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Gastroenterology > Pharmac > Flashcards

Pharmac Flashcards

1
Q

H/o Leg cramps + Visual disturbances + ringing in ears + Prolonged QRS and QT + Hypoglycaemia + Metabolic Acidosis
Salicylate= Normal.

A

Quinine Toxicity.

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2
Q

Quinine Toxicity.

A

H/o Leg cramps + Visual disturbances + ringing in ears + Prolonged QRS and QT + Hypoglycaemia + Metabolic Acidosis
Salicylate= Normal.

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3
Q

How to differentiate bw quinine toxicity and aspirin toxicity ?

A

If salicylate level is normal.
It’s not aspirin toxicity

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4
Q

Does cocaine induce labour ?

A

Yes

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5
Q

2 week history of visual field defect—scotomas + Hearing loss—SNHL+ Numbness in hands

A

Mercury poisoning

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6
Q

MI Secondary to Cocaine. Rx:

A

IV Lorazepam

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7
Q

Allopurinol is strongly associated with SCARs, especially in individuals with the____allele

A

HLA-B*5801

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8
Q

Smoking is a P450 ___

A

enzyme inductor

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9
Q

Enzyme inducers mnemonic :

A

SCRAP GPS (inducers)
Sulphonylureas/Smoking
Carbemazepines
Rifampicin
Alcohol (chronic)
Phenytoin
Griseofulvin
Phenobarbitone
St John’s Wort

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10
Q

monoclonal antibody that acts on the HER2/neu receptor

A

Trastuzumab

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11
Q

Recommend Adult Life Support (ALS) adrenaline doses

A

anaphylaxis: 0.5mg - 0.5ml 1:1,000 IM
cardiac arrest: 1mg - 10ml 1:10,000 IV or 1ml of 1:1000 IV

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12
Q

Aspirin MOA:

A

Decreases the formation of thromboxane A2(Texas themed shoe)
Non reversible inhibitor of COX 1 and COX 2

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13
Q

Doxazosin MOA:

A

Alpha 1 Antagonist

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14
Q

SSRI + MDMA= High temp + Hyperreflexia + Myoclonus + Rigidity. Dx?

A

Serotonin Syndrome.

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15
Q

Rx for Serotonin Syndrome:

A

Cyproheptadine

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16
Q

Lithium toxicity , 1st line Rx:

A

IV saline.

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17
Q

Teicoplanin MOA:

A

Inhibits Bacterial cell wall formation

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18
Q

Adrenaline induced ischaemia - Skin turns blue

A

Phentolamine

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19
Q

Beta-blocker OD Rx:

A

Initial Rx- atropine, glucagon in resistant cases

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20
Q

Local anesthetic toxicity can be treated with :

A

IV 20% lipid emulsion

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21
Q

Buprenorphine MOA

A

Used in opioid Dependance.

MOA: partial agonist of the mu-opioid receptor and an antagonist of the kappa-opioid receptoR

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22
Q

Zero order kinetics mnemonic and examples ?

A

He is zero, because he lost love—Drank Alcohol—had MI and Fits.

Ethanol
Salicylates ( High dose Aspirin )
Phenytoin

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23
Q

Underlying mechanism of Cyanide poisoning ?

A

Inhibition of cytochrome C oxidase.

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24
Q

H/O burning house + Headache + confusion + Flushed face + Bitter Almond taste. Dx?

A

Cyanide Poisoning

Rx: Hydroxycobalamin.

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25
Q

Rx of Cyanide poisoning:

A

Hydroxycobalamin

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26
Q

Amiloride selectively blocks the :

A

Epithelial sodium transport channels

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27
Q

Gingival hyperplasia Is caused by :

A

Amlodipine.

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28
Q

Electrolyte Imbalance seen in MDMA ?

A

Hyponatremia

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29
Q

Which drug will worsen the prognosis in PCM OD ?

A

If patient is on Carbamazapine therapy—Worsens the prognosis

Carbamazapine in an enzyme inducer

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30
Q

Most common S/e of cyclosporine :

A

Nephrotoxicity and Hepatotoxicity

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31
Q

anticholinesterase (acetylcholinesterase inhibitor)? S/e :

A

DUMBBELLS‘ mnemonic for cholinergic overdose
Diarrhoea
Urination
Miosis
Bradycardia
Bronchospasm
Emesis
Lacrimation
Lethargy
Salivation/Sweating (remember sweating is a cholinergic receptor mediated sympathetic nervous system action

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32
Q

Glycaemic control in diabetes may be worsened by:

A

Nicotinic Acid(Niacin)

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33
Q

Which diuretics precipitates Lithium Toxicity ?

A

Thiazide diuretics

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34
Q

A 43-year-old woman is about to start treatment with trastuzumab for metastatic breast cancer. What is the most important investigation to perform prior to initiating treatment?

A

Echo—As cardiac toxicity is common.

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35
Q

Cardiovascular S/E in cyclosporine ?

A

Hypertension

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36
Q

NSAID side effect:

A

Thrombocytopenia—Leads to Bleeding

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37
Q

Octreotide MOA:

A

Somatostatin Analogue( Octagon shaped stop sign )

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38
Q

Octreotide S/E:

A

BIlliary stasis—Gall stones.

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39
Q

Aspiring Overdose Rx:

A

Activated charcoal if admitted within one hour.

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40
Q

safer opioid to use in patients with moderate to end-stage renal failure:

A

Oxycodone

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41
Q

Bromocriptine may cause:

A

Pulmonary Fibrosis ( 6-month history of persistent dry cough and shortness of breath on exertio)

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42
Q

Bromocriptine + 6-month history of persistent dry cough and shortness of breath on exertio

A

Pulmonary Fibrosis

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43
Q

Beta-blockers can cause

A

Sleep disturbances and vivid dreams

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44
Q

antiarrhythmics disopyramide is an example of a:

A

Class 1a agent.

Diesel pyramid=Disopyramide

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45
Q

verapamil is examples of ?

A

Class 4 anti arrythmic

( Vipers on plane= with a large door=4)

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46
Q

Adverse of verapamil ?

A

Constipation
(Bathroom door is locked)

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47
Q

Class 1 B is examples ?

A

Lidocaine ( Cane using teacher who is lighting a ciggerate)

Class 1 B: 1st prize in spelling B

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48
Q

Drugs which are safe in AIP :

A

Hello Barbie , let’s take a sulphi and alcohol. I’ll take you out in Benz and give you OCP after sex.

Halothane
barbiturates
Sulphonamides
Alcohol
OCP
Benzodiazepines

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49
Q

Amiodarone S/E:

A

Corneal opacities

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50
Q

Amiodarone type 2: causes :

A

Destructive thyroiditis
Rx: Steroids

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51
Q

Amiodarone type 1 causes :

A

Ass with underlying thyroid disease
Rx: Antithyroid drugs

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52
Q

Amiodarone induced thyroitoxicosis Rx:

A

Steroids

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53
Q

Loss of vision is ass with Ethanol or methanol poisoning ?

A

Methanol poisoning

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54
Q

Dopamine receptor agonists:

A

Parkinson’s disease
prolactinoma/galactorrhoea
cyclical breast disease
acromegaly

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55
Q

PCM OD pathophysiology :

A

Conjugation of paracetamol becomes saturated in overdose

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56
Q

Digoxin on QT interval ?

A

Shortening of QT interval

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57
Q

Inhibition of acetylcholine esterase causes ?

A

Increase in DMUBEL symptoms

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58
Q

ECG changes in Quinine toxicity ?

A

Prolonged QRS and Qt

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59
Q

Electrolyte imbalance in MDMA:

A

Hyponatremia

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60
Q

OP poisoning Rx:

A

IV Atropine

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61
Q

Heparin ( Enoxaparin ) S/E:

A

Thrombocytopenia ( Broken plates near door )

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62
Q

Drugs causing thrombocytopenia :

A

NSAIDS
Heparin

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63
Q

Aminoglycosides causes nephrotoxicity via ?

A

Tubular necrosis

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64
Q

Thiazides—Rash around face and neck , Due to :

A

Photosensitivity

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65
Q

Aspirin S/e:

A

Urticarial rash

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66
Q

Before increasing dose of metformin :

A

Leave at least one week before increasing

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67
Q

COCP is protective against :

A

Ovarian and endometrial cancer

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68
Q

Paracetamol overdose occurs when glutathione stores run-out leading to an increase in

A

NAPQI (N-acetyl-p-benzoquinone imine)

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69
Q

What is the mechanism of this treatment for PCM poisoning ?

A

Replenishes Glutathione.

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70
Q

In carbon monoxide poisoning, the oxygen dissociation curve :

A

Shift to the left and downwards

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71
Q

Psychiatric history + Confusion + coarse tremors :

A

Lithium Toxicity

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72
Q

Rifampicin MOA :

A

Inhibits RNA synthesis

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73
Q

Aminoglycosides MOA:

A

Inhibits 30 S ribosome—Inhibits protein synthesis.

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74
Q

Urticarial rash is caused by which blood thinner ?

A

Aspirin.

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75
Q

Drugs which precipitate Lithium Toxicity ?

A

DAMN
Diuretics—Thiazide diuretics
ACE/ARb
Metronidazole
NSAID.

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76
Q

Carbon monoxide poisoning - most common feature:

A

Headache

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77
Q

Drugs causing Impaired glucose Tolerance :

A

STATIN

Steroids
Thiazide
Antipsychotics
Tacrolimus
Interferon Alpha
Niacin.

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78
Q

Electrolyte Imbalance and side effects in cyclosporine :

A

Everything is Incresed.

Hyperkaleima
Hypertension
Glucose—Hyperglycaemia
Hair—Hisutism
Gums—Gingival hyperplasia

Nephrotoxcicty and hepatotoxicity

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79
Q

patients with an IgE medicated penicillin allergy will also be allergic to cephalosporins

A

Cephalosporin

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80
Q

Anti diabetic drug which causes ankle Edema and heart failure?

A

Pioglitazone

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81
Q

Agranulocytosis (low neutrophil)is caused by which anti epileptic ?

A

Carbamzapine.

82
Q

Suicide attempts + Metabolic acidosis with High anion gap + No visual problem

A

Ethelyne glycol poisoning

83
Q

Digoxin MOA :

A

Inhibits Na/K ATPase pump.

Used in rate control in Afib.

84
Q

Common Adverse of Amitryptiline:

85
Q

Most common antibiotic to cause urticaria ?

A

Penicillin

86
Q

H/o Immunosupressive drugs + Morbiliform Extensive skin rash, fever and organ dysfunction (Liver , Kidneys, Hear , Lung) + Eosinophilia + DeRANGED LFTS(imp):

A

DRESS syndrome

87
Q

Differentiate DRESS from Steven Johnson and TEN:

A

Dress: Morbiliform skin rash + deranged LFTs

Steven : Mucosal Involvement

TEN: desquamating skin lesion

88
Q

UTI drug which causes Pulmonary Fibrosis:

A

Nitrofurantoin

89
Q

In which poisoning ?

sinus tachycardia
widening of QRS
prolongation of QT interval

A

Tricyclic antidepressant Poisoning.

90
Q

Fibrates Adverse :

91
Q

most appropriate time to take blood samples for therapeutic monitoring of lithium levels?

A

12 hours after the last dose.

92
Q

Drugs that can be cleared with haemodialysis - mnemonic

A

BLAST

Barbiturate
Lithium
Alcohol (inc methanol, ethylene glycol)
Salicylates
Theophyllines

93
Q

the following adrenoceptors cause vasoconstriction and relaxation of GI muscle in response to sympathetic stimulation:

94
Q

Which one of the following adrenoceptors causes inhibition of pre-synaptic neurotransmitter release in response to sympathetic stimulatio

95
Q

Which one of the following is a mixed alpha and beta adrenoceptor antagonist?

A

Carvedilol

96
Q

Drugs causing thrombocytopenia :

A

Queen(quinindine) is playing abacus (abciximab) , had jerky syncope( anti seizures meds) and fell down, breaking down the plates= Decrease in platelets.

Queen= Qanada
Quinidine
Abciximan, anti convulsants
Antibiotics:Penicillin
NSAID
H- Heparin

97
Q

Dopamine receptor agonist is used in :

A

Parkinson’s
Galactorhoea
Acromegaly
Neuroleptic malignant syndrome
Cyclical Breast disease.

98
Q

Nevolumab MOA:

A

Nevo1umab= PD1 inhibitor

99
Q

Ketamine MOA:

A

NMDA receptor Antagonist

100
Q

Octreotide MOA:

A

Somatostatin Analogue

101
Q

Metformin increases insulin sensitivity?

A

by activation of the AMP-activated protein kinase

102
Q

Humanising:

A

decreases the immunogenicity of non-human derived monoclonal antibodies

103
Q

Botox is therapeutically in ?

104
Q

oculogyric crisis Rx:

A

Procyclidine/Benztropine

105
Q

On Schizophrenia meds/Parkinsons + he develops a fixed stare. Shortly after, involuntary upward deviation of the eyes is noted.

A

Oculogyric crisis

106
Q

Macrolides MOA:

A

Inhibits 50S ribosomes—inhibits protein synthesis

107
Q

Most common side effects of metformin :

108
Q

Which antibiotic to avoid in seizure patients ?

A

Ciprofloxacin lowers the seizure threshold

109
Q

Cetuximab acts against ?

A

Epidermal Growth Factor

110
Q

Heparin-induced thrombocytopaenia - antibodies form against

A

complexes of platelet factor 4 (PF4) and heparin

111
Q

Visual problems in which anti tb drugs ?

A

Ethambutol—Causes Optic neuritis

112
Q

Which Tb drug causes Peripheral Neuropathy ?

113
Q

Hydroxychloroquine:

A

Bull’s eye maculopathy

114
Q

Yellow green vision is side effect o which drug ?

115
Q

Digoxin toxicity is precipitated by ?

A

Thiazide diuretics

116
Q

Metformin acts by activation of the AMP-activated protein kinase (AMPK)

A

AMP-activated protein kinase (AMPK)

117
Q

Abciximab is :

A

glycoprotein IIb/IIIa receptor antagonist

118
Q

Sulfonylureas(Chlorpropamide )

A

Hyponatremia

119
Q

Infliximab

A

an anti-TNF monoclonal antibody

120
Q

abdominal pain or rectal bleeding following cocaine ingestion(Mydriasis pupils, anxious, hypertensive)

A

Ischaemic colitis

121
Q

Depolarising muscle relaxant :

A

Suxamethonium

122
Q

Amiodarone—Develops Hypothyroidism. Rx?

A

Continue Amiodarone and add antithyroid drugs

123
Q

Which anaemia does metformin cause ?

124
Q

most appropriate time to take blood samples for therapeutic monitoring of ciclosporin levels?

A

Immediately before next dose.

125
Q

Finasteride S/E:

A

Gyanaecomastia

126
Q

Combined oral contraceptives absolute contraindication :

A

Women more than 35 years old and smoking more than 15 cigarettes/day

127
Q

Anthracyclines S/E:

A

Cardiotoxicity

128
Q

Heparin Induced thrombocytopenia is :

A

Thrombotic condition

129
Q

Most common adverse effect in Progesterone only pill:

A

Irregular vaginal bleeding

130
Q

In patients with renal impairment, monitoring the response to low molecular weight heparin

A

Anti-Factor Xa levels

131
Q

Does TCA OD require dialysis ?

132
Q

The constant region of the antibody is:

A

Human in origin

133
Q

B1 agonist example:

A

Dobutamine

134
Q

Tamsulosin:

A

Alpha 1A antagonist

135
Q

Kawasaki disease :

A

IV Immunoglobulin

136
Q

Heparin MOA:

A

Binds to Antithrombin 3—That inhibits factor 10 A

137
Q

TCA OD , First line Rx:

A

IV Sodium Bicarbonate

138
Q

Pilocarpine MOA :

A

Muscarinic receptor agonist.

Stimulates muscarinic cholinergic receptors to stimulate uveoscleral outflow

139
Q

Rituximab MOA :

A

acts against CD20

140
Q

Quinine toxicity ECG findings:

A

Prolonged QRS and QT interval

141
Q

Which antibiotic is contraindicated in G6PD deficiency ?

A

Ciprofloxacin

142
Q

Mechanism of N acetyl Cystine :

A

Replenishes Glutahione

143
Q

Ciclosporin + tacrolimus:

A

Inhibits calcineurin thus decreasing IL-2.

144
Q

On Metformin— Despite slowly titrating the dose up to 500mg tds he has experienced significant diarrhoea. Next step ?

A

Start Modified Release Metformin 500 Mg OD with evening meal.

145
Q

Fomepizole MOA

A

inhibitor of alcohol dehydrogenase

146
Q

which factor exacerbates Digoxin toxicity ?

A

Two hypers: Hypercalcemia, Hypernatremia.

Rest hypo: Hypokalemia
Hypomagnesemia
Hypothermia

Hypo QT interval—Short Qt interval in Digoxin

147
Q

Blocked nose which drug is used and its MOA :

A

Phenylnephrine—Alpha 1 agonist

148
Q

ECG findings in OP poisoning :

A

Sinus Bradycardia

149
Q

Levothyroxine acts via which receptor ?

A

Nuclear receptor

150
Q

Flouroquinolones MOA :

A

Inhibit bacterial DNA duplication through inhibition of topoisomerase

151
Q

the most useful prognostic marker in paracetamol overdose?

A

Prothrombin Time

152
Q

Does macrolides promote gastric emptying ?

153
Q

Metformin and MI ?

A

Stop Metformin after MI during Lactic Acidosis

154
Q

Oculogyric crisis is caused by ?

A

antipsychotics
metoclopramide
postencephalitic Parkinson’s disease

155
Q

Botox indication :

A

blepharospasm
hemifacial spasm
focal spasticity including cerebral palsy patients, hand and wrist disability associated with stroke
spasmodic torticollis
severe hyperhidrosis of the axillae
achalasia

156
Q

Function of Sodium Bicarbonate in Lithium Toxicity :

A

Increasing the alkalinity of the urine promotes lithium excretion.

157
Q

Which antibiotic to avoid with warfarin?

A

Marcrolides

158
Q

Is hyperthermia a feature of cocaine ?

159
Q

ECG in cocaine ?

A

QRS and QT prolongation

160
Q

Why thirsty and passing more urine after alcohol ?

A

Ethanol suppresses ADH secretion

161
Q

Pupils in cocaine ?

A

Mydriatic pupils

162
Q

Patients receiving CHOP for non-Hodgkin’s lymphoma, which drug to add ?

A

Allopurinol, as there is hyperuricaemia

163
Q

Flecainide C/I :

A

Ischaemic heart disease.
Chronic heart failure
Chronic Hypertension

164
Q

Statin in Pregnancy?

A

Contraindicated.

165
Q

Octreotide in variceal Haemorrhage?

A

Yes can be used

166
Q

Octreotide in VIPoma ?

A

can be used

167
Q

M CAT is synonymous with

A

Ampehtamines

168
Q

Antibiotics causing photosensitive rash:

A

Tetracyclines

169
Q

TB drug causing Gout ?

A

Pyrizinamide

170
Q

Allopurinol MOA :

A

Inhibits Xanthine oxidase

171
Q

Tendinopathy : Adverse of which antibiotics ?

A

Fluorquinolones

172
Q

If metformin is not tolerated due to GI side-effects, try a :

A

If metformin is not tolerated due to GI side-effects, try a modified-release formulation before switching to a second-line.

173
Q

Trastuzumab (Herceptin) MOA

A

acts on the HER2/neu receptor

174
Q

Does Metformin cause Kidney issues ?

A

It causes AKI

175
Q

Does NSAID have nephrotoxicity ?

176
Q

St John’s Wort

A

known inducer of the P450 system

177
Q

High anion Metabolic Acidosis—Think :

A

Anti freeze—ethelyne Glycol Poisoning

178
Q

How is Ethambutol excreted ?

A

Excreted via Kidneys

179
Q

Motion sickness Meds ?

A

Hyoscine > cyclizine > promethazine

180
Q

Differentiate Methhaemoglobinaemia, Co Poisoning and Cyanide poisoning :

A

Methaemoglobinaemia: Normal pO2, low SpO2

CO poisoning: Low pO2, normal SpO2 (False normal SpO2 on Pulse oximeter)—Pulse ox confuses bw oxygen and Carbon Monoxide.

Cyanide poisoning: Normal pO2 and Normal SpO2 – Patient can have High Anion Gap Metabolic Acidosis + flushing (or ‘brick red’ skin)

181
Q

Bleech consumption—unwell + Swallowing difficulty. Next step?

A

Urgent gastroduodenoscopy + Nil by mouth + Proton pump inhibitor

182
Q

phase I drug metabolism?

A

Alcohol dehydrogenase

183
Q

Sildenafil S/e :

A

visual disturbances
blue discolouration
non-arteritic anterior ischaemic neuropathy
nasal congestion
flushing
gastrointestinal side-effects
headache
priapism

184
Q

Sildenafil C/I:

A

Nitrates and Nicorandil

185
Q

Tamoxifen S/e :

A

Cardio toxicity and Hot Flushes

186
Q

What takes place in Phase 2 ?

A

Conjugation

187
Q

Blue vision is caused by which drug ?

A

Sildenafil

188
Q

Sildenafil - MOA

A

phosphodiesterase type V inhibitor

189
Q

First pass metabolism :

A

Love - heart drugs and Sex-testosterone
Aspirin
Isosorbde dinittrate
Glyceryl trinitrate
Propranolol
Verapamil

190
Q

Hypomagnesemia ECG :

A

QT prolongation

191
Q

Which Diurectics causes Hypomagnesemia ?

A

Furosemide

192
Q

Hypomagnesemia causes :

A

TPN
Diarrhoea
Alcohol

Homeless drunk man drinking alcohol.

193
Q

Mepolizumab MOA :

A

Anti IL5 Monoclonal Antibody—used in resistant asthma with high eosinophils

194
Q

Omalizumab MOA :

A

Anti IgE Monoclonal Antibody—used in resistant asthma with raised igE and allergic symptoms

195
Q

Asbestos chemotherapy Rx:

A

Pemetexed ( Antifolate: Inhibits DNA and RNA synthesis )

196
Q

Idiopathic Pulmonary Fibrosis. Rx:

A

Ninetedanib.

197
Q

Roflumilast :

A

PDE4 inhibitor.

Used in exacerbation of COPD

198
Q

How does ACE inhibitor cause increase in creatinine level ?

A

Increase in Efferent renal Arteriolar Dilatation.

199
Q

Long Qt syndrome cause ( Electrolyte imbalance cause ) :

A

Hypokalemia
Hypomagnesemia
Hypocalcemia

Harsha(Long Qt) ka lund chota hein(All Hypo causes)

200
Q

Dobutamine MOA :

A

B1 agonist

DoButamine= B1 Agonist.

Gastroenterology (13 decks)

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