Chapter 2 - Pharmacology & Toxicolgy Flashcards
Presentation of drug induced lupus
Triad:
Arthralgia
Butterfly Rash
Pleurisy
Common causes of drug-induced lupus
B-blockers Phenytoin Isoniazid Lithium Flecainide Haloperidol Penicillin Tetracyclines
Drugs impeded by CYP induction
Hydrocortisone
OCP
Phenytoin
Warfarin
Drugs that jnduce liver enzymes
Barbiturates
Sulphonylureas
Carbamazepine
Rifampicin
Alcohol (chronic), amiodarone
Phenytoin
Griseofulvin
Smoking
Drugs potentiated by liver enzyme inhibitors
Carbamazepine Ciclosporin Phenytoin Theophyllines Warfarin
Drugs that inhibit CYP enzymes
Sulphonamides
Isoniazid
Ciprofloxacin
Ketoconazole
Fluoxetine Allopurinol, acute alcohol Cimetidine Erythromycin Sodium valproate
Chloramphenicol
Omeprazole
Metronidazole
Factors that affect OCP
Absorption (diarrhoea)
Enzyme inducers
Gut flora (enterohepatic oestrogen cycling) - antibiotics
Drugs for breastfeeding mothers to avoid
Amiodarone - thyroid
Cytotoxics/chloramphenicol - dyscrasias
Gold - haem/renal Indomethacin - seizure Iodides - thyroid Lithium - involuntary movements Oestrogen- feminisation of male infant
Teratogenic medications
ACEi/ARB - oligohydramnios Lithium - cardiac Phenytoin- facial fusion Sodium valproate - ntds Warfarin - long bone anomalies
> 16 weeks
Carbimazole - goitre
Gentamicin - CN VIII sensorineural deafness
Drugs that accumulate in renal failure
Atenolol Digoxin Enoxaparin Erythromycin Lithium Penicillin Cephalosporins
Chimeric monoclonal antibody that irreversibly binds GpIIb/IIIa
Abciximab - can only be used once in any individual
A purine nucleoside characterised by short half life
Adenosine - for SVT termination
Side effects of adenosine?
Anxiety
Chest tightening
Bronchospasm (c/I in asthmatics)
Facial flushing
Mechanism of Aliskiren
Direct renin inhibitor prevents angiotensinogen to angiotensin I conversion
Highly protein binding and long half life associated with which drug?
Amiodarone
Side effects of amiodarone
Arrhythmia (torsades due to QT prolongation) Ataxia Alveolitis Hepatitis Thyroid (hyper or hypo) Peripheral neuropathy Photo sensitivity Pulm fibrosis Grey skin
How does ACEi cause cough?
Increased Kirin concentration in alveoli/bronchi
Cautions with ACEi
Renal artery stenosis
Severe renal impairment
Mechanism of digoxin in AF
NA+/K+/ATPase inhibitor - increased intracellular Na prolongs phase 4 and 0, AV nodal delay.
Increased intracellular Ca2+ - increased contracility
Vagus stimulation - further AV nodal prolongation
Digoxin toxicity
Anorexia N&V Arrhythmia Yellow vision (xanthopsia) Diarrhoea
Precipitated by electrolyte imbalance (Hypokalaemia, Hypomagnasaemia, Hypercalcaemia)
Flecainide class and indication
1c antiarrhythmic - sodium blocker prolongs phase 1
For acute cardioversion of AF
Statin indications
MI
DM
HTN
CVD risk factors/PVD
Ivabradine mechanism
K+ opener causing peripheral arterial vasodilatation. Nitrate component causes venous relaxation.
Non-diuretic indication for thiazides
Blood pressure management. Majority of effect at minimal dose
