Pharmacology Flashcards by Shalu James

What are the side effects of sodium valproate?

Teratogenic - Spina bifida
Liver damage and hep
Hair loss
Tremor

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What are the side effects of carbamazepine?

Agranulocytosis
Aplastic anaemia
Induces P450 so drug interactions

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Side effects of phenytoin?

Folate and Vit D deficiency
Megaloblastic anaemia
Osteomalacia

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Ethosuximide side effects?

Night terror

Rashes

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What are the side effects of Lamotrigine?

SJS

Leukopenia

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What are the features of opioid misuse?

Rhinorrhoea
Needle track marks
Pinpoint pupils
Drowsiness
Watering eyes

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What is the management of opioid overdose?

IV orIM naloxone

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What is the management of paracetamol overdose?

Within 1 hour: activated charcoal

Acetylcysteine after 4 hours infused over 1 hour by looking at graph

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What is the clinical features of paracetamol overdose?

Acute liver failure

Young person

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What are the teratogenic effects of anti-epileptic drugs in pregnancy?

Fetal hydantoin syndrome:
Microcephaly 
IUGR
Clef palate/lip
Mental retardation
Hypoplastic fingernails
Distal limb deformities

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What are the signs of opioid withdrawal?

Yawning
Dilated pupils
Rhinorrhea
Epiphora

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What are the side effects of the tuberculosis drugs?

Rifampicin - red/orange pee
Isoniazid - peripheral neuropathy
Pyrazinamide - hyperuricaemia (gout)
Ethambutol - colour blindness

All cause hepatotoxicity

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What is a non-sedating antihistamine?

Loratidine

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What are the side effects of the rheumatic drugs?

Methotrexate: pulmonary fibrosis

Leflunomide: HTN and peripheral neuropathy

Sulfasalazine: male infertility

Hydroxychloroquinine: nightmares and reduced visual acuity

Anti-TNF meds: reactivation of TB or Hep B

Rituximab: night sweats and thormbocytopenia

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Reversal of heparin?

Protamine

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Side effect of ACEi?

Dry cough
Lichen planus
Angioedema

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What is the side effect of statin?

High CK
Muscle cramps
Transaminitis

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What is the treatment for hypersalivation caused by clozapine?

Hycoscine

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What is the antidote for opioid toxicity?

400mcg naloxone boluses

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What is the dose for folic acid in well controlled type 1 diabetic mothers?

5mg pre conception until 12 week gestation

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What is the side effect of colchicine?

Diarrhoea

Side effect of spironalactone?

Breast tenderness

Features of metoclopromide overdose?

Oculogyric crisis

What should you check before starting azathioprine?

Thiopurine methyl transferase activity (TPMT)

What is the parkland formula?

4ml x %burns x weight(kg) Given half in the first 8 hours and the remaining half over the next 16 hours

What is the treatment for a raised INR with a minor bleed?

Stop warfarin and 5mg phytomenadione (vitamin K) orally

What is the treatment for a raised INR with a major bleed?

Stop warfarin Phytomenadione (Vitamin K) Fresh frozen plasma

What are the main classes of laxatives and give examples

``` Softener and stimulant: Docusate sodium and Movicol Bulk forming agents: Psyllium husk Stool softener: Lactulose Stimulant: senna and bisacodyl Osmotic agents: lactulose Lubricants: mineral oil ```

How to calculate the anion gap?

(Na+ + K+) - (HCO3- + Cl-)

What are the symptoms of beta blocker overdose?

Hyoptension Bradycardia Seizures Hypoglycaemia

What constitutes normal bag of 0.9% saline?

154 Sodium, 154 Chloride, 0 Potassium, 0 bicarbonate

What is the medications adherence questionnaire?

Moriskeys scale

What is the treatment for delirium tremens/alcohol withdrawal?

Oral chloradiazepoxide

What is the medical management of breast cancer?

ER+: Tamoxifen - premenopausal Anaztrazole - post menopausal HER2+: Traztazumab (herceptin)

What is the medical treatment for peripheral arterial disease?

Clopidogrel and atorvastatin

Treatment for high INR and emergency surgery

Prothrombinex

Management of bowel obstruction during end of life care

loperamide hydrochloride

Which medication can increase warfarin in blood if used together?

Antibiotics (clarithromycin) SSRI Sodium valproate Ozaloes e.g. metronidazole, omeprazole etc ASS OZALES

Which drugs cannot be given with methotrexate and why?

Trimethoprim because it causes pancytopaenia. Co-trimoxazole as it contains trimethoprim.

Which electrolyte disturbance can PPIs cause?

Hyponatraemia

What needs to be prescribed in addition to SSRIs and NSAIDs?

PPIs due to increased GI bleeding risk

What is the reversal agent for rivaroxiban and apixaban?

Andexanet alfa

Which drug causes a contraindication to chest drain?

INR >1.5

What is the maintenance fluid measurement for kids?

0-10kg: 100ml/kg 11-20kg: 50ml/kg >20kg: 20ml/kg

What is the codeine to morphine conversion?

10mg codeine to 1mg of morphine

What is the ABG of salicylate poisoning immediately and 12 hours afterwards?

t0: Respiratory alkalosis t12: metabolic acidosis

First line treatment for diabetic neuropathy?

Pregabalin, gabapentin, amitriptyline or duloxetine

Which drug increases azathioprine toxicity?

Allopurinol

Which medication needs to be started alongside allopurinol?

NSAIDs or colchicine "cover"

What is a side effect of SSRIs?

SIADH