Pharmacology Flashcards
What are the side effects of amiodarone?
- thyroid dysfunction: both hypothyroidism and hyper-thyroidism
- corneal deposits
- pulmonary fibrosis/pneumonitis
- liver fibrosis/hepatitis
- peripheral neuropathy, myopathy
- photosensitivity
- ‘slate-grey’ appearance
- thrombophlebitis and injection site reactions
- bradycardia
- lengths QT interval
Which drugs are CYP inducers?
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- Carbamazepines
- Rifampicin
- Alcohol
- Phenytoin
- Griseofulvin
- Phenobarbitone
- Sulphnylureas
Which drugs are CYP inhibitors?
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- Sodium valporate
- Isoniazid
- Cimetidine
- Ketoconazole
- Fluconazole
- Alcohol
- Chloramphenicol
- Erythromycin
- Sulfanamides
- Ciprofloxacin
- Ompeprazole
- Metronidazole
- Grapefruit juice
What class of mediciations can cause a black hairy tongue?
Tetracyclines
e.g. doxycycline
What should you do if you suspect digoxin toxicity?
Stop digoxin and repeat concentration within 8-12 hours of the last dose and review
What is a common side effect of a vancomycin infusion?
What is the treatment for this?
Red man syndrome
Stop the infusion nad restart at a slower rate
What medication can cause a megoblastic anaemia?
How does it do this?
Phenytoin
Altering folate metabolism
What is the most common side effect of metformin?
GI - diarrhoea/bloating
What are the first line treatmenets for opioid detoxification?
Methadone or buprenorphine
What is the most important perameter to monitor in paracetamol overdose?
Aterial blood gas pH
If a patient has unpleasent side effects of metformin what can it be changed to?
Try modified-released formulation
How does a statin work?
Inhibits HMG-CoA reductase, the rate-limiting step in cholesterol synthesis
What drugs should be stopped in AKI as they may worsen kidney function?
- NSAIDs (except if aspirin at cardiac dose e.g. 75mg od)
- Aminoglycosides
- ACE inhibitors
- Angiotensin II receptor antagonists
- Diuretics
What drugs are folic acid inhibitors therefore should not be prescribed together?
Methotrexate
Trimethoprim
What drug might caused an abormal BNP measurement?
ACE inhibitors, ARB and diuretics
What is a side effect of adenosine?
Chest pain
What is the treatment for a bezodiazepine overdose?
- Flumazenil
- The majority of overdoses are managed with supportive care only due to the risk of seizures with flumazenil. It is generally only used with severe or iatrogenic overdoses.
What is the treatment for beta blocker overdose?
- if bradycardic then atropine
- in resistant cases glucagon may be used
What is the management of methanol poisoning?
- fomepizole or ethanol
- haemodialysis
What is the management of a tricyclic antidepressant overdose?
- IV bicarbonate may reduce the risk of seizures and arrhythmias in severe toxicity
- arrhythmias: class 1a (e.g. Quinidine) and class Ic antiarrhythmics (e.g. Flecainide) are contraindicated as they prolong depolarisation. Class III drugs such as amiodarone should also be avoided as they prolong the QT interval. Response to lignocaine is variable and it should be emphasized that correction of acidosis is the first line in management of tricyclic induced arrhythmias
- dialysis is ineffective in removing tricyclics
What is the management of a salicylate overdose?
- urinary alkalinization with IV bicarbonate
- haemodialysis
