More drugs

Question 1

how is isoniazid metabolised?

Answer 1

by acetylation

Question 2

slow acetylator status + isoniazid =

Answer 2

peripheral neuropathy

Question 3

fast acetylators + isoniazid =

Answer 3

hepatitis

Question 4

SLE like syndrome (drug induced) - is it ANA positive?

Answer 4

yes

Question 5

what drugs can induce SLE-like?

Answer 5

procainamide,
 isoniazid, 
griseofulvin, 
chlorpromazine 
anticonvulsants

Question 6

Phenytoin SEs

Answer 6

cerebellar syndrome, skin changes – acne, hirscutism, gum hypertrophy, folate deficiency

Question 7

which drugs cause gum hypertrophy?

Answer 7

ciclosporin
phenytoin
nifedipine

Question 8

which antiepileptic cuases cerbellar syndrome?

Answer 8

phenytoin

Question 9

which antiepileptic causes folate deficiency?

Answer 9

phenytoin

Question 10

Rx for trigeminal neuralgia pain

Answer 10

carbamazepine, phenytoin, gabapentin

Question 11

which antiepileptic associated with high rates of steven johnson syndrome?

Answer 11

lamotrigine

Question 12

Vigabatrin is used for?.. and common side effect?

Answer 12

tx resistant epilepsy. SE: irreversible visual field defects

Question 13

5HT1 agonists are what and what are the contraindicaitons

Answer 13

triptans. CIs: previous MI, coronaryartery disease, uncontrolled HTN

Question 14

which antiepileptic contrindicated in liver dysfunction and requires regular LFTs>

Answer 14

sodium valproate

Question 15

which drug causes acute pancreatitis?

Answer 15

sodium valproate

Question 16

is trimethoprim ok in pregnancy?

Answer 16

no, it’s teratogenic and anti-folate

Question 17

is nitrofurantoin ok in pregnancy?

Answer 17

yes, can be used

Question 18

which drug increases neutrophil count?

Answer 18

lithium

Question 19

is lithium ok in pregnancy?

Answer 19

no, teratogenic

Question 20

Side effects of lithium

Answer 20

Teratogen

GI upset, FINE tremor, polyuria, polydipsia.

Question 21

toxicity levels and signs of lithium

Answer 21

Toxicity if levels >1.5mmol/l:
GI effects (anorexia, nausea, diarrhoea),
CNS effects (muscle twitching, weakness, ataxia, COARSE tremor);
>2mmol/l: seizures can progress to death.

Question 22

sodium valproate common side effects

Answer 22

Adverse effects:
Gastric irritation, hyperammmonaemia → nausea
Lethargy, confusion
Weight gain
Teratogenic

Question 23

what causes hyperammonaemia (which drug)

Answer 23

sodium valproate

Question 24

valproate side effects

Answer 24

Valproate
Appetite↑, weight gain
Liver failure (watch lft esp. during 1st 6 months)
Pancreatitis
Reversible hair loss (grows back curly)
Oedema
Ataxia
Teratogenicity, tremor, thrombocytopenia
Encephalopathy (due to hyperammonaemia)

Question 25

which drug causes diplopia?

Answer 25

carbamazepine also lamotrigine

Question 26

side effects of carbamazepine

Answer 26

``` Dizziness, DIPLOPIA, drowsiness, ataxia, nausea, headaches. Dry mouth, oedema, hyponatremia. Chronic low WCC, Rarely agranulocytosis. Teratogenic ```

Question 27

side effects of clozapine

Answer 27

``` Sedation Hypersalivation Constipation Hypotension Hypertension Tachycardia Weight gain Fever (induces inflammatory response: CRP, IL-6) Seizures Nausea Nocturnal enuresis NEUTROPENIA GORD ```

Question 28

Se of lamotrigine

Answer 28

Other: diplopia, blurred vision, photosensitivity (SLE-like), tremor, agitation, vomiting, aplastic anaemia.

Question 29

Teratogenicity of aeds:

Answer 29

Teratogenicity of aeds: Women of child-bearing age should take folic acid 5mg/d. Valproate in particular should be avoided (use lamotrigine).

Question 30

is fiazepam safe in porphyria?

Answer 30

yes, other benzos - no

Question 31

drugs UNsafe in porphyria

Answer 31

``` Alcohol amphetamines antidepressants antihistamines Barbs+benzos Cephalosporins diuretics ergot gold + griseofulvin OCP Sulphonamides sulphonylureas ```