MRCP - Pharmacology Part 1 (Toxicity)
Exam Questions and Answers (Latest
Update 2024)
What monitoring do you need for statins? - Correct Answer
✅ LFTs at baseline, 3 mo and 12 mo
An AST rise of what level is enough to discontinue a statin?
What do you do? - Correct Answer ✅ If AST goes up x3
from baseline and persists. Stop the statin and restart at a
lower dose if symptoms resolve
What monitoring do you need for ACE-I? What is an
acceptable change in function? - Correct Answer ✅ - U&E
at start, when increasing treatment or annually
- Rise in creatinine up to 30%, and K+ up to 5.5mol is allowed
What monitoring do you need for amiodarone? (4/2) -
Correct Answer ✅ - TFTs, U&E, LFTs and CXR prior to
treatment
- TFTs and LFTs at 6 months
,MRCP - Pharmacology Part 1 (Toxicity)
Exam Questions and Answers (Latest
Update 2024)
What happens if amiodarone causes hypothyroidism? -
Correct Answer ✅ Continue it if required and add
levothyroxine
What are the two types of amiodarone induced
hyperthyroidism? - Correct Answer ✅ - AIT1 = excess
iodine causes a goitre and therefore tx with carbimazole
- AIT2 = destructive thyroiditis due to amiodarone = no goitre
and tx with steroids
What monitoring do you need for methotrexate? (3) - Correct
Answer ✅ - Check LFTs, FBC & U&E before treatment, and
then every two weeks for 2 months, then every month then
every 3 months
What drug needs to be given with methotrexate? - Correct
Answer ✅ Folate 5mg on a separate day
When does lithium level need to be taken? - Correct Answer
✅ 12h after the dose when starting the drug, at each dose
change and at 3 months
,MRCP - Pharmacology Part 1 (Toxicity)
Exam Questions and Answers (Latest
Update 2024)
What is a normal lithium level? - Correct Answer ✅ 0.4-0.8
Apart from lithium level, what blood tests need to be done for
monitoring lithium? (2) - Correct Answer ✅ TFTs/U&E at
baseline and 6 months
What montoring is needed for Glitazones? - Correct Answer
✅ LFTs
What monitoring is needed for olanzapine? - Correct
Answer ✅ CBG at baseline and regular intervals
What monitoring is needed for vitamin D? - Correct Answer
✅ Calcium levels at 1 month and vitamin D
- if Vit D >50 = okay
- if Vit D25-50 = deficient for some of the population
- if Vit D <25 = deficient
, MRCP - Pharmacology Part 1 (Toxicity)
Exam Questions and Answers (Latest
Update 2024)
What monitoring, and when, is needed for levothyroxine? -
Correct Answer ✅ - Check TFTs in 6-8 weeks
- Check yearly if on maintenance dose
What monitoring is needed for carbimazole or clozapine? -
Correct Answer ✅ FBC = risk of agranulocytosis
When do you need to check the dose of Gentamicin? What
time of killing does it have? How do you alter the dose -
Correct Answer ✅ Concentration dependant killing
- Check peak level 1h after the 3rd dose and trough level
before next dose
- Peak level should be 3-5
- Trough level should be <1
As concentration dependant killing, ;need to alter the time
between each dose if trough level is raised BUT need to lower
dose if the peak level is high
C/G like DNA base pairs
Exam Questions and Answers (Latest
Update 2024)
What monitoring do you need for statins? - Correct Answer
✅ LFTs at baseline, 3 mo and 12 mo
An AST rise of what level is enough to discontinue a statin?
What do you do? - Correct Answer ✅ If AST goes up x3
from baseline and persists. Stop the statin and restart at a
lower dose if symptoms resolve
What monitoring do you need for ACE-I? What is an
acceptable change in function? - Correct Answer ✅ - U&E
at start, when increasing treatment or annually
- Rise in creatinine up to 30%, and K+ up to 5.5mol is allowed
What monitoring do you need for amiodarone? (4/2) -
Correct Answer ✅ - TFTs, U&E, LFTs and CXR prior to
treatment
- TFTs and LFTs at 6 months
,MRCP - Pharmacology Part 1 (Toxicity)
Exam Questions and Answers (Latest
Update 2024)
What happens if amiodarone causes hypothyroidism? -
Correct Answer ✅ Continue it if required and add
levothyroxine
What are the two types of amiodarone induced
hyperthyroidism? - Correct Answer ✅ - AIT1 = excess
iodine causes a goitre and therefore tx with carbimazole
- AIT2 = destructive thyroiditis due to amiodarone = no goitre
and tx with steroids
What monitoring do you need for methotrexate? (3) - Correct
Answer ✅ - Check LFTs, FBC & U&E before treatment, and
then every two weeks for 2 months, then every month then
every 3 months
What drug needs to be given with methotrexate? - Correct
Answer ✅ Folate 5mg on a separate day
When does lithium level need to be taken? - Correct Answer
✅ 12h after the dose when starting the drug, at each dose
change and at 3 months
,MRCP - Pharmacology Part 1 (Toxicity)
Exam Questions and Answers (Latest
Update 2024)
What is a normal lithium level? - Correct Answer ✅ 0.4-0.8
Apart from lithium level, what blood tests need to be done for
monitoring lithium? (2) - Correct Answer ✅ TFTs/U&E at
baseline and 6 months
What montoring is needed for Glitazones? - Correct Answer
✅ LFTs
What monitoring is needed for olanzapine? - Correct
Answer ✅ CBG at baseline and regular intervals
What monitoring is needed for vitamin D? - Correct Answer
✅ Calcium levels at 1 month and vitamin D
- if Vit D >50 = okay
- if Vit D25-50 = deficient for some of the population
- if Vit D <25 = deficient
, MRCP - Pharmacology Part 1 (Toxicity)
Exam Questions and Answers (Latest
Update 2024)
What monitoring, and when, is needed for levothyroxine? -
Correct Answer ✅ - Check TFTs in 6-8 weeks
- Check yearly if on maintenance dose
What monitoring is needed for carbimazole or clozapine? -
Correct Answer ✅ FBC = risk of agranulocytosis
When do you need to check the dose of Gentamicin? What
time of killing does it have? How do you alter the dose -
Correct Answer ✅ Concentration dependant killing
- Check peak level 1h after the 3rd dose and trough level
before next dose
- Peak level should be 3-5
- Trough level should be <1
As concentration dependant killing, ;need to alter the time
between each dose if trough level is raised BUT need to lower
dose if the peak level is high
C/G like DNA base pairs
