Pharmacology Flashcards
What are the S/Es of rifampicin?
Orange bodily fluids, rash, hepatotoxicity, drug interactions
What are the S/Es of isoniazid?
Peripheral neuropathy, psychosis, hepatotoxicity
What are the S/Es of pyrazinamide?
Arthralgia, gout, hepatotoxicity, nausea
What are the S/Es of ethambutol?
Optic neuritis, rash
What drugs can cause urinary retention?
Amitriptyline Anticholinergics Opioids NSAIDs Disopyramide
How is beta-blocker OD corrected?
Atropine –> in resistant cases, glucagon may be used
How is ethylene glycol and methanol OD corrected?
Fomepizole, an inhibitor of alcohol dehydrogenase, is now used first-line in preference to ethanol –> in refractory cases haemodialysis may be used
How is cyanide poisoning treated?
Hydroxocobalamin
How is lead poisoning treated?
Dimercaprol
How is iron poisoning treated?
Desferrioxamine
How is severe lithium toxicity treated?
Haemodialysis
How is cocaine toxicity managed?
BZDs in the main, if chest pain develops, BZDs + GTN, then if MI develops PPCI. In HTN = BZD + nitroprusside
What are the criteria for liver transplantation as a result of paracetamol-induced liver failure?
Arterial pH < 7.3, 24 hours after ingestion
Or all of the following:
Prothrombin time > 100 seconds
Creatinine > 300 µmol/l
Grade III or IV encephalopathy
Which antibiotics can lower the seizure threshold in epilepsy?
Quinolones - e.g. ciprofloxacin and levofloaxacin
How is tricyclic antidepressant OD managed?
IV bicarbonate, mainly to reduce the risk of seizures
Which drugs can cause lung fibrosis?
Amiodarone
Cytotoxic agents - busulphan, bleomycin
Anti-rheumatoid drugs: methotrexate, sulfasalazine
nitrofurantoin
Ergot-derived dopamine receptor agonists - bromocriptine, cabergoline, pergolide
With what drugs does allopurinol interact?
Azathioprine - excessive myelosuppression = increased risk of neutropenic sepsis
Cyclophosphamide = marrow toxicity
Theophylline = increased theophylline plasma concentration
Patients with which syndrome may take allopurinol for life?
Lesch-Nyhan syndrome
When should allopurinol be offered to patients?
After their first attack of gout, in particular for patients whom have:
>= 2 attacks in 12 months
Tophi
Renal disease
Uric acid renal stones
Prophylaxis if on cytotoxics or diuretics
Which Abx causes a rash when given when a pt has mono?
Amoxicillin
Which drugs can precipitate digoxin toxicity?
Amiodarone Quinidine Verapamil Diltiazem Spironolactone Ciclosporin Also drugs which cause hypokalaemia e.g. thiazides and loop diuretics
What are the features of ecstasy poisoning?
Neurological - agitation, anxiety, confusion, ataxia
Cardiovascular - tachycardia, hypertension
Hyponatraemia
Hyperthermia
Rhabdomyolysis
Which drugs can cause cataracts?
Steroids
Which drugs can cause corneal opacities?
Amiodarone
Indomethacin
Which drugs can cause optic neuritis?
Amiodarone
Metronidazole
Ethambutol
Which drugs can cause retinopathy?
Chloroquine
Quinine
Which drugs can cause thrombocytopenia?
Quinine
Abciximab
NSAIDs
Furosemide
Antibiotics - penicillins, sulphonamides, rifampicin
Anticonvulsants - carbamazepine, valproate
Heparin
Which drug can cause a yellow-green change to vision?
Digoxin
Which drug can cause a blue tinge to vision?
Sildenafil
Which medications can exacerbate heart failure?
Pioglitazone
Verapamil
NSAIDs/glucocorticoids
Flecainide (Class I arrhythmic)
What are the enzyme inhibitors?
Ciprofloxacin Erythromycin Isoniazid Cimetidine Omeprazole Amiodarone Allopurinol Ketoconazole Fluconazole SSRIs Ritonavir Dodium valproate Acute alcohol intake Quinupristin
In which patients is diclofenac contraindicated?
Ischaemic heart disease
Peripheral arterial disease
Cerebrovascular disease
Congestive heart failure (New York Heart Association classification II-IV)
Which BP drug is most likely to precipitate gout?
Bendroflumethiazide
What are the side effects of carbamazepine?
Aplastic anaemia Haemolytic anaemia Eosinophilia Leukopenia Thrombocytopenia
What is amiodarone Rx’d for and what is a side effect?
May be Rx'd in AF Can cause S/Es with the mnemonic SLEPT: S - skin pigmentation/sensitivity L - liver dysfunction E - eye changes P - pulmonary dysfunction T - thyroid dysfunction
What blood monitoring is required for amiodarone, and how often?
TFTs/LFTs/U&Es
6 months
What blood monitoring is required for azathioprine, and how often?
FBC/LFTs
3 months
What blood monitoring is required for lithium, and how often?
U&Es/TFTs - every 6 months
Lithium plasma levels - every 3-6 months
What blood monitoring is required for methotrexate, and how often?
FBC/U&Es/LFTs
2-3 months
What are the enzyme inducers?
Phenobarbitone Rifampicin Carbamazepine Phenytoin Griseofulvin
What should be monitored upon commencing simvastatin?
LFTs and lipid profile 3/12 after starting, and then again at 12/12
What does a PPI work on?
H+/K+ ATP proton-pump
What is a lipid lowering drug suitable for those in whom statins are not well-tolerated?
Ezetimibe
When should initial vanc levels be taken for a patient started on vanc?
Day 2 of treatment, pre- 1 st dose of day
Which AED is safest in pregnancy?
Lamotrigine
What Li therapeutic range should be aimed for in an acute episode?
0.6-1
What Li therapeutic range should be aimed for for prophylaxis?
0.4-0.8
At what serum level of Li do toxic effects occur reliably?
> 1.5
At what serum level of Li is urgent treatment required?
> 2
How can sildenafil affect the vision?
Blue discolouration
Which laxative can stain the urine red?
Co-danthramer
Which anti-hypertensives can cause a deterioration in glycaemic control?
Thiazide diuretics
Which drugs cause gingival hyperplasia?
- Phenytoin
- Ciclosporin
- Nifedipine (+ some other calcium channel blockers)
Which type of anti-HTN is most likely to flare gout?
Bendroflumethiazide
