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Drugs > Passmed Pharmacology > Flashcards

Passmed Pharmacology Flashcards

1
Q

Given to reverse respiratory depression

A

Flumazenil

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2
Q

How is benzodiazepine overdose treated?

A

Generally treated by observation only as a first-line

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3
Q

Used for the treatment of beta-blocker overdose

A

Atropine

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4
Q

When can you give activated charcoal?

A

Can give in paracetamol overdose but only if within an hour of ingestion

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5
Q

Management of salicylate overdose

A

Haemodialysis

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6
Q

Management of lithium overdose?

A

Volume resuscitation

May need haemodialysis

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7
Q

Treatment of iron overdose?

A

Desferrioxamine (a chelating agent)

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8
Q

What typically causes digoxin toxicity?

A

Hypokalaemia

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9
Q

First line treatment for severe digoxin toxicity?

A

Digibind

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10
Q

Why can amiodarone cause thyroid dysfunction?

A

Due to its high iodine content (amIODarone, amiodinarone)

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11
Q

How long does detoxification from opiates take?

A

Usually 4 weeks in residential/inpatient setting

Up to 12 weeks in the community

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12
Q

How does digoxin work?

A

Inhibits the Na+/K+ pump (and increases cardiac contractility)

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13
Q

Can cause sleep disturbance

A

Beta blockers

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14
Q

Side effect of isosorbide mononitrate?

A

Tachycardia

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15
Q

Can cause anal ulceration

A

Nicorandil

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16
Q

When can you not give flecainide?

A

Cannot give if signs of structural heart disease! - must do echo

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17
Q

Would you do rate or rhythm control in young people?

A

You would prefer to do rhythm control

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18
Q

First line for diabetic neuropathic pain

A

Duloxetine

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19
Q

What type of medication is duloxetine?

A

SNRI

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20
Q

Someone has neuropathic pain and orthostatic hypotension, which medication would you give for the neuropathic pain?

A

Pregabalin

orthostatic hypotension is a side effect of amitriptyline so would probably avoid

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21
Q

What is codeine

A

An opiate

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22
Q

What is co-codamol?

A

Paracetamol and codeine

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23
Q

ECG changes of TCA overdose

A

QRS widening

Prolonged QT interval

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24
Q

Which medicines may cause lithium toxicity?

A

ACEis, ARBs, diuretics

- consider this if someone is on lithium and needs blood pressure controlled

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25
Q

Nausea and yellow/green vision

A

Digoxin toxicity

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26
Q

Ondansetron mechanism of action?

A

5-HT3 antagonist

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27
Q

Triptan mechanism of action?

A

Serotonin agonist

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28
Q

Which TB medication can cause gout?

A

Pyrazinamide

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29
Q

What monitoring do you need to do for azathioprine?

A

FBC, LFTs

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30
Q

What monitoring do you need to do for statins?

A

LFTs
baseline
3 months
12 months

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31
Q

What do you need to monitor when a patient is on an ACEi?

A

U&Es prior to treatment
After increasing dose
At least annually

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32
Q

You can’t take sildenafil if you are taking this drug?

A

Cannot take sildenafil and GTN

combining a phosphodiesterase inhibitor and nitrate can lead to significant hypotension and can cause MI

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33
Q

Side effect of viagra?

A

Causes blue discolouration of vision (the blue pill)

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34
Q

How do you monitor heparin?

A

APTT

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35
Q

How do you monitor low-molecular weight heparin (if you need to at all)

A

Routine monitoring not needed, but in special situations check anti-factor Xa levels

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36
Q

Lithium range

A

0.6-1

Measure 12 hours post-dose

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37
Q

What is the most appropriate time to take blood samples for therapeutic monitoring of phenytoin levels?

A

Immediately before giving next dose

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38
Q

Safest epilepsy drugs to use in pregnancy

A

Carbamazepine and lamotrigine

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39
Q

Safest drug for hyperthryroidism in pregnancy?

A

Propylthiouracil

40
Q

Why is metoclopramide useful in acute migraine?

A

It is a dopamine antagonist and speeds up gastric motility

41
Q

What can cause oculogyric crisis, and how do you manage it?

A

Can be caused by phenothiazines, haloperidol, metoclopramide

Treat with IV anti-muscarinic e.g. procyclidine or benztropine

42
Q

Side effects of sildenafil

A

Headache (most common)
Facial flushing
Dyspepsia
Blue-green tinge to vision (blue pill = blue vision)

43
Q

What should you co-prescribe with ethambutol?

A

Give pyridoxine as well (vitamin B6) - to prevent changes in colour vision

Also give with isoniazid to prevent peripheral neuropathy

44
Q

Management of cocaine toxicity

A

Benzodiazepines

45
Q

Medications useful in motion sickness

A

Hyoscine (the best)
Cyclizine
Promethazine

46
Q

When might you have to stop metformin?

A

When you’re going to do anything with contrast -e.g. coronary angiography
-Don’t re-start till 48 hours after test
(due to increases risk of lactic acidosis and renal failure)

47
Q

Single most important factor determining need for liver transplantation?

A

pH (pH <7.3 = need transplant definitely)

48
Q

The main indications for using alpha blockers?

A

Hypertension and benign prostatic hyperplasia

49
Q

Which investigation is essential prior to starting anti-TB therapy?

A

LFTs

50
Q

How can amiodarone affect thyroid function?

A

Can cause hypothyroidism AND thyrotoxicosis

51
Q

Medications which can cause pulmonary fibrosis

A

Antibiotics -especially nitrofurantoin
Amiodarone
Chemotherapy
Methotrexate

52
Q

Which TB med can cause peripheral neuropathy?

A

Isoniazid

53
Q

Which TB med can cause psychosis?

A

Isoniazid

54
Q

Treatment of methanol overdose? (…or antifreeze)

A

Ethanol or fomepizole

55
Q

Treatment of digoxin overdose?

A

Specific antibodies

56
Q

Treatment of salicylate overdose?

A

Haemodialysis

57
Q

Treatment of opioid/opiate overdose?

A

Naloxone

58
Q

Treatment of benzo overdose?

A

Flumazenil

59
Q

Treatment of TCA overdose?

A

IV bicarbonate

60
Q

Treatment of beta-blocker overdose?

A

If bradycardic, then atropine

61
Q

Treatment of insecticide overdose?

A

Atropine

62
Q

Treatment of iron overdose

A

Desferrioxamine

63
Q

Treatment of lead overdose

A

Dimercaprol

Calcium edetate

64
Q

Treatment of cyanide poisoning

A

Hydroxycobalamin

65
Q

What medication can interact with lithium to cause lithium toxicity?

A

Bendroflumethazide

66
Q

Smoking and P450 system?

A

Smoking is an inducer

67
Q

What dose of naloxone should you give in opioid overdose?

A

Give 400 microgram bolus (short half-life though so will likely need more)

68
Q

Do you need to stop aspirin before tooth extraction?

A

no

69
Q

What medications does aspirin interact with?

A

POTENTIATES:

  • oral hypoglycaemics
  • warfarin
  • steroids
70
Q

Side effects of amiodarone

A

Hyperthyroidism, hypothyroidism
Liver cirrhosis
Pulmonary fibrosis

71
Q

How do you monitor standard heparin?

A

APTT

72
Q

How do you monitor LMWH?

A

Activated Xa although rarely required

73
Q

Very common side effect of calcium channel blockers?

A

Peripheral oedema

74
Q

DRUGS TO AVOID IN RENAL FAILURE

LMNNT

A

Antibiotics: tetracycline, nitrofurantoin
Lithium
Metformin
NSAIDs

75
Q

Antibiotics, which are safe in renal disease?

A

Erythromycin, rifampicin

76
Q

Is warfarin safe in renal disease?

A

Yes

77
Q

Is diazepam safe in renal disease?

A

Yea

78
Q

Typical features of carbon monoxide poisoning

A

Most common feature is headache

Confusion and pink mucosae

79
Q

Management of cocaine toxicity?

A

Benzodiazepines generally first line

80
Q

Finasteride mechanism of action?

A

5-alpha reductase inhibitor

81
Q

When should you check digoxin level?

A

at least 6 hours after last dose

82
Q

When should you check lithium levels?

A

12 hours after last dose

83
Q

Ciclosporin side effects

A

Everything is increased - fluid, BP, K+, hair, gums, glucose

84
Q

When should you check ciclosporin level

A

Immediately before next dose

85
Q

How should you prescribe breakthrough morphine?

A

Breakthrough morphone should be 1/6th of the total daily morphine

86
Q

Name 2 medications which exhibit zero order kinestics

A

Phenytoin

Alcohol

87
Q

Which diabetes drugs increase insulin production?

A

Sulphonylureas

88
Q

Who is responsible for collating and assessing the yellow card reports

A

MHRA

89
Q

Blue vision

A

Viagra

90
Q

Yellow green vision

A

Digoxin

91
Q

This drug can cause both corneal opacities and optic neuritis

A

Amiodarone

92
Q

Someone has an overdose and then gets ringing in their ears, what have they taken?

A

Aspirin

93
Q

Should you use unfractioned heparin or LMWH if someone has severe renal disease?

A

Use the classic unfractioned heparin

more likely to have bad bleed on LMWH

94
Q

Heparin mechanism of action

A

Activates anti-thrombin III

95
Q

Heparin mechanism of action

A

Activates antithrombin III

96
Q

Phosphodiesterase type V inhibitor

A

Sildenafil

Drugs (12 decks)

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