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General Med > Pharm > Flashcards

Pharm Flashcards

1
Q

CYP450 inducers

A

PC BRAS
Phenytoin
Carbamazepine

Barbituates
Rifampicin
Alcohol (chronic excess)
Sulphonylureas
St Johns Wort
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2
Q

CYP450 inhibitors

A

AO DEVICES
Allopurinol/Antifungal/Amiodarone
Omeprazole/Cimetidine

Disulfram
Erythromycin/clarithromycin 
valproate
Isonazid
Ciprofloxacin
Ethanol (acute intoxication)

Sulphonamides
Grapefruit

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3
Q

Drugs impacted by CYP450

A 
Warfarin
COCP
Steroids
TCAs
Statins
Pethindine 
theophyline
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4
Q

Narrow therapeutic windows

A 
Gentamicin
Warfarin
Lithium
Digoxin
THeophylline
Methotrexate
Phenytoin
Insulin
Ciclosporin
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5
Q

Metformin interaction

A

Cimetidine (inhibits renal elimination)

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6
Q

Gentamicin

A

Loop diuretics (renal failure risk)

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7
Q

ACEI

A

Potassium sparing diuretics (risk of hyperkalaemia)

Metformin (enhances hypoglycaemic effect)

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8
Q

Statins

A 
Macrolide
Amiodarone (increased statin concentration therefore risk of rhabdomyolysis)
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9
Q

Thiazide

A

PPI (hyponatraemia)

Lithium (increased toxicity)

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10
Q

Cardiac arrest drugs

A 
Adrenaline 10ml of 1 in 10000 IV
Amiodarone 300mg (if shockable)
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11
Q

Anaphylaxis drugs

A

Adrenaline 0.5ml of 1 in 1000 IM
Hydrocortisone 200mg IV
chlorphenamine 10mg IV

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12
Q

Seizure drugs

A

lorazepam IV 4mg

Diazepam 10mg PR

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13
Q

Hypoglycaemia drugs

A

10% glucose 150ml IV
20% glucose 75ml IV
Glucagon IM 1mg (no IV access)

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14
Q

Hyperkalaemia drugs

A

10% calcium gluconate 10ml over 5 mins

THEN - 10% glucose 250ml IV plus 10 units of antrapid insulin over 30 mins

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15
Q

Bradycardia drugs

A

Atropine 500mcg IV (every 3-5 mins to max 3mg - 6 doses)

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16
Q

SVT (without adverse signs) drugs

A

Adenosine 6mg

can be followed by a further 12mg and another if unsuccessful

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17
Q

VT drugs

A

Amiodarone 300mg IV over 20-60 min

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18
Q

Rapid tranquilisation of at risk patient

A

lorazapam 1-2mg PO (or 2-4 IM)

Haloperidol 1.5-3mg PO (or 5-10mg IM)

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19
Q

WHO analgesic ladder

A

Step 1: non-opioid (aspirin, paracetamol or NSAID)
Step 2: Weak opioid (codeine)
Step 3: strong opioid (morphine, fentanyl)

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20
Q

Non-opioid analgesia

A

Paracetamol 0.5-1g QDS
Ibuprofen 400mg QDS
Diclofenac 50mg PO 8 hourly
Naproxen 0.5-1g daily

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21
Q

Ibuprofen CI

A

Gastritis and asthma Hx

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22
Q

Weak Opioid analgesia

A

Dihydrocodeine

Codeine

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23
Q

Compound analgesia

A

co-codamol (paracetamol) 8/500mg or 30/500mg
co-dydramol (dihydrocodiene + paracetamol) 10/500mg
co-codaprin (aspirin)

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24
Q

Strong opioids

A 
Morphine (PO/IV/IM/TD)
oxycodone 
Tramadol 
Buprenorphine 
Fentanyl
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25
Q

Acute morphine dose

A

0.1-0.2 mg/kg + 0.05mg/kg every 5 mins till pain resolved

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26
Q

Renal colic pain mx

A

PR diclofenac

27
Q

Drugs to stop before surgery

A 
I LACK OP
Insulin (variable)
Lithium (day before)
Anticoagulants/antiplatelets variable
cOCP/HRT (4 weeks before)
K-sparing diuretics (day of surg.)
Oral hypoglycaemics (varys)
Periondopril + ACEI (day before)
28
Q

VT causes

A

Infarction
Myocarditis

QT syndrome
Valve abnormalities
Iatrogenic 
Cardiomyopathy
K+/Mg/O2/acidosis
29
Q

Sildenafil CI

A
  • patients taking nitrates (nicorandil)
  • hypotension
  • recent stroke or MI (6 months)
30
Q

Post MI secondary prevention

A 
Conservative: diet, exercise
Medication:
 - dual antiplatelet 
 - ACEI
 - Beta blocker
 - Statin
31
Q

Causes of raised prolactin

A
  • prolactinoma
  • pregnancy
  • oestrogens
  • physiological stress
  • acromegaly
  • PCOS
  • primary hypothyroidism
32
Q

Amiodarone monitoring

A

TFT, LFT

33
Q

Levetiracetam monitoring

A

No routine monitoring needed

34
Q

Methotrexate

A

FBC, LFT, U&Es

35
Q

Antibiotic effecting LFTs

A

Co-amoxiclav, erythromycin, fluclox

Causes cholestasis

36
Q

Drugs causing liver cirrhosis

A

Methotrexate
Methyldopa
Amiodarone

37
Q

Drugs causing lung fibrosis

A 
Amiodarone
Cytotoxic 
 -busulphan 
 - bleomycin
Anti-rheumatoid drugs 
 - methotrexate
 - sulfasalazine
 - gold
Nitrofuratoin
Ergot derived dopamine receptor agonists
 - bromocriptine, cabergoline, pergolide
38
Q

Drugs causing agranulocytosis

A 
Clozapine
Carbimazole/propylthiouracil
carbamazepine
Chlorampenicol/penicillin/co-trimoxazole
Mirtazapine
Methotrexate
39
Q

Benzodiazapine over dose reversal

A

Flumazenil

GABA-antagonist

40
Q

Adverse effects of loop diurectics

A
  • hypotension
  • low Na, K
  • hypochloraemic alkalosis
  • OTOTOXICITY
  • Hypocalcaemia
  • Renal impairment
  • hyperglycaemia
  • gout
41
Q

Statins doses

A

Primary prevention 20mg OD Atorvastatin

secondary prevention 80mg atorvastatin

42
Q

Statin SE

A 
Myopathy
Liver impairment (stop if >=3 abnormal LFT measurments)
43
Q

Drugs to avoid in renal failure

A
  • AB: tetracycline, nitrofurantoin
  • NSAIDs
  • lithium
  • metformin
44
Q

Azathioprine pre-prescribe check

A 
TPMT deficiency
(thiopurine methyltransferase)

SE:

  • bone marrow depression
  • nause and vomitiing
  • pancreatits
45
Q

Animal bite antibiotic

A

Co-amoxiclav

46
Q

Adrenaline dose in cardiac arrest

A

1 mg of 1:10,000

47
Q

Gentamicin SE

A

Ototoxicity
nephrotoxicity

CI of Gent:
- myasthenia gravis

48
Q

Phase 1 drug metabolism (x3)

A

Oxidation
Reduction
hydrolysis

49
Q

Phase 2 drug metabolism

A

Conjugation

50
Q

MAOI (eg phenelzine) SE

A
  • hypertensive reactions

- anticholinergic effects

51
Q

Gynaecomastia causing drugs

A 
Digoxin
Izonasid
Spironolactone
Cimetidine/cannabis
Oestrogens

Anabolic steroids
Gonadorelin analogues: goserelin, buserelin
Finasteride

52
Q

Metformin SE

A

GI disturbance

Lactic acidosis

53
Q

Sulphonylureas (Glimepiride)

A

Hypoglycaemia
Increased appetite and weight gain
SIADH
Liver dysfunction

54
Q

Glitazones

A

Weight gain
Fluid retention
Liver dysfunction
fractures

55
Q

St Johns wort

A

CYP450 inducer

56
Q

Lithium toxicity precipitants and features

A

Precipitated by:

  • dehydration
  • renal failure
  • diuretics
  • ACEI
  • NSAIDs
  • metroodazole

Features:

  • coarse tremor
  • hyperreflexia
  • acute confusion
  • seizure
  • coma
57
Q

Digoxin toxicity precipitants

A 
Hypokalaemia
raised age
renal failure
MI
Low magnesium
Raised Calcium, sodium 
Acidosis
low albumin
hypothermia
hypothyroidism
Drugs: amiodarone, quinidine, verapamil, diltiazem, spironolactone, ciclosporin
58
Q

Mangement of digoxin toxicity

A

digibind
correct arrhythmias
monitor potassium

59
Q

Zero-order kinetics

A

Describes metabolism which is independent of the concentration of the reactant. This is due to metabolic pathways becoming saturated resulting in a constant amount of drug being eliminated per unit time

60
Q

Features of opiod misuse

A 
Rhinorrhoea
needle tracks
pinpoint pupils
drowsiness
watering eyes
yawning
61
Q

Migraine prophylaxis

A

Topiramate or propranolol

62
Q

Absolute contraindications to thrombolysis

A 
Active internal bleeding
Recent haemorrhage, Trauma or surgery (including dental extraction)
Coagulation and bleeding disorders
Intracranial neoplasm
Stroke < 3 months
Aortic dissection
Recent head injury
Pregnancy
Severe hypertension
63
Q

Mx of salicylate overdose

A

ABC + charcoal
urinary alkalinization with IV sodium bicarb
Haemodialysis

64
Q

Bisphosphonates SE

A

Osteonecrosis
GORD, oesophageal ulcers
Atypical stress fractures of proximal femoral shaft

General Med (17 decks)

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