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MSRA > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Simvastatin MOA

A

inhibit HMG-CoA reductase, the rate-limiting enzyme in hepatic cholesterol synthesis

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2
Q

Broad complex tachycardia Mx

A

stable - amiodarone
unstable - DC cardioversion

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3
Q

Regular Narrow complex tachycardia Mx

A

1st - vagal manoeuvre
2nd - adenosine
3 - B Blocker
if unstable - DCCV

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4
Q

Irregular narrow complex tachycardia Mx

A

<48hours - Cardiovert (DC/ Chemical)
B Blocker - rate control

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5
Q

Bradycardia Mx

A

1 - atropine 500mg IV (up to 3mg)
2 - transcutaneous pacing
3 - isoprenaline/ adrenaline

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6
Q

Chronic Heart failure Mx

A

1 - ACEi/ ARB + B Block
2 - Aldosterone antagonist (spironolactone/ eplerenone)
Extra: annual influenza vaccine, one-off pneumococcal vaccine

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7
Q

Post ACS long term Mx (secondary prevention)

A

DAPT (inc Aspirin)
ACEi
beta-blocker
statin

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8
Q

Ca Channel Blocker SE

A

headache, flushing, ankle oedema

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9
Q

paracetamol OD Mx

A

activated charcoal if <1hr ago
n-acetylcysteine
liver transplant

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10
Q

salicylate (aspirin) OD
Fx
Mx

A

Fx - hyperventilation, tinnitus
Mx - IV Bicarbonate, haemodialysis

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11
Q

Benzodiazepines OD Mx

A

Flumazenil

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12
Q

Tricyclic antidepressants OD Mx

A

IV Bicarbonate

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13
Q

Lithium OD Mx

A

haemodialysis

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14
Q

Warfarin OD Mx

A

Vit K, prothrombin complex

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15
Q

Heparin OD Mx

A

protamine sulphate

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16
Q

B blocker OD Mx

A

1st atropine
2nd glucagon

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17
Q

Ethylene glycol (anti freeze) Od Mx

A

fomepizole

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18
Q

Organophosphate insecticide OD Mx

A

atropine

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19
Q

Digoxin OD Mx

A

Digoxin specific antibodies

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20
Q

Iron OD Mx

A

Desferrioxamine

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21
Q

Lead OD Mx

A

Dimercaprol

22
Q

Cyanide OD Mx

A

hydroxocobalamin

23
Q

Lithium in pregnancy leads to what abnormality

A

Ebsteins anomaly (cardiac defect)

24
Q

Rifampicin
MOA
SE

A

MOA prevent transcription of DNA into mRNA
potent liver enzyme inducer
hepatitis, orange secretions
flu-like symptoms

25
Q

Isoniazid
MOA
SE

A

MOA - inhibits mycolic acid synthesis
SE - peripheral neuropathy: prevent with pyridoxine (Vitamin B6)
hepatitis, agranulocytosis
liver enzyme inhibitor

26
Q

Pyrazinamide
MOA
SE

A

MOA: converted by pyrazinamidase into pyrazinoic acid which in turn inhibits fatty acid synthase (FAS) I
hyperuricaemia causing gout
arthralgia, myalgia
hepatitis

27
Q

Ethambutol
MOA
SE

A

MOA - inhibits the enzyme arabinosyl transferase which polymerizes arabinose into arabinan
SE - optic neuritis: check visual acuity before and during treatment
dose needs adjusting in patients with renal impairment

28
Q

P450 inducers

A

antiepileptics: phenytoin, carbamazepine
barbiturates: phenobarbitone
rifampicin
St John’s Wort
chronic alcohol intake
griseofulvin
smoking (affects CYP1A2, reason why smokers require more aminophylline)

29
Q

P450 Inhibitors

A

antibiotics: ciprofloxacin, erythromycin
isoniazid
cimetidine,omeprazole
amiodarone
allopurinol
imidazoles: ketoconazole, fluconazole
SSRIs: fluoxetine, sertraline
ritonavir
sodium valproate
acute alcohol intake
quinupristin

30
Q

Digoxin toxicity precipitatnts

A

hypokalaemia
CCB - verapamil, diltiazem
amiodarone, spirinolactone
AKI

31
Q

Azathioprine + Allopurinol lead to…

A

azathioprine toxicity = pancytopenia

32
Q

liver transplant for paracetamol overdose criteria

A

Arterial pH < 7.3, 24 hours after ingestion

or all of the following:
prothrombin time > 100 seconds
creatinine > 300 µmol/l
grade III or IV encephalopathy

33
Q

cocaine toxicity

A

benzodiazepine
+ GTN (if chest pain)
+ nitroprusside (if HTN)

34
Q

Tamoxifen SE

A

Hot flushes
menstrual disturbance - PV bleed, amenorrhea
endometrial Ca
VTE

35
Q

Heart failure drug exacerbators

A

Flecainide
NSAIDs/ glucocorticoids (apart from low dose aspirin)
verapamil
pioglitazone - causes fluid retention

36
Q

Aminoglycoside (gentamicin) SE (2)

A

ototoxicity
nephrotoxicity

37
Q

Fluroquinolones (ciprofloxacin) SE

A

connective tissue damage eg achilles tendon rupture

38
Q

Macrolides (erythromycin, clarithromycin) SE

A

myopathy (muscle weakness), prolonged QT

39
Q

Tetracyclines (Doxycycline) SE

A

photosensitivity

40
Q

Finasteride
MOA
SE

A

MOA - 5 alpha reductase inhib
SE - gynaecomastia, sexual dysfunction

41
Q

Lithium toxicity precipitated by drugs

A

dehydration
AKI
diuretics (esp thiazides), ACEi/ ARB, NSAIDS, Metronidazole

42
Q

HRT facts

A

progesterone essential to prevent endometrial ca (due to unopposed oestrogen)
If hysterectomy - oestrogen-only is given
cyclical HRT for perimenopause (<1yr LMP)

43
Q

Amitriptyline toxicity
Fx
Mx

A

prolonged QRS
tachycardia, dry mouth, dilated pupils
Mx - sodium bicarbonate

44
Q

Apirin (salicylate toxicity)
Fx
Mx

A

hyperventilation, tinnitus, sweating
respiratory alkalosis followed by metabolic acidosis
Mx - sodium bicarbonate, haemodialysis

45
Q

myasthenia gravis Mx

A

Pyridostigmine (acetylcholinesterase inhibitor)

46
Q

Arsenic toxicity antidote

A

dimercarpol

47
Q

Drug induced jaundice

A

nitrofurantoin
erythromycin
isonazid
methyldopa

48
Q

Amiodarone SE

A

night glare
taste disturbance (metallic)

49
Q

hypoKal

A

steroids
loop diuretics

50
Q

ACEi SE

A

HyperKal
hypotension

51
Q

Digoxin toxicity ECG

A

ST depression + T wave inversion (reverse tick)

MSRA (17 decks)

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