Clinical pharm = Flashcards by Helena Worthington

drug is most likely to cause impaired glucose tolerance in transplant patients

Tacrolimus

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oculogyric crisis Management

Benztropine or procyclidine

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Which common heart drug can cause sleep disturbances and nightmares

Beta blockers

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mechanism underlying the drug-induced renal injury Of aminoglycosides

Acute tubular necrosis

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Mechanism of action of aspirin

non reversible COX 1 and 2 inhibitor

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Drug used for uti that can cause pulmonary fibrosis

Nitrofurantoin

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Inducers of the P450 system

Inducers of the P450 system include
antiepileptics: phenytoin, carbamazepine
barbiturates: phenobarbitone
rifampicin
St John’s Wort
chronic alcohol intake
smoking

reduce the effects of drug

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Inhibitors of the P450 system

Inhibitors of the P450 system include
antibiotics: ciprofloxacin, erythromycin
isoniazid
sodium valproate
cimetidine,omeprazole
amiodarone
allopurinol
imidazoles: ketoconazole, fluconazole
SSRIs: fluoxetine, sertraline
ritonavir
sodium valproate
acute alcohol intake
quinupristin

enhances drug effect/ prolongs drug effect

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primary constituents of granulomatous structures

macrophages

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what cytokine activates macrophages?

Interferon-γ released by Th1 cells activates macrophages

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what cytokine is released by macrophages to cause FEVER and neutrophil chemotaxis?

TNF-a

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what cytokine is released by macrophages to cause B cell differentation?

Interleukin-6

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what cytokine is released by macrophages to cause neutrophil attraction (chemotaxis) to a site of inflammation/infection?

Interleukin-8

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Diabetic nephropathy histological findings

Kimmelstiel-Wilson lesions (nodular glomerulosclerosis)

basement membrane thickening, capillary obliteration, mesangial widening.

hyaline arteriosclerosis

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amyloidosis nephropathy histological findings

Apple-green birefringence under polarised light

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diffuse proliferative glomerulonephritis (often due to SLE) nephropathy histological findings

Wire looping of capillaries in the glomeruli

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which diabetic drug can cause B12 deficiency due to impact on gut mobility and absorption?

metformin

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effect of cocaine during pregnancy?

induce preterm labour

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Parametric tests

Parametric tests:
Student’s t-test - paired or unpaired

Pearson’s product-moment coefficient - correlation

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Non-parametric tests

Mann-Whitney U test
compares ordinal, interval, or ratio scales of unpaired data

Wilcoxon signed-rank test
compares two sets of observations on a single sample, e.g. a ‘before’ and ‘after’ test on the same population following an intervention

chi-squared test
used to compare proportions or percentages e.g. compares the percentage of patients who improved following two different interventions

Spearman, Kendall rank - correlation

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what are the cellular target options for drugs?

ion channels eg. lidocaine acts on these

G-coupled receptors. eg. adrenoreceptors
when drugs bind it triggers series of reactions –> produce cyclic AMP –> effects

Guanylate cyclase receptors
contain intrinsic enzyme activity
e.g. atrial natriuretic factor, brain natriuretic peptide

tyrosine kinase receptors eg. insulin acts on these
results in phosphorylation reactions which then cause cell growth/ differentiation

nuclear receptors eg. prednisolone, steroids and levothyroxine
they are lipid soluble so can penetrate the membrane to target these receptors and thereby increase/decrease gene expression

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significance tests for correlation

parametric (normally distributed): Pearson’s coefficient

non-parametric: Spearman’s coefficient

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treatment ethylyene glycol (antifreeze) or methanol poisoning

fomepizole,

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Patients with which complement deficiency are most predisposed to disseminated meningococcal infection?

C5-9 deficiency

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Patients with which complement deficiency are most predisposed to immune complex deficiencies like SLE, HSP?

C1q, C1rs, C2, C4 deficiency

Patients with which complement deficiency are most predisposed to recurrent bacterial infections?

what cells produce IgE?

plasma cells produce IgE IgE receptors are found on mast cells

50% of the population are deficient in hepatic N-acetyltransferase Drugs affected by acetylator status:

isoniazid procainamide hydralazine dapsone sulfasalazine therefore increased risk of toxicity

which hypersensitivity reaction is caused by immune complex deposition?

type 3

which hypersensitivity reaction is caused by antibodies binding to an antigen?

type 2

overdose associated with respiratory alkalosis?

salicylate and theophylline overdoses (these are respiratory stimulants) theophylline --> seizures, hypoK

why do NSAIDs cause UGI bleeds?

depletes mucosal prostaglandin levels --> mucosal injury

How does NMDA cause its effects?

activates serotonin and sympathetic nervous system SIADH --> hyponatraemia --> seizures

which HLA is most important in avoiding hyperacute organ transplant rejection?

HLA-C

antibodies in myasthenia gravis vs lambert eaton syndrom

lamber eaten: voltage gated calcium myasthenia gravis: anti acetylreceptor autoantibodies

distinguishing feature between methanol vs ethylene glycol (antifreeze) overdose/poisoning?

methanol cause vision loss

the most common lipid storage disorde

Gaucher disease accumulation of glucocerebrosidase in the brain, liver and spleen. Key features include hepatosplenomegaly, aseptic necrosis of the femur

cardiology drug that causes constipation

verapamil

What is the target for rituximab?

Rituximab - CD20 on B cells

what type of receptors are adrenoceptors?

G coupled

lithium tremor trypes

fine = acute toxicity coarse = chronic use

Standard error of the mean equation

Standard error of the mean = standard deviation / square root (number of patients)

where does cocaine act?

cocaine blocks the uptake of dopamine, noradrenaline and serotonin mx. benzos

power equation

Power = 1 - the probability of a type II error

Quinine toxicity signs

Quinine toxicity - anti malarial + leg cramps meds (cinchonism) presents with myriad ECG changes, hypotension, metabolic acidosis, hypoglycaemia and classically tinnitus, flushing and visual disturbances. Flash pulmonary oedema may occur

what is used to demonstrate publication bias in meta-analysis?

funnel plot symmetrical - unlikely bias asymmetrical - bias

vitamin B3 (niacin) deficiency

pellagra dementia, diarrhoea and dermatitis

inheritance of haemophilia

x linked recessive

Causes of drug-induced photosensitivity

thiazides tetracyclines, sulphonamides, ciprofloxacin amiodarone NSAIDs e.g. piroxicam psoralens sulphonylureasDepolarising neuromuscular blocker

name a depolarising muscle relaxant?

suxamethonium

statins and pregnancy/ conception

statins should be discontinued in women 3 months before conception due to the risk of congenital defects

Drug-induced gingival hyperplasia causes

anticonvulsants, calcium channel blockers, and immunosuppressants.

Quit smoking

NRT or Varenicline or Bupropion prescription of NRT, varenicline or bupropion should be sufficient to last only until 2 weeks after the target stop date. Normally, this will be after 2 weeks of NRT therapy, and 3-4 weeks for varenicline and bupropion, to allow for the different methods of administration and mode of action. Varenicline is more effective but caution in self harm/depression Bupropion increases seizure risk so not for epileptic Pregnancy - NRT

Shigella mx

Cipro

What drug is celecoxib?

NSAID

Restless legs syndrome -what is the single most important blood test?

ferritin (common cause of RLS)

Ciclosporin + tacrolimus: mechanism of action

Ciclosporin + tacrolimus: inhibit calcineurin thus decreasing IL-2

drugs that cause Liver cirrhosis

methotrexate methyldopa amiodarone

Ciclosporin side-effects which is most common?

everything is increased - fluid, BP, K+, hair, gums, glucose HTN is most common

Molecular biology techniques

SNOW (South - NOrth - West) DROP (DNA - RNA - Protein) ElISA = detect antigens and antibodies

which cardiac drug can cause corneal opacities?

amiodarone

antiepileptic drug most commonly associated with weight gain?

sodium valproate

Psoriasis triggers

The following factors may exacerbate psoriasis: trauma alcohol drugs: beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab withdrawal of systemic steroids

Drugs which exhibit zero-order kinetics include. aka. saturation kinetics

phenytoin, alcohol and salicylates, heparin

which diabetes drug causes syndrome of inappropriate ADH

Sulphonylureas

Gingival hyperplasia drugs

phenytoin, ciclosporin, calcium channel blockers and AML

Drugs known to induce Toxic Epidermal Necrolysis

phenytoin sulphonamides allopurinol penicillins carbamazepine NSAIDs

Clinical pharm = Flashcards

(67 cards)