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MSRA > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What drug should you give someone with ACS secondary to cocaine use?

A

Diazepam

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2
Q

What UTI abx should be given in renal failure?

A

Trimethoprim should be given in preference to nitro. CKD stage 3 or worse.

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3
Q

Visual changes with drugs?

A

blue vision: Viagra (‘the blue pill’)

yellow-green vision: digoxin

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4
Q

Metformin titration regimen?

A

In steps of 1 week

One tablet with breakfast

Then BD

Then TDS

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5
Q

Mechanism of action of metformin?

A

increases insulin sensitivity

decreases hepatic gluconeogenesis

may also reduce gastrointestinal absorption of carbohydrates

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6
Q

Features of carbon monoxide poisoning?

A 
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
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7
Q

Monitoring of statin therapy? Tests and how often?

A

LFTs at baseline, 3 months and 12 months

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8
Q

Monitoring of ACEI therapy? Tests and how often?

A

U&E U&E prior to treatment
U&E after increasing dose
U&E at least annually

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9
Q

Monitoring of amiodarone therapy? Tests and how often?

A

TFT, LFT, U&E, CXR prior to treatment

TFT, LFT every 6 months

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10
Q

Monitoring of methotrexate therapy? Tests and how often?

A

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’

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11
Q

Monitoring of azathiorpine therapy? Tests and how often?

A

FBC, LFT before treatment

FBC weekly for the first 4 weeks

FBC, LFT every 3 months

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12
Q

Monitoring of Lithium therapy? Tests and how often?

A

TFT, U&E prior to treatment

Lithium levels weekly until stabilised then every 3 months

TFT, U&E every 6 months

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13
Q

Monitoring of Sodium valproate therapy? Tests and how often?

A

LFT, FBC before treatment

LFT ‘periodically’ during first 6 months

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14
Q

Monitoring of glitazone therapy? Tests and how often?

A

LFT before treatment

LFT ‘regularly’ during treatment

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15
Q

What bloods before TB therapy?

A

LFTs

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16
Q

Treatment of lithium toxicity?

A

Hydration with normal saline

Dialysis if above does not work

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17
Q

Management of TCA toxicity?

A

IV bicarb

Treat arrhythmias

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18
Q

Treatment of salicylate toxicity?

A

IV bicarb

Dialysis second line

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19
Q

Side effects of glitazones?

A

Weight gain
Fluid retention
Liver dysfunction
Fractures

20
Q

What drugs can’t you take sildenafil with?

A

Nicorandil and nitrates - similar effect

21
Q

What abx lower seizure threshold?

A

Ciprofloxacin

22
Q

What abx can lead to tendonitis?

A

Quinolones (cipro)

23
Q

Features of ecstasy poisoning?

A

neurological: agitation, anxiety, confusion, ataxia
cardiovascular: tachycardia, hypertension
hyponatraemia
hyperthermia
rhabdomyolysis

24
Q

Minimum time needed from ingestion to take paracetamol level?

A

4 hours

Could give activated charcoal if presents before this (although needs to be within 1hr of taking OD)

25
Q

Confusion and pink mucosae points towards what diagnosis?

A

Carbon monoxide poisoning

26
Q

What meds may exacerbate CCF?

A

thiazolidinediones
- pioglitazone is contraindicated as it causes fluid retention.

Verapamil

NSAIDs/glucocorticoids
- fluid retention
low-dose aspirin is an exception

flecainide

27
Q

If Metformin IR not tolerated what could you try?

A

MR metformin then try second agent

28
Q

Adverse effects of tamoxifen?

A

menstrual disturbance: vaginal bleeding, amenorrhoea

hot flushes - most likely

venous thromboembolism

endometrial cancer

29
Q

What drugs may cause urinary retention?

A 
tricyclic antidepressants e.g. amitriptyline
anticholinergics
opioids
NSAIDs
disopyramide
30
Q

What electrolyte disturbance can precipitate digoxin toxicity?

A

Hypokalaemia

31
Q

What NSAID is contraindicated in cardiovascular disease?

A

Diclofenac

32
Q

What antidiabetic drug should you stop if someone is admitted with an MI?

A

Metformin

33
Q

P450 inducers?

A

PC BRASS

Phenytoin
Carbamazepine

Barbiturates 
Rifampicin
Alcohol (chronic)
Sulphonylureas
St Johns wart
(Smoking)
34
Q

P450 inhibitors?

A

AO DEVICESS

Allopurinol
Omeprazole

Disulfiram 
Erythromycin
Valproate 
Isoniazid 
Ciprofloxacin
Ethanol (acute intake)
Sulphonamides
SSRIs
35
Q

Beta blocker OD management?

A

if bradycardic then atropine

in resistant cases glucagon may be used

36
Q

features of organophosphate poisoning?

A 
Salivation
Lacrimation
Urination
Defecation/diarrhoea
cardiovascular: hypotension, bradycardia
also: small pupils, muscle fasciculation
37
Q

Which anti-TB drug is associated with visual changes?

A

Ethambutol

38
Q

Do you monitor digoxin levels routinely?

A

No

39
Q

Which ant-TB drug causes peripheral neuropathy?

A

Isoniazid

40
Q

Methanol poisoning management?

A

fomepizole or ethanol

41
Q

Digoxin toxicity mangement?

A

Specific antibodies

42
Q

When prescribing HRT what influences decision to prescribe continuous or cyclical?

A

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)
43
Q

What type of diuretics cause ototoxicity?

A

Loop diuretics

44
Q

In TB drugs what do Rifampicin and isoniazid do to the p450 system?

A

Rifampicin is an IDUCER

Isoniazid is an INHIBITOR

45
Q

What abx to give in prostatitis?

A

Cipro or ofloxacin (quinolone)

MSRA (22 decks)

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