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Pharmacology Flashcards

1
Q

calcium channel blockers

- Side effects (2)

A

Diltiazem verapamil amlodipine

Ankle swelling , gingival hyperplasia

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2
Q

Beta blockers

-side effects (1)

A

Atenolol bisoprolol

- bronchoconstriction - wheeze, SOB , heavy chest

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3
Q

Beta agonist

- side effect (6)

A

Salbutamol
Tachycardia, palpitations , muscle twitching and tremors
Shaky hands
HypOkalemia

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4
Q

ACEi

- side effects (2)

A

Lisinopril, enalapril
Dry cough —- give ARBs instead
HypERkalemia

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5
Q

Loop diuretics

- side effects (3)

A

Furosemide

HypOnatremia, HypOkalemia, Gout (hypERuricemia)

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6
Q

Thiazides diuretics

- side effects (5)

A

Bendroflumethiazide
- hypOnatremia, HypOkalemia, gout
Postural hypotension
Hyperglycaemia

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7
Q

Postassium sparing diuretic

A
  • spironolactone
    HypOnatremia, HypERkalemia
    Gynecomastia
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8
Q

Metoclopramide

- side effects

A

Extrapyramidal
- dystocia , akathisia, Parkinsonism, bradykinesia , tremors

Neuroleptic malignant syndrome
- high fever , sweating , tachycardia, agitation, confusion, muscle rigidity , neck stiffness

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9
Q

Haloperidol

- side effect

A

Sexual dysfunction

Gynecomastia

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10
Q

SSRi

- side effect

A

Fluoxetine

HypOnatremia

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11
Q

Citalopram

  • drug type
  • side effect (4)
A

SSRI
Acute angle closure glaucoma - urgent referral to ophthalmologist
HypOnatremia , unstable gait , falls

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12
Q

Duloxetine

  • drug type
  • side effects (1)
A

SNRI

Increased risk of fall - especially in elderly

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13
Q

Uncommon side effect of statin

A

Rhabdomyolysis

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14
Q

Uncommon side effect of Augmentin

A

Cholestatic hepatitis / drug induced hepatotoxicity

Especially in elderly

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15
Q

How to change dose

  • oral morphine to SC morphine
  • oral orhine to SC diamorphine
  • oral tramadol to IV morphine
A

To SC - divide by 2
To SC dia - divide by 3
Tram - iv morphine - divide by 20

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16
Q

Best route to receive benzodiazepines in end of life care

A

Rectal diazepam

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17
Q

4 medications that need to be stopped if patient presents with diarrhoea/vomiting

A 
DAMN 
Diuretics - dehydration 
ACEi & ARBs. - AKI 
Metformin - lactic acidosis in dehydration 
NSAIDs - AKI
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18
Q

Treatment of painful muscle spasm

A

Baclofen - muscle relaxant

Or diazepam

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19
Q

Medications used to treat neuropathic pain (4)

A

Shooting , burning , electric shock type

  • amitriptyline
  • Gabapentin
  • Duloxetine
  • pregabalin
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20
Q

Medication for trigeminal neuralgia

A

Carbamazepine - anticonvulsant

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21
Q

Treatment of bone pain due to mets

A

1st line - radiotherapy

2- bisphosphonate + NSAIDs

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22
Q

Drug that alleviates alcohol withdrawal symptoms

A

Chlordiazepoxide

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23
Q

Drug that alleviates alchol craving

A

Acamprosate

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24
Q

Deterrent drug to be used in alcohol withdrawal

A

Disulfiram

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25
Drug that helps combat opiate withdrawal
Methadone | - method 1 for detoxification and withdrawal sx
26
Nice guideline management of asthma
1.SABA 2.SABA + inhaled corticosteroid 3. 2+ LTRA 4.2+LABA +- LTRA 5.SABA + MART (low dose ICS +- LTRA) 6. SABA + MART (mod dose ICS +- LTRA) 7/SABA +- LTRA + one of the following - further increase in ICS dose - theophylline trial - professional advise
27
BTS guideline asthma
1. SABA 2. SABA + inhaled corticosteroid 3. 2+ LABA 4. SABA + ICS + LTRA
28
LABA vs LTRA | ICS
LABA - salmeterol LTRA - montelukast ICS - inhaled corticosteroids - beclometasone
29
Dry cough can be a side effect of (2)
ACEi Methotrexate - prolonged intake can lead to pulmonary fibrosis (rare) PF - dry cough , dyspnoea on mild exertion , diffuse bilateral infiltrates on xray
30
A medication that is anti folic acid
Methotrexate | Trimethoprim
31
Post operative intractable nausea & vomiting | Medication -
IV ondansetron
32
Antiemetic in renal failure/hypercalcemia | Or drug induced vomiting
``` Haloperidol If CI (Parkinson’s) - levomepromazine ```
33
Anti emetic in raised ICP
Cyclizine
34
Antiemetic in chemo, radio and post op
Ondansetron
35
Hymeresis antiemetic | 1st 2nd 3rd
1- zines = cyclizine , promethazine 2- IV metoclopramide, ondansetron 3- steroids
36
Medication for vertigo (Menderes, BPPV, vestibular neuritis)
Buccal prochlorperazine
37
Most important symptom to urgently report if on warfarin
Headache | They are liable to subdural hematoma
38
Symptom to be urgently reported inpatient on bisphosphonates
Sever sudden heartburn / chest pain
39
Drugs that cause Hyperkalemia
ACEi | Potassium sparing diuretics
40
The use of what drug is CI when using macrolides
Simavastatin** Macrolides - erythromycin, clarithromycin etc Note : macrolides + atorvastatin is fine
41
MOA of tranexamic acid | Use
Inhibits fibrinolysis | - menorrhagia
42
N - acetylcysteine - MOA | Use
Protection form free radicals | For paracetamol overdose
43
LMWH | MOA
Inhibits conversion of prothrombin to thrombin | Activate the anti thrombin
44
How does copper IUD work as an emergency contraception after unprotected sex
Inhibits implantation
45
MOA of POPs
Inhibit ovulation
46
``` Ulipristal acetate (EllaOne) MOA ```
Inhibits or delays ovulation
47
Calculating units of alcohol Beer Wine Cider
Strength ABV % x Volume _______________________ 1000 = units Beer 1 pint- 3.5% - 2 units 1 pint premium - 5-6% - 3 units Wine Small - 125 ml - 1.5 unit Medium - 175 ml - 2 units Large - 250ml - 3 units Cider = 3 units
48
UK guidelines on alcohol consumption per week
Not more than 14 units/week 3 units/day At least 2 alcohol free days / week
49
Drugs causing neuroleptic syndrome
Haloperidol | Metoclopramide
50
Management of neuroleptic malignant syndrome
``` Stop antipsychotic Rapid cooling IV fluids - prevent renal failure Dantrolene - post synaptic muscle relaxant Bromocriptine ```
51
Meds not to be given in Parkinson’s
Metaclopramide | Haloperidol - use lamotrigine
52
Tests before commencing lithium (4)
RFT LFT TFT baseline ECG Pulse, BP , pregnancy test , PTH , FBC , UE, ca, mg
53
When can fentanyl patches be used in pain control of cancer patients
If oral not tolerated + stable patient @ shifting time
54
Oral codeine can be replaced by __
Buprenorphine patch SC morphine * there is no SC codeine
55
Never shift to fentanyl patch if _
Pain is not controlled | Takes 12-24 hrs to achieve therapeutic level
56
Why does the plasma concentration of a drug peak much faster for IV routes than oral route
Hepatic first pass elimination
57
Treatment of ringworm
Clotrimazole cream
58
What is to be given in heroin - overdose - detox
Naloxone | Methadone
59
Heroin withdrawal features
Watery eyes + Runny nose Insomnia Agitation
60
Treatment of ascites 2ry to cirrhosis
Spironolactone
61
Liver cancer + hiccups | Med to be given
Metoclopramide
62
Non sedating anti-histamine
Cetrizine | Loratidine
63
Sedating antihistamine
Chlorpheniramine
64
Co-careldopa (Sinemet) Use Complication
Levodopa + carbidopa Use- Parkinson’s Sudden cessation - can cause akinesia Reduce dose if patient. Develops hallucination
65
Indapamide
Thiazides like diuretic
66
Drug to maintain abstinence in opioid user
Naltrexone
67
Impacted stool tx
Phosphate enema If young healthy - glycerol suppositories
68
Hard stool tx
Stool softener ‘
69
Constipation in pregnancy
Ispaghula - 1 | Lactulose - 2
70
Before commencing sodium valproate check :
LFT FBC Pregnancy
71
Investigations before starting ACEi | How often should they be repeated
RFT Electrolytes - esp K+ 1-2 weeks after initiating , then annular
72
Corticosteroid induced psychosis
Prednisolone in COPD exacerbation
73
1ry biliary cirrhosis
Raised ALP Associated Sjögren’s syndrome Investigation - anti - mitochondrial antibodies
74
1ry sclerosing cholangitis
Usually associated w/ ulcerative colitis | Investigation - ERCP
75
Autoimmune hepatitis
Normal/mildly elevated ALP +- 2ry amenorrhoea +- autoimmune disease Abnormal AST ALT
76
Alcoholic liver disease
Heavy alcohol consumption Raised AST :ALT ratio Raised GGT
77
Cholestatic hepatitis
Recent use of co amoxiclav | Raised ALT ALP GGT Bilirubin
78
Short term oral cortcosteroids can cause
Sleep disturbance Restlessness Indigestion
79
Risk of QT prolongation when clarithromycin is used with -
Methadone
80
Clarithromycin interactions
+ methadone - QT prolongation + statin - rhabdomyolysis +Salbutamol - HypOkalemia
81
Adrenaline + lidocaine | What is the benefit?
Prolongs duration of local anaesthesia | Adrenaline - constricts blood vessels - delays lidocaine absorption
82
Clozapine and smoking
Smoking increases CYP1A2 enzyme Clozapine - metabolised by ^ So dose of clozapine reduced if he stops smoking for fear of toxicity
83
Paracetamol overdose sx 12-36 hrs 2-3 days
1- nausea vomiting abdominal pain | 2- hepatic necrosis, subcostal pain and tenderness, AKI, hepatic encephalopathy
84
Features of fluoxetine overdose
Tremors , agitation Dilated pupils , drowsiness GI sx, QRS QT prolongation - torsades des pointes
85
Drug calculations | 1% , 0.5%
``` 1% = 10 mg/ml .5% = 5mg/ml ```
86
Metronidazole + alcohol
Avoid alcohol during treatment and at least 48 hrs after stopping treatment Due to - disulfiram like reaction
87
S/e of ACEi
Dry cough. Hyperkalemia Recurrent falls in its with postural hypotension

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