Clinical Pharmacology and Therapeutics

Question 1

MOA flecainide

Answer 1

NAv1.5 sodium channel blocker

Question 2

indications of flecainide

Answer 2

atrial fibrillation

SVT associated with accessory pathway e.g. Wolf-Parkinson-White syndrome

Question 3

contraindications flecainide

Answer 3

post myocardial infarction
structural heart disease: e.g. heart failure
sinus node dysfunction; second-degree or greater AV block
atrial flutter

Question 4

amiloride MOA

Answer 4

Na channel blocker in the Distal Convoluted Tubule.

Question 5

Amiloride uses

Answer 5

• weak diuretic - given alongside other diuretics as it is a potassium sparing diuretic to prevent hypokalaemia
• given in Liddles syndrome- reduces increased sodium channel activity

Question 6

aldosterone MOA

Answer 6

acts on the cortical collecting duct

Question 7

what type of metabolic disturbance does cocaine cause

Answer 7

metabolic acidosis

Question 8

what antibiotic to avoid in epileptics

Answer 8

ciprofloxacin

Question 9

side effects of dopamine agonists

Answer 9

nausea/vomiting
postural hypotension
hallucinations
daytime somnolence
ergot derived-cabergoline, bromocript- retroperitoneal fibrosis

Question 10

example of a depolarising muscle relaxant used in rapid sequence induction i a non fasted state

Answer 10

suxamethonium

Question 11

side effects of sildenafil

Answer 11

visual disturbances e.g. blue discolouration, non-arteritic anterior ischaemic neuropathy
nasal congestion
flushing
gastrointestinal side-effects
headache

Question 12

therapeutic drug monitoring mnemonic

Answer 12

have a Date @ 6, so i will be Late @ 12.

Call before you check and PHone if in doubt.

Question 13

Drugs that cause impaired glucose intolerance

Answer 13

thiazides, steroids, Tacrolimus, Ciclosporin, Interferon-alpha, nicotinic acid, anti-psychotics

Question 14

rituximab is a monoclonal antibody that acts on what marker

Answer 14

CD20

Question 15

clinical features of ecstasy poisoning

Answer 15

neurological: agitation, anxiety, confusion, ataxia
cardiovascular: tachycardia, hypertension
hyponatraemia
hyperthermia
rhabdomyolysis

Question 16

Drugs to avoid with people with Hypertrophic Obstructive Cardiomyopathy with left Ventricular outflow tract Obstruction

Answer 16

nitrates
ACE-inhibitors- reduces afterload which exacerbates the LVOT gradient.
inotropes

Question 17

Management of HOCM

Answer 17

Amiodarone
Beta-blockers or verapamil for symptoms
Cardioverter defibrillator
Dual chamber pacemaker
Endocarditis prophylaxis

Question 18

Comfortable at rest but less than ordinary activity results in symptoms NYHA

Answer 18

NYHA class III

Question 19

Comfortable at rest but ordinary activity results in fatigue, palpitations, dyspnoea NYHA

Answer 19

NYHA II

Question 20

which drug is completely contraindicated in Ventricular Tachy cardia management and can predispose patients to Severe hypotension, VF or cardiac arrest

Answer 20

VERAPAMIL

Question 21

high pitched pansystolic murmur heard loudest on inspiration

Answer 21

TRICUSPID REGURGITATION

Question 22

pulmonary hypertension likely to cause what murmur

Answer 22

Tricuspid regurgitation- due to right ventricle dilatation

Question 23

HOCM murmur

Answer 23

ejection systolic murmur left sternal edge loudest on expiration

Question 24

harsh pansystolic murmur left sternal edge

Answer 24

VSD

Question 25

Key management of Mitral stenosis

Answer 25

Percutaneous Mitral Commisurotomy