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MRCP > Clinical Pharmacology > Flashcards

Clinical Pharmacology Flashcards

1
Q

what drugs can cause bilateral parotid swelling?

A

propylthiouracil, phenylbutazone

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2
Q

Best antihypertensive for patients on lithium?

A

beta blockers > amlodipine

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3
Q

which anti-TB medication may precipitate gout flare by increasing uric acid?

A

pyrazinamide

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4
Q

Management of amiodarone induced thyrotoxicosis type 2 (ie amiodarone-related destructive thyroiditis)?

A

Corticosteroids

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5
Q

What anticoagulant to use in the setting of thrombosis from heparin induced thrombocytopenia?

A
  • direct thrombin inhibitor e.g. argatroban

- danaparoid

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6
Q

How to stop anabolic steroids safely?

A

No need to taper, can stop immediately

> ideally lifelong monitoring for potential complications, initially annually with frequency reducing once bloods normalise and no SEs

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7
Q

Management of paraquat poisoning if presenting within first 2 hours?

A

activated charcoal and fuller’s earth

> adsorb paraquat in vitro

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8
Q

Treatment of Weeverfish stings?

A

bathing the affected limb (usually a foot) in hot water to denature the active proteins

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9
Q

Indications for hyperbaric o2 in CO poisoning?

A
  • severe (if levels >25%)
  • loss of consciousness at any point
  • neurological signs other than headache
  • myocardial ischaemia or arrhythmia
  • pregnancy
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10
Q

Thallium poisoning features?

A

painful polyneuropathy
mood change
alopecia

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11
Q

Treatment of thallium poisoning?

A

Prussian Blue PO 10g BD

> this complexes with thallium and is excreted in the faeces.

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12
Q

Treatment of iron overdose if > 60mg/kg or have undissolved tablets in abdo X-ray and present within 4 hours?

A

Whole bowel irrigation

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13
Q

Kings college criteria for liver transplantation following paracetamol OD?

A

Arterial pH < 7.3, 24 hours after ingestion

or all of the following:
prothrombin time > 100 seconds
creatinine > 300 µmol/l
grade III or IV encephalopathy

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14
Q

Antibiotic that interacts with aminophylline?

A

Ciprofloxacin

> strong inhibitor of enzyme 1A2 causing a decrease in function of at least 80% and an average rise in serum concentrations of aminophylline of five-fold

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15
Q

Which opiate can precipitate serotonin syndrome?

A

Tramadol

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16
Q

Management of flecainide OD?

A

Iv sodium bicarbonate

17
Q

Side effects of pyrazinamide?

A
  • hyperuricaemia causing gout
  • arthralgia, myalgia
  • hepatitis
18
Q

Features of Intrathecal baclofen withdrawal syndrome

A

severe spasticity, rhabdomyolysis, acute renal failure and multisystem organ failure

19
Q

Investigation of paraquat overdose?

A

Urine dithionate testing

> presence of paraquat is confirmed by a colour change noted after the addition of a dithionite solution

  • don’t wait for results before treating with oral Fuller’s earth
20
Q

Diagnostic tests for heparin induced thrombocytopenia?

A
  • HIT antibody titre

- serotonin release assay

21
Q

hallucinations, seizure, myoclonus, mydriasis, hypertension, acute kidney injury and hypokalaemia … which OD?

A

synthetic cannabinoid toxicity

22
Q

Management of synthetic cathinone toxicity?

- causing agitation, hypoNa, serotonin syndrome

A

benzodiazepines, cooling and hypertonic saline if hyponatraemic

23
Q

What are the irreversible unwanted side effects of anabolic steroids even after cessation?

A 
Hirsutism
Voice pitch changes
Male pattern baldness
Skin striae or keloid scarring
Chest pain
Clitoral hypertrophy
Short stature due to premature fusion of growth plates
24
Q

Features of amyl nitrate toxicity

A

blurred vision, xanthopsia and haemoptysis

25
Q

Features of toluene toxicity

A

irritation to the eyes, nose and respiratory tract from inhalation, along with confusion, ataxia, headache, slurred speech and euphoria

26
Q

What should be avoided in pts getting trastuzumab because of cardio toxicity?

A

doxorubicin

27
Q

Which drug has very short recovery time?

From GCS3> 15 very quickly

A

GHB

  • CNS depressant.
  • typically present with coma, respiratory depression, mild bradycardia, and vomiting.
  • short recovery time. typically recover in 6 hours
28
Q

dissociative phenomena, + tachycardia, hypertension, confusion, and mydriasis. Patients may also present with an acute cerebellar syndrome.
What drug OD?

A

Methoxetamine

  • analogue of the dissociative anaesthetics ketamine and phencyclidine (PCP).
29
Q

euphoria, synaesthesia, hallucinations and increased visual and tactile sensation
+ snorting with intense nasal pain

Likely what drug?

A

Nexus (2C-B)

  • synthetic phenylethylamine with psychoactive and stimulant effects
  • typically snorted or ingested with the former typically causing intense nasal pain
30
Q

What analgesia are known to induce seizures or worsen seizure control

A

fentanyl, mefenamic acid, and tramadol

MRCP (21 decks)

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