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Question 1
Correct
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An elderly female with a diagnosed psychiatric illness was prescribed prochlorperazine for her complaints of dizziness and nausea. Two days later, she returned to the clinic with no improvement in the symptoms.
Which one of the following is the mechanism of action of prochlorperazine?Your Answer: Dopamine receptor antagonism
Explanation:Prochlorperazine is a phenothiazine drug as it is categorized as a first-generation antipsychotic. It mainly blocks the D2 (dopamine 2) receptors in the brain. Along with dopamine, it also blocks histaminergic, cholinergic, and noradrenergic receptors.
It exerts its antiemetic effect via dopamine (D2) receptor antagonist. It is used to treat nausea and vomiting of various causes, including labyrinthine disorders.
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This question is part of the following fields:
- CNS Pharmacology
- Pharmacology
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Question 2
Correct
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Question 3
Correct
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Mannitol is primarily indicated for which of the following:
Your Answer: Cerebral oedema
Explanation:Mannitol is an osmotic diuretic that can be used to treat cerebral oedema and raised intraocular pressure. Mannitol is a low molecular weight compound and is, therefore, freely filtered at the glomerulus and is not reabsorbed. It, therefore, increases the osmolality of the glomerular filtrate and tubular fluid, increasing urinary volume by an osmotic effect. It also does not cross the blood-brain-barrier (BBB).
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This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 4
Correct
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A 59-year-old man presents to the emergency room with chest pain. He was recently released from the hospital after receiving abciximab during coronary angioplasty.
Which of the following is abciximab (ReoPro) mechanism of action?Your Answer: Antagonism of the glycoprotein IIb/IIIa receptor
Explanation:Abciximab (ReoPro) is a glycoprotein IIb/IIIa receptor antagonist that is a chimeric monoclonal antibody. It is primarily used during and after coronary artery procedures such as angioplasty to inhibit platelet aggregation.
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 5
Correct
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Which of the following is NOT a common side effect of adenosine:
Your Answer: Yellow vision
Explanation:Common side effects of adenosine include:
Apprehension
Dizziness, flushing, headache, nausea, dyspnoea
Angina (discontinue)
AV block, sinus pause and arrhythmia (discontinue if asystole or severe bradycardia occur) -
This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 6
Correct
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A patient presents with haemoptysis, weight loss, and night sweats. You suspect he may have tuberculosis. He works at an asylum seeker hostel, and has not received a BCG vaccination. In which of the following patient groups would the BCG vaccine be safe to administer?
Your Answer: The patient is asplenic
Explanation:Persons with chronic diseases. Persons with chronic renal disease or undergoing dialysis, and those with hyposplenism or asplenia, may receive BCG vaccine if indicated.
Only 2 absolute contraindications apply to all vaccines:
- anaphylaxis following a previous dose of the relevant vaccine
- anaphylaxis following any component of the relevant vaccine
2 further contraindications apply to live vaccines (both parenteral and oral):
- People who are significantly immunocompromised should not receive live vaccines. This is regardless of whether the immunocompromising condition is caused by disease or treatment.
- Pregnant women should not receive live vaccines, in general. Women should be advised not to become pregnant within 28 days of receiving a live vaccine.
Use of live vaccines in people who are immunocompromised:
People who are immunocomprised are at risk of adverse events or vaccine-related disease if they receive a live vaccine.Live vaccines include:
BCG (bacille Calmette–Guérin) vaccine
oral cholera vaccine (Vaxchora)
Some Japanese encephalitis virus vaccines
MMR (measles-mumps-rubella) vaccine
rotavirus vaccine
oral typhoid vaccine
varicella vaccine
yellow fever vaccine
zoster vaccine (Zostavax) -
This question is part of the following fields:
- Immunological Products & Vaccines
- Pharmacology
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Question 7
Incorrect
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You plan to use plain 1% lidocaine for a ring block on a finger that needs suturing.
Which SINGLE statement regarding the use of 1% lidocaine, in this case, is true?Your Answer: It should always be used with adrenaline to lessen the risk of bleeding
Correct Answer: Lidocaine works by blocking fast voltage-gated sodium channels
Explanation:Lidocaine is a tertiary amine that is primarily used as a local anaesthetic but can also be used intravenously in the treatment of ventricular dysrhythmias.
Lidocaine works as a local anaesthetic by diffusing in its uncharged base form through neural sheaths and the axonal membrane to the internal surface of the cell membrane sodium channels. Here it alters signal conduction by blocking the fast voltage-gated sodium channels. With sufficient blockage, the membrane of the postsynaptic neuron will not depolarise and will be unable to transmit an action potential, thereby preventing the transmission of pain signals.
Each 1 ml of plain 1% lidocaine solution contains 10 mg of lidocaine hydrochloride. The maximum safe dose of plain lidocaine is 3 mg/kg. When administered with adrenaline 1:200,000, the maximum safe dose is 7 mg/kg. Because of the risk of vasoconstriction and tissue necrosis, lidocaine should not be used in combination with adrenaline in extremities such as fingers, toes, and the nose.
The half-life of lidocaine is 1.5-2 hours. Its onset of action is rapid within a few minutes, and it has a duration of action of 30-60 minutes when used alone. Its duration of action is prolonged by co-administration with adrenaline (about 90 minutes).
Lidocaine tends to cause vasodilatation when used locally. This is believed to be due mainly to the inhibition of action potentials via sodium channel blocking in vasoconstrictor sympathetic nerves. -
This question is part of the following fields:
- Anaesthesia
- Pharmacology
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Question 8
Correct
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What is the mechanism of action of captopril:
Your Answer: Angiotensin-converting enzyme inhibitor
Explanation:Captopril is an angiotensin-converting enzyme (ACE) inhibitor, which inhibits the conversion of angiotensin I to angiotensin II.
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This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 9
Correct
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A young female was diagnosed with a urinary tract infection and was sent home with medications. However, after 48 hours of discharge, she returned to the hospital because there had been no relief from her symptoms. The urine sensitivity test report is still unavailable. Fresh blood tests were sent, and her estimated GFR is calculated to be >60 ml/minute.
She was prescribed nitrofurantoin 100 mg modified-release orally twice a day for two days.
Out of the following, which antibiotic is most appropriate to be prescribed to this patient?Your Answer: Fosfomycin
Explanation:The NICE guidelines for women with lower UTIs who are not pregnant are:
1. Consider prescribing a different antibiotic if symptoms do not improve within 48 hours or worsen at any time
2. If the urine culture and susceptibility test results are available, review the choice of antibiotic according to the results and change the antibiotic accordingly if symptoms are not improving or bacteria is resistant to the prescribed antibioticThe first choice of antibiotics for non-pregnant women aged 16 years and over is:
1. Nitrofurantoin
100 mg modified-release PO BD for 3 days – if eGFR >45 ml/minute
2. Trimethoprim
200 mg PO BD for three daysThe second-choice (no improvement in lower UTI symptoms on first-choice for at least 48 hours, or when first-choice is not suitable) are:
1. Nitrofurantoin
100 mg modified-release PO BD for three days – if eGFR >45 ml/minute
2. Pivmecillinam
400 mg PO initial dose, then 200 mg PO TDS for three days
3. Fosfomycin 3 g single sachet dose -
This question is part of the following fields:
- Infections
- Pharmacology
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Question 10
Correct
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Regarding oral rehydration therapy, which of the following statements is INCORRECT:
Your Answer: Oral rehydration solutions should be slightly hyperosmolar.
Explanation:Oral rehydration therapy (ORT) is a fluid replacement strategy used to prevent or treat dehydration. It is less invasive than other strategies for fluid replacement and has successfully lowered the mortality rate of diarrhoea in developing countries. Oral rehydration solutions should be slightly hypo-osmolar (about 250 mmol/litre) to prevent the possible induction of osmotic diarrhoea.
ORT contains glucose (e.g. 90 mmol/L in dioralyte). The addition of glucose improves sodium and water absorption in the bowel and prevents hypoglycaemia. It also contains essential mineral salts.
Current NICE guidance recommends that 50 ml/kg is given over 4 hours for the treatment of mild dehydration.
Once rehydrated, a child should continue with their usual daily fluid intake plus 200 ml ORT after each loose stool. In an infant, give ORT at 1-1.5 x the normal feed volume and in an adult, give 200-400 ml after each loose stool. -
This question is part of the following fields:
- Fluids And Electrolytes
- Pharmacology
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Question 11
Correct
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Before a patient is discharged, you are asked to review them. He is a 59-year-old man who was seen with epigastric pain that has since subsided, and he will be seen by his GP in the coming days. He's been hearing a lot about aspirin lately and wants to learn more about it.
Which of the following statements about aspirin's mechanism of action is correct?Your Answer: Inhibition of cyclo-oxygenase
Explanation:Aspirin works by inhibiting cyclo-oxygenase in an irreversible manner, resulting in a decrease in prostaglandin and thromboxane production. As a result, platelet activation and aggregation are reduced.
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 12
Correct
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The mechanism of action of abciximab is by:
Your Answer: Blocking the binding of fibrinogen to GPIIb/IIIa receptor sites
Explanation:Abciximab is a glycoprotein IIb/IIIa inhibitors and prevents platelet aggregation by blocking the binding of fibrinogen to receptors on platelets.
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This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 13
Correct
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The risk of renal impairment in a patient on ACE inhibitor therapy is increased by concomitant treatment with which of the following drug classes:
Your Answer: NSAIDs
Explanation:Concomitant treatment with NSAIDs increases the risk of renal damage, and with potassium-sparing diuretics (or potassium-containing salt substitutes) increases the risk of hyperkalaemia. Hyperkalaemia and other side effects of ACE inhibitors are more common in the elderly and in those with impaired renal function and the dose may need to be reduced.
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This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 14
Correct
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Regarding aciclovir, which of the following statements is INCORRECT:
Your Answer: Aciclovir eradicates herpes simplex virus from the body.
Explanation:Aciclovir is active against herpesviruses but does not eradicate latent virus.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 15
Correct
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You have been called to review a patient and his management in the resuscitation room. A very sick patient has been started on mannitol in his treatment protocol.
Out of the following, what is NOT an FDA-recognized indication for the use of mannitol?
Your Answer: Congestive cardiac failure
Explanation:Mannitol is the most widely used osmotic diuretic that is most commonly used to reduce cerebral oedema and intracranial pressure.
Mannitol has four FDA approved uses clinically:
1. Reduction of intracranial pressure and brain mass
2. reduce intraocular pressure if this is not achievable by other means
3. promote diuresis for acute renal failure to prevent or treat the oliguric phase before irreversible damage
4. promote diuresis to promote the excretion of toxic substances, materials, and metabolitesIt can be used in rhabdomyolysis-induced renal failure, especially in crush injuries. Mannitol reduces osmotic swelling and oedema in the injured muscle cells and helps restore skeletal muscle function.
It is a low molecular weight compound and can be freely filtered at the glomerulus and not reabsorbed. This way increases the osmolality of the glomerular filtrate and tubular fluid, increasing urinary volume by an osmotic effect. It also does not cross the blood-brain barrier (BBB).
Mannitol causes an expansion of the extracellular fluid space, which may worsen congestive cardiac failure. Contraindications to the use of mannitol include:
1. Anuria due to renal disease
2. Acute intracranial bleeding (except during craniotomy)
3. Severe cardiac failure
4. Severe dehydration
5. Severe pulmonary oedema or congestion
6. Known hypersensitivity to mannitol -
This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 16
Correct
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Which of the following is NOT a typical electrolyte disturbance caused by furosemide:
Your Answer: Hypercalcaemia
Explanation:Adverse effects of loop diuretics include:
Mild gastrointestinal disturbances, pancreatitis and hepatic encephalopathy
Hyperglycaemia
Acute urinary retention
Water and electrolyte imbalance
Hyponatraemia, hypocalcaemia, hypokalaemia, hypomagnesaemia, hypochloraemiaHypotension, hypovolaemia, dehydration, and venous thromboembolism
Metabolic alkalosis
Hyperuricaemia
Blood disorders (bone marrow suppression, thrombocytopenia, and leucopenia)
Visual disturbance, tinnitus and deafness
Hypersensitivity reactions -
This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 17
Correct
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A well recognised adverse effect of metoclopramide is which of the following?
Your Answer: Acute dystonic reaction
Explanation:Side effects of metoclopramide are commonly associated with extrapyramidal effects and hyperprolactinemia. Therefore its use must be limited to short-term use. Metoclopramide can induce acute dystonic reactions which involve facial and skeletal muscle spasms and oculogyric crises. These dystonic effects are more common in the young girls and young women, and in the very old. These symptoms usually occur shortly after starting treatment with this drug and subside within 24 hours of stopping it. Abortion of dystonic attacks can be carried out by injection of an antiparkinsonian drug like procyclidine.
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This question is part of the following fields:
- Central Nervous System
- Pharmacology
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Question 18
Correct
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A 60-year-old man comes to your department with complaints of epigastric pain. There is a history of rheumatoid arthritis and he has been taking ibuprofen 200 mg TDS for the last 2 weeks.
The following scenarios would prompt you to consider the co-prescription of a PPI for gastroprotection with NSAIDs EXCEPT?
Your Answer: Long-term use for chronic back pain in a patient aged 30
Explanation:The current recommendations by NICE suggest that gastro-protection should be considered if patients have ≥1 of the following:
Aged 65 or older
– Using maximum recommended dose of an NSAID
– History of peptic ulcer or GI bleeding
– Concomitant use of: antidepressants like SSRIs and SNRIs, Corticosteroids, anticoagulants and low dose aspirin
– Long-term NSAID usage for: long-term back pain if older than 45 and patients with OA or RA at any ageThe maximum recommended dose of ibuprofen is 2.4 g daily and this patient is on 400 mg of ibuprofen TDS.
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This question is part of the following fields:
- Musculoskeletal Pharmacology
- Pharmacology
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Question 19
Incorrect
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The patient is a 61-year-old man with severe central chest pain. An acute myocardial infarction is revealed by his ECG. Clopidogrel is one of the medications he takes as part of his treatment.
Clopidogrel's direct mechanism of action is which of the following?Your Answer: Inhibition of cyclo-oxygenase
Correct Answer: Inhibition of platelet ADP receptors
Explanation:Clopidogrel, a thienopyridine derivative, prevents platelet aggregation and cross-linking by the protein fibrin by inhibiting the ADP receptor on platelet cell membranes (inhibits binding of ADP to its platelet receptor (P2Y12 ADP-receptor).
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This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 20
Correct
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In the Paediatric Emergency Department, you saw a 6-year-old girl with severe bilateral conjunctivitis. You give her mother some general eye hygiene advice and prescribe chloramphenicol eye drops.
What is the chloramphenicol's mechanism of action?
Your Answer: Inhibition of protein synthesis
Explanation:Chloramphenicol is a broad-spectrum antibiotic that inhibits bacterial protein synthesis by blocking the 50S subunit of the bacterial ribosome’s peptidyl transferase activity. When administered systemically, it has limited usage due to the potential of significant side effects such as aplastic anaemia, peripheral neuropathy, and optic neuritis. It’s only used to treat typhoid fever and Haemophilus influenzae meningitis, but it’s usually better to use a broad-spectrum cephalosporin.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 21
Correct
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A 56-year-old female presents at the hospital with a diabetic foot ulcer that has become infected. She has a longstanding history of type 2 diabetes mellitus and diabetic polyneuropathy. She has trouble controlling her blood sugar levels, and recently, she was converted to a new insulin regimen that includes intermediate-acting insulin.
Out of the following, which one is the intermediate-acting insulin?Your Answer: Isophane insulin
Explanation:Insulin is used mainly in type 1 diabetes, where the pancreas makes no insulin and can sometimes be prescribed in type 1 diabetes. There are different types of insulin categorized by their onset of action:
1. Intermediate-acting insulins (isophane insulin NPH):
– intermediate duration of action, designed to mimic the effect of endogenous basal insulin
– starts their action in 1 to 4 hours
– peaks in 4 to 8 hours
– dosing is usually twice a day and helps maintain blood sugar throughout the day
– Isophane insulin is a suspension of insulin with protamine2. Short-acting insulins (regular insulin)
– starts the action in 30 to 40 minutes
– peaks in 90 to 120 minutes
– duration of action is 6 to 8 hours
– taken before meals, and food is necessary within 30 minutes after its administration to avoid hypoglycaemia3. Long-acting insulins (glargine, detemir, degludec)
– start action in 1 to 2 hours
– plateau effect over 12 to 24 hours
– Dosing is usually during the night-time after meals. Their long duration of action helps in reducing the frequency of dosing throughout the day.4. Rapid-acting insulins (lispro, aspart, glulisine)
– start their action in 5 to 15 minutes
– peak in 30 minutes
– The duration of action is 3 to 5 hours
– generally used before meals and always used along with short-acting or long-acting insulins to control sugar levels throughout the day. -
This question is part of the following fields:
- Endocrine Pharmacology
- Pharmacology
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Question 22
Correct
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A 65-year-old man comes for a visit at the clinic with complaints of abdominal pain. On inquiring about drug history, you find out that he has been taking around 8-10 paracetamol to help relieve the pain.
Out of the following, which one is believed to be the main mechanism of action for paracetamol?Your Answer: Selective inhibition of COX-3 receptors
Explanation:The FDA categorizes Paracetamol as an NSAID (nonsteroidal anti-inflammatory drug) as it is believed to selectively inhibit cyclo-oxygenase 3 (COX-3) receptors in the brain and spinal cord.
COX-3 is a unique variant of the more known COX-1 and COX-2. It is responsible for the production of prostaglandins in central areas, which sensitizes free nerve endings to the chemical mediators of pain. Therefore, by selectively inhibiting COX-3, paracetamol effectively reduces pain sensation by increasing the pain threshold.
Acetaminophen does not inhibit cyclooxygenase in peripheral tissues and, therefore, has no peripheral anti-inflammatory effects.
The antipyretic actions of acetaminophen are likely attributed to direct action on heat-regulating centres in the brain, resulting in peripheral vasodilation, sweating, and loss of body heat. -
This question is part of the following fields:
- CNS Pharmacology
- Pharmacology
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Question 23
Correct
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Regarding the management of diabetic ketoacidosis (DKA), insulin should initially be given:
Your Answer: At a concentration of 1 unit/mL at a fixed rate of 0.1 units/kg/hour
Explanation:An intravenous insulin infusion should be started at a concentration of 1 unit/mL, at a fixed rate of 0.1 units/kg/hour. Established subcutaneous long-acting insulin therapy should be continued concomitantly. Blood ketone and blood glucose concentrations should be checked hourly and the insulin infusion rate adjusted accordingly. Blood ketone concentration should fall by at least 0.5 mmol/litre/hour and blood glucose concentration should fall by at least 3 mmol/litre/hour.
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This question is part of the following fields:
- Endocrine
- Pharmacology
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Question 24
Correct
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For which of the following infections is phenoxymethylpenicillin (penicillin V) primarily used?
Your Answer: Streptococcal tonsillitis
Explanation:Phenoxymethylpenicillin (penicillin V) is less active than benzylpenicillin but both have similar antibacterial spectrum. Because penicillin V is gastric-acid stable, it is suitable for oral administration, but should not be used for serious infections as absorption can be unpredictable and plasma concentrations can be variable.
Its uses are:
1. mainly for respiratory tract infections in children
2. for streptococcal tonsillitis
3. for continuing treatment after one or more injections of benzylpenicillin when clinical response has begun.
4. for prophylaxis against streptococcal infections following rheumatic fever and against pneumococcal infections following splenectomy or in sickle-cell disease.It should not be used for meningococcal or gonococcal infections.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 25
Correct
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In a ward round, you come across a patient's treatment chart prescribed an antibiotic to fight his infection. This antibiotic is an inhibitor of cell wall synthesis.
Which of the following antimicrobial drugs is prescribed to this patient?Your Answer: Benzylpenicillin
Explanation:Penicillins and cephalosporins are the major antibiotics that inhibit bacterial cell wall synthesis. They inactivate transpeptidases that help cross-link peptidoglycans in cell walls.
Isoniazid decreases the synthesis of mycolic acids in mycobacterium.
Clarithromycin binds to the 50S subunit of ribosomes and inhibits protein synthesis.
Metronidazole and the other 5-nitroimidazole agents inhibit nucleic acid synthesis by forming toxic free radical metabolites in the bacterial cell that damage DNA.
Tetracycline bind to 30S and prevent attachment of aminoacyl-tRNA.
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This question is part of the following fields:
- Infections
- Pharmacology
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Question 26
Correct
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You're currently treating an infection in a patient and trying to figure out which antibiotic would be best.
Which of the following antimicrobial drugs inhibits the formation of cell walls?Your Answer: Cefuroxime
Explanation:Cefuroxime and other cephalosporin antibiotics are bactericidal ß-lactam antibiotics. They work similarly to penicillins in that they prevent cross-linking between the linear peptidoglycan polymer chains that make up the bacterial cell wall. As a result, they prevent the formation of cell walls.
The following is a summary of the various mechanisms of action of various types of antimicrobial agents:1) Inhibition of cell wall synthesis
Penicillins
Cephalosporins
Vancomycin2) Disruption of cell membrane function
Polymyxins
Nystatin
Amphotericin B3) Inhibition of protein synthesis
Macrolides
Aminoglycosides
Tetracyclines
Chloramphenicol4) Inhibition of nucleic acid synthesis
Quinolones
Trimethoprim
5-nitroimidazoles
Rifampicin5) Anti-metabolic activity
Sulphonamides
Isoniazid -
This question is part of the following fields:
- Infections
- Pharmacology
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Question 27
Correct
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Captopril should not be used if you have any of the following conditions:
Your Answer: Renal artery stenosis
Explanation:Contraindications indications of Captopril include:
– Bilateral renal artery stenosis
– Hypersensitivity to ACE inhibitors
– Anuria
– History of ACEI-induced angioedema
– Hereditary or idiopathic angioedema
– Co-administration of Neprilysin inhibitors (e.g., sacubitril) with ACE inhibitors may increase angioedema risk; do not administer ACE inhibitors within 36 hours of switching to or from sacubitril/valsartan.
If ACE inhibitors are used, they should be initiated only under specialist supervision and renal function should be monitored regularly. ACE inhibitors should also be used with particular caution in patients who may have undiagnosed and clinically silent renovascular disease. This includes patients with peripheral vascular disease or those with severe generalised atherosclerosis. -
This question is part of the following fields:
- Cardiovascular
- Pharmacology
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Question 28
Correct
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Which of the following is a well recognised adverse effect of prochlorperazine:
Your Answer: Acute dystonic reaction
Explanation:Adverse actions include anticholinergic effects such as drowsiness, dry mouth, and blurred vision, extrapyramidal effects, and postural hypotension. Phenothiazines can all induce acute dystonic reactions such as facial and skeletal muscle spasms and oculogyric crises; children (especially girls, young women, and those under 10 kg) are particularly susceptible.
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This question is part of the following fields:
- Central Nervous System
- Pharmacology
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Question 29
Correct
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You are instructed by a senior to administer Mannitol to an RTA patient with increased intracranial pressure.
Mannitol is a low molecular weight compound that freely filters at the glomerulus and is not reabsorbed.
Out of the following, which is a contraindication to the use of mannitol?Your Answer: Severe pulmonary oedema
Explanation:Mannitol is the most widely used osmotic diuretic that is most commonly used to reduce cerebral oedema and intracranial pressure.
It is recommended to use mannitol for the reduction of CSF pressure/cerebral oedema in a dose of 0.25-2 g/kg as an intravenous infusion over 30-60 minutes. This can be repeated 1-2 times after 4-8 hours if needed.Mannitol has several contraindications and some of them are listed below:
1. Anuria due to renal disease
2. Acute intracranial bleeding (except during craniotomy)
3. Severe cardiac failure
4. Severe dehydration
5. Severe pulmonary oedema or congestion
6. Known hypersensitivity to mannitol -
This question is part of the following fields:
- Cardiovascular Pharmacology
- Pharmacology
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Question 30
Correct
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You review a 56-year-old man who has recently been prescribed antibiotics for a chest infection. He suffers from COPD and is currently prescribed salbutamol and Seretide inhalers, and Phyllocontin continus. Since starting the antibiotics, he has been experiencing nausea, vomiting and abdominal pain.
Which of the following antibiotics is he MOST LIKELY to have been prescribed for his chest infection? Select ONE answer only .Your Answer: Levofloxacin
Explanation:Phyllocontin continus contains aminophylline (a mixture of theophylline and ethylenediamine), a bronchodilator used in the management of COPD and asthma.
This patient is exhibiting symptoms of theophylline toxicity, which may have been triggered by the prescription of the antibiotic. Quinolone antibiotics, such as ciprofloxacin and levofloxacin, and macrolide antibiotics, such as erythromycin, increase the plasma concentration of theophyllines and can lead to toxicity.
The drugs that commonly affect the half-life and the plasma concentration of theophylline are summarised in the table below:
Drugs increasing plasma concentration of theophylline
Drugs decreasing plasma concentration of theophylline
Calcium channel blockers, e.g. Verapamil
Cimetidine
Fluconazole
Macrolides, e.g. erythromycin
Quinolones, e.g. ciprofloxacin
Methotrexate
Barbiturates
Carbamazepine
Phenobarbitol
Phenytoin (and fosphenytoin)
Rifampicin
St. John’s wort -
This question is part of the following fields:
- Pharmacology
- Respiratory Pharmacology
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SESSION STATS - PERFORMANCE PER SPECIALTY
