Clinical Pharmacology Flashcards
what drugs can cause bilateral parotid swelling?
propylthiouracil, phenylbutazone
Best antihypertensive for patients on lithium?
beta blockers > amlodipine
which anti-TB medication may precipitate gout flare by increasing uric acid?
pyrazinamide
Management of amiodarone induced thyrotoxicosis type 2 (ie amiodarone-related destructive thyroiditis)?
Corticosteroids
What anticoagulant to use in the setting of thrombosis from heparin induced thrombocytopenia?
- direct thrombin inhibitor e.g. argatroban
- danaparoid
How to stop anabolic steroids safely?
No need to taper, can stop immediately
> ideally lifelong monitoring for potential complications, initially annually with frequency reducing once bloods normalise and no SEs
Management of paraquat poisoning if presenting within first 2 hours?
activated charcoal and fuller’s earth
> adsorb paraquat in vitro
Treatment of Weeverfish stings?
bathing the affected limb (usually a foot) in hot water to denature the active proteins
Indications for hyperbaric o2 in CO poisoning?
- severe (if levels >25%)
- loss of consciousness at any point
- neurological signs other than headache
- myocardial ischaemia or arrhythmia
- pregnancy
Thallium poisoning features?
painful polyneuropathy
mood change
alopecia
Treatment of thallium poisoning?
Prussian Blue PO 10g BD
> this complexes with thallium and is excreted in the faeces.
Treatment of iron overdose if > 60mg/kg or have undissolved tablets in abdo X-ray and present within 4 hours?
Whole bowel irrigation
Kings college criteria for liver transplantation following paracetamol OD?
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
Antibiotic that interacts with aminophylline?
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
Which opiate can precipitate serotonin syndrome?
Tramadol
Management of flecainide OD?
Iv sodium bicarbonate
Side effects of pyrazinamide?
- hyperuricaemia causing gout
- arthralgia, myalgia
- hepatitis
Features of Intrathecal baclofen withdrawal syndrome
severe spasticity, rhabdomyolysis, acute renal failure and multisystem organ failure
Investigation of paraquat overdose?
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
Diagnostic tests for heparin induced thrombocytopenia?
- HIT antibody titre
- serotonin release assay
hallucinations, seizure, myoclonus, mydriasis, hypertension, acute kidney injury and hypokalaemia … which OD?
synthetic cannabinoid toxicity
Management of synthetic cathinone toxicity?
- causing agitation, hypoNa, serotonin syndrome
benzodiazepines, cooling and hypertonic saline if hyponatraemic
What are the irreversible unwanted side effects of anabolic steroids even after cessation?
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
Features of amyl nitrate toxicity
blurred vision, xanthopsia and haemoptysis
Features of toluene toxicity
irritation to the eyes, nose and respiratory tract from inhalation, along with confusion, ataxia, headache, slurred speech and euphoria
What should be avoided in pts getting trastuzumab because of cardio toxicity?
doxorubicin
Which drug has very short recovery time?
From GCS3> 15 very quickly
GHB
- CNS depressant.
- typically present with coma, respiratory depression, mild bradycardia, and vomiting.
- short recovery time. typically recover in 6 hours
dissociative phenomena, + tachycardia, hypertension, confusion, and mydriasis. Patients may also present with an acute cerebellar syndrome.
What drug OD?
Methoxetamine
- analogue of the dissociative anaesthetics ketamine and phencyclidine (PCP).
euphoria, synaesthesia, hallucinations and increased visual and tactile sensation
+ snorting with intense nasal pain
Likely what drug?
Nexus (2C-B)
- synthetic phenylethylamine with psychoactive and stimulant effects
- typically snorted or ingested with the former typically causing intense nasal pain
What analgesia are known to induce seizures or worsen seizure control
fentanyl, mefenamic acid, and tramadol
