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PHARMACOLOGY FRCA > misc > Flashcards

misc Flashcards

1
Q

how does bupropion work?

A

nicotine antagonist
dopamine, Na reuptake inhibitor

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1
Q

how does varenicline work?

A

aka champix

nicotine partial agonist - helps with withdrawal

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2
Q

side effects/ cautions/contraindications of bupropion and verenicline?

A

neither can be used in preg/ breast feeding

bupropion - not in patients with epilepsy

varenicline - caution in patients with depression.

other side effects of verenicline include - nausea, constipation, headache, vivid dreams

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3
Q

how much do blinking and laryngoscopy raise intraocular pressure by?

A

blinking - 10mmHg
laryngoscopy - 30 to 40 mmHg

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4
Q

how does rise in CVP cause increase in intraocular pressure?

A

via episceral vessels

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5
Q

what is pilocarpine and when is it relatively contraindicated?

A

muscarinic agonist
Can cause bronchospasm and is relatively contraindicated in asthma.

Used in glaucoma and to increase saliva in those with xerostomia

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6
Q

how do B blockers work in glaucoma?

A

decrease aqueous humour production

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7
Q

which anti-emetic can increase intraocular pressure?

A

metoclopramide - via dopamine receptors

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8
Q

how does latanoprost effect intraocular pressure?

A

Latanoprost is a prostaglandin analogue and is thought to break extracellular matrix, decreasing resistance to the outflow of aqueous humour.

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9
Q

how does sux increase intraocular pressure?

A

Suxamethonium increased IOP, probably as a result of increased choiroidal blood volume.

even when fasciculations are removed, still increases ocular pressure hence thought to be above mechanism

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10
Q

what is the basic chemical structure for histamine?

A

basic molecule

imidazole ring with amino acid side chain

produced from histadine via decarboxylation

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11
Q

which histamine receptor is found in CNS?

A

H1

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12
Q

what type of GPCR is H1 and H2?

A

H1 - Gq
H2 - Gs

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13
Q

when are antihistamines indicated in anaphylaxis?

A

indicated as second-line after adrenaline and steroids

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14
Q

what is the receptor mechanism for antihistamines?

A

inverse agonists - stabilise inactive state of H1

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15
Q

which generation antihistamine is chlorphenamine?

A

first generation

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16
Q

can loratidine cross BBB?

A

not as sedating first generation but still mild sedating effects

(second generation)

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17
Q

what protein binding is chlorphenamine?

A

70%

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18
Q

what is the bio oral availability of cyclizine?

A

high - 80%
similar dose IV and oral

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19
Q

how is fexofenadine excreted?

A

mostly in faeces unchanged.

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20
Q

how is epoprostenol given in resp disease? what does it do?

A

When nebulised, it acts as a specific pulmonary vasodilator at ventilated alveoli, reducing V/Q mismatch

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21
Q

how does aminophylline act?

A

inhibition of phosphodiesterase - intracellular enzyme

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22
Q

give an example of leukotriene receptor antagonist? when are they used?

A

Montelukast, zafirlukast, and pranlukast

chronic asthma, no effects in acute

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23
Q

what asthma drug is churg straus a side effect of?

A

montelukast - rare

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24
Q

what is the mechanism of terbutaline?

A

short acting b2 agonist

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25
Q

how much prednisolone is given in acute asthma?

A

40-50mg

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26
Q

what is the protein binding of acetazolamide in plasma?

A

70%

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27
Q

what chemical are thiazides related too?

A

sulphonamides

28
Q

what is the function of triamterene?

A

Triamterene blocks elective Na+ channel on the collecting duct luminal membrane

28
Q

how does spironolactone affect digoxin?

A

reduces clearance
hence increases levels

29
Q

what does furosemide do to calcium?

A

lower it

30
Q

which diuretic worsens diabetes?

A

thiazides.

31
Q

what type of receptor is the oxytocin receptor?

A

GPCR

32
Q

what does oxytocin do to diuresis?

A

anti-diuretic effects

33
Q

what does ergometrine do to SVR and coronary vessels?

A

increases systemic vascular resistance
coronary spasm risk

34
Q

what is the route of delivery of carboprost?

A

IM - 250ug every 15 mins up to 2mg

NOT IV

35
Q

what are the symptoms of hyperMg at 4mM and 6mM plasma conc?

A

Muscle weakness and bradycardia are seen at a plasma concentration of 6 mmol/L.

4 mmol/L is associated with hyporeflexia, nausea and slurred speech.

36
Q

what are the functions of oestrogen and progesterone on uterus towards term?

A

Progesterone keeps the uterus in functional quiescence

oestrogen causes the myometrium to become activated - which involves upregulation of oxytocin and prostaglandin receptors

37
Q

which hormone causes uterine involution?

A

oxytocin

38
Q

can oxytocin cross the placenta?

A

yes

39
Q

what does oxytocin do to the CVS?

A

Oxytocin reduces SVR, causes transient hypotension and reflex tachycardia.

40
Q

how is oxytocin metaboliseD?

A

Oxytocin is metabolised by the liver and by plasma oxytocinases.

41
Q

which uterine agent is contraindicated in asthma?

A

carboprost

42
Q

what type of molecule is misoprostal

A

Misoprostol is a synthetic prostaglandin E2⍺ analogue

43
Q

what is the mechanism of ergometrine?

A

Ergometrine causes hypertension by the agonism of ⍺2 receptors.

44
Q

at what stage in PPH is carboprost used?

A

Carboprost should be used third line after oxytocin and Ergometrine (unless ergometrine is contraindicated).

45
Q

which inhalation agents have the most effect on uterus relaxation?

A

Sevoflurane and desflurane have a greater uterine relaxation effect than isoflurane.

46
Q

what is atosiban?

A

Atosiban is an oxytocin receptor antagonist
used second line as tocolysis in pre-term labour

47
Q

where is alcohol absorbed?

A

20% in stomach
80% in duodenum

48
Q

which liver enzyme does chronic alcohol induce?

A

CYP 2E1

49
Q

what does GORD do to alcohol breath test?

A

false positive

50
Q

1 unit of alcohol is equivalent to how much pure ethanol?

A

10ml

51
Q

what is the CIWA-Ar score?

A

measures alcohol withdrawal

52
Q

what is the most common arrhythmia seen in alcoholics?

A

AF

53
Q

which class of ilicit drug is codeine?

A

class B

54
Q

heroin may be cut with scopolamine, what does this do?

A

anti-cholinergic effects

55
Q

what can talc cause that is cut into ectasy ?

A

pulmonary granulomas

56
Q

what blood result finding can be seen with cocaine?

A

thrombocytopenia

57
Q

which opiate receptors does heroin bind?

A

all of them

58
Q

at low doses what can cannabis do to MAC?

A

increase MAC
at low doses canabis can be stimulatory

in general acute canabis, reduces MAC

59
Q

which component of cigarette smoke is nicotine?

A

the particulate phase
(not the gaseous phase)

60
Q

what is the half life of nicotine and how is it metabolised?

A

30 mins
by CYP 450
metabolites are present for up to 20 hr

61
Q

what does nicotine do at high doses?

A

sedative and depressive effects

62
Q

how much greater is the affinity for CO to Hb than O2?

A

300 x

63
Q

what does smoking do for PONV and why?

A

reduces incidence
upregulates CYP2E1 and hence quicker metabolism of anaesthetic agents

64
Q

how does varenicline work?

A

partial nicotinic agonist

65
Q

how does bupropion work?

A

nicotinic receptor antagonist with dopaminergic and adrenergic action

66
Q

Is gentamicin bacteriostatic or cidal? What type of antibiotic

A

Bacteriocidal
Aminoglycoside

PHARMACOLOGY FRCA (13 decks)

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