General Flashcards
How does lactulose treat hepatic encephalopathy?
Lactulose helps trap the ammonia (NH3) in the colon. It does this by using gut flora to acidify the colon, transforming the freely diffusible ammonia into ammonium (NH4+) which can no longer diffuse back into the blood.
Which diuretic is used in heart failure?
Loop diuretic ie frusemide
What is frusemide?
Loop diuretic
Acts on the thick ascending limb of loop of Henle
Causes K+ loss due to increased Na+ in collecting duct (actions of aldosterone)
What are some indications for infliximab?
UC
Crohn’s
What is dilantin?
Anti-convulsant for management of complex partial seizures and generalised tonic-clonic seizures
What is the mechanism of action and effect of benzodiazepines?
Potent inhibitor of GABA in the CNS
Antianolytic, sedative, hypnotic, muscle relaxant, antiepileptic
What is the mechanism of action of metoclopramide?
Blocks dopamine receptor (and when given at higher doses) serotinin receptors in the chemoreceptor trigger zone in the CNS
Enhances the activity of ACh in the gut to increase motility
What are the names of some non-dihydropyridine calcium channel blockers?
Verapamil
Diltiazem
Which diuretic is used in HTN?
Thiazides
What type of drugs rapamil?
Non-dihydropyridine calcium channel blocker
What is targin?
Oxycodone/Naloxone opioid analgesic
Oxycodone is pain relief
Naloxone reduces opioid-induced euphoria & constipation
What is ototoxic mean?
Toxic to the ear - specifically the cochlea or auditory nerve
What is the normal dose of oxycodone for pain relief?
5mg
What type of drug is diltiazem?
Non-dihydropyridine calcium channel blocker
What is spirolactone?
K-sparring diuretic > aldosterone receptor antagonist
What is the indication for colchicine?
Mainly gout - pain relief
What type of drug is nifedipine? Indications? Side effects?
Dihydropyridine calcium channel blocker (peripheral vasodilator)
HTN, angina
Peripheral oedema that doesn’t respond to diuretics
What dose of naloxone is used to reverse opioid overdose? What pharmakinetic factor must be considered?
0.4 to 2mg initial, repeated every 2-3mins until reversal (to a maximum of 10mg)
The duration of action of naloxone is shorter than opioids, must monitor patient
What is the mechanism of action of infliximab?
Inhibitor of TNF-alpha
What is the normal dose of ibuprofen for pain relief?
400mg
Which are the centrally acting calcium channel blockers, dihydropyridines or non-dihydropyridines
Non-dihydropyridines
What is the names of some dihydropyridine calcium channel blockers?
Nifedipine
Amlodipine
What is novorapid?
Fast-acting insulin analog
What is Tazocin?
A combination of the beta-lactam piperacillin and beta-lactamase inhibitor tazobactam
Commonly indicated in patients with hospitally acquired pneumonia/septicaemia
What is the method of action and indication of methotrexate?
Inhibition of folic acid
Acute lymphoblastic leukaemia
What is the triple whammy effect of NSAIDs, diuretics, and ACEIs?
NSAIDs block prostaglandin production, prostaglandin provides tonic vasodilation of afferent renal arterioles
ACEI block angiotensin II, which exerts tonic vasoconstriction of efferent arterioles
Diuretics reduce plasma volume and renal plasma flow
= Reduction in GFR = renal damage
What is celecoxib?
An NSAID used for some arthritis
What type of drug is isosorbide mononitrate?
A nitrate used in the treatment of angina
Dilates blood vessels
What are the side effects of prednisolone?
Weight gain
Increased insulin resistance
Proximal muscle weakness
Hirsutism
Striae
Increased BP
Immunosuppression
Impaired wound healing
Easy of bruising
Osteoporosis
Menstrual changes
Steroid madness, euphoria
What is lactulose indicated for?
Chronic constipation
Hepatic encephalopathy
What is the mechanism of action of calcium channel blockers?
Inhibit the slow inward calcium current in cardiac arteriolar muscle cells, reducing contractility, SA activity, AV node conduction and vascular tone
Can be vascularly selective - dihydropyridine CCBs > arteriolar vasodilation > reduce afterload
Or cardiac and vascular selective with negative inotropic and chronotropic properties > used for arrhythmias and angina
What is the mechanism of action of colchicine?
Inhibits mitotic spindle formation > inhibits neutrophil migration, chemotaxis, adhesion and phagocytosis > reduces inflammatory response to urate crystals
What are some side effects of amiodarone?
Pulmonary fibrosis
Thyrotoxicosis or hypothyroid
Vision changes - yellow vision, reversible
What is the usual dose of paracetamol for pain relief?
1g, QID (4 times per day)
What type of drug is amlodipine?
Dihydropyridine calcium channel blocker (peripheral vasodilator)
What type of drug is midazolam?
A benzodiazepine
What is Fentanyl?
Synthetic opioid analgesic
What are the 3 system you worry about when giving NSAIDs?
Renal: Renal toxicity
Cardiac: Fluid retention
GIT: Ulcers
What is a oculogyric crisis? Which drugs cause it?
A dystonic reaction to certain drugs that causes a prolonged involuntary upward gaze of the eye
- Dopamine D2 antagonists
- Neuroleptics
- Antihistamines
