explanation:The hip adductors are a group of five muscles located in the medial compartment of the thigh. These muscles are the adductor longus, adductor brevis, adductor magnus, gracilis, and pectineus.
The hip flexors consist of 5 key muscles that contribute to hip flexion: iliacus, psoas, pectineus, rectus femoris, and sartorius.
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This question is part of the following fields:
- Anatomy
- Lower Limb
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Question 26
Incorrect
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What is the main mechanism of action of flecainide:
Your Answer: Opens Na+ channels
Correct Answer: Blocks Na+ channels
Explanation:Flecainide inhibits the transmembrane influx of extracellular Na+ ions via fast channels on cardiac tissues resulting in a decrease in rate of depolarisation of the action potential, prolonging the PR and QRS intervals. At high concentrations, it exerts inhibitory effects on slow Ca2+ channels, accompanied by moderate negative inotropic effect.
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This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 27
Correct
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How does dipyridamole mediate its antiplatelet effect:
Your Answer: It is a phosphodiesterase inhibitor.
Explanation:Dipyridamole inhibits both the reuptake of adenosine and phosphodiesterase, preventing the degradation of cAMP and thus blocking the platelet aggregation response to ADP.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 28
Correct
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A patient with a diagnosis of HIV presents with a fever, sore throat, and general malaise and you are concerned the patient may have an AIDS defining illness.
Which one of these, according to the CDC definition, would mean a patient infected with HIV has AIDS?
Your Answer: CD4 T-cell percentage of total lymphocytes of less than 15%
Explanation:According to the CDC definition, a patient co-infected with HIV can be diagnosed with AIDS if he or she has:
A CD4 T-cell count of less than 200 cells/mm3 or;
A CD4 T-cell percentage of total lymphocytes of less than 15% or;
An AIDS defining infectionA Streptococcal throat infection is not an AIDS defining infection.
A normal CD4 count ranges from 500-1000 cells/mm3. A CD4 (not CD8) count of less than 200 cells/mm3 is AIDS defining.
The CD4 count can vary from day to day and depending upon the time that the blood test is taken. It can also be affected by the presence of other infections or illnesses. Treatment with anti-retroviral therapy should be considered at CD4 count of less than 350 cells/mm3.
Serum concentrations of the p24 antigen (the viral protein that makes up most of the core of the HIV) are usually high in the first few weeks after human immunodeficiency virus (HIV) infection and testing for p24 antigen is therefore a useful way of diagnosing very early infection.
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This question is part of the following fields:
- Microbiology
- Specific Pathogen Groups
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Question 29
Correct
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How does abciximab mediate its antiplatelet effect:
Your Answer: It is a GPIIb/IIIa inhibitor.
Explanation:Abciximab, eptifibatide and tirofiban are GPIIb/IIIa inhibitors, inhibiting platelet aggregation by preventing the binding of fibrinogen, von Willebrand factor and other adhesive molecules.
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This question is part of the following fields:
- Haematology
- Pathology
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Question 30
Correct
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Regarding drug interactions with erythromycin, which of the following statements is INCORRECT:
Your Answer: Erythromycin decreases plasma levels of warfarin.
Explanation:Erythromycin and clarithromycin inhibit cytochrome P450-mediated metabolism of warfarin, phenytoin and carbamazepine and may lead to accumulation of these drugs. There is an increased risk of myopathy (due to cytochrome P450 enzyme CYP3A4 inhibition) if erythromycin or clarithromycin is taken with atorvastatin or simvastatin. Erythromycin increases plasma concentrations of theophylline, and theophylline may also reduce absorption of oral erythromycin. All macrolides can prolong the QT-interval and concomitant use of drugs that prolong the QT interval is not recommended.
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This question is part of the following fields:
- Infections
- Pharmacology
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SESSION STATS - PERFORMANCE PER SPECIALTY
