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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
Q

Drug that helps combat opiate withdrawal

A

Methadone

- method 1 for detoxification and withdrawal sx

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26
Q

Nice guideline management of asthma

A

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

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27
Q

BTS guideline asthma

A
  1. SABA
  2. SABA + inhaled corticosteroid
  3. 2+ LABA
  4. SABA + ICS + LTRA
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28
Q

LABA vs LTRA

ICS

A

LABA - salmeterol
LTRA - montelukast
ICS - inhaled corticosteroids - beclometasone

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29
Q

Dry cough can be a side effect of (2)

A

ACEi
Methotrexate
- prolonged intake can lead to pulmonary fibrosis (rare)
PF - dry cough , dyspnoea on mild exertion , diffuse bilateral infiltrates on xray

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30
Q

A medication that is anti folic acid

A

Methotrexate

Trimethoprim

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31
Q

Post operative intractable nausea & vomiting

Medication -

A

IV ondansetron

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32
Q

Antiemetic in renal failure/hypercalcemia

Or drug induced vomiting

A 
Haloperidol 
If CI (Parkinson’s) - levomepromazine
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33
Q

Anti emetic in raised ICP

A

Cyclizine

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34
Q

Antiemetic in chemo, radio and post op

A

Ondansetron

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35
Q

Hymeresis antiemetic

1st 2nd 3rd

A

1- zines = cyclizine , promethazine
2- IV metoclopramide, ondansetron
3- steroids

36
Q

Medication for vertigo (Menderes, BPPV, vestibular neuritis)

A

Buccal prochlorperazine

37
Q

Most important symptom to urgently report if on warfarin

A

Headache

They are liable to subdural hematoma

38
Q

Symptom to be urgently reported inpatient on bisphosphonates

A

Sever sudden heartburn / chest pain

39
Q

Drugs that cause Hyperkalemia

A

ACEi

Potassium sparing diuretics

40
Q

The use of what drug is CI when using macrolides

A

Simavastatin**

Macrolides - erythromycin, clarithromycin etc

Note : macrolides + atorvastatin is fine

41
Q

MOA of tranexamic acid

Use

A

Inhibits fibrinolysis

- menorrhagia

42
Q

N - acetylcysteine - MOA

Use

A

Protection form free radicals

For paracetamol overdose

43
Q

LMWH

MOA

A

Inhibits conversion of prothrombin to thrombin

Activate the anti thrombin

44
Q

How does copper IUD work as an emergency contraception after unprotected sex

A

Inhibits implantation

45
Q

MOA of POPs

A

Inhibit ovulation

46
Q 
Ulipristal acetate (EllaOne)
MOA
A

Inhibits or delays ovulation

47
Q

Calculating units of alcohol
Beer
Wine
Cider

A

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
Q

UK guidelines on alcohol consumption per week

A

Not more than
14 units/week
3 units/day

At least 2 alcohol free days / week

49
Q

Drugs causing neuroleptic syndrome

A

Haloperidol

Metoclopramide

50
Q

Management of neuroleptic malignant syndrome

A 
Stop antipsychotic 
Rapid cooling 
IV fluids - prevent renal failure 
Dantrolene  - post synaptic muscle relaxant 
Bromocriptine
51
Q

Meds not to be given in Parkinson’s

A

Metaclopramide

Haloperidol - use lamotrigine

52
Q

Tests before commencing lithium (4)

A

RFT LFT TFT baseline ECG

Pulse, BP , pregnancy test , PTH , FBC , UE, ca, mg

53
Q

When can fentanyl patches be used in pain control of cancer patients

A

If oral not tolerated + stable patient @ shifting time

54
Q

Oral codeine can be replaced by __

A

Buprenorphine patch
SC morphine

  • there is no SC codeine
55
Q

Never shift to fentanyl patch if _

A

Pain is not controlled

Takes 12-24 hrs to achieve therapeutic level

56
Q

Why does the plasma concentration of a drug peak much faster for IV routes than oral route

A

Hepatic first pass elimination

57
Q

Treatment of ringworm

A

Clotrimazole cream

58
Q

What is to be given in heroin

  • overdose
  • detox
A

Naloxone

Methadone

59
Q

Heroin withdrawal features

A

Watery eyes + Runny nose
Insomnia
Agitation

60
Q

Treatment of ascites 2ry to cirrhosis

A

Spironolactone

61
Q

Liver cancer + hiccups

Med to be given

A

Metoclopramide

62
Q

Non sedating anti-histamine

A

Cetrizine

Loratidine

63
Q

Sedating antihistamine

A

Chlorpheniramine

64
Q

Co-careldopa (Sinemet)
Use
Complication

A

Levodopa + carbidopa
Use- Parkinson’s

Sudden cessation - can cause akinesia
Reduce dose if patient. Develops hallucination

65
Q

Indapamide

A

Thiazides like diuretic

66
Q

Drug to maintain abstinence in opioid user

A

Naltrexone

67
Q

Impacted stool tx

A

Phosphate enema

If young healthy - glycerol suppositories

68
Q

Hard stool tx

A

Stool softener ‘

69
Q

Constipation in pregnancy

A

Ispaghula - 1

Lactulose - 2

70
Q

Before commencing sodium valproate check :

A

LFT
FBC
Pregnancy

71
Q

Investigations before starting ACEi

How often should they be repeated

A

RFT
Electrolytes - esp K+

1-2 weeks after initiating , then annular

72
Q

Corticosteroid induced psychosis

A

Prednisolone in COPD exacerbation

73
Q

1ry biliary cirrhosis

A

Raised ALP
Associated Sjögren’s syndrome
Investigation - anti - mitochondrial antibodies

74
Q

1ry sclerosing cholangitis

A

Usually associated w/ ulcerative colitis

Investigation - ERCP

75
Q

Autoimmune hepatitis

A

Normal/mildly elevated ALP +- 2ry amenorrhoea +- autoimmune disease
Abnormal AST ALT

76
Q

Alcoholic liver disease

A

Heavy alcohol consumption
Raised AST :ALT ratio
Raised GGT

77
Q

Cholestatic hepatitis

A

Recent use of co amoxiclav

Raised ALT ALP GGT Bilirubin

78
Q

Short term oral cortcosteroids can cause

A

Sleep disturbance
Restlessness
Indigestion

79
Q

Risk of QT prolongation when clarithromycin is used with -

80
Q

Clarithromycin interactions

A

+ methadone - QT prolongation
+ statin - rhabdomyolysis
+Salbutamol - HypOkalemia

81
Q

Adrenaline + lidocaine

What is the benefit?

A

Prolongs duration of local anaesthesia

Adrenaline - constricts blood vessels - delays lidocaine absorption

82
Q

Clozapine and smoking

A

Smoking increases CYP1A2 enzyme
Clozapine - metabolised by ^

So dose of clozapine reduced if he stops smoking for fear of toxicity

83
Q

Paracetamol overdose sx
12-36 hrs
2-3 days

A

1- nausea vomiting abdominal pain

2- hepatic necrosis, subcostal pain and tenderness, AKI, hepatic encephalopathy

84
Q

Features of fluoxetine overdose

A

Tremors , agitation
Dilated pupils , drowsiness
GI sx, QRS QT prolongation - torsades des pointes

85
Q

Drug calculations

1% , 0.5%

A 
1% = 10 mg/ml 
.5% = 5mg/ml
86
Q

Metronidazole + alcohol

A

Avoid alcohol during treatment and at least 48 hrs after stopping treatment

Due to - disulfiram like reaction

87
Q

S/e of ACEi

A

Dry cough.
Hyperkalemia
Recurrent falls in its with postural hypotension

Revision (31 decks)

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