Pharmacology Flashcards
Anti-seizure medication to use in pregnant patient with and without eclampsia history
ECLAMPSIA: Magnesium sulfate
Non-eclampsia associated: Gabapentin, Lamotrigine, or Levetiracetam
Treating Essential Tremor versus Parkinsons tremor
Essential Tremor: Primidone + Propranolol
Parkinsons Tremor: Anti-muscarinics
Common side effect to awakening from surgery
Delirium
Teratogenic anti-seizure medications
Carbamazipine
Valproic Acid
Phenytoin
2 types of local anesthetics & their example(s)
Amides (liver breakdown): Lidocaine, Bupivacaine, Articaine
Esters (Plasma cholinesterase): Cocaine
Which of the TCA (tricyclic antidepressants) has the MOST cholinergic side effects?
Amitryptilline
What antibiotic is associated with a disulfuram reaction? What is the reasoning?
Metronidazole –> Consumption of alcohol increases acetylaldehyde (due to inhibiting acetylaldehyde dehydrogenase)
Symptoms of disulfide reaction
Blurred vision Flushing Vomiting Hypotension Tachycardia Dizziness Sweating
**Sounds like signs of a hangover
Common side effect of TIPS (transjugular intrahepatic portosystemic shunt) & treatment
Hepatic encephalopathy (Increased NH3+) Tx: Lactulose
Medicine used in active bleeding esophageal varices
Octreotide –> Induces vasoconstriction by inhibiting hormones from GI
What hormones does Octreotide inhibit
- VIP
- Insulin
- Glucagon
- LH
- GH
Treatment of acute-angle glaucoma
Acetazolimide
Symptoms of acute-angle glaucoma
- Sudden onset of severe headache/pain
- Firm eye on palpation
- Reduced vision with halos
- Red eye
- “steam” appearance on cornea
- Dilated pupils
Trigger of acute-angle glaucoma
- Walking into a dark room
- Medications: Anti-cholinergics (Scopolamine)
Easy way to distinguish between amide & ester local anesthetics
2 i’s: Amide
-Lidocaine
1 or less i’s: Ester
-Cocaine
Drugs causing afib
- Anticholinergics
- Dobutamine
- Theophylline
Drugs causing AV block
- Beta blockers
- Digitalis
- Non-DHP CCBs
Drugs causing reentrant tachycardia
Digoxin
Reversible of benzodiazepine & barbiturate overdose
Flumazenil
*Competitive GABA-R antagonist
Patient on Digoxin is showing symptoms of toxicity (yellow blurred vision, palpitations, etc). Labs show his Digoxin is within normal limits but his potassium is 2.9 mmol. Patient is taking diuretic therapy. What is the reason for his symptoms?
Potassium wasting diuretics such as furosemide can lead to hypokalemia
Hypokalemia allows better binding of Digoxin to receptors, making them “stronger” in effect
This is why hypokalemia is a POOR prognostic factor in digoxin toxicity
Does Atropine affect blood pressure? Explain
NO! It’s a muscarinic inhibitor, they have no affect in vasculature
What medication is absolutely contraindicated in acute and chronic heart failure patients?
NDHP Calcium channel blockers! Negative inotropic effects (Verapamil)
What medication is absolutely contraindicated in acute heart failure?
Beta blockers
*Both reduce heart rate
What are examples of DHP CCBs?
Amlodipine
Nifedipine
