Published: 2 December 2021

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Quiz answers

Published: 2 December 2021
Prescriber Update 42(4): 61
December 2021

1. Which of the following medicines can increase potassium levels?
   1. Amiloride
   2. Losartan
   3. Cilazapril
   4. All of the above

   Potassium-sparing diuretics, ACE inhibitors and angiotensin receptor blockers are associated with hyperkalaemia. (September 2021)

2. The increased risk of angioedema associated with concomitant use of vildagliptin and an ACE inhibitor is thought to be related to:
   1. Reduced degradation of bradykinin and substance P
   2. Increased degradation of bradykinin and substance P
   3. Increased activity of DPP-IV
   4. Deficiency of CYP2D6

   Substance P and bradykinin are vasodilators involved in the pathogenesis of angioedema. ACE and DPP-4 are involved in the degradation of substance P, and ACE is one of the enzymes that degrade bradykinin. Compared with inhibition of ACE or DPP-4 alone, inhibition of both enzymes by the combined use of an ACE inhibitor and vildagliptin increases the risk of accumulation of substance P and bradykinin, resulting in angioedema. (March 2021)

3. What is the recommended dose of chloramphenicol eye drops for children aged under two years?

   The recommended dose of chloramphenicol eye drops for children aged under two years is one drop in the affected eye(s) four times daily for five days. (December 2021)

4. What is the reported frequency of thrombocytopenia and pancytopenia in the sodium valproate data sheet?
   1. Thrombocytopenia: uncommon; Pancytopenia: uncommon
   2. Thrombocytopenia: common; Pancytopenia: common
   3. Thrombocytopenia: common; Pancytopenia: uncommon
   4. Thrombocytopenia: uncommon; Pancytopenia: common

   Sodium valproate treatment is associated with adverse haematological effects. Thrombocytopenia is a common adverse reaction, while pancytopenia is an uncommon adverse reaction. (September 2021)

5. In clinical trials for treatment of neuropathic pain, what were the most commonly reported reasons for patients discontinuing treatment with pregabalin or gabapentin?

   Dizziness and somnolence.
   In clinical trials for treatment of neuropathic pain, dizziness and somnolence were the most commonly reported adverse events for pregabalin and gabapentin compared to placebo. Dizziness and somnolence were also the most commonly reported reasons for treatment discontinuation for both medicines. (March 2021)

6. Fingolimod is an immunomodulating drug indicated for the treatment of relapsing multiple sclerosis. Which of the following are recognised adverse effects of this drug?
   1. Renal impairment
   2. Clinically significant liver injury
   3. Acute liver failure
   4. a and c
   5. b and c

   Clinically significant liver injury and acute liver injury are recognised adverse effects of fingolimod. (September 2021)

7. Omalizumab is a monoclonal antibody drug used in the treatment of asthma. Which component of the immune system is the target of this drug?
   1. IL-6
   2. IL-5
   3. IgE
   4. IgM

   Omalizumab is a monoclonal antibody which binds to free Immunoglobulin E. (December 2021)

8. Which of the following is incorrect? To prevent adrenal insufficiency, dose tapering of prednisone is generally required for patients who have:
   1. Been given repeat prednisone doses in the evening
   2. Received more than 10 mg of prednisone per day for more than one week
   3. Recently had repeated courses
   4. Received prednisone for more than 3 weeks

   Dose tapering is required for patients who have received more than 40 mg of prednisone per day for more than one week (not 10 mg per day). (June 2021)

9. Which of the following is NOT a risk factor for developing diabetic ketoacidosis in patients being treated with empagliflozin?
   1. A low carbohydrate diet
   2. Increasing insulin dose
   3. Prolonged fasting
   4. Surgery

   Increasing the insulin dose is not a risk factor for DKA in patients being treated with empagliflozin. However, insulin dose reduction is a risk factor. (September 2021)

10. What is the length of time that a patient must not become pregnant for after stopping treatment with acitretin (Novatretin)?

    Three years (36 months).
    Pregnancy must be excluded before starting treatment with acitretin. The patient must use effective contraception without interruption from one month before treatment, for the duration of treatment and for three years (36 months) after stopping treatment. (December 2021)