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pharmacology Flashcards

1
Q

features of digoxin toxicity

A

generally unwell - lethargy, N&V, anorexia and confusion
yellow-green tinted vision
arrhythmia (AV block, bradycardia)

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2
Q

drugs which may precipitate digoxin toxicity

A

Amiodarone
Verapamil
Diltiazem
Any drug that causes hypokalaemia - thiazides and loop diuretics

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3
Q

features of cocaine use

A 
coronary artery spasm (-> MI)
seizures
dilated pupils (mydriasis)
agitation and psychosis
ischaemic colitis can occur leading to vomiting
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4
Q

most useful prognostic marker in paracetamol OD

A

prothrombin time

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5
Q

ABG in salicylate overdose

A

respiratory alkalosis then metabolic acidosis

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6
Q

which medication should be used in DVT with reduced renal function

A

eGFR >15 - DOAC

eGFR <15 - unfractionated heparin or dose-adjusted LWMH

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7
Q

blood test to do before starting PO terbinafine

A

LFTs

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8
Q

in which conditions should thiazide-like diuretics be avoided

A

gout

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9
Q

what medications can cause black hairy tongue

A

tetracyclines

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10
Q

what should be done if INR is too low on warfarin

A

increase dose of warfarin and start LWMH for immediate anticoagulation
stop LWMH when INR is normal

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11
Q

general management for any ingested overdose

A

activated charcoal if they present within 1 hour of ingestion

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12
Q

reversal agent for magnesium sulphate induced respiratory depression

A

calcium gluconate

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13
Q

moa of statins

A

inhibit action of HMG-CoA reductase thereby decreasing intrinsic cholesterol synthesis

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14
Q

adverse effects of loop diuretics

A

hyponatraemia, hypokalaemia, hypomagnesaemia
hypocalcaemia (hence fractures)
ototoxicity
gout

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15
Q

which ABX must be avoided with alcohol

A

metronidazole

met = traffic, don’t drink and drive

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16
Q

SE of anticholinergics

A 
dry mouth
constipation
urinary retention
impaired cognition
falls
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17
Q

features of lithium toxicity

A 
confusion
*coarse tremor*
jerking limb movements
polyuria
hyperreflexia
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18
Q

reversal agent in acute dystonia due to antiemetics (e.g. metoclopramide)

A

benztropine or procyclidine

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19
Q

which ABX inhibit protein synthesis

A

macrolides
tetracyclines
aminoglycosides
chloramphenicol

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20
Q

mx of lithium overdose

A

mild-moderate: fluid resus

severe: haemodialysis

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21
Q

features of tricyclic antidepressant overdose

A

early features - anticholinergic properties (dry mouth, dilated pupils, blurred vision, agitation)
later - seizures, arrhythmias, metabolic acidosis

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22
Q

features of ecstasy overdose

A

serotonin syndrome - altered mental state, hyperthermia, pupil dilation
increased reflexes

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23
Q

criteria for liver transplant in paracetamol overdose

A 
arterial pH <7.3, 24h after ingestion
or all of:
PT >100s
creatinine >300
grade III or IV encephalopathy
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24
Q

monitoring for Warfarin

A

E on its side = W = Warfarin
PeTT = PT (prothrombin time)
pEtt = Extrinsic pathway

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25
Q

monitoring for Heparin

A

TT together = H = Heparin
APiTT = APTT (activated prothrombin time)
apItt = Intrinsic pathway

26
Q

monitoring for LMWH

A

anti-factor Xa levels

27
Q

important cause of drug-induced thrombocytopenia

A

heparin

28
Q

mx of paracetamol OD

A

activated charcoal if within 1 hour of overdose
N-acetylcysteine if indicated by paracetamol levels
if staggered OD N-acetylcysteine immediately

29
Q

diabetic med to avoid in eGFR <30

A

metformin

30
Q

dose of adrenaline in cardiac arrest

A

1mg

10 ml 1:10,00 IV

31
Q

dose of adrenaline in anaphylaxis

A
  1. 5 mg

0. 5 ml 1:1,000 IM

32
Q

mx of tricyclic overdose

A

IV bicarbonate if hypotension or arrhythmia (wide QTS >100msec or ventricular arrhythmia)

33
Q

features of LSD intoxication

A

colourful visual hallucinations
depersonalisation
psychosis
paranoia

34
Q

mx of LSD intoxication

A

lorazepam

35
Q

complications of opioid misuse

A

HIV, hep B, hep C from needle sharing
VTE
overdose -> resp depression + death

36
Q

drugs to avoid in renal failure (CKD)

A 
most ABX
digoxin
methotrexate
furosemide
opioids
37
Q

drugs safe in renal failure

A

erythromycin
rifampicin
warfarin
diazepam

38
Q

monitoring when on methotrexate

A

FBC, LFT and U&Es

39
Q

monitoring before starting amiodarone and then when on amiodarone

A

before - TFT + LFT + U&E + CXR

on - TFT and LFT

40
Q

groups of patients at increased risk of developing hepatotoxicity in paracetamol OD

A

patients taking liver enzyme-inducing drugs

malnourished patients

41
Q

how to decide which HRT to give

A 
1. womb or no womb
womb = combined
no = oestrogen only 
2. last LMP
<1 year ago = cyclical
>1 year ago = continuous
42
Q

mx of organophosphate poisoning

A

atropine

43
Q

precipitants of lithium toxicity

A 
dehydration
diuretics (especially thiazides)
ACEi/ARBs
NSAIDs
metronidazole
44
Q

underlying immunology of anaphylactoid reactions

what med is this common in

A

non-IgE mediated mast cell release, commonly seen in N-Acetylcysteine

45
Q

ciclosporin adverse effects

A

everything increased

hepatotoxicity and nephrotoxicity

46
Q

ix before giving flecainide

A

echocardiogram

47
Q

mx of hypomagnesaemia

A

IV Mg if <0.4 mmol/l or tetany, arrhythmias or seizures

PO Mg if >0.4mmol/l

48
Q

amiloride

A

potassium-sparing diuretic

should not be co-prescribed w spironolactone

49
Q

drugs causing urinary retention

A

TCAs
anticholinergics
opioids
NSAIDs

50
Q

what to do in heparin-induced thrombocytopenia

A

swap to direct thrombin inhibitor, e.g. argatroban and bivalirudin

51
Q

receptor that metaclopramide works on

A

dopamine antagonist

52
Q

side effects of sildenafil (viagra)

A

blue discolouration of vision
headaches
flushing

53
Q

ABX to avoid in G6PD

A

quinolone, e.g. ciprofloxacin

54
Q

drugs to avoid if a person is on a statin

A

erythromycin and clarithromycin

taking these together can lead to statin-induced myopathy

55
Q

what should be measured if suspecting carbon monoxide poisoning

A

carboxyhemoglobin

56
Q

target oxygen concentration in carbon monoxide poisoning

A

100%

57
Q

features of carbon monoxide poisoning

A

headache
N&V
vertigo
confusion

58
Q

mx of ethylene glycol toxicity (anti-freeze)

A

fomepizole

ethanol/haemodialysis

59
Q

ABG findings in ethylene glycol toxicity

A

metabolic acidosis w high anion gap and high osmolar gap

60
Q

how may heparin-induced thrombocytopenia present

A

presents after 5-10 days of treatment

prothrombotic condition therefore DVT can occur

finals (25 decks)

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