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Medicine > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Key side effects of methotrexate

A

Bone marrow suppression
and leukopenia and highly teratogenic
Gastro-intestinal disturbance
Folate deficiency - anaemia
Long term- Pulmonary fibrosis, Liver/renal/GI toxicity, Interstitial pneumonitis
Stomatitis – discontinue (sign of severe marrow depression)

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2
Q

Key side effects of Leflunomide

A

Hypertension and peripheral neuropathy

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3
Q

Key side effect of Sulfasalazine

A

Male infertility (reduces sperm count),Myelosuppression
Nausea
Rash
Oral ulcers

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4
Q

Key side effects of Hydroxychloroquine

A

Nightmares and reduced visual acuity and rash

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5
Q

Key side effects of biologics/ Anti-TNF medications

A

immunosuppression, Reactivation of TB or hepatitis B,Allergic reaction, reaction at infusion site

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6
Q

Key side effects of Rituximab (Anti-CD20 )

A

Night sweats and thrombocytopenia

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7
Q

Key side effects of steroids

A

Cushing Syndrome, Avascular necrosis, Addisons,Osteoporosis
Retardation of growth
Thin skin, easy bruising
Immunosuppression
Cataracts and glaucoma
Oedema
Suppression of HPA axis
Teratogenic
Emotional disturbance (including psychosis
Rise in BP
Obesity (truncal)
Increased hair growth (hirsutism)
Diabetes mellitus
Striae

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8
Q

neuronic to remember steroid effects

A

STEROIDS: Stomach ulcers, Thin skin, oEdema, Right and left heart failure, Osteoporosis, Infection (including Candida), Diabetes (commonly causes hyperglycaemia and uncommonly progresses to diabetes), and Cushing’s Syndrome.

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9
Q

Key side effects of cyclosporin

A

Gingival hypertrophy, hypertrichosis, nephrotoxicity

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10
Q

Key side effects of Tacrolimus

A

cardiomyopathy, peripheral neuropathy, diabetes

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11
Q

Key side effect of Anthracyclines (doxorubicin, daunorubicin)

A

cardiomyopathy

(MOA :prevention of the DNA double helix from being resealed)

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12
Q

Key side effects of Platinum agents (cisplatin, carboplatin)

A

peripheral neuropathy and sensorineural hearing loss, nephrotoxicity

(MOA: DNA-binding alkylating agents)

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13
Q

key side effects of Cyclophosphamides

A

haemmorhagic cystitis and transitional cell carcinoma of the bladder.

(MOA: alkylating agent)

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14
Q

Key side effect of tamoxifen

A

increases the risk of endometrial cancer and VTE

vaginal dryness, hot flushes ,weight gain, fatigue .

agranulocytosis and liver failure- rare

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15
Q

Key side effect of bleomycin

A

lung fibrosis

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16
Q

Key side effects of bisphosphonates

A

esophageal ulcer
atrial fibrillation, osteonecrosis of the jaw, atypical femoral stress fractures
Avoid in CKD because renally excreted

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17
Q

medications that can worsen MG

A

Beta-blockers, several antibiotics and antimalarials, Lithium and other drugs used in psychiatric disorders

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18
Q

Riluzole is used in the treatment for

A

Motor neuron disease
(antiglutamatergic drug which dampens motor nerve firing)

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19
Q

Drugs causing ototoxicity

A

Caused by aminoglycoside antibiotics (eg. gentamicin, vancomycin) and loop diuretics (eg. furosemide), most commonly.

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20
Q

treatment for Parkinson disease where there isn’t significant motor symptoms

A

MAO-B monoamine a oxidase inhibitors ,Monoamine Oxidase Type B (MAO-B) is an enzyme in our body that breaks down several chemicals in the brain, including dopamine. By giving a medication that blocks the effect of MAO-B, an MAO-B inhibitor), more dopamine is available to be used by the brain.

(Selegiline/Rosagiline)

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21
Q

COMT inhibitors MOA

A

Prolong effects of Levodopa by preventing it from breaking down, so given as adjuvant therapy
eg tolcapone and entacapone

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22
Q

physiological effects of Dopamine

A

Cognition
prevents lactation
emetic function (causes nausea)- example of an antagonist is Metoclopramide
inhibits gastric stimulation (anti-kinetic effect) – example of an antagonist is Domperidone
cardiac stimulation effects and peripheral vasoconstriction- dopamine is converted to norepinephrine/noradrenaline

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23
Q

CI/side effects of co-careldopa/co-beneldopa

A

CI: breast feeding and severe psychiatric illness
cautioned in endocrine disorders as well as severe pulmonary or cardiovascular diseases.
side effects: nausea, vomiting and anorexia. Disturbances in sleep,dizziness, syncope and arhythmias.
Important side effects:
Involuntary movements, or dyskinesia,
postural hypotension and psychological effects which includes dementia, depression and schizophrenia-like syndrome with delusions and hallucinations

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24
Q

Levodopa interactions with other medications

A

risk of a hypertensive crisis when used with MAOI.
Risk of arrythmias with a general anaesthetic
with antihypertensives there is the increased risk of hypotension.

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25
Q

Why should you never stop Parkinson’s drug treatment abruptly?

A

Neuroleptic Malignant Syndrome
=sudden Depletion of dopamine in the hypothalamus/nigrostriatal pathway

Signs and symptoms: intense rigidity, causes fever, altered GCS- confusion

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26
Q

drug monitoring for sodium valproate

A

Monitor LFTs before and during first 6 months
Measure FBC before surgery to assess bleeding risk

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27
Q

Cautions for lamotrigine

A

Can exacerbate myoclonic seizures and Parkinson’s disease
Renal failure and hepatic failure (reduced dose) renally excreted

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28
Q

Alteplase Absolute contraindications for ischaemic stroke

A

Intracranial haemorrhage, neurosurgery/head trauma/stroke in past 3 months, uncontrolled hypertension, previous intracranial haemorrhage, known AV malformation/neoplasm/aneurysm, active internal bleeding, suspected endocarditis, bleeding diathesis, abnormal blood glucose

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29
Q

Alteplase Relative contraindications for ischaemic stroke

A

Minor/rapidly improving symptoms, seizure at stroke onset, severe stroke, major surgery or serious trauma in previous 2 weeks, previous GI/urinary tract haemorrhage in previous 3 weeks, recent lumbar puncture or arterial puncture at non-compressible site, post MI pericarditis which can turn hemorrhagic , pregnancy

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30
Q

Caution use of Atorvastatin in

A

Elderly patients
High alcohol intake or liver disease
Hypothyroidism (increases the risk of myositis with statins)
Patients at risk of muscle toxicity
Haemorrhagic stroke
Fibrates with statin increases rhabdomyolysis risk

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31
Q

Side effects Atorvastatin

A

GI disturbance
CNS effects – dizziness, headache, blurred vision
Colchicine (increased risk of rhabdomyolysis)
Hepatic effects
Muscle effects
Skin reactions
Hyperglycaemia
Weight change
Epistaxis

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32
Q

benzylpenicillin mainly effective against

A

aerobic gram-positive bacteria, with some activity against gram-negative cocci eg meningococcus and anaerobic organisms (no activity against gram-negative bacilli.)

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33
Q

Cephalosporins MOA

A

inhibit cell wall synthesis in a similar manner to penicillins but they are more resistant to hydrolysis by beta-lactamases.
succeeding generations having enhanced activity against gram-negative bacilli at the expense of gram-positive activity and increased ability to cross the blood-brain barrier

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34
Q

Adverse effects Cephalosporins

A

•Hypersensitivity
•GI disturbance
•Skin reactions
Cholestatic jaundice (clarythomycin and coamoxiclav can cause this too)
• interstitial nephritis
•Blood disorders
•Antibiotic associated colitis

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35
Q

chloramphenicol MOA

A

Inhibits protein synthesis in bacteria by binding reversibly to the 50S subunit of bacterial ribosomes.

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36
Q

Chloramphenicol adverse effects

A

Used ONLY in life-threatening conditions, because of its toxicity. Biggest unwanted effect is bone marrow toxicity (aplastic anaemia, reversible anaemia).
Can cause “grey baby” syndrome

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37
Q

Aciclovir MOA

A

inhibits synthesis of viral DNA. targets viral DNA polymerase terminating viral DNA synthesis and thus replication.
Most active against HSV.

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38
Q

NSAID Side effects

A

GI disturbance- due to inhibition of mucosal production of COX-1 generated prostaglandins.
Renal insufficiency
Salt/water retention
Hyponatraemia/hyperkalaemia
Cardiovascular effects
Hypersensitivity reactions
Headaches/dizziness
Skin reactions

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39
Q

COX 1 and COX 2 difference

A

COX 1 has a constitutive ‘housekeeping’ role, contributing to the regulation of homeostatic processes, such as renal and gastric blood flow, gastric cytoprotection and platelet aggregation.
COX 2 is expressed only after stimulation by an inflammatory process. The production of these prostaglandins contribute to the inflammatory/painful process, through vasodilation, increasing vascular permeability and sensitisation of nerve fibres to inflammatory mediators.

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40
Q

NSAIDS Contra-indications

A

GI bleeding/ulceration
Hypersensitivity reactions
Severe heart failure ( they cause water retention so NSAID would worsen this)
Severe renal impairment
Varicella zoster infection
Avoid 3rd trimester of pregnancy (inbhibits closure of ductus arteriosus)

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41
Q

NSAID cautions and contraindications neumonic

A

NSAID: No urine (i.e. renal failure), Systolic dysfunction (i.e. heart failure), Asthma, Indigestion (any cause), and Dyscrasia (clotting abnormality)

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42
Q

How does Allopurinol reduce the concentration of uric acid?

A

Xanthine oxidase inhibitor, reducing uric acid formation.

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43
Q

Cautioned use of infliximab in

A

•Malignancy
•Hepatitis B
•Pregnancy
•Tuberculosis

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44
Q

Interactions of methotrexate with other dugs

A

Trimethoprim/Co-trimoxazole (which is also a folic acid antagonist, severe bone marrow depression)
NSAIDs (toxicity)

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45
Q

Epidural anaesthesia

A

Injection or slow infusion via a cannula of an aqueous solution adjacent to the spinal column, but outside the dura mater, produces anaesthesia both above and below the site of injection after 15–30 min
Often used in combination with an opiate
Can be topped up , needs larger doses as it needs to diffuse into spinal cord

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46
Q

Spinal anaesthesia

A

Involves injection of an aqueous solution (1.5–2.5 mL) of local anaesthetic alone (often bupivacaine) or with an opioid into the lumbar subarachnoid space, usually between the third and fourth lumbar vertebrae
Quicker onset of action, lower dose needed

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47
Q

Unwanted effects local anaesthesia:

A

Local:irritation and inflammation, ischaemia from the use of vasoconstrictor agents
Systemic
Cardiovascular: myocardial depression, vasodilatation, hypotension, arrhythmias
CNS: agitation, confusion, tremors, convulsions, respiratory depression

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48
Q

Minimum Alveolar Concentration (MAC)

A

Minimum alveolar concentration at which 50% of the population will fail to respond to a single noxious stimuli

Measure of POTENCY,The lower the MAC the more potent the agent

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49
Q

Thiopental

A

(rarely used now)
Enhances activity at GABA A receptors
•Thiopental diffuses readily into the CNS due to its lipid solubility and predominantly un-ionised state
•Metabolism of thiopental occurs predominantly in the liver and up to 30% of the original dose may remain in the body at 24 h causing a ‘hangover’ effect
•zero-order kinetics- saturation related

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50
Q

Propofol

A

•
Enhances activity at GABA A receptors
Does not accumulate
replaced thiopental as an induction agent
•More rapid recovery and less hangover effect than occurs with thiopental
•Metabolism is by first order kinetics

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51
Q

Etomidate

A

•enhances activity at GABA A receptors
rapid onset of action after intravenous injection
•Its action is terminated by rapid metabolism in plasma and the liver by esterases
•Duration of action is about 6–10 min with minimal hangover
•Less effect on CVS so may be preferred in shocked patients
•Not used as a continuous infusion due to toxicity on adrenals and adrenocortical suppression

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52
Q

Ketamine

A

•Believed to act by blocking activation of the glutamate NMDA receptor, inhibit ACh nicotinic receptors, open 2 pore K channels
•‘dissociative anaesthesia’, in which there is a marked sensory loss and analgesia, as well as amnesia, without complete loss of consciousness

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53
Q

Depolarising Neuromuscular blocking drugs

A

Suxamethonium

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54
Q

Non-depolarising Neuromuscular blockers

A

•Atracurium
•Cisatracurium
•Mivacurium
•Pancuronium
•Rocuronium
•Vecuronium

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55
Q

Non-depolarising agents
MOA

A

Nerve impulse results in release of ach and drug
Drug binds to ach receptor but does not cause depolarisation
Calcium is not released from storage sarcoplasmic reticulum
Contraction does not occur, muscle therefore relaxes

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56
Q

Suxamethonium MOA

A

Nerve impulse results in release of ACh and drug
Drug binds to ach receptor causing depolarization
Drug stays on receptor causing repeated contractions
Calcium returns to storage and muscle isunreposnive to further contraction
A very prolonged paralysis occurs in about 1 in 2000–3000 individuals, who have a genetic deficiency of pseudocholinesterase

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57
Q

Neostigmine

A

the effect of a non-depolarising blocker can be reversed by intravenous injection of neostigmine, an anticholinesterase
An anti-muscarinic such as atropine or glycopyrrolate is given immediately before the neostigmine to prevent bradycardia or excessive salivation produced by stimulation of muscarinic receptors

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58
Q

Amiodarone

A

Class III anti-arrhythmic
•Prolongs cardiac action potential and delays refractory period
•Inhibits K+ channels involved in repolarisation
•Used to prevent myocardium going back into VF or VT

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59
Q

Side effects with amiodarone

A

Gastrointestinal disturbances
Corneal microdeposits
Hypothyroidism
Hyperthyroidism- high iodine content
Skin reactions – photosensitive skin rashes and blue-grey discolouration
Hepatotoxicity
Progressive pneumonitis and lung fibrosis
Proarrhythmic effects
Peripheral neuropathy/myopathy
Too much of it can cause bradycardia and heart blocks

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60
Q

Adenosine

A

has potent effects on the SA node inducing sinus bradycardia and slows impulse conduction through the AV node, with no effect on conduction in the ventricles. Therefore, it is useful in the emergency management of supraventricular tachycardia (SVT) for rapid conversion back to sinus rhythm

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61
Q

Adenosine Contra-indications

A

•Asthma/COPD (can trigger acute bronchospasm)
•Decompensated heart failure
•Long QT syndrome/AV block/sick sinus syndrome
•Severe hypotension
•Many cautions associated with cardiac disease

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62
Q

Adenosine side effects

A

Side effects are common but last less than 1 minute.
Arrhythmias, chest discomfort/pain, dizziness, dyspnoea, flushing, headache, hypotension, apprehension/impending doom, sweating, metallic taste, blurred vision, nausea/vomiting, cardiac arrest, apnoea, loss of consciousness

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63
Q

Atropine MOA

A

Muscarinic antagonist.
Blockade of muscarinic receptors reduces the inhibitory effect of the vagus nerve on the heart, increasing the rate of firing of the SA node and increasing conduction through the AV node.

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64
Q

Atropine side effects

A

Eyes (pupillary dilatation): blurred vision, mydriasis, angle closure glaucoma
GI tract (decreased motility/secretions/tone): constipation, abdominal distension, nausea, vomiting, dysphagia
CVS (increased HR, contractility, BP): tachycardia, palpitations, angina, hypertension, arrhythmias
Secretions (decreased sweat/salivary gland secretion): dry mouth, anhidrosis, thirst, increased body temperature
Urinary tract (decreased detrusor function and increased sphincter tone): urinary retention,
CNS: confusion, hallucination

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65
Q

Atropine contraindications

A

•GI: obstruction, paralytic ileus, pyloric stenosis, severe ulcerative colitis, toxic megacolon
•Urinary tract: bladder outflow obstruction, prostatic enlargement, retention
•Myasthenia gravis

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66
Q

Mirabegron

A

B3 adrenergic agonist, relaxes detrusor muscle, does not have anticholinergic effects, more expensive

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67
Q

Why is Aspirin not prescribed for children?:

A

Reyes syndrome
•Rare
•Usually occurs in children between 5 and 14 years of age
•Acute encephalopathy and fatty degeneration of the liver
•Usually follows viral illness, with rapid deterioration
•Overall mortality rate ~ 20%

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68
Q

Choice of Analgesia in Children ladder

A
  1. paracetamol
  2. paracetamol + NSAID eg ibuprofen
  3. Pareceamol NSAID +opiod (eg morphine)
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69
Q

Codeine use in children

A

restricted due to reports of morphine toxicity.
Codeine should only be used to relieve acute moderate pain in children >12 years and only if it cannot be relieved by other analgesic agents.
life-threatening adverse reactions have been identified in children with obstructive sleep apnoea who received codeine after tonsillectomy or adenoidectomy
Codeine not recommended for children with conditions that may compromise breathing (neuromuscular, cardiorespiratory, etc).

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70
Q

Gastric pH in children

A

Neutral at birth due to residual amniotic fluid. Continues to be neutral during neonatal period due to decreased gastric acid production. Adult values achieve around 2-3 years. This high pH means increased absorption of weak base drugs such as penicillins, resulting in lower doses needed whereas higher doses of acidic drugs will be required. Premature neonates have higher gastric pH due to immature gastric mucosa with reduced secretion of gastric acid.

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71
Q

Bile acid secretion neonates

A

decreased due to immaturity
Reducing fat absorption and therefore absorption of fat-soluble drugs such as diazepam.

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72
Q

Paracetamol metabolism in neonates

A

the predominant pathway is via sulphation.
In neonates CYP450 is immature so paracetamol is not metabolised via this route, resulting in less toxic metabolites and lower risk in overdose.

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73
Q

Vancomycin adverse effects

A

Nephrotoxicity
ototoxicity
Thrombophlebitis
Neutropenia
Thrombocytopenia
red man syndrome; occurs on rapid infusion of vancomycin
Moa:prevents bacteria making cell walls

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74
Q

Aminoglycoside MOA

A

Inhibit bacterial protein synthesis by binding to the 30S subunit of the ribosome irreversibly.
eg Gentamicin

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75
Q

Macrolides MOA

A

Inhibit bacterial protein synthesis by binding to the 50S subunit of the ribosome, preventing ribosomal translocation and therefore protein elongation eg Clarithromycin, Erythromycin, Azithromycin

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76
Q

Quinolones MOA

A

Inhibit bacterial DNA duplication through inhibition of topoisomerases, which interfere with DNA unwinding and therefore transcription and translation. eg Ciprofloxacin,
used mainly for Gram-negative infections

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77
Q

Quinolones side effects

A

GI upset
Prolonged QT interval
High risk of C. difficile
tendon damage (especially in patients > 60 and those with renal impairment or taking steroids)
Aortic aneurysm / dissection
Quinolones should also be used with caution in patients with epilepsy as they may lower the seizure threshold

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78
Q

Metronidazole MOA

A

inhibits bacterial DNA synthesis.specific antibiotic for anaerobic infections eg c difficile

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79
Q

Metronidazole Cautions/Contraindications

A

Alcohol must not be drunk while on metronidazole and for ~48 hours after the end of the course. Metronidazole interferes with alcohol metabolism leading to acetaldeyhyde accumulation and gives severe side effects as a result.
Use with caution in severe liver disease

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80
Q

Trimethoprim MOA

A

Inhibits bacterial folate synthesis through inhibition of dihydrofolate reductase.

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81
Q

Trimethoprim side effects

A

Commonly causes a skin rash
GI upset
Hypersensitivity is common and can be severe
Hyperkalaemia

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82
Q

Penicillin common side effects

A

GI upset, including antibiotic-associated C. difficile infection.
A degree of allergy to penicillin is very common, affecting up to 10% of the population.
Neurological toxicity (including convulsions and coma) can occur with very high-dose therapy or accumulation due to severe renal impairment.

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83
Q

Potential risks of SSRIs in pregnancy:

A

First-trimester use has a link with congenital heart defects
First-trimester use of paroxetine has a stronger link with congenital malformations
Third-trimester use has a link with persistent pulmonary hypertension in the neonate
Neonates can experience withdrawal symptoms, usually only mild

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84
Q

Metoclopramide

A
  • a D2 receptor antagonist mainly used in the management of nausea.
  • gastro-oesophageal reflux disease
  • prokinetic action is useful in gastroparesis secondary to diabetic neuropathy
  • often combined with analgesics for the treatment of migraine
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85
Q

Enzyme inducers: PC BRAS

A

Phenytoin
Carbamazepine
Barbiturates
Rifampicin
alcohol (chronic excess)
sulphonylureas.
Others: topiramate, St John’s Wort, and smoking.

Eg if someone takes st johns wort and warfarin, St John’s Wort is a P450 inducer so will reduce the concentration of warfarin, meaning the INR will decrease, increase warfarin metabolism and risk of clots.

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86
Q

Enzyme inhibitors: AO DEVICES

A

Allopurinol
Omeprazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin
ethanol (acute intoxication)
sulphonamides.
Others: grapefruit juice, amiodarone, and SSRIs (fluoxetine, sertraline).

eg these decrease warfarin metabolism and increase bleeding risk

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87
Q

Etodimate, propofol and thiopental MOA

A

enhance activity at GABA A receptors

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88
Q

what is zero order kinetics

A

constant amount (e.g. in grams / milligrams / micrograms) of drug is eliminated per unit of time (e.g. seconds / minutes). The metabolism is independent of the concentration of the reactant.

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89
Q

examples of zero kinetic drugs

A

Constantly aspiring to phone ethan
Constant ( zero order kinetics)
Aspirin (e.g. high-dose aspirin)
Phenytoin
Ethanol
Others: heparin, fluoxetine,omeprazole

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90
Q

Half life

A

Half life is the time taken to metabolise 50% of the drug

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91
Q

what is First order kinetics

A

drug elimination is proportional to the plasma concentration of drug
This means that the higher the drug concentration, the higher its elimination rate.the HALF-LIFE is constant

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92
Q

examples of first order kinetics

A

majority of drugs exhibiting ‘first-order’ elimination kinetics eg amitriptyline, ampicillin, apixaban, atenolol

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93
Q

Clinical features of lithium toxicity

A

coarse tremor (a fine tremor is seen in therapeutic levels)
hyperreflexia
acute confusion
Polyuria
Visual disturbance
CNS disturbance including seizures, impaired co-ordination, dysarthria
arrythmias
coma

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94
Q

Rasburicase

A

Intravenous prophylaxis against gout during cancer chemotherapy

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95
Q

haemophilia A

A

deficiency in clotting factor VIII

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96
Q

HIV entry inhibitors

A

prevent HIV-1 from entering and infecting immune cells
maraviroc (binds to CCR5, preventing an interaction with gp41)
enfuvirtide (binds to gp41, also known as a ‘fusion inhibitor’)

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97
Q

factor IX

A

haemophilia B, also called christmas disease

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98
Q

Nucleoside analogue reverse transcriptase inhibitors (NRTI)

A

Acting as a chain-terminator to stop reverse transcription. examples: zidovudine (AZT), abacavir, emtricitabine

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99
Q

Non-nucleoside reverse transcriptase inhibitors (NNRTI)

A

Block the action of reverse transcriptase.transcriptase enzyme.examples: nevirapine, efavirenz

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100
Q

Protease inhibitors (PI)

A

These drugs inhibit HIV protease,
examples: indinavir, nelfinavir, ritonavir, saquinavir

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101
Q

Integrase inhibitors

A

block the action of integrase, a viral enzyme that inserts the viral genome into the DNA of the host cell
examples: raltegravir, elvitegravir, dolutegravir

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102
Q

Drugs causing hyperkalaemia

A

Aldosterone inhibitors ( aldosterone normally promotes K secretion)
heparin (inhibits aldosterone secretion)
ACEi and ARB ( decrease aldosterone)
Potassium sparing diuretics ( drugs that cause diuresis without causing K loss)
Trimethoprim

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103
Q

Monitoring for statins

A

LFTs are checked before a statin is initiated, again within 3 months of initiation, and then 12 months after it was first prescribed.

QRISK 2 calculator for patients up to and including 84 years of age.
Non hdl/ Ldl should improve by 40 %, reduction

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104
Q

Statin MOA

A

inhibit 3-hydroxy-3-methylglutaryl co-enzyme A (HMG CoA) reductase, an enzyme involved in cholesterol synthesis. Inhibition of HMG CoA reductase reduces low density lipoprotein cholesterol (LDL-C) levels by slowing down the production of cholesterol in the liver and increasing the liver’s ability to remove the LDL-C already in the blood

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105
Q

Desferrioxamine

A

indicated in:
Patients with serum iron level > 90umol/l or 60-90umol/l, who are symptomatic or have persistent iron on abdominal x-ray despite whole bowel irrigation or any patient with shock, coma or metabolic acidosis

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106
Q

CI statins

A

Do not prescribe atorvastatin to:
People with active liver disease, or unexplained persistent elevations of transaminases that are three or more times the upper limit of normal.
Women who are pregnant or breastfeeding.
Women of child-bearing potential not using appropriate contraception.

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107
Q

Key side effect of topiramate

A

weight loss

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108
Q

TB treatment

A

R – Rifampicin for 6 months
I – Isoniazid for 6 months
P – Pyrazinamide for 2 months
E – Ethambutol for 2 months

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109
Q

Causes of agranulocytosis

A

Associated with depleted levels of basophils and eosinophils.

Drug causes:

Carbamazepine
Carbimazole
Clozapine

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110
Q

h pylori treatment

A

Omeprazole (PPI) 20mg bd + Clarithromycin 500mg bd + Amoxicillin 1gram bd or Metronidazole

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111
Q

Warfarin anticoagulation reversal

A

Vitamin K1, start with this
Prothrombin complex concentrate can be used to reverse eg beriplex
(fresh frozen plasma)

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112
Q

Factor Xa inhibitors reversal

A

Andexanet alfa

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113
Q

Dabigatran (Direct thrombin inhibitor) reversal

A

Idarucizumab (monoclonal antibody fragment)

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114
Q

Digoxin MOA

A

Blocks NA/K ATPase
induces an increase in intracellular sodium that will drive an influx of calcium in the heart and cause an increase in contractility (positively inotropic) ,decreases heart rate ( negatively chronotropic)
reduces conduction at the atrioventricular (AV) node, preventing some impulses from being transmitted to the ventricles, thereby reducing the ventricular rate.

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115
Q

Antidysrhythmic drugs
Class I
Class II
Class III
Class IV

A

Class I – sodium channel blocker, lidocaine, is considered ‘membrane stabilising’.
Class II – are the B-blockers.
Class III – k channel blocker/ widen AP duration. amiodarone and sotolol. they act on both supraventricular and ventricular arrhythmias
Class IV – calcium channel blockers.

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116
Q

Thiazide and thiazide related diuretics MOA

A

inhibit sodium reabsorption (Na/cl cotransporter) at the beginning of the distal convoluted tubule.This prevents reabsorption of sodium and its osmotically associated water. Also causes vasodilation. The increased delivery of sodium to the distal tubule, where it can be exchanged for potassium, increases urinary potassium losses and may therefore cause hypokalaemia.
Thiazides reduce the clearance of uric acid, and raise the levels of uric acid in the blood.

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117
Q

HyperGLUC mnemonic for side effects of thiazides

A

→ hyperglycemia
→ Hyperlipidaemia
→ hyperuricemia
→ hypercalcemia
It can have HYPO effects in serum: including HYPOkalemia, HYPOnatremia and HYPOtension

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118
Q

dihydropyridines

A

selectively bind to Ca2+ channels in vascular smooth muscle in its inactivated state.
including amlodipine and nifedipine

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119
Q

non-dihydropyridine

A

more selective for the heart. reduce myocardial contractility.
bind in open state
Eg verapamil and diltiazem

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120
Q

Doxazosin, tamsulosin MOA

A

Alpha adrenoceptor blockers,blockade induces relaxation. α1-blockers therefore cause vasodilatation and a fall in blood pressure (BP), and reduced resistance to bladder outflow.

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121
Q

Monitoring of Azathioprine and methotrexate

A

Need to measure TMPT enzyme before starting treatment with azathioprine because some people are deficient which could result in toxic level. FBC and LFT every 3 months, U&E every 6 months ( 3 months for methotrexate)

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122
Q

Azathioprine, methotrexate Side effects

A

Increased susceptibility to infections,bone marrow suppression, potential risk of lymphoma, increased risk of sunburn, increased risk of cervical abnormalities ,hypersensitivity reactions, increased risk of non melanoma skin cancer

123
Q

Oxybutynin, tolterodine
MOA

A

Contraction of the smooth muscle of the bladder is under parasympathetic control. Blocking muscarinic receptors therefore promotes bladder relaxation, increasing bladder capacity.

124
Q

Oxybutynin, tolterodine
Side effects

A

( due to muscarinic blockage) include dry mouth, tachycardia, constipation, blurred vision .In elderly may get cholinergic burden and its when they are on too many of anticholinergic drugs leading to confusion leading to increase in falls et

125
Q

Anastrozole MOA

A

aromatase inhibitor , blocks production of oestrogen from testosterone , this inhibits signals to the breast cancer,ineffective method in pre menopause

126
Q

SSRI side eddects

A

GI upset, changes in appetite,
Hypersensitivity
Hyponatremia
suicidal thoughts and behaviour (<30 yrs increased risk) ,
may lower seizure threshold,
prolong QT interval (especially associated with citalopram)
increase the risk of bleeding due to their effect on platelet function.
Gastric ulcer
Sexual dysfunction
Anxiety, angitation

127
Q

Non selective MAOIS side effects

A

Postural hypotension
Headache
Insomnia
Sexual dysfunction
Dry mouth, urinary retention
‘Cheese reaction’ with dietary tyramine - life-threatening hypertensive crisis

128
Q

Methylphenidate

A

Dopamine and noradrenaline reuptake inhibitors
Used in ADHD

129
Q

Drugs used for managing opioid withdrawal

A

Methadone ( long acting opioid agonist )
Buprenorphine ( partial agonist) available alone (subutex) or with naloxone ( suboxone , quick acting opioid antagonist)
Naltrexone is a long acting opioid antagonist

130
Q

Drugs used for smoking cessation

A

Nicotine replacement therapy
Bupropion → enhancing mesocorticolimbic dopaminergic activity; it also has nicotine receptor antagonist activity, norepinephrine/dopamine-reuptake inhibitor,Reduces cravings and helps relieve withdrawal symptoms
Varenicline → partial agonist at nicotinic receptors,smoking doesn’t provide the desired effects.

131
Q

Drugs used for alcohol withdrawa

A

Chlordiazepoxide (long acting BDZ)
Acamprosate (used for maintenance of abstinence, unclear moa , NMDA receptor antagonist and positive allosteric modulator of GABAA receptors.)
Naltrexone ( opioid receptor antagonist)
Disulfiram (Disulfiram works by inhibiting the enzyme acetaldehyde dehydrogenase, causing many of the effects of a hangover to be felt immediately following alcohol consumption.)

132
Q

Lithium adverse effects

A

thyroid disorders eg hypothyroidism
mild cognitive and memory impairment.
Nephrogenic Diabetes Insipidus
cardiac
diuretic treatment (risk of toxicity)
elderly (reduce dose)
epilepsy (may lower seizure threshold) myasthenia gravis
psoriasis (risk of exacerbation)
QT interval prolongation
Ebstein’s anomaly

133
Q

Lithium side effects

A

Metallic taste, Fine tremor, Weight gain, Hypothyroidism,, Idiopathic intracranial hypertension, Leukocytosis, Hyperparathyroidism and hypercalcaemia,arrhythmias, hyperglycaemia, peripheral oedema,sexual dysfunction, polyuria,peripheral neuropathy

134
Q

Anticholinesterases

A

Inhibit acetylcholinesterase and enhance cholinergic transmission in cerebral cortex and hippocampus
Examples:Donepezil, Rivastigmine

135
Q

Conventional antipsychotic drugs Side effects

A

extrapyramidal effects- movement abnormalities that arise from D2 blockade in the nigrostriatal pathway
acute dystonic reactions ( involuntary parkinsonia movements or muscle spasm),
akathisia (inner restlessness)
neuroleptic malignant syndrome and seizures
tardive dyskinesia ( includes movements that are pointless involuntary )
sedative effect, Drowsiness, hypotension, QT interval prolongation, erectile dysfunction, hyperprolactinemia symptoms
Metabolic - weight gain, increased risk of T2DM, hyperlipidaemia, increased risk of metabolic syndrome
Anticholinergic - tachycardia, blurred vision, dry mouth, constipation, urinary retention

136
Q

pharmacodynamics

A

What the drug does to the body, power of the drug

137
Q

pharmacokinetics

A

What body does to drug, how the drug moves around the body

138
Q

Valproate side effects

A

Valproate
Appetite increase, so weight gain
Liver failure (monitor LFTs during 1st 6 months)
Pancreatitis
Reversible hair loss (grows back curly, apparently)
Oedema
Ataxia
Teratogenicity, Tremor, Thrombocytopaenia
Encephalopathy (due to hyperammonaemia) / Enzyme inducer

139
Q

Antacids and Alginates

A

Magnesium trisilicate
Aluminium/magnesium mixtures (Maalox)
Use: dyspepsia and GORD

140
Q

H2-receptor antagonists

A

Ranitidine
Use:dyspepsia, GORD, peptic ulceration, prophylaxis of NSAID associated peptic ulceration

141
Q

Proton pump inhibitors

A

Lansoprazole
Omeprazole

Use: dyspepsia, GORD, oesophagitis, peptic ulceration, prophylaxis of NSAID associated peptic ulceration, H. pylori eradication

142
Q

Aminosalicylate

A

Mesalazine

Use: IBD

143
Q

Cytokine inhibitors

A

Infliximab
Adalimumab

Use:Crohns

144
Q

Antimuscarinic agent for IBS

A

Hyoscine (Buscopan)

145
Q

antispasmodics

A

Mebeverine
Peppermint oil

Use:IBS

146
Q

Anti-fungal agents

A

Nystatin
Fluconazole

147
Q

Antiprotozoal agents

A

Metronidazole

148
Q

Antibiotics used to treat C. difficile associated diarrhoea (colitis)

A

Metronidazole
Vancomycin

149
Q

treatment of immune based renal disease i.e. Wegener’s granulomatosis, types of glomerulonephritis or SLE

A

Cyclophosphamide (anti-proliferative agent)

150
Q

Transplant immunosuppression

A

ciclosporin- (calcineurin inhibitor)
tacrolimus- (calcineurin inhibitor)
azathioprine - (anti-proliferative agent)

151
Q

Muscarinic receptor antagonists

A

Oxybutinin
Tolterodine+E19

Used in Overactive bladder syndrome, urge predominant incontinence

152
Q

Alpha1-adrenoceptor antagonists

A

Doxazosin
Tamsulosin

used in BPH

153
Q

5∝-reductase inhibitors

A

Dutasteride
Finasteride

used in BPH

154
Q

Antimicrobial agents for urinary infections

A

Trimethoprim (UTI)
Nitrofurantoin (UTI)
Co-amoxiclav (pyelonephritis)
Ciprofloxacin (pyelonephritis)
Gentamicin (serious gram -ve infections)

155
Q

Phosphodiesterase type 5 inhibitors

A

Sildenafil
Tadalafil
Erectile dysfunction

156
Q

Alprostadil

A

synthetic prostaglandin E1 analogue
Erectile dysfunction

157
Q

Thionamides

A

Carbimazole
Propylthiouracil

158
Q

Fludrocortisone

A

Mineralocorticoids

159
Q

Synthetic human growth hormone

A

Somatropin (synthetic human GH)
used to replace growth hormone (a natural hormone produced by your body) in adults and children with growth hormone deficienc

160
Q

Synthetic ACTH

A

Tetracosactide
used in the diagnosis of adrenocortical insufficiency
ACTH will stimulate healthy adrenal glands to produce cortisol .A failure of cortisol to rise indicates primary adrenal insufficiency (Addison’s disease)

161
Q

Dopamine D2 agonists

A

Cabergoline
Quinagolide

162
Q

Testosterone and its esters

A

Sustanon 250® (testosterone esters - IM depot)
Testogel® (testosterone - transdermal)

163
Q

Bisphosphonates

A

Alendronic acid
Residronate
Zolendronic acid

164
Q

Vitamin D compounds

A

Alfacalcidol (1a-hydroxycholecalciferol)
Calcitriol (1,25-dihydroxycholecalciferol)
Ergocalciferol (vitamin D2)

165
Q

Calcium salts

A

Calcichew® (oral supplement)
Calcium gluconate (Parenteral - IV)
Calcium chloride (Parenteral - IV)

166
Q

Vasopressin analogues

A

Desmopressin
Terlipressin

uses:cranial diabetes insipidus [desmopressin], oesophageal bleeding [terlipressin], bleeding reduction in mild to moderate haemophilia [desmopressin]

167
Q

Opiate/opioid based analgesics

A

Codeine phosphate
Morphine sulfate
Diamorphine
Tramadol

168
Q

Non-opioid non-NSAID analgesics

A

Amitriptyline
Duloxetine
Gabapentin
Carbamazepine
Capsaicin

169
Q

Antiemetics (antihistamines, antimuscarinic agents, dopamine receptor antagonists, 5-HT3 receptor antagonists, neurokinin 1 receptor antagonists and cannabinoids)

A

Cyclizine (antihistamine)
Hyoscine (antimuscarinic)
Metoclopramide (dopamine receptor antagonist)
Prochlorperazine (dopamine receptor antagonist)
Ondansetron (5-HT3 receptor antagonist)
Aprepitant (neurokinin 1 receptor antagonist)
Nabilone (cannabinoid)

170
Q

Cyclophosphamide

A

Alkylating drugs

171
Q

Doxorubicin

A

Cytotoxic antibiotics

172
Q

Anti-oestrogens

A

Tamoxifen
Anastrazole

173
Q

Tamoxifen

A

Tamoxifen is a oestrogen antagonist, commonly indicated for ER+ positive breast cancers. However, it also works as an agonist on endometrial tissue which can result in endometrial proliferation

174
Q

Iron forms

A

Oral - ferrous sulphate
Parenteral - iron sucrose

175
Q

Thiazide and thiazide-related diuretics

A

Bendroflumethiazide
Chlortalidone
Indapamide
Metolazone

Use:Hypertension, chronic heart failure

176
Q

Loop diuretics

A

Furosemide
Bumetanide

Use:Acute pulmonary oedema, chronic heart failure, diuretic resistant oedema, resistant hypertension

177
Q

Potassium-sparing diuretics

A

Amiloride
Spironolactone

Use:Prevention of hypokalaema alongside a loop or thiazide diuretic [e.g. amiloride]; oedema in cirrhosis of liver, severe heart failure, Conn’s syndrome [aldosterone antagonists]

178
Q

Beta-adrenoceptor blockers

A

Atenolol
Propranolol
Bisoprolol

use:Angina, hypertension, myocardial infarction, arrhythmias, heart failure, anxiety conditions, symptomatic relief of thyrotoxicosis, prophylaxis of migraine

179
Q

Calcium channel blockers

A

Amlodipine
Felodipine
Diltiazem
Verapamil

180
Q

ACE inhibitors

A

Ramipril
Lisinopril

Use:Chronic heart failure, hypertension, diabetic nephropathy, prophylaxis of cardiovascular events

181
Q

Monitoring requirements for ACEi

A

UE renal function should be checked before starting or increasing the dose
also monitored during treatment

182
Q

Angiotensin receptor blockers

A

Losartan
Candesartan

183
Q

Alpha-adrenoceptor blockers

A

Doxazosin
Tamsulosin (benign prostatic hyperplasia)

Use: Resistant hypertension, prostatic hyperplasia

184
Q

Drugs to reduce cardiovascular risk

A

Statins, vibrates, exetemibe

185
Q

Parenteral anticoagulants

A

Unfractionated heparin
Dalteparin
Fondaparinux

Use: Prevention of venous thromboembolism, treatment of DVT and PE, myocardial infarction, unstable coronary disease

186
Q

Vitamin K antagonist

A

Warfarin

Use: Prevention of venous thromboembolism, treatment of DVT and PE, myocardial infarction, unstable coronary disease, anticoagulation in valvular and non-valvular AF

187
Q

Directly acting oral anticoagulants

A

Apixaban
Rivaroxaban
Dabigatran

Use: Prevention of venous thromboembolism, treatment of DVT and PE, anticoagulation in non-valvular AF

188
Q

Common antibiotics for bacterial endocarditis

A

Benzylpenicillin
Amoxicillin
Gentamicin
Vancomycin
Flucloxacillin

189
Q

Nitrates

A

Glyceryl trinitrate (GTN)
Isosorbide dinitrate

Use: angina

190
Q

Potassium channel openers

A

Nicorandil
Use: angina

191
Q

Ivabridine & Ranolazine

A

Use: angina

192
Q

Anti-platelet agents

A

Aspirin
Clopidogrel
Ticagrelor
Dipyridamole
Tirofiban

Use:Secondary prevention of cardiovascular events, prevention of atherothrombotic events post PCI

193
Q

Thrombolytic (fibrinolytic) drugs

A

Alteplase
Tenecteplase

Use: Thrombolysis in STEMI and massive PE

194
Q

Cardiac glycoside

A

Digoxin

Use:Heart failure, supraventricular arrhythmias [AF and atrial flutter]

195
Q

Anti-dysrhythmic drugs

A

Amiodarone
Lidocaine
Flecainide
Sotalol
Adenosine
Atropine

Use:Ventricular arrhythmias, supraventricular arrhythmias

196
Q

Drugs used during cardiac arrest

A

Adrenaline
Amiodarone
Atropine (bradycardia)
8.4% sodium bicarbonate (hyperkalaemia)
Calcium chloride (hyperkalaemia)
Magnesium sulfate (hypomagnesaemia, Torsades de pointe, digoxin toxicity)

197
Q

Aldosterone antagonists

A

Spironolactone
Eplerenone

Use:HF

198
Q

Topical emollients

A

E45® cream
Diprobase® cream
Emulsifying ointment

Use: Atopic dermatitis and psoriasis

199
Q

Topical corticosteroids

A

Mild- hydrocortisone 0.5% 1% and 2.5%
Moderate- eumovate (clobetasone butyrate 0.05%)
Potent- betnovate (betamethasone valerate 0.1%)
Very potent -dermovate (clobetasol propionate 0.05%)

Use:Atopic and contact dermatitis and psoriasis

200
Q

Topical calcineurin inhibitors in term

A

Tacrolimus 0.03% or 0.1% ointment used in atopic dermatitis ( excema)

201
Q

Immunosuppressant drugs in dermatology

A

Ciclosporin
Methotrexate

Use: Atopic dermatitis and psoriasis

202
Q

Topical Vitamin D analogues

A

Calcipotriol ointment for psoriasis

203
Q

Topical retinoids

A

Tazarotene
Isotretinoin

Use: Atopic dermatitis and psoriasis

204
Q

Oral retinoids

A

Alitretinoin for acne vulgaris and psoriasis

205
Q

Tazarotene/coal tar ( not used a lot because its messy) called evorex lotion

A

psoriasis

206
Q

Dithranol

A

vit a analogue, for psoriasis

207
Q

Topical antibiotics for acne

A

Clindamycin 1% cream
Mupirocin

208
Q

Systemic antibiotics for dermatological conditions

A

Oxytetracycline
Doxycycline
Flucloxacillin
Erythromycin

209
Q

Beta2-adrenoceptor agonists

A

Salbutamol
Terbutaline
Salmeterol
Formoterol

210
Q

Antimuscarinic bronchodilators

A

Ipratropium
Tiotropium

211
Q

Inhaled corticosteroids

A

Beclometasone
Fluticasone

212
Q

Systemic corticosteroids

A

Hydrocortisone
Prednisolone

213
Q

Common antibiotics used in respiratory disease

A

Amoxicillin
Co-amoxiclav
Clarithromycin
Doxycycline
Cefuroxime

214
Q

Cromolyn sodium

A

mast cell stabilizer

Use: bronchial asthma, allergic rhinitis, and certain allergic eye conditions such as vernal conjunctivitis, keratitis, and keratoconjunctivitis.

215
Q

Antituberculous drugs

A

Isoniazid
Rifampicin
Pyrazinamide
Ethambutol

216
Q

Benzodiazepines

A

Diazepam
Lorazepam
Temazepam

217
Q

Selective serotonin reuptake inhibitors

A

Citalopram
Fluoxetine
Paroxetine
Sertraline

218
Q

Serotonin and noradrenaline reuptake inhibitors

A

Duloxetine
Venlafaxine

219
Q

Selective noradrenaline reuptake inhibitors

A

Reboxetine

220
Q

Presynaptic α2-adrenoceptor blockers

A

Mirtazapine

221
Q

Tricyclic antidepressants

A

Amitriptyline
Imipramine
Lofepramine

222
Q

Non-selective MAOIs

A

Phenelzine

223
Q

reversible inhibitors of monoamine oxidase A (RIMAs)

A

Moclobemide

224
Q

Drugs used for managing opioid withdrawal

A

Methadone
Buprenorphine

225
Q

Drugs used for smoking cessation

A

Nicotine replacement therapy
Bupropion
Varenicline

226
Q

Drugs used for acute alcohol withdrawal

A

Chlordiazepoxide
Pabrinex®
Thiamine

Acamprosate
Naltrexone
Disulfiram

227
Q

Mood stablising anticonvulsant drugs

A

Sodium valproate
Carbamazepine
Lamotrigine

228
Q

Antipsychotic drugs uses

A

Psychosis, schizophrenia, rapid tranquillisation, mania

229
Q

Atypical antipsychotic drugs

A

Risperidone
Olanzapine
Clozapine
Aripiprazole
Quetiapine

230
Q

Conventional antipsychotic drugs

A

Haloperidol (a butyrophenone)
Chlorpromazine (a phenothiazine)
Flupentixol (a thioxanthine)
Sulpiride (a substituted benzamide)

231
Q

Goserelin

A

Gonadorelin analogues

Use:Testosterone reduction in prostate cancer, preparation for IVF

232
Q

Drugs used for infertility

A

Clomifene
Human Menopausal Gonadotrophins (HMG) for super ovulation

233
Q

Oestrogen based (combined) oral contraceptives

A

Gedarel (Ethinylestradiol with desgestorel [20/150 or 30/150])
Mercilon (Ethinylestradiol with desgestorel)
Yasmin (Ethinylestradiol with drospirenone)
Femodene (Ethinylestradiol with gestodene)
Cilest (Ethinylestradiol with norgestimate)
Microgynon 30 (Ethinylestradiol with levonorgesterol)

234
Q

Progestogen-only oral contraceptives

A

Desogestrel based (Cerelle, Ceravette,)
Levonorgestrel based (Norgeston)

235
Q

Long-acting reversible contraceptives

A

Nexplanon (etonogestrel) implant (3 years)
Depo-Provera (medroxyprogesterone) IM depot inj (3 months)

236
Q

Spermicidal contraceptives

A

Nonoxinol ‘9’ (Gygel)

237
Q

Spermicidal contraceptives

A

Nonoxinol ‘9’ (Gygel)

238
Q

Contraceptive devices and intra-uterine systems

A

Mirena (IUS) - levonorgestrel based (5 years)
Jaydess (IUS) - levonorgestrel based (3 years)
Nova-T 380 (copper coil) (5 years)
TT 380 slimline (copper coil) (10 years)

239
Q

Emergency contraception

A

Levonorgestrol
Ulipristal
Copper intra-uterine contraceptive device

240
Q

Emergency contraception

A

Levonorgestrol
Ulipristal
Copper intra-uterine contraceptive device

241
Q

Gemeprost (PGE1 analogue)

A

Prostaglandin derivative for Induction of abortion

242
Q

Mifepristone

A

Progesterone receptor antagonists for Induction of abortion

243
Q

Hormonal therapy for HRT

A

Oestradiol alone or with progestogens
Raloxifene
Tibolone

244
Q

Antidepressants used for peri menopausal symptoms

A

Fluoxetine (SSRI)
Citalopram (SSRI)
Venlafaxine (SNRI)

245
Q

Drugs for induction of labour

A

Oxytocin and Dinoprostone (exogenous PGE2)

246
Q

Prevention and treatment of post-partum haemorrhage drugs

A

Ergometrine
Oxcytocin
(Syntometrine®)
Carboprost (prostaglandin)

247
Q

Myometrial relaxants (tocolytics)

A

Atosiban (oxcytocin receptor antagonist)
Nifedipine (dihydropyridine calcium channel blocker)
Salbutamol (beta2 agonist)

preterm labour

248
Q

Anti-emetics used in pregnancy

A

Promethazine (1st line)
Cyclizine (1st line)
Metoclopramide (2nd line)
Ondansetron (2nd line)

249
Q

Topical beta-blockers in glaucoma

A

Betaxolol
Timolol

250
Q

Brimonidine

A

Topical sympathomimetics in glaucoma

251
Q

Carbonic anhydrase inhibitors

A

Acetazolamide
Brinzolamide
Dorzolamide

Use:glaucoma

252
Q

Prostaglandin analogues in glaucoma

A

Latanoprost
Travoprost

253
Q

Pilocarpine

A

Miotic drugs (muscarinic agonists) in glaucoma

254
Q

Drugs for Pupil dilation for fundoscopy

A

(antimuscarinics)
Atropine
Cyclopentolate
Homatropine
Tropicamide

255
Q

Phenylephrine

A

Sympathomimetic used in cataract surgery

256
Q

Phenylephrine

A

Sympathomimetic used in cataract surgery

257
Q

Topical antibacterial agents in ocular infections

A

Gentamicin
Chloramphenicol
Ciprofloxacin
Fusidic acid
Neomycin

258
Q

Topical corticosteroids for uveitis/scleritis

A

Dexamethasone
Prednisolone

259
Q

Topical antihistamines for Allergic conjunctivitis

A

Antazoline
Levocabastine

260
Q

Topical ocular anaesthetics

A

Oxybuprocaine
Lidocaine
Tetracaine

261
Q

Oral and nasal antihistamines for allergic rhinitis

A

Cetirizine (oral)
Loratidine (oral)
Azelastine (nasal)

262
Q

Nasal corticosteroids for allergic rhinitis

A

Beclometasone
Fluticasone

263
Q

Drugs for Vertigo and Ménière’s disease

A

Promethazine (anti-histamine)
Cinnarizine (anti-histamine)
Prochlorperazine (phenothiazine)
Bendroflumethiazide

264
Q

Levodopa and associated DOPA decarboxylase inhibitors

A

Co-beneldopa (Levodopa + benserazide)
Co-careldopa (Levodopa + carbidopa)

PD

265
Q

Dopamine-receptor agonists in PD

A

Pramipexole
Ropinirole
Rotigotine

266
Q

Catechol-O-methyltransferase inhibitors

A

Entacapone

267
Q

Antimuscarinic drugs in PD

A

Orphenadrine
Procyclidine

268
Q

Epilepsy Sodium channel blocking drugs

A

Carbamazepine
Phenytoin
Lamotrigine

269
Q

Epilepsy GABA receptor agonists

A

Clonazepam (benzodiazepine)
Diazepam (benzodiazepine)
Lorazepam (benzodiazepine)
Phenobarbital (barbiturate)

270
Q

other GABA receptor related antiepileptic drugs

A

Vigabatrin (GABA transaminase inhibitor)
Sodium valproate (GABA potentiator and Na channel blockade)
Gabapentin (GABA analogue)
Pregabalin (GABA analogue)

271
Q

Topiramate

A

Glutamate receptor antagonist
Epilepsy

272
Q

Ethosuximide

A

Neuronal calcium channel blocker
Epilepsy

273
Q

Levetiracetam

A

Epilepsy

274
Q

Acute treatment of migraine

A

Sumatriptan
Zolmitriptan

275
Q

Prophylaxis of migraine

A

Propranolol
Topiramate (antiepileptic drug)
Sodium valproate (antiepileptic drug)
Gabapentin (antiepileptic drug)
Amitriptyline (tricyclic antidepressant)

276
Q

Zolpidem and Zopiclone

A

Non-benzodiazepine hypnotics that modulate the GABA-A/chloride channel

for insomnia

277
Q

Temazepam

A

BDZ for insomnia

278
Q

Antibiotics for CNS infections

A

Benzylpenicillin
Ceftriaxone
Cefotaxime
Ampicillin

279
Q

Dexamethsaone in neurology

A

Bacterial meningitis, space occupying lesions with local cerebral oedema

280
Q

Alzheimer’s disease drugs

A

Anticholinesterase drugs:
Donepezil
Galantamine
Rivastigmine

NMDA receptor antag:Memantine

281
Q

Non-steroidal anti-inflammatory drugs (NSAIDs)

A

Ibuprofen (non-selective)
Naproxen (non-selective)
Celecoxib (Cox2-selective inhibitor)

282
Q

Disease-modifying antirheumatic drugs (DMARDs)

A

Sulfasalazine
Hydroxychloroquine (anti-malarial)
Leflunomide
Methotrexate (anti-metabolite)
Sodium aurothiomalate (Gold)
Azathioprine (anti-metabolite)
Ciclosporin (calcineurin inhibitor)
Penicillamine

283
Q

Antibodies against tumour necrosis factor α in RA

A

Adalimumab
Etanercept
Infliximab

284
Q

Other biological agents used in the treatment of rheumatoid arthritis

A

Anakinra (Interleukin-1 receptor antagonist)
Tocilizumab (Interleukin-6 receptor antagonist)
Abatacept (T-cell co-stimulation modulator)
Rituximab (Anti-CD20 B-cell depleter)

285
Q

Colchicine

A

Acute gout

286
Q

Allopurinol and Febuxostat

A

Xanthine oxidase inhibitors
Used for Hyperuricaemia and prevention of gout

287
Q

Rasburicase

A

Intravenous prophylaxis against gout during cancer chemotherapy

288
Q

Local anaesthesia for suturing

A

Lidocaine
Bupivacaine

289
Q

Intravenous anaesthetics

A

Etomidate
Ketamine
Propofol
Thiopental

290
Q

Intravenous opioids during anaesthesia

A

Fentanyl
Remifentanil

291
Q

Inhalational anaesthetics

A

Desflurane
Halothane
Isoflurane
Nitrous oxide
Sevoflurane

292
Q

Depolarising neuromuscular-blocking drugs

A

Suxamethonium (succinylcholine)

Use:Endotracheal intubation, muscle relaxation during surgery or on the ICU

293
Q

Competitive N2 receptor antagonists (non-depolarising blockers)

A

Atracurium
Cisatracurium
Mivacurium
Pancuronium
Rocuronium
Vecuronium

294
Q

Edrophonium

A

Acetylcholinesterase inhibitor
to test the therapeutic response to AChE inhibitors in myasthenia gravis

295
Q

Neostigmine

A

Acetylcholinesterase inhibitor
Reversal of musle relaxants used during general anaesthesia

296
Q

Pyridostigmine

A

Acetylcholinesterase inhibitor
Reversal myasthenia gravis

297
Q

LFT Hepatocellular drugs (PASS):

A

Paracetamol, Alcohol, Sodium Valproate and Statins

298
Q

Long term proton pump inhibitor therapy can cause

A

hypomagnesaemia

299
Q

drugs that tend to cause a hepatocellular picture

A

paracetamol
sodium valproate, phenytoin
MAOIs
halothane
anti-tuberculosis: isoniazid, rifampicin, pyrazinamide
statins
alcohol
amiodarone
methyldopa
nitrofurantoin

300
Q

drugs that tend to cause cholestasis (+/- hepatitis):

A

combined oral contraceptive pill
antibiotics: flucloxacillin, co-amoxiclav, erythromycin*
anabolic steroids, testosterones
phenothiazines: chlorpromazine, prochlorperazine
sulphonylureas
fibrates
rare reported causes: nifedipine

301
Q

drugs causing liver cirrhosis

A

methotrexate
methyldopa
amiodarone

302
Q

side effects of cyclosporin 5H’s

A

Hypertrophy of the gums, Hypertrichosis, Hypertension, Hyperkalaemia and Hyperglycaemia (diabetes)

303
Q

Tamoxifen

A

Tamoxifen is a oestrogen antagonist, commonly indicated for ER+ positive breast cancers. However, it also works as an agonist on endometrial tissue which can result in endometrial proliferation

304
Q

Typical antibiotics for meningitis

A

Under 3 months – cefotaxime plus amoxicillin (the amoxicillin is to cover listeria contracted during pregnancy)
Above 3 months – ceftriaxone

GP-(IM or IV) of benzylpenicillin

Medicine (72 decks)

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