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MRCOG - PART 1 > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Yellow staining of baby’s teeth due to mother taking which drug during pregnancy

A

Lymecycline (Tetracyclins)

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2
Q

Which antibiotic is associated with the risk of neonatal hemolysis

A

Nitrofurantoin (treating UTI)
Co-trimoxazole (treating upper respiratory infections)

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3
Q

Baby has a defect of the 8th cranial nerve, which medication did his mother take during pregnancy

A

Streptomycin (aminoglycosides)

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4
Q

Mode of Action of Atosipan (tocolytic)

A

Oxytocin receptor antagonist

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5
Q

according to nice guidelines, what is the 1st line tocolytic

A

Nefidipine (ca channel blocker)

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6
Q

Only indications to give b2 agonist as a tocolytic

A

External cephalic version: Terbutaline SC
Emergency tocolyisis (in case of oxytocin hyper-stimulation): Terbutaline IV

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7
Q

Most used uterotonic

A

Oxytocin

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8
Q

Oxytocin side effects

A

• Tachycardia/Arrhythmia
• HTN
• Oliguria
• Natriuretic/Hyponatremi

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9
Q

Forms of prostaglandin used as uterotonic

A

○ Misoprostol(Most commonly used).
○ Dinoprostone
○ Dinoprost
○ Carboprost

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10
Q

All prostaglandins are derived from

A

arachidonic acid

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11
Q

Uses of mifepristone as a uterotonic

A

• Emergency contraception.
• Medical termination of pregnancy (IUFD – Abortion) #

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12
Q

Mifepristone mode of action

A

Competitive progesterone receptor antagonist
“Selective progesterone receptor modulator (SPRM)”

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13
Q

Side effects of Ergometrin

A

Ergotism (st anthony’s fire)
Diarrhea
Vomiting.
can cause sever vasoconstriction

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14
Q

Misoprostol is of what type of prostaglandin

A

Synthetic Prostaglandin E1 analogue (most commonly used)

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15
Q

Dinoprostone is of what type of prostaglandin

A

Naturally occurring Prostaglandin E2

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16
Q

Dinoprost is of what type of prostaglandin

A

Naturally occurring Prostaglandin F2 Alpha.

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17
Q

Carboprost is of what type of prostaglandin

A

Synthetic Prostaglandin F2 Alpha analogue

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18
Q

Half life of Misoprostol

A

40 minutes

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19
Q

1st choice uterotonic in preventing PPH

A

Oxytocin

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20
Q

Half life of Oxytocin

A

5 minutes

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21
Q

Oxytocin Side effects

A

• Tachycardia/Arrhythmia
• HTN
• Oliguria
• Natriuretic/Hyponatremia

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22
Q

The half-life of ergometrine

A

approximately 30-120 minutes

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23
Q

Uteritonic Drugs used in the third stage of labour

A
  1. Syntometrine® (Ergometrine 500mcg / Syntocinon 5IU) IM.
  2. Syntocinon
  3. Misoprostol 800mcg (PGE1 analogue)
  4. Carboprost® (PGF2α analogue)
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24
Q

Syntometrine is contraindicated in

A

hypertensive pregnancies.

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25
Q

Side effects of misoprostol

A

commonly diarrhoea and nausea/vomiting

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26
Q

Misoprostol method of administration

A

Taken orally / vaginally / rectally

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27
Q

Carboprost method of administration

A

IM or intra-myometrial

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28
Q

Carboprost cautions

A

Caution required in hypertension
Avoided in asthmatics.

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29
Q

the preferred method of induction of labour

A

vaginal PGE2

unless there are specific clinical reasons for not using it (in particular the risk of uterine hyperstimulation)

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30
Q

Misoprostol & Mifepristone should only be offered as a method of induction of labour in a women with?

A

Intrauterine fetal death

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31
Q

Why we don’t give oral oxytocin?

A

As it is destroyed by gastric acid

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32
Q

Peripheral function of Oxytocin

A
  1. letdown reflex
  2. Uterine contractions
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33
Q

From where prostaglandin is produced by

A

all nucleated cells except for lymphocytes

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34
Q

Prostaglandin is used in obstetrics in

A
  1. Induction of labour
  2. Termination of pregnancy
  3. Management of PPH
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35
Q

Common side effects of Dinprostone PGE2

A

Diarrhea
Transient Pyrexia

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36
Q

What is Ergotism?

A

Side effect of Ergometrine
prolonged vasospasm results in gangrene, hallucination, abortion)

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37
Q

In induction of labour, Membrane sweeping is indicated for nulliparous women at

A

40 to 41 weeks of gestation

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38
Q

In induction of labour, Membrane sweeping is indicated for parous women at

A

41 weeks of gestation

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39
Q

Mifepristone isn’t offered in which types of abortions

A

missed and incomplete miscarriage

(we use vaginal misopristol)

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40
Q

Medical management of missed miscarriage

A

single dose 800 micrograms of vaginal misoprostol

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41
Q

Medical management of incomplete miscarriage

A

single dose of 600 micrograms of misoprostol.

(800 micrograms can be used as an alternative to allow alignment of treatment protocols for both missed and incomplete miscarriage.)

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42
Q

We offer all women receiving medical management of miscarriage ?

A

pain relief and anti-emetics as needed.
Rhesus Anti-D IgG (if needed)

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43
Q

We offer antibiotic prophylaxis to medical or surgical abortion

A

Only surgical

(oral doxycycline 100 mg twice a day for 3 days)

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44
Q

In managing PPH, we offer how many RBC units

A

4 units of red blood cells

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45
Q

In managing PPH, What is the ration of RBC to FFP offered

A

RBC:FFP
6:4

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46
Q

In managing PPH, When we start FFP administration

A

after 4 units of RBCs

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47
Q

First line surgical intervention in managing PPH

A

Intrauterine balloon tamponade

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48
Q

What are Uterotonics contraindicated in HTN

A
  1. Oxytocin
  2. Ergometrine
    3.Syntometrine
  3. Carboprost
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49
Q

What are Uterotonics tolerable in HTN

A
  1. Syntocinon (infusion of 40IU in saline)
    2.Misoprostol (orally - vaginally - rectally)
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50
Q

Mechanism of action of Terbutaline

A

B2 agonist

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51
Q

mifepristone mode of action

A

Progesterone antagonist

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52
Q

Half life of Mifepristone?

A

25-30 hrs

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53
Q

Types of Tocolytics

A
  1. Atosiban (Oxytocin receptor antagonist)
  2. B2 agonists (salbutamol- terbutaline- ritodrine
  3. Ca channel Blockers (nifedipine)
  4. MGSO4
  5. GTN Patches
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54
Q

Route of administration of Atosiban

A

IV

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55
Q

Side effects of Nifedipine

A

VD, Hypotension and tachycardia

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56
Q

Side effects of B2 agonist

A

• Tachycardia
• Hypotension
• Pulmonary oedema
• Hypokalaemia
• Hyperglycaemia

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57
Q

Guidelines in Tocolysis in Preterm Labour

A

○ Intact membrane, Suspected PTL, 24w to 25+6 = consider Nifedipine
○ Intact membrane, Suspected PTL, 26w to 33+6 = offer Nifedipine

○ If nifedipine is CI, offer oxytocin receptor antagonists for tocolysis.
○ Do not offer beta-mimetics for tocolysis

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58
Q

the major mood stabilizer in the UK for over 40 years

A

lithium carbonate

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59
Q

therapeutic window of lithium carbonate

A

The therapeutic range of plasma concentration is narrow: 1–1.5 mEq/l.

Below 1 mEq/l there is no psychotropic effect
Above 1.5 mEq/l toxic effects begin to develop.

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60
Q

Two of the most important actions of lithium are

A
  1. inhibition of cyclic AMP production
  2. reduction in receptor-stimulated phosphatidylinositol turnover.
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61
Q

Most serious in using Lithium during pregnancy

A

Epstein anomaly in the fetus

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62
Q

Which anti-epileptic drug carries the greatest risk of neural tube defects

A

Sodium valproate

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63
Q

Midazolam is an effective anxiolytic drug, used for preoperative sedation. Which receptor is responsible for its action

A

GABA

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64
Q

Paroxetine is teratogenic to which organ ?

A

CVS

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65
Q

Diazepam can cross placenta, due to?

A

Lipid solubility

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66
Q

Use of which agents during pregnancy is associated with “floppy
infant syndrome?

A

Diazepam

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67
Q

First line Antihypertensive drug in pregnancy

A

Labetalol (labipress)

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68
Q

Labetalol mode of action

A

Selective alpha and non-selective beta antagonist

It exerts its antihypertensive effect mainly through blockade of the β 1 -receptors expressed in the heart.

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69
Q

Labetalol Side-effects

A

• Atrioventricular block and congestive cardiac failure
•IUGR with prolonged use.
• Neonatal hypoglycaemia + bradycardia have rarely been reported.
• avoided in asthmatics, leads to bronchospasm
diabetics leads to hypoglycemia
in people with peripheral vascular disease as it leads to ischemic limb.

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70
Q

Methyldopa mode of action

A

Centrally acting α2 –adrenoceptor agonists

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71
Q

Role of Methyldopa as an antihypertensive drug in pregnancy

A

considered as second line treatment as an add on to labetolol but may be used first line instead

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72
Q

Major side effect of Methyldopa that puts Labetalol in advantage

A

Postpartum depression (with long term use)

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73
Q

Mode of action of Hydralazine as antihypertensive

A

direct acting vasodilator

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74
Q

Mode of administration of Hydralazine

A

It needs to be given slowly over a minimum of 5 minutes IV.
It can be repeated IV every 15 minutes if needed

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75
Q

It’s proven to be the best prevention and best treatment of fits in severe PET / Eclampsia.

A

MgSO4

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76
Q

While treating with MgSO4, when it’s required to monitor MgSO4 level?

A

If the patient is oliguric

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77
Q

MgSO4 toxicity signs

A

• Hyporeflexia presents in advance of more serious effects
• Respiratory depression
• Cardio-respiratory arrest

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78
Q

Monitoring of MgSO4 therapy

A

• Clinical (Hourly tendon reflexes)
• Renal function (Hourly urine output)
• Cardio-respiratory (ECG during and for 1 hour after loading dose – O2 saturation continuously)

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79
Q

Anti-HTN drugs to be avoided in pregnancy

A
  1. ACEI
  2. Thiazaide diuretics
  3. Statins
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80
Q

Which anti-epileptic drug carries the greatest risk of neural tube defects?

A

Sodium Valproate

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81
Q

Use of which agent during pregnancy is associated with “floppy infant syndrome”?

A

Diazepam

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82
Q

Diazepam can cross placenta, due to?

A

Lipid solubility

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83
Q

Pregnant women with epilepsy have the highest risk of breakthrough seizures during?

A

Postpartum

84
Q

All babies born to WWE taking enzyme-inducing AEDs should be offered

A

1 mg of intramuscular vitamin K to prevent hemorrhagic disease of the newborn.

85
Q

Main Cause of Death in WWE (women with epilepsy)

A

SUDEP - Sudden unexpected death of epilepsy

86
Q

the strongest risk factor for SUDEP

A

uncontrolled tonic-clonic seizures

87
Q

Enzyme Inducing AEDs

A

Carbamazepine,
Phenytoin,
Phenobarbital,
Topiramate,
Primidone,
Oxcarbazepine &
Eslicarbazepine

88
Q

Non-enzyme Inducing AEDs

A

Sodium Valproate,
Levetiracetam,
Gabapentin,
Vigabatrin,
Tiagabine
&Pregabalin

89
Q

Anti-epileptic Drugs are associated with increased teratogenicity like

A

✓ NTDS
✓ Cleft lip and palate
✓ Cardiac defects
✓ Urogenital defects
✓ Neonatal coagulopathies
✓ Skeletal abnormalitie

90
Q

Malformations associated with Phenytoin

A

Phenytoin is associated with malformations mainly due to alterations in folate metabolism.
The fetal anticonvulsant syndrome is:
✓ Cleft lip/palate
✓ Microcephaly
✓ Cardiac abnormalities
✓ Mental retardation

• Not associated with NTDS

91
Q

Mode of action of Diazepam

A

Positive modulator of GABA

92
Q

Antidote of Diazepam

A

Flumazenil

93
Q

Diazepam can causes

A

Neonatal benzodiazepine withdrawal syndrome (floppy infant syndrome) when taken in 3rd trimester.

94
Q

What AEDs has the least risk of fetal malformations

A

lamotrigine, and carbamazepine monotherapy at lower doses

95
Q

According to RCOG guidance antenatal steroids should be offered to which group undergoing elective C-section?

A

C-section prior to 38+6 weeks gestation

96
Q

Which antiemetic drug can cause uncontrolled muscle movements?

A

Metoclopramide
(2nd line ttt after promethazine)

97
Q

Is labetalol associated with orthostatic hypotension

A

NO

98
Q

What drug can be given to reverse myelosuppression (bone marrow suppression) in methotrexate toxicity?

A

Folonic Acid

99
Q

Which cytokines are secreted by virally infected host cells and Stimulates
uninfected neighbouring cells to synthesize antiviral proteins?

A

Interferons alpha and beta (IFN α and IFN β)

100
Q

Acyclovir mode of action

A

guanine analogue, Inhibits viral DNA polymerase.

101
Q

Is Ribavirin indicated in pregnancy

A

FDA pregnancy category X.

102
Q

Clinically used interferons

A

(INF-α) are used in treatment of chronic HBV and HCV infections and
also in refractory condyloma acuminate (genital warts).

103
Q

What is Protein C

A

Physiological anticoagulant
Activated by thrombin
Degrades factors Va and VIIIa

104
Q

What is Protein S

A

Co-factor with protein C

105
Q

What is Factor V Leiden

A

Variant of factor V that cannot be inactivated by protein C
Causes hyper-coagulant state
Autosomal dominant condition
Present in 30% of patients with DVT and PE

106
Q

Heparin mechanism of action

A

Activates anti-thrombin III causing inactivation of Thrombin (factor IIa) and factors IXa, Xa, XIa, and XII.

107
Q

Heparin Route of administration

A

○ Heparin is administered intravenously or subcutaneously
○ It has a half life of about 1 hour.
○ Usually it is given by infusion after a bolus loading.
○ It is monitored by APTT.

108
Q

Antidote of Heparin

A

Protamine sulphate.

109
Q

Is heparin safe in pregnancy

A

Yes, it doesn’t cross placenta. It also isn’t secreted in milk

110
Q

Heparin Side effects

A
  1. Haemorrhage (Treated by ceasing administration and, if necessary, administration of protamine)
  2. Heparin-induced thrombocytopenia (Due to the development of antibodies after 4–5 days
    administration).
  3. Osteoporosis.
  4. Alopecia.
  5. Hyperkalemia.
111
Q

Is warfarin safe in pregnancy

A

No, it crosses the placenta.
may cause warfarin embryopathy in 5% of fetuses exposed in 6-12 weeks

112
Q

Is warfarin safe in breast feeding

A

yes

113
Q

What should women on warfarin do during pregnancy

A

Convert to LMWH, unless the thrombo-embolic risk is so high that it needs to be continued e.g. metallic heart valves”.

Convert back to warfarin 5-7 days after delivery

114
Q

Can we use warfarin anytime in pregnancy.

A

May be used between 12 – 36 weeks if absolutely necessary, but as they cross the placenta they cause anti-coagulation in the fetus and as such there is a risk of fetal intracranial haemorrhage, especially if taken close to delivery.

115
Q

Warfarin mode of action

A

inhibiting vitamin K dependent clotting factors (10,9,7,2)

116
Q

Warfarin antidote

A

FFP, Vitamin K and Prothrombin complex concentrate.

117
Q

Warfarin embryopathy

A

It is associated with multiple cranio-facial and skeletal abnormalities (Conradi-Hunnerman syndrome)

○ Hypoplasia of nasal bridge
○ Congenital heart defects
○ Ventriculomegaly
○ Agenesis of the corpus callosum
○ Stippled epiphyses

118
Q

When should the last therapeutic dose of low molecular weight heparin (LMWH) be stopped before regional anaesthesia?

A

24 hrs

119
Q

What is Tissue plasminogen activator (t-PA)

A

• Catalyzes conversion of plasminogen to plasmin which is a fibrinolytic enzyme.
• Examples: Alteplase and Reteplase.
• Antidote: Aminocaproic acid (anti-fibrinolytic)

120
Q

What is the mechanism of action of Dabigatran?

A

Thrombin inhibitor

121
Q

When should the prophylactic dose of low molecular weight heparin (LMWH) be stopped before regional analgesia?

A

12 hrs

122
Q

Coumarin drug antagonize which vitamin?

A

Vit K

123
Q

Thromboprophylaxis on patient with hyperemesis ?

A

Until discharge (disease dissolve)

124
Q

recommended drug of choice for prophylaxis of malaria in pregnancy

A

Mefloquine (5mg/kg once a week) is the recommended drug of choice for prophylaxis in the second and third trimesters for chloroquine-resistant areas.

125
Q

Severe or complicated malaria TTT

A

Artesunate I.V.
Or
Quinine I.V + Clindamycin I.V.

Quinine is associated with severe and recurrent hypoglycaemia in late pregnancy.

126
Q

Uncomplicated malaria TTT

A

P. Falciparum - Resistant P. Vivax:
Quinine (oral) + Clindamycin (oral)
Or
Riamet
Or
Malarone

Non P. Falciparum (P. Vivax – P. Ovale – P. Malariae):
Chloroquine (oral)

127
Q

What is the mechanism of action of trimethoprim?

A

Inhibits dihydrofolate reductase

(Anitbiotic)

128
Q

Heparin structure

A

sulphate polysaccharide

129
Q

Which of the following Antineoplastic drugs causing hemorrhagic cystitis?

A

Cyclophosphamide

130
Q

Mechanism of action of ulipristal acetate

A

selective progesterone receptor modulator

used in emergency contraception and fibroids

131
Q

Botulinum toxin is now used to treat neurogenic bladder because of its ability t

A

Inhibit the release of acetylcholine

132
Q

Male came for infertility check up who was taking Finasteride for treatment of his
male pattern baldness. Finasteride exert its action by inhibition of which enzyme?

A

5-alpha reductase

133
Q

What is the mechanism of Letrozole drug ?

A

Aromatase inhibitor

134
Q

Drosperinone is?

A

Progestogen

135
Q

What is the mode of action of Tranexamic acid?

A
135
Q

What is the mode of action of Tranexamic acid?

A

Inhibits Plasminogen Activation

136
Q

Which is non-ergot dopamine agonist drug used to treat hyperprolactinemia?

A

Quinagolide

137
Q

How much Mirena secretes in 24 hours ?

A

20 micro grams

138
Q

What is the most common side effect with etonogestrel implant?

A

Infrequent bleeding

139
Q

Why ramifentanil used in patient controlled analgesia?

A

Short acting easily metabolized by serum esterase

140
Q

The generation of prostanoids is catalysed by the enzyme

A

prostaglandin H2 synthase, also known as cyclooxygenase (COX)

141
Q

NSAIDs mode of action

A

lock the first oxidation step of arachidonic acid (precursor of all eicosanoids) that is catalysed by COX enzyme.

142
Q

With regard to opioid receptors. Fentanyl acts primarily as a potent?

A

Mu receptor agonist

  • morphine
  • methadone
143
Q

Types of Progesteron only pills

A
  1. Traditional (e.g. Femulen®, Micronor®, Norgeston®): thickening cervical mucus so preventing sperm entry at neck of womb.
  2. Desogestrel (e.g. Cerazette®):have potential benefits over traditional POPs because ovulation is inhibited in up to 97% of cycles and they have a 12-hour window for missed pills.
144
Q

Benefits of using Desogestrel POPs

A

have potential benefits over traditional POPs because ovulation is inhibited in up to 97% of cycles and they have a 12-hour window for missed pills. It also thicken cervical mucus.

145
Q

Side effects of POPs

A

○ Changes in bleeding patterns (Irregular bleeding)
○ Mood changes (Depression)
○ Acne
○ Breast discomfort
○ While the overall risk of pregnancy is reduced with use of traditional POPs, around 1 in 10 pregnancies that do occur may be ectopic

146
Q

If a woman vomits within 2 hours of POPs taking?

A
  • If a woman vomits within 2 hours of pill taking, another pill should be taken as soon as possible.
  • If the subsequent pill is missed, additional precautions are required until 48 hours after pill taking has been resumed.
147
Q

Window for missed pills in Desogestrel?

A

12 hours window

148
Q

Window for missed pills in traditional POPs?

A

3 hours window

149
Q

POPs missed pills protocol

A

-the pill should be taken once the patient remembered it.
- if 2 pills are missed, only one pill should be taken.
- the next pill should be taken at the usual time, that may mean that 2 pills may be taken in one day.
- Additional contraceptive precautions shall be used for 48 hours after resuming the POPs.
-Emergency contraception is indicated if unprotected sexual intercourse happened within this 48 hours.

150
Q

Types of Combined hormonal contraceptives in UK

A

○ Combined oral contraceptive pill (COC)
○ Combined transdermal patch (CTP) that releases an average of 33.9 μg EE and 203 μg norelgestromin per 24 hours.
○ Combined vaginal ring (CVR) that releases EE and etonogestrel at daily rates of 15 μg and 120 μg, respectively.

151
Q

Constituents of Combined transdermal patch (CTP)

A

Combined transdermal patch (CTP) releases an average of 33.9 μg ethinyloestradiol and 203 μg norelgestromin per 24 hours.

152
Q

Constituents of Combined vaginal ring (CVR)

A

Combined vaginal ring (CVR) releases Ethinyloestradiol and etonogestrel at daily rates of 15 μg and 120 μg, respectively.

153
Q

What is Co-cyprinidiol?

A

Co-cyprindiol (containing 35 μg EE with cyproterone acetate, an anti-androgen) is indicated for management of
moderate to severe acne and hirsutism. Women using co-cyprindiol for these indications do not require additional
contraception.

154
Q

Emergency contraception

A
  1. Ulipristal (EllaOne®) :Effective up to 5 days after sexual intercourse.
  2. Copper IUD: Can be inserted up to 120 hours after SI.
  3. Levonogestrel: up to 72 hours after SI
155
Q

Ulipristal is thought to prevent pregnancy by what primary mechanism?

A

Inhibition of ovulation

156
Q

Which of the following best describes Ulipristal?

A

Selective Progesterone Receptor Modulator

157
Q

What is the most common adverse effect experienced by women taking the progestogen only pill?

A

Irregular bleeding pattern

158
Q

FINASTERIDE EXERT ITS ACTION BY INHIBITION OF WHICH ENZYME?

A

5-ALPHA REDUCTASE

159
Q

Following Ectopic pregnancy, What percentage of women treated mediccaly with methotrexate single dose will require surgical intervention?

A

7% will require surgical intervention
15% will require another dose

160
Q
  1. What is the most common adverse effect experienced by women taking the progestogen-only pills
A

Erratic bleeding

161
Q

What is the most common side effect with etonogestrel implant

A

Infrequent bleeding

162
Q

Mirena secret in 24 hours ?

A

20 mcg initially.
18mcg 1 year after insirtion.
12 mcg 4 years after insertion
10mcg 5 years after insertion

163
Q

Mechanism of action of Apixaban

A

Direct inhibitor of factor Xa

164
Q

Fluconazole mechanism of action

A

Potent inhibitor of ergosterol synthesis

165
Q

Diethylstilbestrol associated with which neoplasm

A

Clear cell adenocarcinoma

166
Q

What is diethystilbesterol

A

Synthetic estrogen

167
Q

Mechanism of action of indomethacin

A

Cyclo-oxygenase inhibitor

168
Q

What normal physiological changes seen in pregnancy are associated with a slower drug metabolism

A

Delayed gastric emptying

169
Q

Mechanism of action of Neostigmine is?

A

Anticholinesterase

170
Q

INH (isoniazid) Metabolism is by ?

A

Acetylation

171
Q

For women with GBS who have agreed to IAP what drug should be used

A
  • Benzylpenicillin (till delivery)
  • cephalosporin (if not severely allergic to penicillin)
  • vancomycin ( if severely allergic to penicillin)
  • Clindamycin (no longer used as it’s 16% resistant)
172
Q

First line outpatient therapy of PID

A

IM ceftriaxone 1g single dose +
Oral doxycycline 100mg BD for 14 days +
Oral metronidazole 400mg BD for 14 days

173
Q

S/E of chemotherapy

A
  1. Bone Marrow suppression (neutropenia-anemia-thrombocytopenia)
  2. Nausea and Vomiting
  3. Mucositis (esp. methotrexate)
  4. Alopecia (esp. Taxanes)
174
Q

Pregnancy related nausea and vomiting uses PUQE index. What is the Maximum
score?

A

15

175
Q

Pregnant women with Nausea and vomiting. Which fluid should no be given?

A

5% Dextrose

176
Q

Clavulanic acid is what type of drug

A

Beta lactamase inhibitor

177
Q

What is the maximum dose of lidocaine the should be used in a pregnant woman

A

21ml 1% lidocaine

178
Q

Which antiepileptic drug induced cytochrome P450

A

Phenytoin

179
Q

Tamoxifen mode of action

A

Selective estrogen receptor modulator

180
Q

Contraindicated antimalarial in pregnancy

A

Doxycycline
Primaquine

181
Q

What are the eicosanoids

A
  • prostaglandins
  • prostacyclins
  • thromboxane
  • leukotreines
182
Q

Fentanyl is approximately how many times more potent than morphine

A

100 times

183
Q

Bromocriptine and Cabergoline are agonists of what receptor

A

D2

184
Q

Cyclizine and Promethazine mode of action

A

Histamine H1-receptor antagonist

185
Q

Lidocaine acting by blocking what?

A

Fast Voltage gated sodium channels

186
Q

Lidocaine half-life

A

2 hours

187
Q

Maximum dose of Lidocaine

A

3 mg/kg

188
Q

Maximum dose of lidocaine with adrenaline

A

7mg/kg

189
Q

Two most common Dihydrofolate reductase inhibitor

A

Methotrexate
Trimethoprim

190
Q

Antidote of Heroin

A

Naloxone

191
Q

Ramipril side effects

A

-IUGR
-Renel dysgenesis

(ACEI)

192
Q

LFT, RFT and Blood tests, in initiation Methotrexate ttt?

A

every 1-2 weeks

193
Q

LFT, RFT and Blood tests, in established Methotrexate ttt?

A

2-3 months

194
Q

What percent of patients allergic to penicillin will be allergic to cephalosporin

A

10%

194
Q

Most common side effects of OAB therapy

A

Dry mouth = 1 in 10 patients

195
Q

1st line ttt of OAB

A

-Oxybutynin
-Tolterodin
-Darifencain

196
Q

Which method of contraception reduces the effect of Lamotrigine?

A

Estrogen component of contraception
(NOT PROGESTERON)

197
Q

Resume COCs after Abortions and Birth giving

A

After Abortion immediately
After delivery if not breastfeeding with 3 weeks

198
Q

Mode of action of Mefenamic Acid

A

Prostaglandin synthesis inhibitor

199
Q

Choanal Atresia is a side effect of what drug

A

Carbimazol

200
Q

LMWH is monitored by

A

Anti-factor Xa activity

201
Q

First line ovulation induction (ttt of PCO)

A

Letrozol

(Less risk of multiple pregnancy)

202
Q

Ovulation induction drugs

A

1- Letrozole #1
2- Gonadotrophins #2
3- Metformin
4- Clomiphene Citrate

203
Q

Phase 2 reaction of drug metabolism

A

Conjugation

204
Q

Hematological action of Prostacyclin PGI2

A

Inhibit platelet aggregation

205
Q

Hematological action of Thromboxane TXA2

A

Induce platelet aggregation

MRCOG - PART 1 (15 decks)

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