Pharmacology

Question 1

Relationship between carbamazepine and CYP3A4

Answer 1

Carbamazepine is both substrate and inducer of CYP3A4

Question 2

CYP2C9 substrates
CYP2C9 inhibitors
CYP2C9 inducers

Answer 2

Substrates:
NSAIDs
Warfarin
Anti-epileptic drugs
Angiotensin II antagonists

Inhibitors:
Sulfamethoxazole
Sodium valproate
Metronidazole
Amiodarone
Anti-fungals
Chloramphenicol

Inducers:
Griseofulvin
St John’s Wort
Rifampicin

Question 3

CYP2D6 substrates
CYP2D6 inhibitors
CYP2D6 inducers

Answer 3

Substrates:
Beta-blockers
Anti-psychotics (paroxetine)
Some SSRIs/SNRIs (fluoextine/venlafaxine)
Flecainide
Tamoxifen

Inhibitors:
Amiodarone
Anti-psychotics
Metoclopramide

Inducers:
Rifampicin
Dexamethasone

Question 4

CYP3A4 substrates
CYP3A4 inhibitors
CYP3A4 inducers

Answer 4

Substrates:
Statins (except pravastatin)
Steroid hormones
OCP
Carbamazpine
Haloperidol
Cyclosporin/tacrolinus
Macrolides
Warfarin
Anti-HIV medication
CCBs

Inhibitors:
Amiodarone
Macrolides
Anti-HIV medications
Grapefruit juice
Sodium valproate
Anti-fungals

Inducers:
Carbamazpine
Rifampicin
Phenytoin

Question 5

Type A drug reaction

Answer 5

Related to pharmacodynamics of a drug
Dose dependent, predictable

Question 6

Type B drug reaction

Answer 6

Unrelated to pharmacodynamics
Idiosyncratic
Unpredictable, mostly immunological

Question 7

Drugs with zero order elimination

Answer 7

Aspirin
Phenytoin
Ethanol

PHEN-t-AS-E

Question 8

Vancomycin - Red Man Syndrome - MOA?

Answer 8

Not IgE mediated
Due to vancomycin directly activated mast cells resulting in release of vasoactive mediators (e.g. histamine)

Question 9

Oral morphine > oral hydromorphone

Answer 9

5:1 ratio

Question 10

Oral morphine > oral oxycodone

Answer 10

1.5 : 1 ratio

Question 11

Best benzodiazepines for elderly/cirrhotics

Answer 11

The LOT (Lorazepam, Oxazepam, Temazepam)

Metabolised by the liver through Phase II (glucoronidation)