Clinical pharmacology Flashcards
Give examples of macrolides
Erythromycin, azithromycin, clarithromycin
What is the MOA of macrolides?
Reversible inhibition of 50S subunit ribosome
Give example of tetracycline
Doxycycline
MOA of tetracyclines + aminoglycosides
Inhibit 30S subunit of ribosome
Aminoglycoside examples
Gentamycin
How are aminoglycosides nephrotoxic?
Cause acute tubular necrosis
Examples of quinolones
Ciprofloxacin
SEs of quinolones
Lowers seizure tershold
tendon damage + rupture
What group of patients must you avoid quinolones in and why?
G6PD deficiency –> haemolytic reaction
P450 inhibitors
allopurinol amiodarone ketoconazole sodium valproate omeprazole fluoxetine ciprofloxacin acute alcohol intake isoniazid erythromycin cimetidine ritonavir fluconazole sertraline
P450 inducer
carbamazepine smoking chronic alcohol intake phenytoin phenobarbitone rifampicin St John's Wort
Drugs safe in breastfeeding
antibiotics: penicillins, cephalosporins, trimethoprim
endocrine: glucocorticoids (avoid high doses), levothyroxine*
epilepsy: sodium valproate, carbamazepine
asthma: salbutamol, theophyllines
psychiatric drugs: tricyclic antidepressants, antipsychotics** (clozapine avoid)
hypertension: beta-blockers, hydralazine
anticoagulants: warfarin, heparin
digoxin
Drugs to avoid in breast feeding
antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides
psychiatric drugs: lithium, benzodiazepines
aspirin carbimazole methotrexate sulfonylureas cytotoxic drugs amiodarone
Drugs causing pancreatitis
Steroids
Thiazides
Sodium valproate
Azathioprine
Amiodarone adverse effects
Hypo/hyperthyroid (as contains iodine)
Liver toxicity
Lung fibrosis
What to monitor with amiodarone therapy?
LFTs
TFTs
What precipitates digoxin toxicity?
HYPOKALEMIA
Drugs (verapamil, amiodarone, diltiazem, drugs that cause hypokalaemia), hypothermia, hypothyroid
MoA sildenafil
2 contraindications for sildenafil
Phosphodiesterase Type 5 inhibitor (cause vasodilation through an increase in cGMP leading to smooth muscle relaxation in blood vessels)
CI’s: Nitrates + nicorandil
Drug causes of gingival hyperplasia
give some other causes
phenytoin
ciclosporin
calcium channel blockers (especially nifedipine)
AML
MOA Flecainide
Sodium channel blocker
Class 1c
widening of the QRS complex and prolongation of the PR interval
What is phase I of drug metabolism?
Oxidation, reduction, hydrolysis
What is phase 2 of drug metabolism?
Conjugation
Examples of drugs that exhibit zero order kinetics?
Aspirin
Salicylates
Dobutamine MoA
Beta 1 agonist
What is a common side effect of verapamil?
Constipation
What cancers does COCP increase and decrease risk of?
Increase: cervical + breast
Decrease: endometrial + breast
Examples of quinolones+MOA
Ciprofloxacin + levofloxacin
Inhibit DNA synthesis
What antiepileptic can cause agranulocytosis?
Carbemazapine
What drugs can cause serotonin syndrome?
SSRIs and TRAMADOL!!!!1
EXAM Q: How does digoxin work?
Inhibition of Na-K-ATPase pump
Causes intracellular sodium accumulation
Exam Q: tirofiban mechaniam of action
Glycoprotein IIb/IIIa receptor antagonists
EAT: Eptifibatide, Tirofiban and Abciximab
Drug
OMEPRAZOLE
hepB vaccine
isotretinoin
