Block 18B past paper Flashcards
Match the drug to the side effect Salbutamol Beclomethasone Ipratropium Ketotifen Theophylline
Salbutamol - palpitations Beclomethasone - oral thrush Ipratropium - constipation Ketotifen - drowsiness Theophylline - insomnia
ACE-I does not have which side effect?
Hypokalemia
2 drug combination that you would give to a patient with BP 180/120 type I diabetic
ACE I (enalapril) and diuretic (hydrochlorothiazide)
Name the drug class of the following drugs Nifedipine Doxazosin Alpha methyldopa Propranolol Guanethidine
Nifedipine - CCB Doxazosin - alpha 1 blocker Alpha methyldopa - alpha 2 agonist Propranolol - beta blocker Guanethidine - ganglion blocker
What is not a defensive factor in the pathogenesis of PUD?
Does not increase in H+ ion production
What is the MOA of tetracycline
Inhibits bacterial protein synthesis at 305 subunit
What is the MOA of cotrimoxazole
Interferes with bacterial folate synthesis
What is the MOA of erythromycin
Inhibits bacterial protein synthesis at 505 subunit
What is the MOA of amoxicillin
Intereferes with cross-linking of peptidoglycans
What is the MOA of ciprofloxacin
Inhibits DNA gyrase + topoisomerase
Which drug class eradicates H pylori?
AB therapy
PPI
Which drug class reduces secretion of gastric acid?
PPI
H2 receptor antagonists
Which drug class provides agents that protect the gastric mucosa
Misoprostol
Sucralfate, alginates, bismuth
Which drug class neutralizes gastric acid?
Non-absorbable antacids
What are causative factors in the pathogenesis of PUD?
NSAIDS
Infection with Helicobacter pylori
Increased hydrochloric acid secretion
Inadequate mucosal defence against gastric acid
What are the principles of management in PUD?
Symptomatic relief
Promoting of ulcer healing
Prevention of recurrence once healing has occurred
Prevention of complications
Peptic ulcers can appear and disappear spontaneously
True or false?
True
What are the long term effects of ACE-inhibitors?
Cough (15% of patients. Is reversible) -> suggests intolerance of whole group Taste disturbance (reversible) Angiodema First-dose hypotension Hyperkalaemia (esp. in patients with type II DM and renal dysfunction)
Function and dosage off hydrochlorothiazide?
Can lower the dose and still have a effect (12.5mg - 25mg)
Vasodilator
Diuretic
Side effects of hydrochlorothiazide?
Hypokalemia
Hyperuricemia
Hyperlipidaemia
Hyperglycemia
Treatment of allergic rhinitis?
1st line = intranasal corticosteroids
Other: oral corticosteroids, antihistamines, decongestants e.g pseudoephidrine
Why do intranasal corticosteroids have a delayed effect?
DNA changes
What are mediators of rhinitis symptoms?
Histamine Destabilised mast cells TNF Leukotrienes Cytokines
Side effects of new generation antihistamines?
Sedation
Raised IOP
Prostate hypertrophy
Types of rhinitis?
Allergic
Vasomotor
Infective
What is the allergic reaction incidence in penicillin?
High
Pharmacological treatment of anaphylaxis and mechanism of action
Adrenaline
Adrenocorticosteroids
Antihistamine
Aminophylline
Decrease bronchoconstriction
Increase BP
Stop angioedema
Reverse bradycardia
What do you use when penicillin or cephalosporins cannot be used?
Macrolides e.g clarithromycin
Most common UTI pathogen?
E.coli
Treatment of e.coli infection?
1st line: co-trimoxazole
Ciprofloxacin
Ceftriaxone
Which drug inhibits the liver metabolism of warfarin?
Ciprofloxacin
Side effect of tetracyline use in children?
Teeth discolouration
H. pylori is responsible for what percentage of ulcers?
70% gastric
90% duodenal
Aliminium salt antacids have what side effect?
Constipation
Mechanism of action of penicillin?
Attacks cell wall
Mechanism of action of macrolides?
Ribosomal inhibitors
Atypical pathogens in community acquire pneumonia
Chlamydia pneumonia
Mycoplasma pneumoniae
Legionella spp
Treatment of CAP?
Macrolides
Which drug do you not use in asthma?
Atenolol (beta 1 blocker)
Will cause bronchospasm
What is the mainstay of asthma treatment?
Corticosteroids
Common side effects of inhaled corticosteroids?
Oral thrush
Dysphonia (hoarseness)
Side effect of theophylline?
Insomnia
Side effect of bismuth?
Black mouth
Side effect of magnesium hydroxide?
Diarrhoea
What is the mechanism of action of nitrofurantoin?
Inhibits ribosomal proteins and other macromolecules to interfere with metabolism and cell wall synthesis
Sucralfate only reacts in a basic environment
True or false?
False
Alginates are safe in pregnancy
True or false?
True
Prostaglandins (e.g. misoprostol) cannot be given to pregnant people
True or false?
True
Which drug class can cause nasal congestion?
Alpha blockers
Histamine is the only mediator of inflammation
True or false?
False
H. pylori is a spirochete
True or false
False
Characteristics of PUD
Occurs after eating or at night,
Worsens when a person lies down or bends over.
Is common in pregnant women
May be triggered by consuming food in large quantities, or specific foods containing certain spices,
high fat content, or high acid content
Danger signs in PUD?
Dysphagia
Weight loss
Haematemesis
In PUD, dyspepsia combined with what is a danger sign?
Family history
Palpable virchow’s nodes
Gastric acid secretion by parietal cells is stimulated by?
Acetylcholine
Histamine
Gastrin
The presence of bile in vomit does not indicate heartburn
True or false
True
Omeprazole inhibits which enzyme?
CYP450
Side effect of prolonged omeprazole use?
Low vitamin B12
Side effects of PPIs
Hypomagnesemia
Facture risk
Diarrhoea (c. difficile)
Cimetidine affects which enzyme?
CYP450
What are H2 histamine receptor blockers best for?
Good for nocturnal acid secretion
PPI vs H2 histamine receptor blockers?
PPI - irreversible
H2 - reversible
When does bismuth subcitrate precipitate?
Acidic pH
Side effect of calcium antacids?
Rebound acid hypersecretion
