Medicines 41 Flashcards
What are the two main MOA classes of DOACs
Direct Factor “Xa” Inhibitors
Drugs:
Apixaban
Rivaroxaban
Edoxaban
Betrixaban (not commonly used in the UK)
Direct Thrombin (Factor IIa) Inhibitor
Drug:
Dabigatran
What is an Orthoptist?
An orthoptist is a healthcare professional who specialises in diagnosing and managing disorders of eye movement and binocular vision (how the eyes work together).
What is an occupational therapist?
An Occupational Therapist (OT) is a healthcare professional who helps people develop, recover, or maintain the skills needed for daily living and working, especially after illness, injury, or due to disability.
What is Ursodeoxycholic acid (UDCA)
Ursodeoxycholic acid (UDCA) is a bile acid used as a medication to treat certain liver and gallbladder conditions by improving bile flow and reducing toxic bile acid buildup.
Out of bisacodyl and senna which one acts faster
Senna:
Onset: 8–12 hours
Usually taken at night for a morning bowel movement
Oral Bisacodyl:
Onset: 10–12 hours
Also best taken at bedtime
Both stimulate peristalsis in the colon, but senna may act slightly faster.
What drug interaction do you need to be aware of with carbapenems
Sodium Valproate
Carbapenems decreases the concentration of valproate
What drug interaction is key to be aware of with fusidates?
Fucidates interact with statins causing rhabdomyolysis
Hold statin for the course and for one week after
What is the interaction between TETRACYCLINES and retinoids?
Increased risk of INTRACRANIAL HYPERTENSIION
What key drug interactions should you be aware of with QUINOLONES
Quinolones don’t have the NAQ
NSAIDS - risk of convulsions
ANTICOAGULANTS like warfarin - effects INR
QT prolongation - any drugs that cause QT prolongation
What key drug interactions should you be aware of with Macrolides?
In parkinsons early treatment with what drug can help delay the need for levodopa therapy
SELEGILINE
It may be used alone in early Parkinson’s disease for symptomatic relief to delay the need for levodopa (with or without decarboxylase inhibitor) or as an adjunct to levodopa (with or without decarboxylase inhibitor)
Note rasagiline is not indicated for delaying the need for levodopa therapy although it is a monoamine oxidase B inhibitor as well)
What is Amantadine and what is a key side effect to look out for with it
📌 Indications:
Parkinson’s disease – ↑ Dopamine release, ↓ reuptake
Drug-induced extrapyramidal symptoms – Helps with tremor, rigidity
Influenza A (historical) – Rarely used now due to resistance
⚠️ Key Side Effect:
Livedo reticularis
▫️ Mottled purplish-blue skin (legs)
▫️ Usually benign, but may require discontinuation
🧠 Other Side Effects:
CNS: Confusion, hallucinations, dizziness, insomnia (esp. elderly)
Other: Peripheral oedema, dry mouth, orthostatic hypotension
WHat is Trihexyphenidyl
Trihexyphenidyl (also known as benzhexol) is a centrally acting antimuscarinic medication.
🔍 Uses / Indications:
Parkinson’s disease
▸ Used to treat tremor and rigidity
▸ Often helpful in younger patients with tremor-dominant Parkinson’s
Drug-induced extrapyramidal symptoms
▸ Manages acute dystonia, Parkinsonism, or tremor caused by antipsychotic medications
Antimuscarinic side effects
What are some common symptoms of alcohol poisoning
No Drinking Alcohol - nystagmus dysarthria, ataxia
Ataxia:
Loss of full control of bodily movements, especially affecting coordination, balance, and walking (gait instability).
Dysarthria:
Slurred or slow speech that can be difficult to understand, due to poor control of the muscles used for speech.
Nystagmus:
Involuntary, rhythmic eye movements — may be horizontal, vertical, or rotary.
Phenytoin also has some of.these symptoms in overdose
Which medications interact with Tamoxifen ?
PAROXETINE AND FLUOXETINE
decreased efficacy of tamoxifen
What can be taken with Itraconazole to improve its bioavailabilty
Carbonated drinks
The use of carbonated drinks, such as cola, improves itraconazole bioavailability. (BNF)
Which Beta blockers are licensed in heart failure
CAN NOT BEAT
Carvedilol, Nebivolol, Bisoprolol
WHat drug do you give for hypotension in parkinsons
1st line: midodrine hydrochloride
2nd line: fludrocortisone acetate [unlicensed indication] as an alternative
What are the Non-Ergot-Derived Dopamine-Receptor Agonists
Pramipexole
Ropinirole
Rotigotine (patch)
Used in:
Parkinson’s disease (especially in early stages or as adjunct to levodopa)
Restless Legs Syndrome (RLS) (pramipexole & ropinirole)
How long after stopping methotrexate is it advised to continue contraception?
6 months (EMC)
What should you be cautious with in lamotragine treatment (first 8 weeks in particular)
Stevens-Johnson Syndrome (SJS) & Toxic Epidermal Necrolysis (TEN):
Can occur especially in children
Most rashes develop within the first 8 weeks of treatment
Urgent withdrawal needed if serious rash appears
Discontinuation advice:
Taper off gradually over ≥2 weeks
Exception: If serious skin reaction → stop immediately
Why is clavulanic acid combined with amoxicillin in some infections?
Clavulanic acid is a beta-lactamase inhibitor.
It protects amoxicillin from degradation by beta-lactamase-producing bacteria, allowing it to work effectively against resistant strains.
What is Thyrotoxicosis?
overactive Thyroid
**“FAST METABOLISM”
(Hyperthyroidism = increased metabolic rate)
F – Fast heart rate (palpitations)
A – Anxiety
S – Sleep disturbances
T – Tremors
M – Mood swings
E – Enlarged thyroid (goitre)
T – Thin build (weight loss)
A – Agitation/irritability
B – Burning up (heat intolerance)
O – Overactive nervous system
L – Loss of weight
I – Insomnia
S – Sweaty/Sensitive to heat
M – Muscle weakness **
shared theme
What is key to remember about the three common medications beginning with CAR
Carbimazole - teratogenic
Carbamazepine - Teratogenic
Carbocistiene - Teratogenic in 1st Trimester
