The PSA
Section 6 of 8
Adverse drug reactions
Identify likely ADRs, the culprit drug, important interactions, and how to manage them (item types A–D).
16 marks · 8% of the exam8 items × 2
What it tests
Four flavours: which ADR, which drug caused it, which drug interaction, and how to manage. Learn the signature adverse-effect of the common classes.
How to tackle it
- 1Link the clinical picture to a drug class effect
- 2For culprit questions, scan the drug list for the class that causes that ADR
- 3For management, know the specific antidote/action (e.g. naloxone, vitamin K, stop the drug)
Worked example
A patient started on ramipril develops a persistent dry cough.
Answer
ACE-inhibitor-induced cough (bradykinin); switch to an ARB (e.g. losartan).
Pitfalls & high-yield
- Signature ADRs to know: ACEi → cough/hyperkalaemia; gentamicin → nephro/ototoxicity; amiodarone → thyroid/lung/liver; statins → myopathy; steroids → hyperglycaemia/osteoporosis; opioids → constipation/respiratory depression.
- Key antidotes: opioids→naloxone, warfarin→vitamin K/PCC, benzodiazepines→flumazenil, paracetamol→NAC, digoxin→Digibind.
How it’s marked
2 marks per item, 8 items = 16 of 200 marks. Standard-set per sitting (pass mark ≈ 60–63%, varies).