Pharmacology Flashcards
What are the side effects of sodium valproate?
Teratogenic - Spina bifida
Liver damage and hep
Hair loss
Tremor
What are the side effects of carbamazepine?
Agranulocytosis
Aplastic anaemia
Induces P450 so drug interactions
Side effects of phenytoin?
Folate and Vit D deficiency
Megaloblastic anaemia
Osteomalacia
Ethosuximide side effects?
Night terror
Rashes
What are the side effects of Lamotrigine?
SJS
Leukopenia
What are the features of opioid misuse?
Rhinorrhoea Needle track marks Pinpoint pupils Drowsiness Watering eyes
What is the management of opioid overdose?
IV orIM naloxone
What is the management of paracetamol overdose?
Within 1 hour: activated charcoal
Acetylcysteine after 4 hours infused over 1 hour by looking at graph
What is the clinical features of paracetamol overdose?
Acute liver failure
Young person
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
What are the signs of opioid withdrawal?
Yawning
Dilated pupils
Rhinorrhea
Epiphora
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
What is a non-sedating antihistamine?
Loratidine
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
Reversal of heparin?
Protamine
Side effect of ACEi?
Dry cough
Lichen planus
Angioedema
What is the side effect of statin?
High CK
Muscle cramps
Transaminitis
What is the treatment for hypersalivation caused by clozapine?
Hycoscine
What is the antidote for opioid toxicity?
400mcg naloxone boluses
What is the dose for folic acid in well controlled type 1 diabetic mothers?
5mg pre conception until 12 week gestation
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
