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FRACP Paediatrics > Medications > Flashcards

Medications Flashcards

1
Q

Which chemotherapy drugs cause secondary malignancy?

A
  • Cyclophosphamide.

- Etoposide (AML).

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2
Q

What is the most common long term side effect of cyclosporin?

A
  • Hirsuitism.
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3
Q

Side effects of asparginase?

A
  • Pancreatitis, hyperglycaema, allergies, coagulopathy, encephalopathy.
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4
Q

Side effects of cyclophosphamide?

A
  • Myelosuppression, haemorrhagic cystitis, secondary malignancy, sterility, lung fibrosis, SIADH.
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5
Q

Side effects of doxorubicin?

A
  • Myelosuppression, necrosis on extravasation, cardiotoxicity, radiation recall.
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6
Q

Side effects of vincristine?

A
  • Peripheral neuropathy, ptosis, constipation, jaw and bone pain, extravasation injury.
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7
Q

Side effects of 6-mercaptopurine?

A
  • Myelosuppression, hepatic necrosis.
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8
Q

Which hepatic enzyme is induced by St Johns Wort?

A
  • CYP3A4
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9
Q

Which hepatic enzyme does cyclosporin inhibit?

A
  • CYP3A4
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10
Q

What medication is used as first line treatment for threadworm/pinworm (Enterobius vermiculars)?

A
  • Pyrantel or mebendazole.

- Shower on the night medication and again in the morning to remove eggs laid overnight.

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11
Q

How many half lives does it take for a drug to reach steady state?

A

5

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12
Q

Which antiepileptic should not be used in JME?

A
  • Carbemazapine.

- Known to cause deterioration in 68% of patients with JME.

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13
Q

Side effects of Vigabatrin?

A
  • Visual field constriction from peripheral retinal atrophy.
  • Optic neuritis.
  • Vision loss (rods > cones so predominantly night vision).
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14
Q

Side effects of Carbamazepine?

A
  • Nausea and vomiting.
  • Dizziness.
  • Drowsiness.
  • Liver dysfunction.
  • Hyponatraemia (SIADH).
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15
Q

Side effects of Gabapentin?

A
  • Somnolence.
  • Dizziness.
  • Tremor/ataxia.
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16
Q

Side effects of Lamotrigine?

A
  • Rash.
  • Nausea.
  • Dizziness.
  • Tremor.
  • Diplopia.
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17
Q

Side effects of Sodium Valproate?

A
  • Weight gain.
  • Hair loss.
  • Tremor.
  • Dizziness.
  • Nausea and vomiting.
  • Easy bruising.
  • Birth defects.
18
Q

What medications increase cyclosporin levels?

A
  • Ketoconazole, erythromycin, warfarin, itraconazole and fluconazole.
19
Q

What medications decrease cyclosporin levels?

A
  • Phenytoin, phenobarbitol, carbamazepine, rifampicin, alcohol abuse, sulphynyureas, St Johns Wort.
20
Q

What are side effects of hydroxycholoquine?

A
  • Nausea - most common side effect and may stop children from eating. Wean the dose and advise to give at night.
  • Corneal toxicity - reversible.
  • Retinal toxicity - rare, loss of colour vision and blindness. Irreversible.
21
Q

How does Tocilizumab work?

A
  • Tocilizumab is a recombinant humanized anti-human monoclonal antibody directed against IL-6 receptor.
22
Q

How does Infliximab work?

A
  • Chimeric monoclonal antibody that binds TNFa.

- Etnercept also binds TNFa but is a recombinant protein.

23
Q

How does Anakinra work?

A
  • IL1 inhibitor.

- Canakinumab and Rilanocept are also IL1 inhibitors.

24
Q

Why does topiramate cause nephrolithiasis?

A
  • Inhibits carbonic anhydrase leading to metabolic acidosis.
  • Defect in renal tubular acidification as a result of loss of carbonic anhydrase impairs compensatory drop in urine pH.
  • This leads to development of calcium phosphate nephrolithiasis.
25
Q

What is the mechanism of action of penicillins?

A
  • Inhibit cell wall synthesis.

- Irreversibly bind to DD transpeptidase (penicillin binding protein) and prevent transpeptidation.

26
Q

What antibiotics are used for MRSA?

A
  • Glycopeptides (vancomycin and teicoplanin).
27
Q

What are the relative potencies of glucocorticoids compared to cortisol?

A
  • Prednisilone 4:1
  • Betamethasone 25:1
  • Dexamethasone 25:1
28
Q

Omeprazole affects gastric parietal cell function by inhibition of which pathway?

A
  • Inhibits H+K+ ATPase (proton pump) by irreversibly binding on the luminal surface.
  • Blocks the final step in gastric acid secretion by parietal cells.
29
Q

What features are associated with in utero alcohol exposure?

A

-short palpebral fissures, blepharoptosis. epicanthal folds, telcanthus, smooth philtrum, small upper lip.

30
Q

What features are associated with in utero phenytoin exposure?

A
  • Craniofacial abnormalities, hypoplastic phalanges/nails.
31
Q

What features are associated with in utero sodium valproate exposure?

A
  • Spina bifida, preaxial defects, low IQ.
32
Q

What features are associated with in utero warfarin exposure?

A
  • Nasal hypoplasia, stippled epiphyses, CNS defects secondary to cerebral haemorrhage.
33
Q

What antibiotic does not have action against Pseudomonas?

A
  • Cefotaxime
34
Q

Which antiepileptics are inducers?

A
  • Phenytoin, phenobarbital and carbemazepine.
35
Q

Which chemotherapy agent is most likely to cause renal Fanconi syndrome

A
  • Ifosfamide.
  • Particularly doses >54g/m2.
  • Hypophosphataemia, hypokalaemia, glycosuria, proximal RTA, hypouricaemia.
  • Decreased tubular reabsorption on PO4 and increased fractional excretion of Na, K and Ca.
  • Increased urinary amino acids and HCO3.
  • Can cause glomerular and tubular toxicity.
  • Proximal tubular dysfunction is prominent and characterised by Fanconi syndrome and hypophosphataeimic ricketts.
  • IFO dose >100g/m2, age <5y and combination therapy with platins increase risk.
36
Q

What is a bacteriostatic antibiotic?

A
  • Antibiotic that limits the growth of bacteria by interfering with the bacterial protein production.
  • Examples: Macrolides, sulfonamides, trimethoprim, chloramphenicol, licosamides (clindamycin).
37
Q

What is a bacteriocidal antibiotic?

A
  • Kill bacteria.

- Examples: aminoglycosides, b-lactams, fluoroquinolones, nitrofurantoin, vancomycin, daptomycin.

38
Q

What medications and drugs are serotinergic?

A
  • SSRI and SNRI antidepressants.
  • TCA’s.
  • Amphetamines, MDMA and cocaine.
  • Tramadol.
  • St Johns Wort.
  • Triptans.
  • Metocloparmide and ondansetron.
39
Q

What are features of serotonin syndrome?

A
  • Fever, tachycardia, sweating.
  • Dilated pupils.
  • Agitation, confusion, hypomania.
  • Tremor, myoclonus and increased reflexes.
  • Also develop nausea and diarrhoea.
40
Q

Side effects of cytarabine?

A
  • Fever is a common side effect.

- Oral mucocytis.

FRACP Paediatrics (16 decks)

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