Pharmacology

Question 1

Anti-seizure medication to use in pregnant patient with and without eclampsia history

Answer 1

ECLAMPSIA: Magnesium sulfate

Non-eclampsia associated: Gabapentin, Lamotrigine, or Levetiracetam

Question 2

Treating Essential Tremor versus Parkinsons tremor

Answer 2

Essential Tremor: Primidone + Propranolol

Parkinsons Tremor: Anti-muscarinics

Question 3

Common side effect to awakening from surgery

Answer 3

Delirium

Question 4

Teratogenic anti-seizure medications

Answer 4

Carbamazipine
Valproic Acid
Phenytoin

Question 5

2 types of local anesthetics & their example(s)

Answer 5

Amides (liver breakdown): Lidocaine, Bupivacaine, Articaine

Esters (Plasma cholinesterase): Cocaine

Question 6

Which of the TCA (tricyclic antidepressants) has the MOST cholinergic side effects?

Answer 6

Amitryptilline

Question 7

What antibiotic is associated with a disulfuram reaction? What is the reasoning?

Answer 7

Metronidazole –> Consumption of alcohol increases acetylaldehyde (due to inhibiting acetylaldehyde dehydrogenase)

Question 8

Symptoms of disulfide reaction

Answer 8

Blurred vision
Flushing
Vomiting
Hypotension
Tachycardia
Dizziness
Sweating

**Sounds like signs of a hangover

Question 9

Common side effect of TIPS (transjugular intrahepatic portosystemic shunt) & treatment

Answer 9

Hepatic encephalopathy (Increased NH3+)
Tx: Lactulose

Question 10

Medicine used in active bleeding esophageal varices

Answer 10

Octreotide –> Induces vasoconstriction by inhibiting hormones from GI

Question 11

What hormones does Octreotide inhibit

Answer 11

• VIP
• Insulin
• Glucagon
• LH
• GH

Question 12

Treatment of acute-angle glaucoma

Answer 12

Acetazolimide

Question 13

Symptoms of acute-angle glaucoma

Answer 13

• Sudden onset of severe headache/pain
• Firm eye on palpation
• Reduced vision with halos
• Red eye
• “steam” appearance on cornea
• Dilated pupils

Question 14

Trigger of acute-angle glaucoma

Answer 14

• Walking into a dark room

- Medications: Anti-cholinergics (Scopolamine)

Question 15

Easy way to distinguish between amide & ester local anesthetics

Answer 15

2 i’s: Amide
-Lidocaine

1 or less i’s: Ester
-Cocaine

Question 16

Drugs causing afib

Answer 16

• Anticholinergics
• Dobutamine
• Theophylline

Question 17

Drugs causing AV block

Answer 17

• Beta blockers
• Digitalis
• Non-DHP CCBs

Question 18

Drugs causing reentrant tachycardia

Answer 18

Digoxin

Question 19

Reversible of benzodiazepine & barbiturate overdose

Answer 19

Flumazenil

*Competitive GABA-R antagonist

Question 20

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?

Answer 20

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

Question 21

Does Atropine affect blood pressure? Explain

Answer 21

NO! It’s a muscarinic inhibitor, they have no affect in vasculature

Question 22

What medication is absolutely contraindicated in acute and chronic heart failure patients?

Answer 22

NDHP Calcium channel blockers! Negative inotropic effects (Verapamil)

Question 23

What medication is absolutely contraindicated in acute heart failure?

Answer 23

Beta blockers

*Both reduce heart rate

Question 24

What are examples of DHP CCBs?

Answer 24

Amlodipine

Nifedipine

Question 25

What are examples of NDHP CCBs?

Answer 25

Verapamil

Diltiazem

Question 26

What drug can never be combined with Verapamil?

Answer 26

Digoxin

Question 27

Medications for treating hypertension in pregnancy

Answer 27

Hydralazine
Labetalol
Methyldopa
Nifedipine