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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
monitoring for Heparin
TT together = H = Heparin APiTT = APTT (activated prothrombin time) apItt = Intrinsic pathway
26
monitoring for LMWH
anti-factor Xa levels
27
important cause of drug-induced thrombocytopenia
heparin
28
mx of paracetamol OD
activated charcoal if within 1 hour of overdose N-acetylcysteine if indicated by paracetamol levels if staggered OD N-acetylcysteine immediately
29
diabetic med to avoid in eGFR <30
metformin
30
dose of adrenaline in cardiac arrest
1mg | 10 ml 1:10,00 IV
31
dose of adrenaline in anaphylaxis
0. 5 mg | 0. 5 ml 1:1,000 IM
32
mx of tricyclic overdose
IV bicarbonate if hypotension or arrhythmia (wide QTS >100msec or ventricular arrhythmia)
33
features of LSD intoxication
colourful visual hallucinations depersonalisation psychosis paranoia
34
mx of LSD intoxication
lorazepam
35
complications of opioid misuse
HIV, hep B, hep C from needle sharing VTE overdose -> resp depression + death
36
drugs to avoid in renal failure (CKD)
``` most ABX digoxin methotrexate furosemide opioids ```
37
drugs safe in renal failure
erythromycin rifampicin warfarin diazepam
38
monitoring when on methotrexate
FBC, LFT and U&Es
39
monitoring before starting amiodarone and then when on amiodarone
before - TFT + LFT + U&E + CXR | on - TFT and LFT
40
groups of patients at increased risk of developing hepatotoxicity in paracetamol OD
patients taking liver enzyme-inducing drugs | malnourished patients
41
how to decide which HRT to give
``` 1. womb or no womb womb = combined no = oestrogen only 2. last LMP <1 year ago = cyclical >1 year ago = continuous ```
42
mx of organophosphate poisoning
atropine
43
precipitants of lithium toxicity
``` dehydration diuretics (especially thiazides) ACEi/ARBs NSAIDs metronidazole ```
44
underlying immunology of anaphylactoid reactions | what med is this common in
*non*-IgE mediated mast cell release, commonly seen in N-Acetylcysteine
45
ciclosporin adverse effects
everything increased | hepatotoxicity and nephrotoxicity
46
ix before giving flecainide
echocardiogram
47
mx of hypomagnesaemia
IV Mg if <0.4 mmol/l or tetany, arrhythmias or seizures | PO Mg if >0.4mmol/l
48
amiloride
potassium-sparing diuretic | should not be co-prescribed w spironolactone
49
drugs causing urinary retention
TCAs anticholinergics opioids NSAIDs
50
what to do in heparin-induced thrombocytopenia
swap to direct thrombin inhibitor, e.g. argatroban and bivalirudin
51
receptor that metaclopramide works on
dopamine antagonist
52
side effects of sildenafil (viagra)
blue discolouration of vision headaches flushing
53
ABX to avoid in G6PD
quinolone, e.g. ciprofloxacin
54
drugs to avoid if a person is on a statin
erythromycin and clarithromycin | taking these together can lead to statin-induced myopathy
55
what should be measured if suspecting carbon monoxide poisoning
carboxyhemoglobin
56
target oxygen concentration in carbon monoxide poisoning
100%
57
features of carbon monoxide poisoning
headache N&V vertigo confusion
58
mx of ethylene glycol toxicity (anti-freeze)
fomepizole | ethanol/haemodialysis
59
ABG findings in ethylene glycol toxicity
metabolic acidosis w high anion gap and high osmolar gap
60
how may heparin-induced thrombocytopenia present
presents after 5-10 days of treatment | prothrombotic condition therefore DVT can occur

finals (25 decks)

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