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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
Nausea and yellow/green vision
Digoxin toxicity
26
Ondansetron mechanism of action?
5-HT3 antagonist
27
Triptan mechanism of action?
Serotonin agonist
28
Which TB medication can cause gout?
Pyrazinamide
29
What monitoring do you need to do for azathioprine?
FBC, LFTs
30
What monitoring do you need to do for statins?
LFTs baseline 3 months 12 months
31
What do you need to monitor when a patient is on an ACEi?
U&Es prior to treatment After increasing dose At least annually
32
You can't take sildenafil if you are taking this drug?
Cannot take sildenafil and GTN | combining a phosphodiesterase inhibitor and nitrate can lead to significant hypotension and can cause MI
33
Side effect of viagra?
Causes blue discolouration of vision (the blue pill)
34
How do you monitor heparin?
APTT
35
How do you monitor low-molecular weight heparin (if you need to at all)
Routine monitoring not needed, but in special situations check anti-factor Xa levels
36
Lithium range
0.6-1 | Measure 12 hours post-dose
37
What is the most appropriate time to take blood samples for therapeutic monitoring of phenytoin levels?
Immediately before giving next dose
38
Safest epilepsy drugs to use in pregnancy
Carbamazepine and lamotrigine
39
Safest drug for hyperthryroidism in pregnancy?
Propylthiouracil
40
Why is metoclopramide useful in acute migraine?
It is a dopamine antagonist and speeds up gastric motility
41
What can cause oculogyric crisis, and how do you manage it?
Can be caused by phenothiazines, haloperidol, metoclopramide Treat with IV anti-muscarinic e.g. procyclidine or benztropine
42
Side effects of sildenafil
Headache (most common) Facial flushing Dyspepsia Blue-green tinge to vision (blue pill = blue vision)
43
What should you co-prescribe with ethambutol?
Give pyridoxine as well (vitamin B6) - to prevent changes in colour vision Also give with isoniazid to prevent peripheral neuropathy
44
Management of cocaine toxicity
Benzodiazepines
45
Medications useful in motion sickness
Hyoscine (the best) Cyclizine Promethazine
46
When might you have to stop metformin?
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
Single most important factor determining need for liver transplantation?
pH (pH <7.3 = need transplant definitely)
48
The main indications for using alpha blockers?
Hypertension and benign prostatic hyperplasia
49
Which investigation is essential prior to starting anti-TB therapy?
LFTs
50
How can amiodarone affect thyroid function?
Can cause hypothyroidism AND thyrotoxicosis
51
Medications which can cause pulmonary fibrosis
Antibiotics -especially nitrofurantoin Amiodarone Chemotherapy Methotrexate
52
Which TB med can cause peripheral neuropathy?
Isoniazid
53
Which TB med can cause psychosis?
Isoniazid
54
Treatment of methanol overdose? (...or antifreeze)
Ethanol or fomepizole
55
Treatment of digoxin overdose?
Specific antibodies
56
Treatment of salicylate overdose?
Haemodialysis
57
Treatment of opioid/opiate overdose?
Naloxone
58
Treatment of benzo overdose?
Flumazenil
59
Treatment of TCA overdose?
IV bicarbonate
60
Treatment of beta-blocker overdose?
If bradycardic, then atropine
61
Treatment of insecticide overdose?
Atropine
62
Treatment of iron overdose
Desferrioxamine
63
Treatment of lead overdose
Dimercaprol | Calcium edetate
64
Treatment of cyanide poisoning
Hydroxycobalamin
65
What medication can interact with lithium to cause lithium toxicity?
Bendroflumethazide
66
Smoking and P450 system?
Smoking is an inducer
67
What dose of naloxone should you give in opioid overdose?
Give 400 microgram bolus (short half-life though so will likely need more)
68
Do you need to stop aspirin before tooth extraction?
no
69
What medications does aspirin interact with?
POTENTIATES: - oral hypoglycaemics - warfarin - steroids
70
Side effects of amiodarone
Hyperthyroidism, hypothyroidism Liver cirrhosis Pulmonary fibrosis
71
How do you monitor standard heparin?
APTT
72
How do you monitor LMWH?
Activated Xa although rarely required
73
Very common side effect of calcium channel blockers?
Peripheral oedema
74
DRUGS TO AVOID IN RENAL FAILURE | LMNNT
Antibiotics: tetracycline, nitrofurantoin Lithium Metformin NSAIDs
75
Antibiotics, which are safe in renal disease?
Erythromycin, rifampicin
76
Is warfarin safe in renal disease?
Yes
77
Is diazepam safe in renal disease?
Yea
78
Typical features of carbon monoxide poisoning
Most common feature is headache | Confusion and pink mucosae
79
Management of cocaine toxicity?
Benzodiazepines generally first line
80
Finasteride mechanism of action?
5-alpha reductase inhibitor
81
When should you check digoxin level?
at least 6 hours after last dose
82
When should you check lithium levels?
12 hours after last dose
83
Ciclosporin side effects
Everything is increased - fluid, BP, K+, hair, gums, glucose
84
When should you check ciclosporin level
Immediately before next dose
85
How should you prescribe breakthrough morphine?
Breakthrough morphone should be 1/6th of the total daily morphine
86
Name 2 medications which exhibit zero order kinestics
Phenytoin | Alcohol
87
Which diabetes drugs increase insulin production?
Sulphonylureas
88
Who is responsible for collating and assessing the yellow card reports
MHRA
89
Blue vision
Viagra
90
Yellow green vision
Digoxin
91
This drug can cause both corneal opacities and optic neuritis
Amiodarone
92
Someone has an overdose and then gets ringing in their ears, what have they taken?
Aspirin
93
Should you use unfractioned heparin or LMWH if someone has severe renal disease?
Use the classic unfractioned heparin | more likely to have bad bleed on LMWH
94
Heparin mechanism of action
Activates anti-thrombin III
95
Heparin mechanism of action
Activates antithrombin III
96
Phosphodiesterase type V inhibitor
Sildenafil

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