General pharmacology stuff Flashcards
Adverse effects of metformin
gastrointestinal upsets are common (nausea, anorexia, diarrhoea), intolerable in 20%
reduced vitamin B12 absorption - rarely a clinical problem
lactic acidosis* with severe liver disease or renal failure
Contraindications for metformin
chronic kidney disease: NICE recommend that the dose should be reviewed if the creatinine is > 130 µmol/l (or eGFR 150 µmol/l (or eGFR
How to treat metastatic bone pain
NSAIDs, bisphosphonates or radiotherapy
Side effects of the glitazones
upper respiratory tract infection, edema (CI in heart failure), and hypoglycemia.
weight gain
liver impairment: monitor LFTs
recent studies have indicated an increased risk of fractures
bladder cancer: recent studies have showed an increased risk of bladder cancer in patients taking pioglitazone (hazard ratio 2.64)
What 3 drugs do you give for anaphylaxis?
adrenaline, hydrocortisone and chlorphenamine
How should patients with newly diagnosed active RA be treated?
With a combination of DMARDs (including methotrexate and at least one other DMARD, plus short-term glucocorticoids)
In RA, what do you move on to if there is insufficient response to DMARDs?
TNF inhibitors such as etanercept, infliximab and adalimumab
How does heparin have its effect?
Heparins generally act by activating antithrombin III. Unfractionated heparin forms a complex which inhibits thrombin, factors Xa, IXa, XIa and XIIa. LMWH however only increases the action of antithrombin III on factor Xa
First line treatment for partial seizures
carbamazepine
Who should sodium valproate not be given to?
Female children, female adolescents, women of childbearing potential or pregnant women unless other treatments are ineffective or not tolerated’
What kind of seizure is ethosuximide second line for?
Petit mal
Venous thromoboembolism - length of warfarin treatment
provoked (e.g. recent surgery): 3 months
unprovoked: 6 months
First line treatments for neuropathic pain
amitriptyline, duloxetine, gabapentin or pregabalin
Giving amoxicillin with which disease leads to widespread, pruritic maculopapular rash?
Infectious mononucleosis
Hep B serology
surface antigen (HBsAg) is the first marker to appear and causes the production of anti-HBs
HBsAg normally implies acute disease (present for 1-6 months)
if HBsAg is present for > 6 months then this implies chronic disease (i.e. Infective)
Anti-HBs implies immunity (either exposure or immunisation). It is negative in chronic disease
Anti-HBc implies previous (or current) infection. IgM anti-HBc appears during acute or recent hepatitis B infection and is present for about 6 months. IgG anti-HBc persists
HbeAg results from breakdown of core antigen from infected liver cells as is therefore a marker of infectivity
