General pharm

Question 1

How does bupropion work?

Answer 1

Dopamine and noradrenaline reuptake inhibitor
Antidepressant
Reduces nicotine cravings

Question 2

How does varenicline work?

Answer 2

Full agonism on α7 nicotinic acetylcholine receptors and is a partial agonist on the α4β2, α3β4, and α6β2 subtypes.
Partial agonism acts as competitive inhibition with nicotine, with less effect on the dopamine system.

Question 3

Which medications may precipitate serotonin syndrome?

Answer 3

Levodopa
Tramadol
Fentanyl
SSRIs
SNRIs
TCAs
MAOIs
5-HT3 receptor antagonists
Metoclopramide
Valproate
Carbamazepine
Triptans
Lithium

Question 4

Which medications can cause neuroleptic malignant syndrome?

Answer 4

Haloperidol
Risperidone
Olanzepine
Quetiapine
Clozapine
Amisulpride
Aripiprazole
Metoclopramide
Prochlorperazine
Droperidol
Domperidone

Question 5

What are 3 substances with zero order kinetics?

Answer 5

EtOH
Aspirin
Phenytoin

Question 6

What is the relationship between the following?

• Dose rate (Rd)
• Plasma concentration (Cp)
• Clearance (CL)

Answer 6

Rd = Cp x CL

Question 7

How is the elimination rate constant K defined in terms of the following?

• Volume of distribution (Vd) and clearance (CL)
• Half-life (T-half)

Answer 7

K = CL / Vd

K = ln2 / T-half

Question 8

How is the loading dose calculated based on the volume of distribution (Vd) and plasma concentration (Cp)?

Answer 8

Loading dose = Vd x Cp

Question 9

Name 5 drugs that inhibit p-glycoprotein

Answer 9

Verapamil
Clarithromycin
Ritonavir
Amiodarone
Ketoconazole

Question 10

How do digoxin, dabigatran, loperamide, tacrolimus, cyclosporin, and erythromycin all interact with p-glycoprotein?

Answer 10

They are all substrates

Question 11

Which features are typical of DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms)?

Answer 11

1. Exposure to an implicated drug 2-6 weeks prior to symptoms
2. Morbilliform eruption progressing to confluent and infiltrated erythema or exfoliative dermatitis involving >90 percent of the total body surface area (BSA)
3. Eosinophilia or atypical lymphocytsosis
4. Systemic symptoms and organ involvement:
   - Fever
   - Lymphadenopathy
   - Renal impairment
   - Pneumonitis / pleural effusion
   - Myocarditis
   - Abnormal LFTs

Question 12

What affect does urinary alkalinsation have on aspirin excretion?

Answer 12

Aspirin, being an acidic medication, is ionised in alkaline urine, and hence excreted more efficiently (ionised drugs are more water-soluble)

Question 13

What is the mechanism of action of methyldopa?

Answer 13

Conversion to alpha-methylnoradrenaline, which is a potent central alpha-2 agonist