Pharmacology Flashcards
What drug should you give someone with ACS secondary to cocaine use?
Diazepam
What UTI abx should be given in renal failure?
Trimethoprim should be given in preference to nitro. CKD stage 3 or worse.
Visual changes with drugs?
blue vision: Viagra (‘the blue pill’)
yellow-green vision: digoxin
Metformin titration regimen?
In steps of 1 week
One tablet with breakfast
Then BD
Then TDS
Mechanism of action of metformin?
increases insulin sensitivity
decreases hepatic gluconeogenesis
may also reduce gastrointestinal absorption of carbohydrates
Features of carbon monoxide poisoning?
headache: 90% of cases nausea and vomiting: 50% vertigo: 50% confusion: 30% subjective weakness: 20% severe toxicity: 'pink' skin and mucosae, hyperpyrexia, arrhythmias, extrapyramidal features, coma, death
Monitoring of statin therapy? Tests and how often?
LFTs at baseline, 3 months and 12 months
Monitoring of ACEI therapy? Tests and how often?
U&E U&E prior to treatment
U&E after increasing dose
U&E at least annually
Monitoring of amiodarone therapy? Tests and how often?
TFT, LFT, U&E, CXR prior to treatment
TFT, LFT every 6 months
Monitoring of methotrexate therapy? Tests and how often?
FBC, LFT, U&E - regularly
The Committee on Safety of Medicines recommend ‘FBC and renal and LFTs before starting treatment and repeated weekly until therapy stabilised, thereafter patients should be monitored every 2-3 months’
Monitoring of azathiorpine therapy? Tests and how often?
FBC, LFT before treatment
FBC weekly for the first 4 weeks
FBC, LFT every 3 months
Monitoring of Lithium therapy? Tests and how often?
TFT, U&E prior to treatment
Lithium levels weekly until stabilised then every 3 months
TFT, U&E every 6 months
Monitoring of Sodium valproate therapy? Tests and how often?
LFT, FBC before treatment
LFT ‘periodically’ during first 6 months
Monitoring of glitazone therapy? Tests and how often?
LFT before treatment
LFT ‘regularly’ during treatment
What bloods before TB therapy?
LFTs
Treatment of lithium toxicity?
Hydration with normal saline
Dialysis if above does not work
Management of TCA toxicity?
IV bicarb
Treat arrhythmias
Treatment of salicylate toxicity?
IV bicarb
Dialysis second line
Side effects of glitazones?
Weight gain
Fluid retention
Liver dysfunction
Fractures
What drugs can’t you take sildenafil with?
Nicorandil and nitrates - similar effect
What abx lower seizure threshold?
Ciprofloxacin
What abx can lead to tendonitis?
Quinolones (cipro)
Features of ecstasy poisoning?
neurological: agitation, anxiety, confusion, ataxia
cardiovascular: tachycardia, hypertension
hyponatraemia
hyperthermia
rhabdomyolysis
Minimum time needed from ingestion to take paracetamol level?
4 hours
Could give activated charcoal if presents before this (although needs to be within 1hr of taking OD)
Confusion and pink mucosae points towards what diagnosis?
Carbon monoxide poisoning
What meds may exacerbate CCF?
thiazolidinediones
- pioglitazone is contraindicated as it causes fluid retention.
Verapamil
NSAIDs/glucocorticoids
- fluid retention
low-dose aspirin is an exception
flecainide
If Metformin IR not tolerated what could you try?
MR metformin then try second agent
Adverse effects of tamoxifen?
menstrual disturbance: vaginal bleeding, amenorrhoea
hot flushes - most likely
venous thromboembolism
endometrial cancer
What drugs may cause urinary retention?
tricyclic antidepressants e.g. amitriptyline anticholinergics opioids NSAIDs disopyramide
What electrolyte disturbance can precipitate digoxin toxicity?
Hypokalaemia
What NSAID is contraindicated in cardiovascular disease?
Diclofenac
What antidiabetic drug should you stop if someone is admitted with an MI?
Metformin
P450 inducers?
PC BRASS
Phenytoin
Carbamazepine
Barbiturates Rifampicin Alcohol (chronic) Sulphonylureas St Johns wart (Smoking)
P450 inhibitors?
AO DEVICESS
Allopurinol
Omeprazole
Disulfiram Erythromycin Valproate Isoniazid Ciprofloxacin Ethanol (acute intake) Sulphonamides SSRIs
Beta blocker OD management?
if bradycardic then atropine
in resistant cases glucagon may be used
features of organophosphate poisoning?
Salivation Lacrimation Urination Defecation/diarrhoea cardiovascular: hypotension, bradycardia also: small pupils, muscle fasciculation
Which anti-TB drug is associated with visual changes?
Ethambutol
Do you monitor digoxin levels routinely?
No
Which ant-TB drug causes peripheral neuropathy?
Isoniazid
Methanol poisoning management?
fomepizole or ethanol
Digoxin toxicity mangement?
Specific antibodies
When prescribing HRT what influences decision to prescribe continuous or cyclical?
Cyclical unless:
- taken cyclical combined for at least 1 year or
- it has been at least 1 year since their LMP or
- it has been at least 2 years since their LMP, if they had premature menopause (menopause below the age of 40)
What type of diuretics cause ototoxicity?
Loop diuretics
In TB drugs what do Rifampicin and isoniazid do to the p450 system?
Rifampicin is an IDUCER
Isoniazid is an INHIBITOR
What abx to give in prostatitis?
Cipro or ofloxacin (quinolone)
