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Medicine Year 5 > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

management of paracetamol overdose

A

n-acetylcysteine
activated charcoal if presented within 1 hour

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2
Q

pH needed for a liver transplant in paracetamol overdose

A

less than 7.3 after 24 hours

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3
Q

management of salicylate poisoning

A

IV bicarbonate and haemodialysis

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4
Q

ABG and ECG in salicylate poisoning

A

mixed respiratory and metabolic acidosis

prolonged QRS

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5
Q

management of opioid overdose

A

naloxone

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6
Q

opioid detoxification in the community

A

buprenorphone / methodone

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7
Q

management of benzodiazepine overdose

A

flumazenil if severe or iatrogenic as risk of seizure

otherwise supportive

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8
Q

management of tricyclic antidepressant overdose

A

IV bicarbonate and dialysis

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9
Q

presentation of tricyclic overdose

A

anticholinergic side effects (arrhythmia, seizure, coma)

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10
Q

ABG and ECG in tricyclic overdose

A

ABG: metabolic acidosis
ECG: sinus tachycardia and prolonged QRS

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11
Q

management of lithium overdose

A

IV saline and haemodialysis

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12
Q

coarse tremor, increased reflexes, confusion, polyuria, seizure and coma are found in an overdose of what?

A

lithium

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13
Q

what can precipitate a lithium overdose

A

dehydration / renal faiure / NSAIDs / thiazides / ACEI/ARB / metronidazole

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14
Q

management of warfarin overdose

A

vitamin K and prothrombin complex

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15
Q

management of heparin overdose

A

protamine sulphate

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16
Q

management of BB overdose

A

atropine if low heart rate

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17
Q

management of ethylene glycol and methanol overdose

A

fomepizole and haemodialysis
ethanol for methanol

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18
Q

ABG in ethylene glycol poisoning

A

metabolic acidosis with a high anion gap

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19
Q

moa of fomepizole

A

inhibits alcohol dehydrogenase

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20
Q

management of organophosphate poisoning

A

atropine

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21
Q

reduced heart rate, miosis, salivation, lacrimation, urination, diarrhoea, reduced bp and fasciculations in an overdose of what

A

organophosphates (insesticides)

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22
Q

which overdose is desferrioxamine used for

A

iron

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23
Q

management of theophylline overdose

A

haemodialysis

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24
Q

confusion, pink mucosa and low grade fever

A

carbon monoxide poisoning

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25
Q

management of carbon monoxide poisoning

A

100% oxygen

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26
Q

which drug causes colourful visual hallucinations, psychosis, paranoia, depersonalisation

management

A

LSD
Lorazepam

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27
Q

which drug causes agitation, anxiety, confusion, ataxia, tachycardia, HTN, hyponatremia, pyrexia and rhabdomyolysis

management

A

ecstasy

supportive

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28
Q

which drug causes htn, prolonged QT, seizures, reduced tone, increased reflexes, agitation, psychosis, hallucinations, ischaemic colitis, pyrexia, rhabdomyolysis and metabolic acidosis

management

A

cocaine

benzodiazepines

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29
Q

MOA of benzodiazepines

A

blocks dopamine, noradrenaline and serotonin

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30
Q

which medication causes nausea, vomiting, anorexia, confusion, YELLOW GREEN VISION, AV block, bradycardia, acidosis and electrolyte disturbances when overdosed

A

digoxin

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31
Q

MOA of digoxin

A

positive inotrope which inhibits the Na/K ATPase pump for rate control of the heart

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32
Q

which medication can precipitate digoxin toxicity

A

thiazides

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33
Q

how do you manage digoxin toxicity

A

monitor K and correct arrhythmias
digoxin specific antibody (digiband)

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34
Q

how many hours post dose do you check digoxin levels

A

6-12 hours

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35
Q

how many hours post dose do you check lithium levels

A

12 hours

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36
Q

when do you check ciclosporin and phenytoin levels

A

immediately before the dose

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37
Q

which drug would you monitor LFT at baseline, 3m and 12m

A

statins

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38
Q

which drug would you monitor U+E at baseline, when the dose changes and annually

A

ACEi

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39
Q

which drug would you monitor baseline TFT, U+E, LFT, CXR and 6 monthly TFT and LFT

A

Amiodarone

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40
Q

which drug would you monitor FBC, LFT, U+E at baseline then weekly until stable then every 3m

A

methotrexate

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41
Q

which drug would you monitor TFT, U+E baseline then every 6m
drug levels weekly until stable then every 3m

A

lithium

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42
Q

which drug would you monitor LFT and FBC baseline then LFT during the first 6m

A

sodium valproate

43
Q

which drug would you monitor LFT baseline and regularly

A

glitazones

44
Q

which diabetic drug caused GI disturbance, lactic acidosis (stop in MI) and nephrotoxicity (stop if eGFR under 30)

45
Q

which diabetic drug causes hypoglycaemia, weight gain, increased appetite, SIADH and cholestatic liver disease

A

sulphonylureas

46
Q

which diabetic drug causes increased weight, fluid retention, liver dysfunction and fractures

A

glitazones

47
Q

which diabetic drug causes pancreatitis

48
Q

which TB medication inhibits RNA polymerase and can cause hepatitis, flu like symptoms and orange bodily fluids

A

RIFAMPICIN

49
Q

which TB medication inhibits myoclonic acid and causes peripheral neuropathy, hepatitis and agranulocytosis

50
Q

how do you treat isoniazid induced peripheral neuropathy

A

pyridoxine

51
Q

which TB medication inhibits enzymes and causes, optic neuritis and renal impairment

A

ETHAMBUTOL (check visual acuity before starting)

52
Q

which receptor do decongestants such as phenylephrine and oxymetazoline work on

A

alpha 1 agonist

53
Q

which receptor does topical brimonidine for glaucoma work on

A

alpha 2 agonist

54
Q

which receptor does tamsulosin for BPH and doxasoin for HTN work on

A

alpha antagonist

55
Q

SE of alpha antagonists

A

drowsy, dry cough, SOB, postural hypotension

56
Q

which receptor do inotropes such as doxybutamine work on

A

beta 1 agonist

57
Q

which receptor do selective and non-selective beta blockers such as atenolol and bisoprolol work on

A

beta 1 antagonist

58
Q

which receptor do bronchodilators such as salbutamol work on

A

beta 2 agonist

59
Q

which receptor do non selective beta blockers such as propanolol and labetalol work on

A

beta 2 antagonist

60
Q

which receptor do Parkinson’s medications such as ropinirole work on

A

dopamine agonist

61
Q

which receptor do antipsychotics such as haloperidol and antiemetics such as metoclopramide and domperidone work on

A

dopamine antagonist

62
Q

which receptor do benzodiazepines and baclofen work on

A

GABA agonist

63
Q

which receptor does flumenezil work on

A

GABA antagonist

64
Q

which receptor do antihistamines such as loratadine work on

A

histamine 1 antagonist

65
Q

which receptor do antacids such as ranitidine work on

A

histamine 2 antagonist

66
Q

which receptor do glaucoma medications such as pilocarpine work on

A

muscarinic agonist

67
Q

which receptor does atropine, ipratropium and oxybutynin work on

A

muscarinic antagonist

68
Q

which receptor do depolarising muscle relaxants such as suxamethonium and vareniciline for smoking cessation work on

A

nicotinic agonist

69
Q

which receptor do non depolarising muscle relaxants such as atracurium work on

A

nicotinic antaognist

70
Q

which receptor does syntocinon for labour induction work on

A

oxytocin agonist

71
Q

which receptor do triptans for migraine work on

A

serotonin agonist

72
Q

which receptor do anti emetics such as ondansetron work on

A

serotonin antagonist

73
Q

name three medications used for motion sickness

A

hyoscine - cyclizine - promethazine

74
Q

why is cyclizine used in caution in heart failure

A

reduces the cardiac output

75
Q

fast onset symptoms of increased reflexes, clonus, dilated pupils, confusion, rigidity, tachycardia, hypertension, pyrexia and sweating

A

serotonin syndrome

76
Q

slow onset symptoms of reduced reflexes, lead pipe rigidity, normal pupils, rigidity, tachycardia, hypertension, pyrexia and sweating

A

neuroleptic malignant syndrome

77
Q

difference in the cause of serotonin syndrome and neuroleptic malignant syndrome

A

serotonin: SSRI, MAOi, ecstasy
neuroleptic: antipsychotics

78
Q

management of serotonin syndrome and neuroleptic malignant syndrome

A

IV fluids and benzodiazepines

chlorpromazine in resistant serotonin
dantrolene in resistant neuroleptic

79
Q

SE of the following medications: tricyclic antidepressants, NSAID, opioids, disopyramide, anticholinergics (antipsychotics and antihistamines)

A

urinary retention

80
Q

dosages of adrenaline in anaphylaxis and arrest

A

1:1000 IM 0.5mg-0.5ml in anaphylaxis

1:10000 IV 1mg-10ml or 1:1000 1ml in arrest

81
Q

MOA of aspirin

A

non reversible COX 1 and 2 inhibitor

82
Q

aspirin before a tooth extraction

A

take as normal

83
Q

which medication can cause urticaria

84
Q

% of carboxyhaemoglibin in smokers

85
Q

side effects of CCB

A

ankle swelling, headache, flushing

nifedipine: peripheral vasodilation and reflex tachycardia

86
Q

diclofenac in CVD

A

contraindicated

87
Q

flecainide in AF

A

check for structural heart disease

88
Q

2 causes of reduced Mg and presentation

A

PPI and chronic alcoholism

similar presentation to Ca deficiency

89
Q

amiodarone and thyroid disease

A

causes thyroid dysfunction but can be continued when you add levothyroxine

90
Q

which medication causes corneal opacitis, pulmonary fibrosis and optic neuritis

91
Q

immunosuppressant used post transplant and for RA, UC, psoriasis and pure red cell aplasia which causes nephrotoxicity, hepatotoxicity, impaired glucose tolerance, fluid retention, hair and gum growth

A

ciclosporin

92
Q

which medication reduces seizure threshold and is contraindicated in G6PD deficiency

A

ciprofloxacin

93
Q

what is the safest opioid in renal failure

94
Q

MOA of spironolactone and amiloride

A

potassium sparing diuretics

95
Q

2 antibiotics to monitor in renal failure

A

vancomycin
gentamycin

96
Q

why does alcohol cause you to go to the toilet

A

ethanol inhibits vasopressin (ADH) secretion

97
Q

how long do you continue HRT for in premature menopause

A

until the age of 50

98
Q

MOA, monitoring and SE of unfractionated heparin

A

activates antithrombin III
monitor with APTT
can cause drug induced thrombocytopenia

99
Q

which medication causes impotence, reduced libido, gynaecomastia, ejaculation disorders and reduced PSA

A

5 alpha reductase inhibitor (finasteride)

100
Q

which medication caused headaches, blue discolouration, nasal congestion, flushing, priapism and GI disturbance

A

phosphodiesterase V inhibitor (sildenafil)

101
Q

what is finasteride used to treat

102
Q

name the drugs which induce the CYP450 enzyme system

103
Q

name the drugs which inhibit the CYP450 enzyme system

Medicine Year 5 (27 decks)

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