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MRCP part 1 > Clinical pharmacology > Flashcards

Clinical pharmacology Flashcards

(53 cards)

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1
Q

ADP receptor inhibitors

A

Clopidogrel
Ticagrelor
PrasugrelA

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2
Q

ADP receptor inhibitor mechanism

A

prevents ADP-mediated pltelet activation and aggregation
adenosine concentration in circulation can increase and give rise to dyspnoea

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3
Q

Aspirin mechanism

A

block prostaglandin synthesis
non-selective for COX1 and COX2 enzymes

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4
Q

ARB mechanism

A

block angiotensin II at the AT1 receptor

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5
Q

Liver enzyme inducers

A

Phenytoin
Carbamazepine
Barbiturates
Rifampicin
Alcohol (chronic excess)
St Johns Wort

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6
Q

Drugs whose effectiveness is reduced by induction…

A

hydrocortisone
oral contraceptive
phenytoin
warfarin

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6
Q

Liver enzyme induction…

A

increases metabolism and therefore reduces effectiveness of some drugs

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7
Q

Liver enzyme inhibitors

A

Allopurinol
Omepazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin
Cimetidine
Ethanol (acute intoxication)
Sulfonamide

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8
Q

Liver enzyme inhibition…

A

slows metabolism of drugs thereby increasing plasma concentration and risk of adverse effects

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9
Q

Drugs whose effects increased by liver inhibition

A

Carbamazepine
Ciclosporin
Phenytoin
Statins
Theophyline
Warfarin

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10
Q

Drugs to be avoided in pregnancy

A

ACEI and ARB
Lithium
Phenytoin
Sodium valproate
Warfarin
Antibiotics - tetracycline, aminoglycosides, trimethoprim, quinolones

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11
Q

Drugs to be avoided in breast feeding

A

Amiodarone
Cytotoxics
Chloramphenicol
Gold
Indometacin
Iodides
Lithium
Oestrogens

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12
Q

Quinolones

A

Bactericidal
Inhibits DNA synthesis
Avoid in G6PD, pregnancy breastfeeding
Prolong QT
Lower seizure threshold

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13
Q

Trastuzumab

A

(Herceptin)
Acts on the HER2/neu receptor
i.e. for HER-2 positive breast Ca

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14
Q

Metabolic acidosis with a high anion gap and high osmolar gap

A

Ethylene glycol poisoning

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15
Q

Paracetamol liver failure transplant criteriA

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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16
Q

Anion gap cal

A

(Na + K) - (Cl +Bic)
Normal 4-12

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17
Q

Causes of normal anion gap MA

A

Addison’s
Bicarbonate loss: GI (e.g. diarrhoea) or renal (e.g. renal tubular acidosis)
Chloride excess
Diuretics (e.g. acetazolamide)

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18
Q

Causes of high anion gap MA

A

Lactate
Toxins (e.g. methanol, paracetamol, propylene glycol)
Ketones
Renal failure

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19
Q

Anion gap high

A

blood too acidic

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20
Q

Anion gap low

A

blood too alkali

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21
Q

Drug act on nuclear receptor

Study These Flashcards
A

Levothyroxine
Prednisolone
(must be lipid soluble to cross into cell)

22
Q

Drug act on G coupled protein receptor

23
Q

Drug act Guanylate cyclase receptor

24
Drug act on Ion channel receptors
Zolpidem (these receptors mediate fast actions i.e. GABA)
25
Drugs act on Tyrosine kinase receptor
insulin like growth factor IL-2
26
Direct thrombin inhibitor
Dabigatran
27
LMWH mechanism
activation of antithrombin III to inhibit Xa
28
Anthracycline example and adverse effects
Doxorubicin, epirubicin Cardiac dysfunction (myopathy)
29
Vinca alkaloids example and adverse effects
Vincristine, vinblastine Peripheral neuropathy
30
Platinum-based compounds example and adverse effects
Cisplatin, carboplatin Nephrotoxicity, ototoxicity
31
Taxanes example and adverse effects
paclitaxel, docetaxel peripheral neuropathy
32
Topoisomerase I inhibitors example and adverse effects
Irinotecan, topotecan Diarrhoea, myelosuppression
33
Tricyclic OD management
IV bicarb if: pH <7.1 QRS >160 ms Arrhythmias Hypotension
34
Tricyclic OD toxidrome
anticholinergic: dry mouth, dilated pupils, agitation, sinus tachycardia, blurred vision. severe poisoning : arrhythmias seizures metabolic acidosis coma ECG: sinus tachycardia widening of QRS prolongation of QT interval
35
Rifampicin mechanism
Inhibits RNA synthesis
36
Clarithromycin mechanism
reversible inhibition of 50s ribosome subunit
37
Tacrolimus mechanism
Decreases IL-2 release by inhibiting calcineurin
38
Digoxin mechanism
Inhibition of the Na+/K+ ATPase pump
39
Organophosphate poisoning
Bradycardia hypotension miosis urination, defecation
40
Amiloride mechanism
potassium sparing diuretic acts on epithelial sodium channels
41
Antibiotic contraindicated in G6PD
Ciprofloxacin (quinolones) (fava beans infection also precipitate haemolytic crises)
42
Dopamine receptor agonist example and indications
Bromocriptine, cabergoline, ropinirole Parkinsons, prolactinoma, cyclical breast disease, acromegaly
43
Adrenaline induced ischaemia
local phentolamine
44
Drugs commonly causing urticaria
penicillins aspirin NSAIDs Opiates
45
Metformin mechanism
Activation of the AMP-activated protein kinase (AMPK) Increases insulin sensitivity Decreases hepatic gluconeogenesis May also reduce gastrointestinal absorption of carbohydrates
46
Allopurinol mechanism
inhibits xanthine oxidase
47
rituximab mechanism
monoclonal antibody against CD20
48
Factors predisposing to lithium toxicity
Dehydration Renal failure Drugs - Diuretics, ACEI, ARB, metronidazole, NSAIDs
49
Drugs that can be cleared by a blast of haemodialysis
Barbiturate Lithium Alcohol Salicylates Theophylline
50
Drugs which cannot be cleared by haemodialysis
Dig Benzos Tricyclics Bblockers
51
Nicotinic acid in diabetics
May increase insulin resistance
52

MRCP part 1 (15 decks)

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