Pharm & tox Flashcards
Indications for IViG (10)
Primary and 2ry immunodeficiency
ITP
Myasthenia gravis
GBS
Kawasaki Disease
TEN
Pneumonitis induced by CMV following transplantation
Low serum IgG after haematopoetic stem cell transplant for malignancy
Chronic Inflammatory demyelinating polyradiculopathy
Cocaine - cardio effects (5)
MI Tachy/brady HTN QRS widening and QT prolongation Aortic dissection
Cocaine - neuro effects (4)
Seizures
Mydriasis
hypertonia
hyperreflexia
Cocaine psych effects (3)
Agitation
Psychosis
Hallucinations
Cocaine other effects (4)
Ischaemic colitis post ingestion
Hyperthermia
Metabolic acidosis
Rhabdomyolysis
Cocaine Mx
Chest pain - benzos + GTN, if MI -> PPCI
HTN - benzos + sodium nitroprusside
Common drug causes of Utricaria (4)
Aspirin
PEnicillins
NSAIDs
OPiates
Octreotide uses (6)
Carcinoid syndrome Acute Rx of variceal haemorrhage ACromegaly Prevent Cx post pancreatic Sx VIPomas Refractory diarrhoea
Octreotide SEs
Gallstones - 2ry to bilary stasis
Indications for haemodialysis in salicylate poisoning (6)
- serum concentration >700
- metabolic acidosis resistant to Rx
- Acute renal failure
- pulmonary oedema
- Seizures
- coma
Mechanism of action Sarin gas
acetylcholinesterase inhibitor
synthetic organophosphatase
Effects of increased ACh (ie sarin gas) DUMBELS
Diarrhoea Urination Miosis/muscle weakness Bronchorrhea/Bradycardia Emesis Lacrimation Salivation/sweating
Trastuzumab (herceptin) MoA, indication
HER2/neu monoclonal Ab
Used in metastatic breast Ca
Trastuzumab (herceptin) adverse effects
flu-like symptoms and diarrhoea are common
cardiotoxicity: more common when anthracyclines (-rubicin) have also been used. An echo is usually performed before starting treatment
Drugs that trigger Acute Intermittent Porphyria (6)
Barbiturates - eg thiopentone Halothane Benzos Alcohol OCP Sulphonamides
Drug induced thrombocytopaenia (7)
Quinine Abciximab NSAIDs Diuretics - furosemide ABx - penicillins, sulphonamides, rifampicin Anticonvulsants - CBZ, valproate Heparin
Lithium monitoring range, timing
0.4-1.0 mmol/l
12h post dose
Ciclosporin monitoring timing
trough levels immediately before dose
Digoxin monitoring timing
at least 6h post dose
Phenytoin monitoring timing & indications (3)
Trough immediately pre next dose
Adjustment of dose, Suspected toxicity, detection of nonadherence
Abx to avoid in pregnancy (4)
Tetracyclines
Aminoglycosides
Sulphonamides and trimethoprim
Ciprofloxacin
Drugs to Avoid in pregnancy (7)
Statins ACEi, ARBs Warfarin Sulfonylureas Retinoids - inc topical Cytotoxic agents Majority of anti-convulsants (lamotrigine/Keppra are the preferred choice)
Causes of raised anion gap (4)
Lactic acidosis
Ketoacidosis
Renal failure - high urate
Toxins - methanol, ethylene glycol, salicylates
Drugs that undergo extensive first pass metabolism (9)
Aspirin Isosorbide dinitrate GTN Lignocaine Propranolol Verapamil Isoprenaline Testosterone Hydrocortisone
Drugs that exhibit zero order kinetics (4)
phenytoin
salicylates (e.g. high-dose aspirin)
heparin
ethanol
Atropine MoA, physiological effects and use
Anti-muscarinic
Tachycardia and mydriasis (dilatation)
Organophosphate poisoining
