Pharmacology Flashcards

1
Q

POP - forgot one pill, UPSI for the last 2 days. Advice?

A

Emergency contraception

POP
Take missed pill asap
Condoms for 2 days
If UPSI within 2 days of the missed pill, emergency contraception is needed.

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2
Q

What drug can be given in methotrexate toxicity?

A

Folinic Acid

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3
Q

The drug coumarin antagonises which vitamin?

A

Vitamin K

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4
Q

Clomifene citrate mechanism of action?

A

Selective estrogen receptor modulator

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5
Q

Which of the antineoplastic drugs causes hemorrhagic cystitis?

A

Cyclophosphamide

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6
Q

Mechanism of action of ulipristal acetate ?

A

Selective progesterone receptor modulator

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7
Q

What nerve can aminoglycosides effect? (side effect)

A

Vestibulocochlear (8th CN)

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8
Q

Mechanism of Action of Indometacin?

A

COX and prostaglandin inhibitor

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9
Q

Woman 12/40 on lamotrigine has Hb 9.9, MCH 34. Cause of blood count?

A

Folate deficiency

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10
Q

Diazepam can cross placenta due to what characteristic?

A

Lipid solubility

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11
Q

Heavy menstrual bleeding for 1 year limiting activity. BG asthma. Wants family in 1 year. First line management?

A

Mirena coil

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12
Q

Which drug can cause kernicterus?

A

Sulphonamides
e.g. sulfasalazine for Crohn’s etc

kernicterus = brain damage in baby due to raised bilirubin

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13
Q

What is the mechanism of Letrozole?

A

Aromatase inhibitor

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14
Q

Mechanism of action of terbutaline

A

Beta 2 agonist

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15
Q

The antibacterial action of Penicillin is due to its effect on?

A

Cell wall synthesis

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16
Q

Which organ anomaly occurs with the use of Tetracycline

A

Teeth

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17
Q

What is the mechanism of action of Clindamycin?

A

It inhibits bacterial protein synthesis by binding to the 50s subunit of the ribosome

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18
Q

What is the mechanism of action of Dabigatran?

A

Direct thrombin inhibitor

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19
Q

Which drug trial phase primarily assesses the safety of a drug?

A

Phase 1

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20
Q

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

A

5-alpha reductase

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21
Q

Which antihypertensive can cause postnatal depression?

A

Methyldopa

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22
Q

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

A

Inhibit the release of acetylcholine

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23
Q

Paroxetine (SSRI) is teratogenic to which organ

A

Cardiovascular

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24
Q

What is the mechanism of action of labetalol. Be specific

A

selective alpha and non-selective beta blocker

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25
Q

Which of the following drugs is used to suppress lactation postpartum in mother who suffers from stillbirth?

A

Cabergoline and Quinagolide

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26
Q

Drospirenone is (action)

A

Progestin and Antiandrogenic

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27
Q

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

A

12 hours

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28
Q

How much progesterone does mirena coil secrete in 24 hours

A

20 micrograms

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29
Q

Woman on antiemetics presents with involuntary muscle movements / extrapyramidal side effects. Which drug?

A

Metoclopramide

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30
Q

Main action of COCP

A

Inhibits ovulation

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31
Q

Drugs readily cross the placenta because of which quality?

A

Lipid solubility
(small lipophilic drugs)

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32
Q

What is the objective of a phase 3 clinical trial

A

Check effectiveness of the drug

1 - safety
2 - dose/side effects
3 - efficacy in comparison with standard
4 - long term benefits and side effects

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33
Q

What is the term used for the anticancer agent methotrexate?

A

Antimetabolite

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34
Q

What is the mechanism of action of hydralazine?

A

Direct smooth-muscle relaxant

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35
Q

What is the mechanism of action of trimethoprim?

A

Inhibits dihydrofolate reductase enzyme

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36
Q

Pregnant patient on lithium - which anomaly can occur?

A

Ebstein anomaly

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37
Q

Pregnant patient on ACE - which organ anomaly can occur?

A

Kidney

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38
Q

Woman on carbamazepine for epilepsy, what is suitable contraception

A

Mirena IUS coil

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39
Q

Woman on ulipristal acetate for fibroids, what is suitable contraception

A

Condoms only

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40
Q

What type of drug is carboprost

A

Prostaglandin F2

41
Q

What is the difference in action between aspirin and ibuprofen

A

Aspirin irreversibly inhibits COX 1

42
Q

Most common side effect of misoprostol

A

Diarrhoea

43
Q

What is the mechanism of action of mifepristone

A

Progesterone antagonist
Makes Cx and uterine vessels dilate, and causes uterine contraction

44
Q

For overactive bladder a new drug called Mirabegron is used. MoA?

A

Selective beta-3 agonist

(relaxes smooth muscle of detrusor)

45
Q

Misoprostol is analogue of

A

PGE1
Prostaglandin E1

46
Q

Name a side effect of Terbutaline

A

Maternal tachycardia

47
Q

Pregnant woman with Nausea and vomiting. Which fluid should not be given?

A

Dextrose 5%

48
Q

Epileptic patient, best contraception?

A

IUD

49
Q

COCP is contraindicated in what active disease?

A

Systemic Lupus Erythematous

+ive antiphospholipid antibodies

50
Q

Side effect of atropine on the detrusor muscle?

A

Stops contraction, causes urinary retention

51
Q

Intramuscular adrenaline dose for anaphylaxis

A

500 micrograms of 1:1000

52
Q

Alkylating agents like vincristine act against

A

Tubules

vincristine: micro tubule inhibition

53
Q

DMPA (depo contraception) is associated loss of bone mass in first 6 months of:

A

5%

54
Q

What can warfarin cause if used during pregnancy

A

Nasal hypoplasia

55
Q

Rate of bone loss per year for pre-menopausal women on GnRH

A

Rate of loss increases by 5%

56
Q

Which contraceptive is contraindicated with a history of PE

A

COCP

57
Q

Mercaptopurine is a metabolite of

A

Azathioprine

58
Q

Mechanism of action in medroxy progesterone (Depo contraception)

A

inhibits ovulation

59
Q

What should be monitored in pethidine overdoes?

A

RR

60
Q

What family of drugs cause hyperprolactinaemia

A

antipsychotics

61
Q

What is the action of atosiban?

A

oxytocin antagonist

Atosiban is a tocolytic agent

62
Q

Contraindication of oxybutinin

A

narrow/closed angle glaucoma

63
Q

What is entonox made up of

A

Nitrous oxide + O2

64
Q

Which receptors does ondansetron act on

A

5HT / serotonin

65
Q

Midazolam acts on which receptors?

A

GABA

66
Q

Drug causes fluid retention

A

Oxytocin

67
Q

Which long term contraception has the lowest failure rate

A

Copper IUCD
(implant not on the list)

68
Q

What is the chemical structure of GnRH?

A

Decapeptide

69
Q

40-year old w heavy regular periods for 5 years. USS NAD. What is the most appropriate first line pharmaceutical treatment for this patient?

A

Insertion of a levonorgestrel-releasing intrauterine system

70
Q

What are the second line drugs used in hyperemesis?

A

First line
Cyclizine (H), promethazine (H), prochlorperazine (D)

Second line
Metoclopramide (D+), ondansetron (serotonin)

71
Q

Isoniazid metabolism is by

A

Hepatic acetylation

72
Q

Why is ramifentanyl used in patient controlled analgesia?

A

Short acting easily metabolized by serum esterase

73
Q

Where does warfarin primarily act in the clotting cascade?

A

Inhibits Vitamin K

Reduces clotting factors
II, VII, IX, and X

74
Q

Which drug trial phase primarily assesses the safety of a drug?

A

Phase 1

75
Q

Light PVB 3/52 after starting COCP. Chlamydia test negative, cx smear negative. Management?

A

Follow up 3 months after starting pill

76
Q

Half life of Mifepristone?

A

Lack of consensus online
?85-90 hours

77
Q

What is the most common adverse effect experienced on POP?

A

Erratic bleeding

78
Q

What is the mechanism of action of oxytocin?

A

Acts on g-like receptors and increases intracellular Ca

79
Q

What structure is Heparin?

A

polysaccharide

80
Q

Oxybutynin side effects? 3 groups

A

Antimuscarinic:
Dry mouth, dry eyes
Diarrhoea / vomiting / constipation
Headaches / dizziness
(all common)

81
Q

Fluconazole mechanism of action

A

p450 inhibits ergosterol and membrane

82
Q

Tranexamic acid (TXA) mechanism of action

A

Anti-fibrinolytic

83
Q

What should be monitored when a patient is on LMWH?

A

Anti-Xa activity

84
Q

What are the windows of use for
Levonorgestrel
Ulipristal
IUD

A

Levonorgestrel - 72 hours (3 days)
Ulipristal - 120 hours (5 days)
IUD - 120 hours (5 days)

85
Q

What is a common side effect of DMPA (depo provera injection contraception)

A

irregular bleeding

86
Q

Raltegravir MoA

A

Inhibits HIV integrase
(which would insert viral DNA into host cell)

87
Q

Why can’t oxytocin be given orally?

A

It disturbs gastric epithelium, and is destroyed by gastric juice

88
Q

Metronidazole MoA

A

Inhibits nucleic acid synthesis, disrupting microbial DNA

89
Q

Name a second generation progesterone

A

Levonogestrel

90
Q

Which hormone is given for vaginal atrophy?

A

DHEA - a steroid precursor

91
Q

Doxazosin MoA

A

Alpha adrenergic antagonist
(alpha blocker / ARB)

92
Q

Nevirapine MoA

A

non-nucleoside reverse transcriptase inhibitor (NNRTI)
HIV drug

93
Q

POP mechanism of action

A

Inhibits ovulation
Thickens cervical mucus

94
Q

Which antiemetic causes hyperprolactinaemia

A

metoclopramide

95
Q

neostigmine MoA

A

Inhibits acetylcholine hydrolysis
Used in myasthenia gravis

96
Q

What is the MoA of apixaban?

A

Inhibits factor Xa

97
Q

What is carbaprost (an oxytotic) a synthetic analogue of?

A

Synthetic prostaglandin analogue of PGF2α

98
Q

What is DMPA and how long does it last?

A

DMPA is the depo contraceptive
It lasts 3 months

99
Q

Atropine (used to treat post op bradycardia). What receptors does it act on?

A

Blocks acetylcholine receptors