Pharmacology Flashcards
Which drug inhibits Vitamin K dependant factor?
- A ) Abciximab
- B ) Aspirin
- C ) Clopidogrel
- D ) Dabigatran
- E ) GbII/IIIa inhibitors
- F ) Heparin
- G ) Paracetamol
- H ) Rivaroxaban
- I ) Streptokinase
- J ) Warfarin
Which drug inhibits Vitamin K dependant factor?
= J) Warfarin
- *Answer: Phenytoin**
- *Explanation:** About one-third of children whose mothers are taking this drug during pregnancy typically have intrauterine growth restriction with a small head and develop minor dysmorphic craniofacial features and limb defects including hypoplastic nails and distal phalanges
Answer: Inhibit reabsorption of Na+ and Cl- in DCT
- *Answer: MAOIs**
- *Explanation:** MAOIs destroy the function of MAO -> unrestricted diet could increase the available tyramine. Tyramine is a naturally occurring trace amine derived from the amino acid tyrosine. Tyramine acts as a catecholamine releasing agent. Notably, it is unable to cross the blood-brain barrier, resulting in only non-psychoactive peripheral sympathomimetic effects following ingestion. A hypertensive crisis can result, however, from ingestion of tyramine-rich foods in conjunction with monoamine oxidase inhibitors (MAOIs).
Answer: bronchospasm : β2 agonist
Answer: NSAIDs (Indomethacin)
Explanation: Although Colchicine has been used to treat acute gout since the sixth century and is of proven efficacy, it should rarely be prescribed as a primary treatment because of its toxicity.
Answer: Clopidogrel
Explanation: ADP receptor inhibitors (e.g. clopidogrel and prasugrel) work by inhibiting platelet aggregation. This irreverisbly blocks ADP receptors, which in turn prevents expression of glycoprotein IIb/IIIa on the platelet surface. It is used in the management of ACS and during coronary stenting.
Answer: Blurred vision, dry mouth, urinary retention
Answer: 4-5 hrs
Answer: Cephalosporins
Cephalosporins are beta-lactam antibiotics that inhibit cell wall synthesis and are therefore bactericidal.
Answer: Vitamin B6, peripheral neuropathy
Answer: Aspirin
Answer: Celecoxib
Answer: Drowsiness, sedation
The ECG shown below is most commonly seen in what type of drug overdose?
- A) Amphetamines
- B) Cocaine
- C) Paracetamol
- D) SSRIs and SNRIs
- E) TCAs
Answer: TCAs
Answer: antagonist, Vitamin K reductase
Explanation: Warfarin antagonises Vitamin K reductase, a co-enzyme that reduces activation of factors II, VII, IX and X. It initially has a pro-coagulant effect by inhibiting protein C and S; therefore it’s important to use heparin for atleast 48 hours until a therapeutic INR range has been reached.
Answer: Postural hypotension
Answer: Hyperkalaemia
Explanation: Digoxin directly inhibits Na+/K+ ATP-ase in the sodium/potassium pump of the non-pacemaker cells of the heart and the smooth muscle of vessels. This means that there will be a slow leak of potassium outwards, and a slow leak of sodium inwards. The presence of hyperkalaemia is an earlier indicator of digitalis toxicity.
Answer: Flumazenil
Answer: Benzodiazepine receptor antagonist
Answer: Via stimulation at the M2 receptor of the vagus nerve
Explanation: Digoxin exhibits its anti-arrhythmic effects via vagal nerve stimulation at the M2 receptor.
It does block Na+/K+ ATP-ase, but this increases cardiac inotropy.
By inhibiting the Na+/K+ ATPase, cardiac glycosides cause intracellular sodium concentration to increase. This enhances the ability for the cell to depolarise, and leads to an accumulation of intracellular calcium via the Na+/Ca2+ exchange system. In the heart, increased intracellular calcium causes more calcium to be released by the sarcoplasmic reticulum, thereby making more calcium available to bind to troponin-C, which increases contractility (inotropy).
Answer: Verapamil
Answer: administration of N-acetylcysteine, glutathione
Answer: QTc; torsades de pointes
Answer: Streptokinase
Answer: Early distal tubule
Answer: Thromboxane A2
Answer: Aspirin
Explanation: Aspirin’s anti-platelet action works by blocking the synthesis of thromboxane A2 from arachidonic acid in platelets (it does this by irreversibly inhibiting cyclooxygenase). Thromboxane A2 stimulates phospholipase C, which increases calcium levels and causes platelet aggregation. Aspirin also has analgesic, anti-inflammatory, and antipyretic actions.
Answer: Prednisone
Explanation: The patient’s history and symptoms indicate that he was most likely suffering from steroid-induced cataract development. Long-term therapy with a high dose of glucocorticoids has been associated with the development of posterior subcapsular cataracts, which occur in about 20% of patients treated for 1 year or more. Mifepristone and fludrocortisone are not used to treat rheumatoid arthritis, nor do they cause cataracts. Methotrexate, azathioprine, and cyclophosphamide are sometimes used to treat rheumatoid arthritis, but they do not cause cataract formation.
Answer: Clozapine
Answer: Lithium
Lithium is a common medication prescribed for bipolar depression. One complication of this medication is lithium nephropathy, which usually presents within the first month.
Answer: Rheumatoid arthritis
Answer: Polymixins
Polymixins are highly toxic antibiotics that destroy cell membranes. They have powerful gram-negative activity and are used for pseudomonas otitis externa (topical) and pseudomonas pneumonia in CF patients (nebulised).
Answer: Theophylline
= A
Answer: Selegiline
Answer: Monoamine oxidase and Aldehyde dehydrogenase
Answer: Haloperidol
Answer: Dexamethasone
Corticosteroids significantly reduce hearing loss and neurological sequelae but do not reduce overall mortality.
Answer: Sedation
- Sedation is a result of blocking H1 receptors.
- Urinary retention, dry mouth, and blurred vision all occur due to blocking M receptors.
- Postural hypotension occurs due to blocking alpha-1 receptors.
Answer: Competitively antagonises acetylcholine action on muscarine receptors.
Answer: Nifidepine
Dihydropyridine calcium channel blockers, such as nifidepine, mainly affect arterial vascular smooth muscle.
Answer: Cyproheptadine
In patients with significant agitation and neuromuscular excitation, oral cyproheptadine may be used; a H1-, 5-HT1A-, and 5-HT2A-receptor antagonist.
In patients with severe serotonin toxicity who are unable to take oral medications, chlorpromazine may be used as an alternative drug for sedation.
Answer: Bromocriptine
Answer: Phenytoin and carbamazepine
Answer: It is polar and metabolises in the periphery
Although there is no cure for Parkinson’s disease, many medications are available to control the symptoms. Some of these drugs will boost the production of dopamine in the brain. Others mimic the effects of dopamine. Interestingly, dopamine itself is not used. This is because the dopamine molecule is too polar to cross the blood-brain barrier, and thus cannot enter the brain. The most common treatment used contains the chemical L-dopa. This molecule is also polar, however, because it is an amino acid it is recognised by proteins that carry amino acids across the blood-brain barrier. L-dopa is therefore safely transported across the interface.
Answer: Ipratropium
Answer: Miosis
DUMBELS: Diarrhoea, Urination, Miosis, Bronchoconstriction, Excitation (of skeletal muscle and CNS), Lacrimation, Salivation/Sweating
Answer: Anticholinergics
Answer: inhibiting constriction of the efferent arteriole
Answer: They are contraindicated in patients with renal impairment
Bisphosphonates are most commonly used to treat patients with osteoporosis because they are antiresorptive agents and act on osteoclasts to decrease or stop the resorption of the bone. They can pass into breast milk and, therefore, should not be used by patients who are breastfeeding. They also cause esophageal erosions and should be used with caution in patients with gastrointestinal diseases. The older generation of bisphosphonates (eg, etidronate) caused osteomalacia when used in continuous mode and in high dosages; however, the newest medications in this class (eg, alendronate, risedronate) are safer and have not been shown to cause this complication.
Answer: Quinolones
- Quinolones - DNA gyrase inhibition
- Tetracyclines - Ribosomal subunit inhibition
- Carbepenem - Inhibition of cell wall synthesis
- Cephalosporins - Inhibition of cell wall synthesis
- Macrolides - Ribosomal subunit inhibition
Other antibiotics that interfere with DNA include: quinolones, metronidazole, cotrimoxazole, rifampicin, and fusidic acid.
Answer: Ceftriaxone
Cell-membrane inhibitors are almost all excreted renally. Ceftriaxone is the only cell-membrane inhibitor that is eliminated hepatically. This is useful to know, as it concentrates in the gallbladder and can be used in the treatment of cholecystitis.
Answer: conjugation
Answer: Mimic dopamine transmission at the postsynapse
Answer: Salmeterol
The question is asking for a prolonged method of therapy which is salmeterol -> long-acting (8–12h). Salbutamol has the same MoA but it is short acting.
Answer: Digoxin-specific antibody Fab fragments
Answer: Sulfonyureas
Answer: Heparin
Answer: Xa
Answer: Xa
Potentiates the action of ATIII, increasing inhibition of Xa and IIa, but (unlike unfractionated heparin) in a 4:1 ratio.
Answer: Xa
Answer: Draw a stat paracetamol level and administer NAC.
Survival from a paracetamol overdose is generally considered to be 100% in cases receiving NAC within 8 hours of exposure. Efficacy declines after this point. The threshold for potential paracetamol-induced hepatic injury in adults is >10g or >200 mg/kg (whichever is less) within 24 hours. With an unknown amount, a toxic dose should be presumed.
Answer: Cytochrome P-450
Answer: Kidney injury occurs by metabolite other than NAPQI
Answer: Clopidogrel
Answer: Heparin
Answer: Thrombomodulin
Answer: Antithrombin
Answer: Protamine sulfate
Answer: Vitamin K
Answer: Aspirin
Answer: Factor Xa
Answer: Activation of D2 receptors (Bromocriptine)
Answer: Reversible inhibition of COMT (Entacapone)
Answer: Carbidopa
Answer: Carbimazole
- A) Administer a nonsteroidal anti-inflammatory drug (NSAID)
- B) Administer chewable aspirin (325mg) and activate the cardiac catheterization team
- C) Administer IV thrombolytic therapy
- D) Administer IV heparin bolus followed by an infusion for 48 hours
- E) Admit to the CCU to rule out myocardial infarction and perform stress testing in the morning
Answer: Administer a nonsteroidal anti-inflammatory drug (NSAID)
The patient’s clinical history is consistent with acute pericarditis, likely viral in nature. The ECG supports this diagnosis, with findings of PR-segment depression as well as concave ST-segment elevation in a large territory that does not follow a coronary artery distribution. An NSAID should be administered to alleviate the patient’s chest discomfort. Atrial fibrillation was incidentally found on physical examination at the time of presentation. Atrial fibrillation is not an uncommon finding in patients with pericarditis and may resolve on its own after the inflammatory process subsides. The use of anticoagulation in this young woman with no significant risk factors for stroke or thromboembolism would be of little benefit, and it may be harmful given that the patient might have a pericardial effusion associated with pericarditis, which can be worsened by anticoagulation. The patient is not experiencing an acute MI; therefore, IV thrombolytic therapy and aspirin and cardiac catheterization are not indicated.
Answer: Allopurinol
Allopurinol is a xanthine oxidase inhibitor and it should be used as first-line urate-lowering therapy.
Answer: Somatostatin analogue
Somatostatin analogues such as ocreotide are used to treat acromegaly.
