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MRCP > Clinical pharmacology > Flashcards

Clinical pharmacology Flashcards

1
Q

Alpha 1 adrenoreceptor function (4)

A

vasoconstriction
relaxation of GI smooth muscle
salivary secretion
hepatic glycogenolysis

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2
Q

alpha 2 adrenoreceptor main functions (3)

A

mainly presynaptic: inhibition of transmitter release (inc NA, Ach from autonomic nerves)
inhibits insulin
platelet aggregation

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3
Q

Serotonin syndrome Mx

A

1st - supportive
2nd - Benzodiazepines
3rd - cyproheptadine or chlorpromazine

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4
Q

Ethelyne glycol toxicity (aka antifreeZe) Mx

A

Fomepizole

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5
Q

Haemodialysis drugs that can be cleared (5)

A

BLAST

Barbituates
Lithium
Alcohol
Salicylates (eg aspirin)
Theophylline
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6
Q

Quinolones (Ciprofloxacin) side effects (4)

A

Lowers seizure threshold
Tendon damage
Cartilage damage (Quinolones contraindicated in children)
lengthens QT

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7
Q

Paracetamol OD liver transplant criteria (4)

A

Ph < 7.3 (24 hours post ingestion)
Encephalopathy grade 3/ 4
Increased PT >100s
Creatinine >300

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8
Q

P450 inducers (eg reduce the effects of warfarin = lower INR)

A

antiepileptics: phenytoin, carbamazepine
barbiturates: phenobarbitone
rifampicin
St John’s Wort
chronic alcohol intake
griseofulvin
smoking (affects CYP1A2, reason why smokers require more aminophylline)
spirinolactone

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9
Q

Inhibitors of the P450 system include (eg increase the effect of warfarin = higher INR)

A 
antibiotics: ciprofloxacin, erythromycin
isoniazid
cimetidine, omeprazole
amiodarone
allopurinol
imidazoles: ketoconazole, fluconazole
SSRIs: fluoxetine, sertraline
ritonavir
sodium valproate
acute alcohol intake
Cranberry
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10
Q

Drug metabolism
phase I: (2)
phase II: (1)

A

Drug metabolism
phase I: oxidation, reduction, hydrolysis
phase II: conjugation

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11
Q

oculogyric crisis
features (2)
Causes (3)
Mx (1)

A

features: upward gaze deviation, restless agitation
causes: metoclopramide, antipsychotics, parkinson’s
Mx - Benztropine, procyclidine

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11
Q

oculogyric crisis
features (2)
Causes (3)
Mx (1)

A

features: upward gaze deviation, restless agitation
causes: metoclopramide, antipsychotics, parkinson’s
Mx - Benztropine, procyclidine

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12
Q

Ketamine MOA

A

NMDA antagonist

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13
Q

Agranulocytosis causes (6 types)

A

Antithyroid drugs - carbimazole, propylthiouracil
Antipsychotics - atypical antipsychotics (CLOZAPINE)
Antiepileptics - carbamazepine
Antibiotics - penicillin, chloramphenicol, co-trimoxazole
Antidepressant - mirtazapine
Cytotoxic drugs - methotrexate

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14
Q

Side effects of common diabetic medication

  • Metformin (2)
  • Sulfonylureas (4)
  • Glitazones (2)
  • Gliptins (1)
A

Metformin - GI s/e, Lactic acidosis
Sulfonylureas - Hypoglycaemia, Increased appetite and weight gain, SIADH, Liver dysfunction (cholestatic)
Glitazones - Weight gain, Fluid retention, Liver dysfunction Fractures
Gliptins - Pancreatitis

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15
Q

Causes of drug-induced photosensitivity (5)

A 
thiazides
tetracyclines, sulphonamides, ciprofloxacin
amiodarone
NSAIDs e.g. piroxicam
sulphonylureas
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16
Q

N-acetylcystiene (NAC) MOA

A

Replenish Glutathione in liver

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17
Q

Amiodarone induced thyrotoxicosis Type 1
pathophys
goitre?
Mx

A

pathophys - excess iodine induced thyroid hormone stimulation
goitre - present
Mx - carbimazole/ perchlorate

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18
Q

Amiodarone induced thyrotoxicosis Type 2
pathophys
goitre?
Mx

A

pathophys - amiodarone-related destructive thyroiditis
goitre - absent
Mx - corticosteroids

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19
Q

HARMFUL medications in pregnancy (5)

A 
Antibiotics - tetracyclines, aminoglycasides, trimethoprim, quinolones
ACEi, ARBs
Statins
Warfarin
Sulfonylurea
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20
Q

Organophosphate insecticide treatment

A

atropine

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21
Q

Indications for haemodialysis in salicylate overdose (5)

A 
serum concentration > 700mg/L
metabolic acidosis resistant to treatment
acute renal failure
pulmonary oedema
seizures
coma
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22
Q

Ciclosporin and Tacrolimus MOA

A

inhibit calcineurin thus decreasing IL-2

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23
Q

Fomepizole (Antidote for ethylene glycol toxicity) MOA

A

Inhibit alcohol dehydrogenase

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24
Q

Drugs exhibiting zero-order kinetics (4)

A

phenytoin
salicylates (e.g. high-dose aspirin)
heparin
ethanol

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25
Q

Adrenaline induces… (glucose, lactate, potassium)

A

hyperglycemia, hyperlactatemia and hypokalaemia

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26
Q

The following drugs commonly cause urticaria: (4)

A

aspirin
penicillins
NSAIDs
opiates

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27
Q

Benzodiazepine overdose treatment

A

Flumazenil

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28
Q

Adrenaline induced ischaemia Mx

A

phentolamine

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29
Q

Drugs that cause urinary retention (5)

A 
TCA e.g. amitriptyline
anticholinergics e.g. antipsychotics, antihistamines
opioids
NSAIDs
disopyramide
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30
Q

DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome features (4)

A

extensive skin rash
high fever
organ involvement (usually liver)
eosinophillia

31
Q

Ciclosporin
MOA
SE

A

inhibits calcineurin to reduce IL2

SE - nephrotoxicity, hepatotoxicity, fluid retention, hypertensionhyperkalaemia

32
Q

What medication reduces threshold for seizures (thus increasing seizures)

A

Ciprofloxacin

33
Q

Lithium toxicity features

A

Chronic: fine tremor
Acute: Coarse tremor

34
Q

Abx inhibit cell wall formation

A

penicillin, cephalosporin, vancomycin

35
Q

Abx inhibit protein synthesis

A

Erythromycin, chloramphenicol, gentamicin, doxycycline, clindamycin

36
Q

Abx inhibit DNA synthesis

A

quinolones (ciprofloxacin)

37
Q

Abx damage DNA

A

metronidazole

38
Q

Abx inhibit folic acid

A

sulphonamides, trimethoprim

39
Q

Abx inhibit RNA synthesis

A

Rifampicin

40
Q

Causes of raised anion gap

A 
lactic acidosis
ketoacidosis
renal failure (high urate)
toxins such as methanol, (antifreeze) ethylene glycol, salicylates
41
Q

Benzodiazepine overdose MxD

A

Flumazenil

42
Q

Drugs that cause pulmonary fibrosis

A 
amiodarone
cytotoxic agents: busulphan, bleomycin
anti-rheumatoid drugs: methotrexate, sulfasalazine
nitrofurantoin
bromocriptine
43
Q

Verapamil SE

A

constipation
heart failure
hypotension, bradycardia, flushing

44
Q

Infliximab MOA

A

anti-TNF

45
Q

RItuximab MOA

A

anti CD-20

46
Q

Alemtuzumab MOA

A

anti CD-52

47
Q

Cetuzimab MOA

A

EGFR inhibitor

48
Q

Trastuzumab MOA

A

HER2/ Neureceptor antagonist

49
Q

Abciximab MOA

A

glycoprotein IIb/ IIIa receptor complex

50
Q

Drugs that cause photo sensitivity

A 
Thiazides
Amiodarone
NSAIDs
Tetracycline, sulphonamides, ciprofloxacin
Sulphynurea
51
Q

Digoxin MOA

A

Inhibit Na/K ATPase pump

52
Q

Statin contraindicated in statins due to risk of

A

rhabdomyolysis

53
Q

Mercury overdose features (3)

A

visual field defects, hearing loss, paraesthesia

54
Q

Lead poisoning features (3)

A

abdominal pain, constipation, headaches.

55
Q

Ethylene Glycol (anti freeze) overdose features (3)

A

nausea and vomiting, headaches and intoxication before seizures.

56
Q

Organophosphate (insecticide) poisoning Mx

A

atropine

57
Q

Aspirin MOA (2)

A

Non reversible COX 1 + 2 inhibitor

Thromboxane 2 inhibitor

58
Q

Pilocarpine MOA

A

Muscarinic agonist

59
Q

Local anaesthetic toxicity Mx

A

Lipid emulsion

60
Q

Metoclopramide side effects

A

galactorrhea

61
Q

Opioid withdrawal features

A

abdominal pain
diarrhoea
agitation
sweating

62
Q

Alcohol withdrawal features

A

hallucinations - visual, tactile, auditory
seizures
autonomic hyperactivity - sweating, agitation

63
Q

Theophylline toxicity features

A

metabolic acidosis

hypokalaemia

64
Q

carbimazole moa

A

inhibition of iodinisation of tyrosine

65
Q

Contraindication to COCP

A 
if age >35 + smoking >15/day
BP > 160/95
<6 months post partum if breastfeeding
Raynauds, SLE
VTE
Breast Ca
Cardiovascular disease
66
Q

Cyclophosphamide SE

A

urinary frequency

suprapubic pain

67
Q

Ethambutol toxicity

A

visual disturbance

high urate

68
Q

Isoniazide toxicity

A

hepatic impairment
suicidal
psychosis

69
Q

B Blocker OD treatment

A

1st - Atropine

2nd - Glucagon

70
Q

Primaquine MOA

A

removal of hypnozoites from liver

for vivax + ovale

71
Q

Raised anion gap (>16) causes

A

lactic acidosis
DKA
ureamia
Aspirin toxicity

72
Q

Fungal nail infection Mx

A

oral terbinafine

73
Q

salicylate OD features

Mx

A

F - tinnitus, sweating, dizziness, hyperventilation, resp alkalosis
Mx - IV bicarb, haemodialysis (if severe)

74
Q

Tumour lysis syndrome
Features
Mx

A

hypoCa
hyperK
hyperPhos

Mx - pre chemo hydration + allopurinol

75
Q

isoniazid SE

A

peripheral neuropathy

Due to Vit B6 (pyridoxine) deficiency

76
Q

Mycoplasma pneumonia Mx (2)

A

Doxy

Clarithromycin

MRCP (14 decks)

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