Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MRCP - Passmed > Clinical pharmacology + toxicology > Flashcards

Clinical pharmacology + toxicology Flashcards

1
Q

Features of lithium toxicity?

A

coarse tremor (a fine tremor is seen in therapeutic levels)
hyperreflexia
acute confusion
polyuria
seizure
coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Mx of lithium toxicity?

A

mild-moderate - fluid resus
(monitor Na levels if concern of nephrogenic DI)

severe - haemodialysis may be required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some side effects of metformin?

A

GI side effects

Lactic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some side effects associated with sulphonureas?

A

Hypoglycaemic episodes
Increased appetite and weight gain
Syndrome of inappropriate ADH secretion
Liver dysfunction (cholestatic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some side effects associated with Glitazones?

A

Weight gain
Fluid retention + decompensation of HF
Liver dysfunction
Fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some side effects associated with Gliptins?

A

Pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

paraesthesia
visual field defects
hearing loss
irritability
renal tubular acidosis

Suggest what type of poisoning?

A

Mercury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which drugs can cause urinary retention?

A

tricyclic antidepressants e.g. amitriptyline
anticholinergics e.g. antipsychotics, antihistamines
opioids
NSAIDs
disopyramide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which drugs can cause lung fibrosis?

A

Amiodarone

Cytotoxic agents - busulphan, bleomycin

anti-rheumatoid drugs - methotrexate, sulfasalazine

Nitrofurantoin

Ergot derived dopamine agonists eg bromocriptine, cabergoline, pergolide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Octreotide MoA

A

Somatostatin analogue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Blood gas findings in ethylene glycol / methanol poisoning?

Mx?

A

Raised anion gap metabolic acidosis w high osmolar gap

Use Fomepizole / ethanol - act as competitive inhibitor of alcohol dehydrogenase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which CCB can cause constipation?

A

Verapamil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Adverse effects associated with aminoglycoside use? examples? when to avoid?

A

Aminoglycosides like gentamicin can cause:

Irreversible ototoxicity - due to auditory / vestibular nerve damage

Nephrotoxicity secondary to ATN - using furosemide increases this risk

CI in myasthenia gravis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Examples of Quinolones? When are these CI?

A

Examples:
ciprofloxacin
levofloxacin

Contraindications:
Quinolones should generally be avoided in women who are pregnant or breastfeeding
avoid in G6PD - can percipitate haemolytic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Licenced indications of Botox

A

blepharospasm
hemifacial spasm
focal spasticity including cerebral palsy patients, hand and wrist disability associated with stroke
spasmodic torticollis
severe hyperhidrosis of the axillae
achalasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Digoxin MoA?

A

Na/K ATPase pump inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Adrenaline doses in cardiac arrest and anaphylaxis?

A

anaphylaxis: 0.5mg - 0.5ml 1:1,000 IM

cardiac arrest: 1mg - 10ml 1:10,000 IV or 1ml of 1:1000 IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Tamoxifen MoA?

Adverse effects?

A

SERM (Selective oEstrogen Receptor Modulator)

menstrual disturbance: vaginal bleeding, amenorrhoea
hot flushes - 3% of patients stop taking tamoxifen due to climacteric side-effects
venous thromboembolism
endometrial cancer (can use Raloxifene - pure oestrogen receptor antagonist - lower risk)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are phase I and phase II reactions in drug metabolism?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

TB drug side effects?

A

Rifampicin = Red/orange body secretions

Isoniazid= Ice causes numbness on the skin = peripheral neuropathy

Pyrazinamide= P looks like a big toe = big painful toe bcz of hyperuricemia = Gout

Ethambutol = Eye = optic neuritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Metformin MoA?

A

activation of the AMP-activated protein kinase (AMPK)

-> increased insulin sensitivity, decreased hepatic gluconeogenesis + ?reduced GI absorption of carbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

abciximab MoA? use case?

A

glycoprotein IIb/IIIa receptor antagonist

used in prevention of ischaemic events in patients undergoing percutaneous coronary interventions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Adverse effects associated with Quinolones? what are some examples?

A

Examples:
- Levofloxacin
- Ciprofloxacin

Adverse effects:
- Reduces seizure threshold
- Tendon damage inc. rupture
- Cartilage damage in animal models - hence generally avoided in children
- QT prolongation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Abdo pain / rectal bleeding following cocaine ingestion

Diagnosis?

A

Ischaemic colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Aspirin MoA?

A

Non-reversible COX 1 + 2 inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

MoA of LMWH?

A

LMWH activates antithrombin III.

This forms a complex that inhibits factor Xa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

MoA of Unfractionated heparin?

A

Unfractionated heparin forms a complex which inhibits thrombin, factors Xa, IXa, XIa and XIIa.

28
Q

Rituximab MoA? Use?

A

MAb against CD20 used in R-CHOP regimen for non-hodgkins lymphoma

Also used in RA

29
Q

Infliximab MoA? use?

A

Anti-TNFa used in RA and Crohns

30
Q

Daratumumab MoA? Use?

A

Anti-CD38 used in multiple myeloma

31
Q

Alemtuzumab MoA? Use?

A

Anti-CD52 used in CLL

32
Q

Trastuzumab (Herceptin) MoA? Use?

A

Anti-HER2 used in HER2 +ve metastatic breast ca

33
Q

Class 1a antiarrhytmics and some examples?

Mneumonic

A

“I am Ambivalent about the QUEEn PROofreading my DISsertation”: Class IA antiarrhythmic drugs are QUEEnidine, PROcainamide, DISopyramide.

34
Q

Class 1b antiarrhytmics and some examples?

A

“LInDO MEXIco Is the Best”: LIDOcaine and MEXIletine are class IB antiarrhythmic drugs.

35
Q

Class 1c antiarrhytmics and some examples?

Mneumonic

A

“I Can’t Fail, Please”: Class IC antiarrhythmics are Flecainide, Propafenone.

36
Q

Class 3 antiarrhytmics and some examples?

Mneumonic

A

“I Am Sober, Doctor, for III days”: Ibutilide, Amiodarone, Sotalol, and Dofetilide are class III antiarrhythmic drugs.

37
Q

Features of organophosphate poisoning? Mneumonic

A

SLUDD

s=salivation
l=lacrimation, low BP, low pluse
u= urination
d=defecation
d=diarrhea, decrease pupil size.

38
Q

Prognostic factors in Paracetamol Overdose

A

The arterial pH is the single most important prognostic factor ( <7.3 24h post-ingestion)

Others:
- Creatinine >300
- Increased PT time
- Grade III or IV encephalopathy

NB these are the indications for liver transplantation (need all 3 others)

39
Q

MoA of allopurinol?

A

Allopurinol inhibits xanthine oxidase

(which oxidises 6-mercaptopurine into 6-thiouric acid)

40
Q

TCA overdose with hypotension / widened QRS / VT

Mx?

A

IV bicarb

41
Q

Which drugs commonly interact with CYP450 inhibitors / inducers?

A

Warfarin the Combined Contraceptive Pill, Theophylline, Corticosteroids, Tricyclics, Pethidine, and Statins.

42
Q

Which drugs are common CYP450 inducers?

A

CRAP GPS - generally need prolonged exposure

Carbemazepines (+Phenytoin)
Rifampicin
Alcohol - chronic
Phenytoin
Griseofulvin
Phenobarbitone (Barbiturates)
Sulphonylureas + Smoking + St Johns Wort

Reduced drug concentration

43
Q

Which drugs are common CYP450 inhibitors? effect?

A

SICK FACES.COM

Sodium valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Alcohol & Grapefruit juice - acute (Also amiodarone + allopurinol)
Chloramphenicol
Erythromycin
Sulfonamides (SSRIs too)
Ciprofloxacin
Omeprazole
Metronidazole

Increased drug concentration

44
Q

Drugs which are known to cause impaired glucose tolerance include:

A

‘STATIN’:

Steroids
Thiazides - Furosemide also but less
Antipsychotics
Tacrolimus/ciclosporin
Interferon-alpha
Nicotinic acid

45
Q

Pilocarpine MoA?

A

Muscarinic agonist - M1-3 -> induction of parasympathetic action

46
Q

Which drugs can cause cataracts?

A

steroids

47
Q

Which drugs can cause corneal opacities?

A

amiodarone
indomethacin

48
Q

Which drugs can cause optic neuritis?

A

ethambutol
amiodarone
metronidazole

49
Q

Which drugs can cause retinopathy?

A

chloroquine, quinine

50
Q

What can happen to the eyes with sildenafil?

A

Blue discolouration
Non-arteritic anterior ischaemic neuropathy

51
Q

Why can Sodium Bicab be considered in lithium toxicity?

A

Increases urine alkalinity thus promoting lithium excretion

52
Q

HTN in Lithium patients?

A

ACE-i and ARBs can cause toxicity

CCBs - Diltiazem / Verapamil - increase risk of neurotoxicity

Amlodipine is fine

53
Q
A
54
Q

When to give sodium bicarb in mx of TCA overdose?

A

pH <7.1
widened QRS esp >160 ms
Arrhythmias
Hypotension

55
Q

Example of a1 antagonist?

A

doxasosin

56
Q

Example of a1a agonist?

A

tamsulosin acts mainly on urogenital tract

57
Q

Example of a2 antagonist?

A

yohimbine

58
Q

example of non-selective a antagonist

A

phenoxybenzamine - used be used in peripheral arterial disease

59
Q

Example of b1 antagonist?

A

Atenolol

60
Q

Example of non-selective b antagonist?

A

Propanolol

61
Q

example of a + b mixed antagonists?

A

Carvedilol
Labetalol

62
Q

confusion, headache, and characteristically cherry-pink mucous membranes

Suggestive of what condition?

A

CO poisoning

63
Q

How does aspirin achieve antiplatelet effect?

A

Inhibits the production of thromboxane A2 secondary to irreversible inhibition of COX1

64
Q

How do ciclosporin and tacrolimus work?

A

Inhibit calcineurin in T cells thus decreasing IL-2

65
Q

Mx of organophosphate poisoning?

A

Atropine

66
Q

Which drugs commonly cause urticaria?

A

aspirin
penicillins
NSAIDs
opiates

MRCP - Passmed (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions