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MRCP > Clinical Pharmacology, Toxicology and Poisoning > Flashcards

Clinical Pharmacology, Toxicology and Poisoning Flashcards

1
Q

What does half-life mean?

A

The time taken for plasma drug concentrations to fall by half

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2
Q

What does volume of distribution mean?

A

A theoretical volume that describes the extent to which a drug is retained within the circulation or distributes into other tissues

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3
Q

What is the efficacy of a drug?

A

A measure of the effect of a drug on a particular system

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4
Q

What is the potency of a drug?

A

The efficacy of a drug with respect to the concentration or dose

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5
Q

What factors can effect drug metabolism?

A

Genetics
Drug acetylation
Drug-induced lupus

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6
Q

What are symptoms of drug-induced lupus?

A

Arthralgia
Butterfly rash
Pleurisy

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7
Q

What drugs can cause lupus erythematosus-like syndrome?

A 
Beta blockers
Hydralazine
Phenytoin
Chlorpromazine
Isoniazid
Procainamide
Clonidine
Lithium
Sulfasalazine
Flecainide
Methyldopa
Sulfonamides
Haloperidol
Penicillin
Tetracyclines
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8
Q

What is enzyme induction?

A

The induction of liver enzyme systems which increases the metabolism - and decreases the effectiveness - of other drugs

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9
Q

What drugs are affected by enzyme induction?

A

Hydrocortisone
Oral contraceptive pill
Phenytoin
Warfarin

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10
Q

What drugs can cause enzyme induction?

A 
Phenytoin
Carbamazepine
Barbiturates
Rifampicin
Alcohol (excess)
St John's Wort
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11
Q

What is enzyme inhibition?

A

Some drugs cause the inhibition of enzyme systems meaning drugs aren’t metabolised quickly enough

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12
Q

What drugs can cause enzyme inhibition?

A 
Allopurinol
Omeprazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin
Cimetidine
Ethanol
Sulfonamide
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13
Q

What drugs effects can be dangerous in enzyme inhibition?

A 
Carbemazepine
Ciclosporin
Phenytoin
Statins
Theophylline
Warfarin
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14
Q

What can cause contraceptive pill failure?

A

Diarrhoea
Vomiting
Liver enzyme induction
Antibiotic usage (e.g. penicillins, cephalosporins, quinolones or tetracyclines)

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15
Q

Name 7 drugs which are dangerous to take in pregnancy and what do they cause?

A

Ace inhibitors and angiotensin receptor blockers - oligohydramnios
Lithium - cardiac abnormalities
Phenytoin - facial fusion abnormalities e.g. cleft lip/palate
Sodium valproate and retinoids - neural tube defects and spina bifida
Warfarin - abnormalities of long bones and cartilage
Carbimazole - neonatal goitre
Gentamicin - cranial nerve VIII deafness

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16
Q

What drugs can be toxic to a baby if excreted through breastmilk and why?

A

Amiodarone - thyroid abnormalities
Cytotoxics and chloramphenicol - blood dyscrasia
Gold - haematological reactions and kidney injury
Indometacin - neonatal seizures
Iodides - thyroid disturbance
Lithium - involuntary movements
Oestrogens - feminisation of male infants

17
Q

In what four ways can liver disease affect drug activity?

A

Drugs excreted by bile e.g. rifampicin may accumulate in patients with obstructive jaundice

Hypoalbuminaemia reduces the extent of drug protein binding so there is more ‘free’ drug increasing risk of toxicity

Reduced clotting factor synthesis may enhance risk of bleeding associated with warfarin

Salt and water retention and ascites may be worsened by NSAIDS and corticosteroids

18
Q

Patients in renal failure aren’t able to excrete toxins well. What 8 drugs are particularly dangerous to give to these patients due to drug accumulation and what could each drug cause?

A

Atenolol - bradycardia, heart block
Digoxin - cardiac arrhythmias, heart block
Enoxaparin - bleeding risk
Erythromycin - encephalopathy
Lithium - cardia arrhythmias and seizures
High dose penicillins - encephalopathy
High dose cephalosporins - encephalopathy
Trimethoprim - hyperkalaemia

19
Q

What 7 drugs are nephrotoxic?

A 
ACE inhibitors and angiotensin receptor antagonists
Aminoglycosides
Amphotericin
Cytotoxics e.g. cisplatin
Diuretics
NSAIDS
Calcineurin inhibitors

MRCP (20 decks)

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