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PHARMACOLOGY FRCA > pastest > Flashcards

pastest Flashcards

1
Q

how are NSAIDs categorised by risk of GI bleeding? give examples?

A

low risk - ibuprofen
intermediate - ketorolac, diclofenac, indomethacin
high - piroxicam , azopropazone

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2
Q

which is the most ototoxic drug?

A

cisplatin - everyone gets a degree of hearing loss

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3
Q

what is more ototoxic aminoglycosides or furosemide?

A

aminoglycoside abx - gentamicin

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4
Q

what is the mechanism of clonidine and dexamedetomidine? what effects does this have?

A

alpha 2 agonist

hypotension
analgesia
sedation

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5
Q

is tramadol safe in renal failure?

A

no,
active metabolite (O-desmethyltramadol) which is excreted renally

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6
Q

what is the mechanism of cabergoline?
what is another example of drug in this group?

when are these used?

A

dopamine D2 receptor agonist

bromocriptine

hyperprolactinaemia - inhibits prolactin at anterior pituitary
acromegaly - inhibits GH release

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7
Q

give an example of a somatostatin analogue ?

what is the indication?

A

octreotide

used for acromegaly as it inhibits GH release

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8
Q

what is the bio-oral availabiltiy of paracetamol and aspirin and diclofenac?

A

paracetamol - 90%
aspirin - 70%
diclofenac - 50%

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9
Q

what breaks down succinylcholine?

A

pseudo cholinesterase
aka as plasma esterases.

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10
Q

which class I antiarrhythmic can be used in ALS?

A

lidocaine (1b)
when amiodarone is not available/contraindicated.

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11
Q

which class of anti-arrhyhmic is lidocaine?

A

1b

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12
Q

outline main mechanism of class I to IV anti-arrhythmics and their main effect on ECG…

A

class 1 = Na channel blocker
2 = B blocker
3 = K channel blocker
4 = Ca channel blocker

class 1 - widens QRS
class 2 - slows rate and widens PR
class 3 - prolongs QT
class 4 - slows rate and widens PR

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13
Q

list the inducers of warfarin at CYP450

A

Abx - rifampicin

antiepileptic - phenytoin, carbemazepine, topiramate, barbiturates

other - Griseofulvin and st johns

PS CRAPT = phenytoin, st johns, carbemazepine, rifampicin, alcohol (indirect), phenobarbital (barbiturates) , topiramate

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14
Q

which antiemetic is particularly useful for chemo induced N&V?

A

dexamethasone

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15
Q

how do the class I anti-arrhythmics affect phase 0 of action potential, the refractory period and action potential duration?

A

phase 0
- class I a - moderate reduction
- class I b - small reduction
- class Ic - large reduction

action potential duration
- a - increased
b - reduced
c - no effect

refractory period
a - increased
b - reduced
c - no effect

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16
Q

how do amiodarone and digoxin differ in effects on vision?

A

amiodarone - optic neuropathy
digoxin - red green colour vision change

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17
Q

which anti-arrhythmic drug class does phenytoin belong to? what can it do to heart rhythm with IV administration?

A

clas Ib
complete heart block - increases PR

reduces refractory period

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18
Q

what is the oil gas partition for sevoflurane?

A

80

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19
Q

what is the molecular weight of sevo?

A

200Da

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20
Q

which volatile has highest molecular weight?

A

SEVO

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21
Q

what is the % of metabolism of the different volatiles?

A

0.02% desflurane
0.2% - isoflurane
2% - sevoflurane & enflurane
20% - halothane

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22
Q

what is the SVP of halothane

A

32

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23
Q

what is the SVP of isoflurane?

A

33

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24
Q

what is the SVP of desflurane?

A

89

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25
Q

what is the SVP of enflurane?

A

23.3

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26
Q

what is the SVP of sevoflurane

A

22.7

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27
Q

what is the MAC of halothane?

A

0.75

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28
Q

what is the MAC of sevoflurane?

A

2.2

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29
Q

what is the MAC of isoflurane? and enflurane?

A

isoflurane = 1.17
enflurane = 1.91

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30
Q

what is the MAC of desflurane?

A

6

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31
Q

what is the mac of nitrous oxide?

A

103

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32
Q

what muscarinic receptor is found in heart and what type of receptor is this

A

M2
Gi

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33
Q

where are M1 receptors located?

A

autonomic ganglia
salivary glands
gastric tissue

Gq receptor

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34
Q

where are M3 receptors located? what type of receptor is this?

A

smooth muscle - bronchoconstriction, GI movement
also eyes - miosis

Gq

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35
Q

where are M4 and M5 receptors found and what type of receptors are these?

A

both in CNS

M4 = Gi
M5 = Gq

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36
Q

what does phentolamine do to the nasal mucosa?

A

congestion
increases risk of bleeeding
Phentolamine = adrenoreceptor alpha antagonist

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37
Q

which model is used for TCI propofol in kids?

A

2 options
kataria
paedfusor

38
Q

what is the Shuttler model?

A

TCI propofol model

39
Q

what is the domino model?

A

TCI for ketamine

40
Q

what class drug is pioglitazone?

A

TZD -
Thiazolidinedione

41
Q

what class drug is sitagliptin?

A

gliptins
DDP4 inhibitors
diabetes

42
Q

which pain med is well suited for chronic pain/ chronic regional pain syndrome?

A

IV ketamine

43
Q

what are routes of administration for salbutamol?

A

IV
oral
inhaled
sub cut

44
Q

what mixture does salbutamol consist of?

A

Racemix mixture of R and S enantiomers

45
Q

which anaesthetic induction agent has the highest clearance?

A

propofol
30-60ml/kg/min

46
Q

which anaesthetic induction agent has highest Vd?

A

propofol

47
Q

which anaesthetic induction agents have active metabolites?

A

thio
ketamine

48
Q

which anaesthetic induction agent is least protein bound?

A

ketamine - 25%

49
Q

what anaesthetic drug is most likely to cause bronchospasm ?

A

atracurium
(more so than desflurane)

50
Q

what is the delta ratio?

A

the ratio of change in the anion gap to the ratio of change in bicarbonate..

<0.4 = normal anion gap
0.4-0.8 = mixed normal and high gap
1-2 = high anion gap met acidosis
>2 = met acidosis and alkalosis

51
Q

how can TRALI and TACO be differentiated by time frame?

A

TRALI
- within 6 hours

TACO
- within 12 hours, up to 24

52
Q

what does a funnel plot in statistics do?

A

checks for risk of publication biased

53
Q

which type of study does a forest plot look at?

A

meta analysis

54
Q

what is the power of a study?

A

the sample size that is required to pick up a significant difference

55
Q

how do sulphonamide antibiotics work?

A

false substrate for folic acid synthesis pathway - prevent folic acid production and DNA synthesis

56
Q

how does chloramphenicol work?

A

binds 50s - inhibits protein synthesis

57
Q

how does fusidic acid work?

A

bacteriocidal
inhibits protein synthesis

58
Q

what are the symptoms of a stellate ganglion block?

A

warm dry hand
horners - constricted pupil, ptosis, enopthalmos, anhydrosis

59
Q

what is the reason for urinary retention with cauda equina?

A

reduced bladder sensation

60
Q

what are the different degrees of nerve injury?

A

neuropraxia - compression - local myelin damage only

axonotmesis - crush - neuron damaged but surrounding e.g. epineureum, perinerum remain in tact

neurotmesis - transection

61
Q

what are the nerve roots of the common peroneal nerve?

A

L4-S2

62
Q

how many values lie within 1, 2, 3 Standard deviations of the mean?

A

1= 67.7 %
2 = 95
3 = 99.7

63
Q

what is the most accurate info that can be obtained from an arterial line?

A

directly measured is systolic and diastolic pressures therefore this is most accurate

indirectly calculated is stroke volume, contractility , SVR - less accurate

64
Q

which statistical test is used for parametric data comparing 2 groups?

A

student unpaired t test

e.g. comparing group having a placebo and drug - unpaired because they are 2 separate groups

or student paired t test
e.g. comparing before and after results - paired because the each result needs to be paired for each patient.

65
Q

when is chi squared test used?

A

for categorical data

66
Q

which zone of the liver is for drug detox?

A

zone 3 - furtherest from portal triad, lowest perfusion

67
Q

which zone of the liver does bile production? what else occurs here?

A

zone 1

cholesterol production
gluconeogenesis

68
Q

what do sodium levels do to MAC?

A

hyponatremia - lower MAC

69
Q

what is class I , II and III electrical equipment ?

A

class I - earthed case
class 2 - double insulation of all parts
class 3 - extra low voltage

70
Q

how is SVT treated?

A

adenosine

if asthmatic - verapamil / diltiazam (CaCB)

71
Q

how does venturi effect and bernouli principle relate?

A

venturi effect is an APPLICATION of the bernoulli principle

72
Q

what is the formula for estimating weight of a child?

A

(age x 3) + 7

73
Q

how do different LMA sizes relate to weight?

A

0-5kg - size 1
5-10kg - size 1.5
10-20kg - size 2
20-30kg - size 2.5
>30kg - size 3

74
Q

how is amps of power of a circuit calculated?

A

watts/ volts

75
Q

what is the normal value for vital capacity?

A

around 4500ml

ERV (1000) +IRV(3000)+ TV(500)

76
Q

when is liver damage at its max post paracetamol OD?

A

3-4 days

77
Q

when is IV acetylcysteine given before blood results are back?

A

if more than 150mg/kg
8-24 hours post ingestion

78
Q

which enatiomer of bupivacaine is less cardiotoxic?

A

S (not R)

79
Q

which metabolite of pancuronium is active and can cause prolonged muscle paralysis in renal failure?

A

3 - hydroxypancuronium (50% as potent)

80
Q

which anticoag has shortest half life?

A

unfractionated heparin

81
Q

what are the levels of evidence?

A

1a = systematic review
1b = well designed RCT
2a = well designed, controlled non randomised
2b - cohort
3 - case control
4 - expert opinions

82
Q

what are the recommendation grades in in statistics?

A

A - level 1 evidence = 1a and 1b
B - level 2 evidence
C- level 3 evidence
D - level 4 evidence

83
Q

size of LMA ?

A

0-5 kg = 1
5-10kg = 1.5
10-20 = 2
20-30 = 2.5
30 -50 = 3
50-70=4
70+ = 5

84
Q

which statistical test looks at incidence?

A

chi squared

85
Q

what are more powerful, parametric or non-parametric tests?

A

parametric

86
Q

how does confidence interval vary with sample size?

A

larger sample size
smaller confidence interval - i.e. narrower range of which 95% chance of true value lying between

87
Q

what type of data can median and SD be used?

A

Median and Standard Deviation are reserved for quantiative data that has a normal distribution.

88
Q

give examples of ordinal data

A

qualaitive but given a value e.g. ASA, frailty score

can be compared by Chi squared

89
Q

if the P value is <0.05 what can we say?

A

statistically significant
but cant say if clinically significant i.e. cant confirm one treatment is better than the other

90
Q
A

PHARMACOLOGY FRCA (13 decks)

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