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Tomakesense 3 > Drugs > Flashcards

Drugs Flashcards

1
Q

Why would Pyroxidine be prescribed?

A

Prevent side effect of Isoniadzid (peripheral neuropathy)- TB mediation

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2
Q

What are the side effects of Phenytoin?

A

Gingival hyperplasia, peripheral neuropathy, lymphadenopathy

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3
Q

How does Memantine work?

A

NMDA antagonist - second line treatment for alzheimers

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4
Q

What enzyme needs to be tested prior to started Aziothiarpine? and what is Azathioprine used for?

A

TPMT levels prior to staring treatment. Azathioprine is used to induce remission in Crohns

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5
Q

Side effects of calcium channel blockers? eg Amlodipine

A

Ankle swelling

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6
Q

What is the reversal agent for Dabigitran (DOAC)?

A

idarucizumab

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7
Q

What is the reversal agent for Heparin?

A

protamine sulfate

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8
Q

What are some examples of anti musclarinics used in urge incontinence?

A

First line: Oxybutanin. Second line: tolterodine

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9
Q

What monitoring is required with use of Amiodarone?

A

LFTS/ TFTS/ U+Es 6 monthly. ECG every 12 months

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10
Q

What type of antibiotic is Clarithryomycin and what is a side effect?

A

Macrolide. Side effect is VT (torsades de points)

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11
Q

What morphine drugs can be used in patients with CKD 4 (palliative care)?

A

Alfentanil, oxycodone, buprenorphine, fentanyl

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12
Q

How does Gliclazide work?

A

ATP dependent K channels on pancreatic beta cells

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13
Q

What is a side effect of nicorandil?

A

Ulceration including anal ulceration

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14
Q

What monitoring is required for Hydroxychloroquine?

A

Ophthalmology referral prior to commencing treatment. Need annual visual check

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15
Q

What is a side effect of Co-amoxiclav?

A

Can cause cholestasis- elevated bilirubin/ itching

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16
Q

What are the side effects of Cisplatin?

A

Hypomagnesium, ototoxicity and peripheral neuropathy

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17
Q

What are the side effects of Methotrexate?

A

Bone marrow suppression, liver fibrosis, lung fibrosis.

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18
Q

What are the side effects of Doxorubcin?

A

Cardiomyopathy

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19
Q

What would a side effect of long term oral trimethoprim for acne be?

A

Depress haemopoetisis

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20
Q

What type of drug is Losartan ?

A

ARB

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21
Q

What drugs can cause hypercalcaemia?

A

Thiazide drugs eg Bendroflumethazide or calcium containing antiacids

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22
Q

What type of drug is Carvedilol?

A

B blocker. Used post MI

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23
Q

What type of drug is Gliclazide and what are some of the side effects?

A

Sulphonylurea.
SI include weight gain and hypoglycaemia

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24
Q

What type of drug is Bumetanide? and what is the side effect?

A

Loop Diuretic
Ototoxicity

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25
Q

What are SGLT1 inhibitors associated with/ side effects?

A

Necrotising fascititis of the perineum
Normoglycaemic ketoacidosis
UTIs

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26
Q

What monitoring does Amiodarone need?

A

TFT, LFT, U&E, CXR prior to treatment
TFT, LFT every 6 months

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27
Q

What monitoring does Sodium Valporate need?

A

LFT, FBC before treatment
LFT ‘periodically’ during first 6 months

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28
Q

What monitoring does Glitazones need?

A

LFT before treatment
LFT ‘regularly’ during treatment

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29
Q

What is the antibiotic for cellulitis if allergic to penicillin?

A

Clarithromycin

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30
Q

What medications can cause gingival hyperplasia?

A

phenytoin, ciclosporin, calcium channel blockers

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31
Q

What condition can gingival hyperplasia be seen in?

A

AML

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32
Q

Clozapine is an example of which type of drugs?

A

Atypical antipsychotic

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33
Q

What is the management for acute prostatitis?

A

Ciprofloxacin

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34
Q

What are the monitoring requirements for statins?

A

LFTs at baseline, 3 months and 12 months

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35
Q

How does varenicline work?

A

Parial nicotinic agonist

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36
Q

What is an example of an SGLT2 drugs for diabetes?

A

Dapagliflozin

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37
Q

What are side effects of calcium channel blockers?

A

Headaches/ flushing/ ankle oedema

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38
Q

What are some examples of calcium channel blockers?

A

Amlodipine

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39
Q

What is a side effect of Doxorubacin?

A

Cardiomyopathy / Cardiotoxicity

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40
Q

Erythromycin is contraindicated in which 3 drugs?

A

amiodarone, warfarin and simvastatin

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41
Q

Side effect of long term PPI (Omeprazole)

A

Osteoporosis and fractures increase fracture risk, hyponatraemia

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42
Q

What drug can cause duptenyrns contracture?

A

Phenytoin

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43
Q

What is an example of aminoglycoside?

A

Gentamicin, neomycin

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44
Q

Which diabetic medication is contraindication in heart failure?

A

Pioglitazone- can cause fluid retention and therefore bad in HF

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45
Q

What antibiotic for a dental abcess?

A

Amoxicillin

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46
Q

What are the side effects of Finasteride?

A

Gynaecomastia/ decreased libido/ ejaculation disorders

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47
Q

What is the dose of rectal diazepam for seizures (in community)

A

10mg rectal diazepam

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48
Q

Side effect of Pioglitazone?

A

Fluid retention

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49
Q

Which drugs can precipitate lithium toxicity?

A

NSAIDs, Diuretics, ACE/ARB

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50
Q

Side effects of Amiodarone?

A

Pulmonary fibrosis, corneal deposits, photosensitivity reactions, derangement in liver function tests and TFS

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51
Q

Treatment of Campylobacter enteritis

A

Clarithryomycin

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52
Q

What is an example of a selective serotonin reuptake inhibitors?

A

SSRI = citalopram/ fluoxetine

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53
Q

What drugs are contraindicated with an SSRI?

A

Warfarin, Aspirin, NSAIDs, Triptans, MAO inhibitors.

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54
Q

What drug can cause a blue tinge to vision?

A

Sildenafil

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55
Q

What drug interacts with levothyroxine?

A

IRON!

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56
Q

What drugs can cause urinary retention?

A

Amitriptylline, anticholingerics (oxybutanin), NSAIDs, opioids

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57
Q

Donepezil
-What type of drug
- Indication
- Side effect/ CI?

A

acetylcholinesterase inhibitor
Indicated for Alzheimers
Side effect: Insomnia/ Bradycardia

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58
Q

Agranulocytosis is a side effect of which drug?

A

Carbamazepine

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59
Q

Side effect of Varenicline?

A

Nictonic receptor parital agonist
Side effect) nausea/ insomnia

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60
Q

What blood test needs to be done prior to starting TB treatment?

A

LFTs

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61
Q

Side effect of Benzodizepine drugs?

A

Anterograde amnesia

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62
Q

What type of drug is indapamide?

A

Thiazide like diuretic

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63
Q

What is the most common drug caused of Gynaecomastia?

A

Spironlactone

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64
Q

What is an example of a drug that can cause drug induced thrombocytopenia?

A

Quinine (others include NSAIDs, diuretics)

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65
Q

When should Metformin be held?

A

Recent MI, AKI, Sepsis (risk of lactic acidosis)

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66
Q

Campylobacter diarrhoea is treated with?

A

Clarithromycin

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67
Q

Clarithromycin interacts with which common drug?

A

Statins! increased risk of rhabdo

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68
Q

What drugs can precipitate digoxin toxicity?

A

Anything that causes hypokaemia eg loop diuretics, quinine, amiodarone, vermapril, diltazam, ciclosporin

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69
Q

What is Digoxin used for?

A

Rate control in AF

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70
Q

Important side effect of hydroxychloroquine?

A

EYE TOXICITY

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71
Q

Aspirin overdose is treated with?

A

Urinary alkalisation
Haemodialysis if severe.

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72
Q

Beta blocker overdose treated with?

A

Atropine first line
If doesn’t respond then Glucagon

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73
Q

Side effect of ethabutamol

A

Optic neuritis- need to check visual acuity.

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74
Q

What type of drug is empagliflozin ?

A

Flozins are SGLT2 inhibitors

75
Q

What is a side effect of empagliflozin ?

A

Increased frequency of UTIs due to renal excretion of glucose.

76
Q

What drugs cause erythema nodosum?

A

penicillins, sulfonamides (such as sulfasalazine), and the combined oral contraceptive pill.

77
Q

What drugs raise prolactin?

A

metoclopramide, domperidone, prochlorperazine

78
Q

How does paroxetine work?

79
Q

What drugs can cause gynaecomastia?

A

Sprinolactone, goserelin, digoxin, finasteride.

80
Q

Side effect of NSAIDS?

A

Cardiovascular events

81
Q

What type of drug is Amitrptylline and what is the side effect?

A

Tricyclic Antidepressant
Side effect- Antimusclarinic effects eg dry mouth and blurred vision

82
Q

Side effect of Cetrizine?

A

Anticholingeric effects if combined with other antimusclarinics

83
Q

Side effects of Montelukast ?

A

Common- diarrhoea/ GI/ fever
Can also cause neuropsychiatric problems and sleep disorders.

84
Q

What type of drug is Xylometazoline ?

A

Nasal decongestant. avoid in things like angle closure glaucoma

85
Q

What antidepressant has a long half life and therefore increased risk of serotonin syndrome?

A

Fluoxetine ( long half life- can cause interactions for up to 5 weeks after stopping)

86
Q

What type of drugs is Moclobemide?

A

MAO inhibitor for depression

87
Q

What are some examples of Macrolide antibiotics? and what drug would need to be held when prescribing them?

A

‘Mycins’ Erthyromycin, clarithryomycin.
Hold statins!

88
Q

LABA (long acting B agonist) for asthma must be prescribed alongside what?

A

LABA+ steroid inhaler. If LABA used without steroid can increase risk of exacerbations

89
Q

How do propanolol and bisoprolol act on b receptors?

A

Bisoprolol is cardioselective (less problematic in astmatics) and propanolol works on all the beta receptors.

90
Q

Which drugs interact with amiodarone?

A

Statin- simvastatin.

91
Q

Amiodarone- side effects?

A

Slate grey appearance/ HYPO or HYPER thyroid!
Hypotension
Ocular involvement

“Amiodarone is a bitch”

Blue man
Intersitital lung disease
Thyroid (hypo/hyper)
Corneal
Hypotension

92
Q

Side effects of Methylphenidate? (and use of this drug)

A

ADHD drug
Side effects- decreased appetite, dropping height centiles.

93
Q

What drug increases risk of tendon injuries?

A

Ciprofloxacin!

94
Q

Side effect of Clarithryomycin?

A

CVS events.

95
Q

Side effect of Doxycycline?

A

Ototoxic/ Oesphagitis

96
Q

Side effect of Pen V

A

Decreased platelet count - easy bruising

97
Q

What is eflornithine used for?

A

To prevent excess hair growth on the face of women with PCOS

98
Q

What is second line in BB overdose?

A

Glucagon (second line after atropine)

99
Q

What are some examples of SSRI?

A

Fluoxetine/ Sertraline/ Citalopram

100
Q

What SSRI for under 18’s?

A

Fluxoxetine

101
Q

Side effect of Nitrofurotin?

102
Q

What drugs cause the side effect of gynaecomastia? (5)

A
  1. Spirinolactone
  2. Cimetidine
  3. Zoladex
  4. Finasteride
  5. Calcium channel blockers
103
Q

What drugs can cause tardive dyskinesia? (2)

A
  1. Antipsychotics
  2. Metoclopramide
104
Q

What drug can cause rhabdomyolysis?

105
Q

What drugs can cause erectile dysfunction?

A

Antihypertensives, Antidepressants, nicotine

106
Q

What drugs can cause Jaundice?

A

Nitrofurotonin, Erythromycin, Isonidazid, Methydopa, Indomethocin and Salicytes

107
Q

What are the side effects of Leflunomide?

A

Hypertension/ GI upset/ Hepatitis

108
Q

What are the side effects of Sulphalazine?

A

Low sperm count/ mouth ulcers/ depression hepatitis

109
Q

Side effect of Ethambutol

A

OPTIC NEURITIS!

110
Q

What are the side effects of these cytotoxic agents -(toxicity bear)

Doxorubicin
Bleomycin
Cisplatin
Methotrexate
Vincristine/ Vinblatine
Cyclophosphamide

A

Doxorubicin- cardiotoxicity
Bleomycin- Lungs
Cisplatin- Ears and kidneys
Methotrexate- liver
Vincristine - Peripheral neuropathy
Cyclophosmaide- haemorraghic cystitis

111
Q

Side effect of Acarbose (diabetic med)

112
Q

Side effect of Propanolol?

A

Cold fingers/ toes, tiredness, sleep disturbance

113
Q

Side effects of Thiazide diuretics eg bendoflumethazide?

A

Impaired glucose tolerance
Hypokaemia
Hyponatraemia
Gout
Dehydration
Postural hypotension

114
Q

What are some of the side effects of long term Nitrofuratoin?

A

Pulmonary fibrosis/ and its renally excreted so not for patients with eGFR less 45

115
Q

What can omeprazole do to electrolytes?

A

Hypomagnesium/ Hyponatraemia

116
Q

How is Dabigitran/ Rivaroxaban/ Apixiban excreted?

A

Dabigitran- Renal
Rivaroxban- Liver
Apixiban- fecal

117
Q

What 2 SSRIs are most likely to cause discontinuation syndrome?

A

Paroxetine and Venlafaxine

118
Q

What are the side effects of SSRI?

A

Increased thoughts of suicide
Hyponatraemia
GI bleeding
GI upset
Citalopram- INCREASED QT interval

119
Q

What drugs cannot be co-prescribed with SSRIs? (5)

A

NSAIDS
Warfarin/ Heparin
Aspirin
Triptans

120
Q

Clozapine toxicity presents how?

A

Hypersalivation/ drowsiness/ seizures and confusion (Remember clozapine= agranulocytosis)

121
Q

What is a side effect of Carbamazepine?

A

Leucopaenia, thrombocytopenia and agranulocytosis

122
Q

Common side effects of melatonin?

A

Odd dreams, arthralgia, increased risk of infection, pain

123
Q

What is a normal QT interval?

A

430 in males
450 in females

124
Q

Side effect of Mefloquine (malaria prophylaxis) and what patients is it contraindicated in?

A

Neuropsychiatric disorders.
Contraindicated in epilepsy/ GAD/ psychiatric disorders

125
Q

What drugs can cause pancreatitis?

A

Thiazides/ Tetracyclines and Aziothioprine

azathioprine, mesalazine, didanosine, bendroflumethiazide, furosemide, pentamidine, steroids, sodium valproate

126
Q

Mechanism of action Bromocriptine?

A

Dopamine Agonist

127
Q

Mechanism of action of Proclorperazine ?

A

Dopamine R Antagonist
Side effect- muscle spasms, movement disorders.

128
Q

How do Cabergoline (Dostinex) and Bromocriptine work?
Side effects?

A

Dopamine Receptor Agonist.
Side effect- rare= pulmonary fibrosis
Postural hypotension/ Hallunicaitons

129
Q

What needs to be done prior to treatment with Cabergoline or Bromocriptine?

A
  1. ESR,
    2.creatinine
    3.chest x-ray should be obtained prior to treatment
130
Q

How does Procyclidine work? and what are its uses?

A

Anticholinergic
Used for Parkinsonism/ extrapyramidal side effects

131
Q

What are each of these drugs?
- Clozapine
- Chlorpromazine hydrochloride
- Carbamazepine

A

Clozapine- Atypical Antipsychotic. (Aganulocytosis)
Chlorpromazine hydrochloride - Schizophrenia, N+V in pal care.
Carbamazepine- Antieplieptic

132
Q

What condition do ACE inhibitors need to be prescribed carefully?

A

Renal artery stenosis. Avoid ACE inhibitors if bilateral renal artery stenosis.

133
Q

Octreotide- what is it used for and what is a side effect?

A

Used for carcinoid tumours
Side effect- gall stones!

134
Q

What SSRIs to avoid with Tamoxifen?

A

Avoid fluoxetine and paroxetine

135
Q

Side effect of Thiazide like diuretics?

A

Hyponatraemia
Hypokaemia

136
Q

Side effects of these Rheumatoid Arthritis drugs:
Sulphasalazine
Leflunomide
Hydroxychloroquine
Gold
‘MABs’
Gold
Penicillamine
NSAIDs

A

Sulphasalazine- oligospermia, rashes.
Leflunomide - HTN, liver disease, fibrosis
Hydroxychloroquine- eye checks!
Gold- proteinuria
‘MABs’- Reactivation of TB
Penicillamine- proteinuria/ exacerbation of myasthenia graves
NSAIDs - bronchospasm/ peptic ulceration

137
Q

When does the BNF suggest gradual reduction in steroids?

A
  • If 40mg Prednisone for more than a week
  • More than 3 weeks of treatment
  • Repeated courses of steroids
138
Q

What are the drug causes of galactorrhea? (Raised prolactin =3)

A

Metoclopramide
Phenothiazines eg: Levomepromazine
Haloperidol

139
Q

What is a side effect of Atenolol? (beta blockers in general)

A

Raynauds
Hypoglycaemia in diabetics
Exacerbate psoriasis

140
Q

Withdrawing a patient from Benzodiazepines- what is the schedule?

A

Switch to an equivalent dose of DIAZEPAM
Reduce in steps about 2-3mg each 2-3 weeks

141
Q

What are the side effects of Flozins sglt2 inhibitors?

A

Euglycaemic ketosis
Increased risk of foot amputation
Urine infections due to glycosuria

142
Q

Side effect of Pioglitazone (Thiazolidinediones)

A
  1. Fluid retention (CI in heart failure)
  2. Weight gain
  3. Liver impairment
  4. BLADDER CA.
143
Q

What are the 2 drugs used for opioid dependence?

How do you switch from one to another?

A

Buprenorphine and Methadone

Stop methadone and restart Buprenorphine when withdrawal symptoms start.

144
Q

Doxycycline (tetracycline) contraindicated in which patient groups? (3)

A

pregnancy - tooth abnormalities
Myasthenia Gravis - increase muscle weakness
Lupus - exacerbate

145
Q

What drugs can cause dyspepsia?

A

NSAIDS
Steroids
SSRIs
Digoxin
Viagra

146
Q

What antiemetic for gastric stasis/ functional bowel obstruction?

A

Metoclopramide

147
Q

What antiemetic for metabolic causes of N+V?

A

Haloperidol eg hypercalcaemia or renal failure

148
Q

Cyclizine is used for which types of N+V?

A

Motion sickness
Raised ICP
Mechanical bowel obstruction

149
Q

What eGFR would you avoid Apixiban?

A

eGFR 15 or below avoid apixiban

150
Q

What to remember about Amlodipine and simvastatin?

A

Max dose of Simvastatin is 20mg when coprescribed with Amlodipine

151
Q

3 drug of gingival hyperplasia

A

Phenytoin
CCB (Amlodipine/ Nifedipine)
Ciclosporin

152
Q

Side effects of Digoxin?

A

YELLOW VISION (Xanthopsia)
Arrhythmias

153
Q

Side effect of Adenosine ?

A

Flushing, Bronchospasm, chest discomfort

154
Q

What antihypertensive is contraindicated in Gout?

A

Thiazide like diuretics

155
Q

What are the main ototoxic drugs?

A

Aminoglycosdies (Gentamicin)
Loop diuretics
Salicylates

156
Q

Palliative care- what drug is first line in Agitation and confusion?

A

Haloperidol

157
Q

Lithium and Digoxin Toxicity
- Precipating factors
- Classic Presentation
- Treatment

A

Lithium
Precipitating: ACE/ ARB. NSAIDS. Thiazide like diuretics
Presentation: Hyperreflexia/ Coarse tremor
Mx) Fluid resus. Haemodialysis if severe.

Digoxin
Precipitating: HYPOkaleamia
Presentation: Arrythmias/ Yellow green vision
Mx) Digibind ( digoxin specific antibody fragments)

158
Q

What may antifreeze be referred to?

A

Ethylene Glycol

159
Q

Antidote to antifreeze/ ethylene glycol?

A

Fomepizole
(traditionally ethanol used)
Haemodialysis

160
Q

Poisioning from methanol would be from ingestion of what?

A

Windscreen wash
Liquids used in distilling

161
Q

Antidotes to the following (common ones)
Beta blockers
Paracetamol
Salyciliates
Benzodiazepines
TCAs
Methanol
Organophosphate insecticide

A

Beta blockers : Atropine/ Glucagon if resistant
Paracetamol: Charcoal if 1hr/ NAC/ Liver transplant
Salyciliates: 1. Urinary alkinsation 2. Haemodialysis
Benzodiazepines : Flumezanil
TCAs: IV Bicarbonate/ Dialysis
Methanol: Fomepeziole (same as antifreeze)
Organophosphate insecticide: Atropine (same as BB)

162
Q

What are the antidotes to the following:
Iron
Lead
Carbon monoxide
Cyanide

A

Iron - Desferrioxamine
Lead - Dimercaprol
Carbon monoxide - 100% O2
Cyanide- Hydroxycobalamin

163
Q

How does COCAINE use present?

A

Most things go up
Hypertension/ Hyperreflexia/ Hypertonia/ Tachycardia
Psychotic episodes/ Anxiety

Treatment is with Benzodiazepines eg: coronary artery spasm

164
Q

How does ecstasy ( MDMA) use present and management in toxicity?

A

HYPONATRAEMIA
Anxiety/ agitation/ hypertension/ Rhabdomyaysis/ Tachycardia

Mx) Dantrone if severe - if not supportive.

165
Q

Barbituates- overdose would present how and management?

A

eg Thiopentone is a medically used barbiturate.

Present with Reduced GCS/ Reduced respiratory drive

MX) Activated charcoal/ haemodialysis

166
Q

How would cannabis use present?

A

Can present with psychotic symptoms
Cyclical vomiting syndrome ( relieved with hot shower)
Gynaecomastia

167
Q

How would GHB use present?

A

(opposite to amphetamines)
Respiratory depression

168
Q

What is the antidote to Benzodiazepine overdose?

A

Flumenazil

169
Q

What is the antidote to TCAs overdose?

A

IV Bicarbonate/ Dialysis

170
Q

What is the antidote for organophosphate poisoning?

171
Q

What is the antidote for Digoxin/ Lead/ Cyanide?

A

Digoxin: Digibind
Lead: Dimercaprol
Cyanide: Hydroxycobalamin

172
Q

What analgesia for shingles related pain? Post herpetic pain?

A

Amitriptylline

173
Q

What 2 drugs can increase saliva production?

A

Clozapine/ Neostigmine

174
Q

What are some drug causes of erectile dysfunction?

A

Finasteride
BB eg Atenolol
Thiazide diuretics eg indapamide
TCA antidepressants eg Amitriptylline

175
Q

Side effect of Beta Blockers?

A

Erectile dysfunction

176
Q

Drugs that cause erectile dysfunction?

A

BB
Spirnolactone
Thiazide diuretic
Finasteride
Digoxin

177
Q

What is an example of a Tetracycline and what are the side effect?

A

Tetracyclines eg Minocycline
Caution– can exacerbate lupus!!
Can also cause facial pigmentation

178
Q

What are some examples of phenothiazines?

A

chlorpromazine hydrochloride, prochlorperazine,

179
Q

Apart from orange secretions what are the other side effects of Rifamicin?

A

N+V
Thrombocytopenia
Diarrhoea
Leukpenia

180
Q

Side effects of Orlistat and when should it be used?

A

BMI over 28 with risk factors
OR BMI over 30

Side effects: flactulance/ fecal incontinence
Pancreatic lipase inhibitor

181
Q

Tamoxifen - uses (2)
Increases risk of?
Cannot use in which patient groups?
Side effects

A

Tamoxifen - used for ER + breast ca in pre menopausal women
- treatment of gynaecomastia

Increases risk of VTE/ Endometrial ca.

Cannot use in breastfeeding or pregnancy

Side effects: N+V/ HOT FLUSHES

182
Q

Is Erythromycin safe in pregnancy?

183
Q

Side effects of Stains

A

Myositis
Altered LFTs
GI side effects (rarely pancreatitis)
Rarely ILD

184
Q

What are the side effects of Carbamazapine?

A

Ataxia, Diplopia, Dizzyness

Tomakesense 3 (15 decks)

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