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Pharmacology Flashcards

1
Q

How does acute intermittent porphyria often present? (2)
Age

A

Abdominal and neuropsychiatric symptoms
20-40yo

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2
Q

What medication promotes ETOH abstinence?
Contraindications (2)

A

Disulfram
Ischaemic heart disease, psychosis

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3
Q

What is acamprosate used in? MOA

A

NMDA antagonist
Used to reduce cravings for ETOH

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4
Q

Allopurinol SE

A

Dermatological e.g Steven Johnson’s, severe cutaneous adverse reaction etc

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5
Q

Amiodarone SE (8)

A

Thyroid dysfunction
Corneal deposits
Pulmonary fibrosis
Liver fibrosis
Peripheral neuropathy
Slate grey appearance
Bradycardia
Long QT

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6
Q

Amiodarone effect on warfarin and digoxin

A

Increases INR and digoxin levels

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7
Q

P450 inhibitors
SICKFACES.COM

A

Increases levels/ toxicity/ reduces excretion

Sodium valproate/ SSRI
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Alcohol..binge drinking acute, allopurinol, amiodarone
Chloramphenicol
Erythromycin
Sulfonamides
Ciprofloxacin
Omeprazole
Metronidazole
Grapefruit juice

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8
Q

P450 inducers
CRAP GPS

A

Increased breakdown, lowers levels in the blood, increases excretion

Carbemazepines, chronic
Rifampicin
Alcohol (chronic)
Phenytoin
Griseofulvin
Phenobarbitone
Sulphonylureas , St John’s wart, smoking

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9
Q

Contraindications to sildenafil (3)

A

Patients taking nitrates e.g nicorandil
Hypotension
Recent stroke/ MI (wait six months)

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10
Q

Sildenafil SE (6)

A

Visual disturbances (blue discolouration)
Nasal congestion
Flushing
GI effects
Headache
Priapism

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11
Q

Where does spiro work?

A

Acts in the cortical collecting ducts

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12
Q

What is amiloride?
Where does it work?

A

K+ sparing diuretics
Distal convoluted tubule

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13
Q

Name four medications which can exacerbate heart failure

A

Pioglitazone (SE fluid retention)
Verapamil
NSAIDS/ steroids
Flecainide

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14
Q

Name four drugs to avoid in renal failure

A

NSAIDs
Lithium
Metformin
Tetracycline/ nitro

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15
Q

Drugs safe in CKD (4)
Abx (2)
Blood thinner (1)
Benzo

A

Erythromycin
Rifampacin
Diazepam
Warfarin

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16
Q

Name three anti-epileptics that harmful in pregnancy

A

Sodium valproate
Carbamezapine
Phenytoin

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17
Q

Medications not safe in pregnancy (6)

A

Warfarin
Statin
Sulfonylureas
Retinoids
ACE inhib
Tetracyclines

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18
Q

Adverse effects quinolones (3)

A

Tendon damage
Lengthen QT
Lower seizure threshold

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19
Q

Feature of serotonin syndrome (5)

A

Hyperreflexia
Myoclonus
Rigidity
Hyperthermia
Sweating

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20
Q

SE CCB (3)

A

Headache
Flushing
Ankle oedema

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21
Q

SE bendroflumethiazide (3)

A

Gout
Low potassium and sodium
Impaired glucose tolerance

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22
Q

BB SE (3)

A

Cool peripheries
Impaired glucose tolerance
Bronchospasm

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23
Q

Common SE
Amoxi (1)
Coamox (1)
Fluclo (1)

A

Rash
Cholestasis
Cholestasis

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24
Q

Common SE
Erythro (2)
Cipro (2)
Metro (1)

A

GI upset, long QT
Seizure lower threshold, tenodinitis
Reaction with ETOH

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25
Q

Common SE
Doxy (1)
Trimethoprim (2)

A

Photosensitivity
Rashes, pruritis

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26
Q

SE metformin (2)

A

GI
Lactic acidosis

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27
Q

Sulfonylureas SE (4)

A

Hypoglycaemia
Weight gain
SIADH
Liver dysfunction

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28
Q

Glitazones SE (4)

A

Weight gain
Fluid retention
Liver dysfunction
Fractures

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29
Q

Gliptin SE

A

Pancreatitis

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30
Q

Lithium range
When to take the level

A

0.4-1
12 hours post dose

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31
Q

Digoxin when to check the level?

A

At least 6 hours post dose

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32
Q

Phenytoin when to check the level?

A

Trough, immediately before next dose

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33
Q

SE TB drugs
Rifampacin (3)

A

Flu like symptoms
Hepatitis
Red urine

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34
Q

SE TB drugs
Isoniazid (3)

A

Peripheral neuropathy
Agranulocytosis
Hepatitis

35
Q

Pyrazinamide (3)
SE TB drugs

A

Gout
Arthralgia
Hepatits

36
Q

SE TB drugs
Ethambutol (1)

A

Optic neuritis

37
Q

What is the Yellow Card Scheme for?

A

Report adverse reactions

38
Q

SE verapamil (4)

A

Flushing
Heart failure
Constipation
Hypotension

39
Q

Diltiazem SE (4)

A

Ankle swelling
Hypotension
Bradycardia
Heart failure

40
Q

Features of CO poisoning (5)

A

Headache
N&V
Vertigo
Confusion
Pink skin and mucosae

41
Q

CO poisoning
Ix (2)
Mx (2)

A

VBG/ABG
CarboxyHb levels

Mx
1. High flow oxygen through non re-breathe for a minimum of 6 hours
2. Hyperbaric oxygen

42
Q

Ciclosporin
Adverse effects (4)

A

Gingival hyperplasia
Hypertrichosis
Impaired glucose tolerance
Hyperlipidemia

43
Q

Indications for ciclosporin (4)

A

Post organ transplant
RA
Psoriasis
UC

44
Q

Neurological effects of cocaine (4)

A

Seizures
Hypertonia
Hyperreflexia
Mydriasis

45
Q

Mx cocaine toxicity
General (1)
CP (1)
HTN (1)

A

Benzos
CP GTN
HTN sodium nitroprusside

46
Q

Diclofenac is contraindicated in (4)

A

Ischaemic heart disease
PAD
Cerebrovascular disease
Congestive heart failure

47
Q

Digoxin toxicity
When to check the level?

A

8 to 12 hours post dose

48
Q

Digoxin toxicity features (4)

A

Gynaecomastia
Arrhythmias
N&V, confusion
Yellow green vision

49
Q

Precipitating factors for digoxin toxicity (6)

A
  1. Hypokalaemia
  2. Increasing age
  3. Renal failure
  4. MI
  5. Hypomagnesium
  6. High calcium and sodium
50
Q

Mx digoxin toxicity (1)

51
Q

Drug monitoring
Statin

A

LFTs
Baseline, 3 + 12 months

52
Q

Drug monitoring
ACE

A

U+E
Prior to rx, after increasing dose and annually

53
Q

Drug monitoring
Amiodarone

A

TFT, LFT every 6 months

TFT,LFT, U+E, CXR prior to treatment

54
Q

Drug monitoring
Glitazone

A

LFT
Before treatment and regularly

55
Q

Drug monitoring
Lithium

A

Lithium level, TFT, U+E

TFT, U+E prior to treatment + every 6 months
Lithium weekly until stabilised

56
Q

Drug monitoring
Sodium valproate

A

LFT FBC before treatment
LFT regularly during first 6 months

57
Q

Drug monitoring
MTX

A

FBC, LFT, U+E
Before rx started and weekly until stabilised, then every 2-3 months

58
Q

Drug monitoring
AZT

A

FBC LFT before treatment and every 3 months
FBC weekly for 4 weeks

59
Q

Name five drugs that can cause impaired glucose tolernace

A

Steroids
Thiazides
Ciclosporin
Antipsychotics
BB

60
Q

Drugs causing lung fibrosis (5)

A

Amiodarone
MTX
Sulfasalazine
Bromocriptine
Cabergoline

60
Q

Features of ecstasy poisoning (3)

A

Hyponatraemia
Hyperthermia
HTN

61
Q

Adverse effects finasteride (4)

A

Impotence
Decreased libido
Ejaculation disorder
Gynaecomastia

62
Q

Heparin overdose can be reversed by?

A

Protamine sulphate

63
Q

Premature menopause
How long should HRT be continued for?

A

Until 50yo

64
Q

Name two drugs that can cause low mag
Name four other causes of low mag

A

Diuretics
PPIs

ETOH
Diarrhoea
Low K+
High calcium

64
Q

paraesthesia
tetany
seizures
arrhythmias
decreased PTH secretion → hypocalcaemia
ECG features similar to those of hypokalaemia
exacerbates digoxin toxicity
=

A

Hypomagnesiumia
(similar to low calcium)

65
Q

When to give IV mag replacement versus PO

A

<0.4 IV 40mmol over 24 hours
>0.4 PO 10-20mmol PO/day

66
Q

coarse tremor (a fine tremor is seen in therapeutic levels)
hyperreflexia
acute confusion
polyuria
seizure
coma
=

A

Lithium toxicity

67
Q

Mx lithium toxicity (2)

A

Fluids
Haemodialysis

68
Q

Overdose and poisoning management
Paracetamol (2)
Salicyclate (2)
Opiods (1)

A

Activated charcoal if <1 hour
NAC

IV bicarb
Haemodialysis

Naloxone

69
Q

Overdose and poisoning management
Benzos (1)
TCAs (2)
Lithium (2)

A

Flumezanil

IV bicarb
Dialysis

Fluids
Haemodialysis

70
Q

Overdose and poisoning management
Heparin (1)
BB (1)
Methanol (2)

A

Protamine sulphate

Atropine

Fomepizaole
Haemodialysis

71
Q

Overdose and poisoning management
Organophosphate insecticides (1)
Iron (1)

A

Atropine

Desferrioxamine

72
Q

Overdose and poisoning management
Lead CO (2)
Cyanide (1)
Ethylene glycol (1)

A

100% oxygen
Hyperbaric oxygen

Hydroxocobalamin

Fomepizole

73
Q

Salivation
Lacrimation
Urination
Defecation/diarrhoea
(SLUD)
cardiovascular: hypotension, bradycardia
also: small pupils, muscle fasciculation
=

A

Organophosphate insecticide poisoning

74
Q

Mx of opioid dependence (2)
How long should detox last? Inpt versus community

A

Methadone
Buprenorphine

4 weeks
12 weeks

75
Q

Name two medications that can cause occulogyric crisis (2)

Mx (2)

A

Antipsychotics
Metoclopramide

Benztropine
Procyclidine

76
Q

Motion sickness mx (3)

A

Transdermal hyoscine
Cyclizine
Cinnarizine

77
Q

What creatinine should lead to a review in metformin, when should it be stopped

78
Q

Iodine XRs such as coronary angio can increase risk of renal impairment. If on metformin when should it be discontinued and restarted

A

On the day of the procedure and 48 hours after

79
Q

SE of mefloquine (3)
How long can it last?

A

Neuropsychiatric side effects
- suicide and deliberate self harm
- nightmares
- anxiety

Long half life so can continue for several months

80
Q

Examples of macrolides (3)
Adverse effects (2)

A

Clarithro
Azithro
Erythro
Bacteriostatic

Long QT
Cholestatic jaundice

81
Q

Azithro SE (2)

A

Hearing loss
Tinnitus

AKT (52 decks)

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