Adverse drug reactions

doi:10.1136/bmj.b4501

Published 4 November 2009, doi:10.1136/bmj.b4501
Cite this as: BMJ 2009;339:b4501

Endgames

OnExamination Quiz

Adverse drug reactions

The answers to this question, and more questions on this topic,are available from www.onexamination.com/endgames until midnighton Wednesday.

This week’s quiz on adverse drug reactions is taken fromthe OnExamination revision questions for a variety of exams.

Presentation 1

A 40 year old man with a history of eczema has recently beendiagnosed with angina. He now presents with a cough and wheeze.

Presentation 2

A 66 year old woman with mitral valve disease and atrial fibrillationpresents with an international normalised ratio (INR) of 10.She has recently had an exacerbation of chronic obstructivepulmonary disease.

Presentation 3

A 68 year old man with a history of penicillin allergy and hypercholesterolaemiais found to have Helicobacter pylori infection and receiveseradication therapy. He now presents with profound myalgia.

For each of the above presentations, select the most likelyadverse drug reaction or drug interaction responsible.

A Adverse drug reaction to amoxicillin

B Adverse drug reactionto atenolol

C Adverse drug reaction to colestyramine

D Adversedrug reaction to diltiazem

E Adverse drug reaction to prednisolone

FAdverse drug reaction to ramipril

G Interaction between ramipriland co-amilofruse

H Adverse drug reaction to simvastatin

IInteraction between simvastatin and amoxicillin

J Interactionbetween simvastatin and clarithromycin

K Adverse drug reactionto warfarin