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Year 3 Drugs > Extra Info > Flashcards

Extra Info Flashcards

1
Q

What is hyoscine butylbromide the first line treatment for?

A

IBS

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2
Q

How does salbutamol affect potassium levels?

A

Can increase cellular uptake –> reduced plasma levels -> hypokalaemia

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3
Q

Which drugs can beta blockers not be used with?

A

Non-dihydropyridine calcium channel blockers! E.g. verapamil, diltiazem. Can cause HF, bradycardia and even asystole

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4
Q

How may oral calcium affect the absorption of other drugs?

A

Iron, bisphosphonates, tetracyclines and levothyroxine

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5
Q

What interaction must you be careful of when prescribing calcium channel blockers?

A

That they’re not on a beta blocker. Verapamil and diltiazem can cause HF with this interaction

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6
Q

Which antibiotics may increase the action of warfarin?

A

Cephalosporins and carbapanems

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7
Q

What drugs may reduce the activation of clopidogrel?

A

Drugs that inhibit cytochrome P450: PPIs (omeprazole), ciprofloxacin, erythromycin, fluconazole, SSRI

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8
Q

What drug interaction may reduce the efficacy of systemic corticosteroids?

A

Cytochrome P450 enzyme inducers: phenytoin, carbamazepine, rifampicin

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9
Q

Which drugs can increase the risk of digoxin toxicity?

A

Loop and thiazide diuretics as they can cause hypokalaemia OR amiodarone, CCB, spironolactone and quinine can increase plasma levels –> increased risk of toxicity

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10
Q

What is the first line treatment following a TIA?

A

Dipyridamole

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11
Q

What main drug does dipyridamole interact with?

A

Adenosine - inhibits its cellular uptake –> increased effects on heart –> increases risk of cardiac arrest

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12
Q

What are fibrinolytic drugs?

A

Dissolve fibrinous clots and re-canalise occluded vessels

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13
Q

When are fibrinolytic drugs used?

A

> In acute ischaemic stroke (alteplase within 4.5 hours)
Acute STEMI within 12 hours if PCI not available
Massive PE with haemodynamic instability

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14
Q

In major bleeding associated with unfractionated heparin therapy, what drug can be given to reverse the anticoagulation

A

Protamine

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15
Q

How may iron supplements affect other medications?

A

Reduce the absorption of levothyroxine and bisphosphonates. These drugs should be taken at least 2 hours before oral iron

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16
Q

Which drugs inhibit cytochrome P450?

A

PPIs (omeprazole), ciprofloxacin, erythromycin, fluconazole, SSRI, metronidazole

17
Q

What drugs increase the QT interval?

A

Amiodarone, antipsychotics, quinine, SSRIs

18
Q

What is the major interaction to know about for metformin?

A

Can’t be taken with IV contrast media, metformin must be withheld for 48hrs. As there is increased risk of renal impairment, metformin accumulation and lactic acidosis

19
Q

What’s the relationship between metformin and IV contrast media?

A

Can’t be taken with IV contrast media, metformin must be withheld for 48hrs. As there is increased risk of renal impairment, metformin accumulation and lactic acidosis

20
Q

What’s the mechanism of action of nicorandil?

A

Arterial and venous vasodilator through nitrates and activation of K+ ATP channels

21
Q

What’s an important drug interaction of nicorandil?

A

Sildenafil (viagra) - can’t be used together –> major hypotension

22
Q

Which drug interacts with nitrates?

A

Sildenafil –> major vasodilatation –> hypotension

23
Q

How may rifampicin interact with the oral contraceptive pill?

A

it’s a cytochrome P450 inducer –> can reduce efficacy of contraceptive pill, particularly progesterone only forms

24
Q

What drugs can penicillin interact with?

A

Methotrexate and warfarin

25
Q

How can penicillin affect warfarin?

A

Can increase the effect of warfarin by killing normal GI flora that synthesises vitamin K

26
Q

How can penicillin affect methotrexate levels?

A

Penicillins reduce renal excretion of methotrexate –> accumulation and toxicity may develop

27
Q

What electrolyte disturbance may trimethoprim cause?

A

Hyperkalaemia

28
Q

Which drugs, when co-prescribed with vancomycin, increase the likelihood of ototoxicity and/or nephrotoxicity?

A

Aminoglycoside, loop diuretics, ciclosporin

29
Q

Which drugs are cytochrome P450 inducers?1

A

Phenytoin, carbamazepine, rifampicin

30
Q

Which drugs are metabolised by cytochrome P450 enzymes?

A 
COW PATS
> Ciclosporin
> Oral contraceptive pill
> Warfarin
> Phenytoin
> ACh esterase inhibitors (e.g. Donepezil)
> Theophylline 
> Statins & steroids
31
Q

What drug interaction may occur with spironolactone?

A

High risk of hyperkalaemia if used with ACEi or ARBs (K+ elevating drugs)

32
Q

What happens if ACEi/ARBs are used alongside NSAIDs?

A

Increases risk of renal failure

Year 3 Drugs (1 decks)

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