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Year 4 Final > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Drugs that cause corneal opacities?

A

amiodarone
indomethacin

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2
Q

Adverse effects of gentamicin?

A

Otoxcity and nephrotoxicity

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3
Q

What should be given if present 8-24 hours after paracetemol OD?

A

Acetylcysteine

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4
Q

Mneumonic for inducers of cytochrome P450s

A

‘Barbs funny mom refuses greasy carbs - still smokes and drinks’
Barbiturates
Phenytoin
Modafinil
Rifampicin
Griseofulvin
Carbamazepine
St Johns Wort
Smoking
Alcohol (chronic)

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5
Q

Allopurinol and azathioprine interaction

A

metabolised to active compound 6-mercaptopurine
xanthine oxidase is responsible for the oxidation of 6-mercaptopurine to 6-thiouric acid
allopurinol can therefore lead to high levels of 6-mercaptopurine
a much reduced dose (e.g. 25%) must therefore be used if the combination cannot be avoided

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6
Q

First line for insecticide posoning?

A

Atropine

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7
Q

First line for OD on iron tablets?

A

Desferrioxamine

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8
Q

First line for drinking antifreeze?

A

Fomepizole

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9
Q

Recommended adrenaline dose in cardiac arrest?

A

10ml 1:10,000 IV or 1ml of 1:1000 IV

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10
Q

What hapens in terms of metabolic and respiratory acidosis/alkalosis in salicylate overdose?

A

Early stimulation of the respiratory centre leads to a respiratory alkalosis whilst later the direct acid effects of salicylates (combined with acute renal failure) may lead to an acidosis.

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11
Q

What can peripheral neuropathy in isoniazid be prevented with?

A

Pyridoxine

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12
Q

Ciclosporin side effects

A

nephrotoxicity
hepatotoxicity
fluid retention
hypertension
hyperkalaemia
hypertrichosis
gingival hyperplasia
tremor
impaired glucose tolerance
hyperlipidaemia
increased susceptibility to severe infection
(Notice how everything is increased)

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13
Q

Best antibiotic for bacterial sore throat if pencillin allergic?

A

Clarithromycin

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14
Q

Quinolones adverse effect?

A

ower seizure threshold in patients with epilepsy
tendon damage (including rupture) - the risk is increased in patients also taking steroids
cartilage damage has been demonstrated in animal models and for this reason quinolones are generally avoided (but not necessarily contraindicated) in children
lengthens QT interval

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15
Q

Side effects of veramapril?

A

Heart failure, constipation, hypotension, bradycardia, flushing

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16
Q

What are phoshodinesterases used in?

A

used in the treatment of erectile dysfunction.

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17
Q

P450 inhibitors (low enzyme activity) mneumonic

A

Sodium valproate
Isoniazid
Cimetidine
Ketofluconazole
Fluconazole
Alcohol (acute) / amiodarone
Chloramphenicol
Erythromycin
Sulphonamides
Ciprofloxacin
Omeprazole
Metronidazole

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18
Q

Theophylline definitive management?

A

Haemodialysis

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19
Q

Causes of low magnesium

A

drugs
diuretics
proton pump inhibitors
total parenteral nutrition
diarrhoea
may occur with acute or chronic diarrhoea
alcohol
hypokalaemia
hypercalcaemia
e.g. secondary to hyperparathyroidism
calcium and magnesium functionally compete for transport in the thick ascending limb of the loop of Henle
metabolic disorders
Gitleman’s and Bartter’

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20
Q

Adverse effects of finasteride?

A

impotence
decrease libido
ejaculation disorders
gynaecomastia and breast tenderness

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21
Q

Side effects of viagra?

A

visual disturbances: blue discolouration and non-arteritic anterior ischaemic neuropathy
nasal congestion
flushing
gastrointestinal side-effects
headache
priapism

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22
Q

First line for tricyclic overdose?

A

IV bicarbonate

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23
Q

Contraindications to metformin?

A

CKD
May cause lactic acidosis if taken during period where tissue hypoxia
Iodine containing X-ray contrast mediaq

24
Q

What teratogen is lithium associated with?

A

Ebstein’s anomaly

25
Q

Adverse effects of macrolides?

A

prolongation of the QT interval
gastrointestinal side-effects are common. Nausea is less common with clarithromycin than erythromycin
cholestatic jaundice: risk may be reduced if erythromycin stearate is used
P450 inhibitor (see below)
azithromycin is associated with hearing loss and tinnitus

26
Q

Mechanism of action of metformin?

A

acts by activation of the AMP-activated protein kinase (AMPK)
increases insulin sensitivity
decreases hepatic gluconeogenesis
may also reduce gastrointestinal absorption of carbohydrates

27
Q

What is ethylene glycol?

A

Type of alcohol used as coolant or antifreeze

28
Q

Serotonin syndrome mneumonic

A

STEAM
SSRI
Tramadol
Ectasy
Amphemtamines
MAOI

29
Q

Management of a beta blocker OD?

A

Atripine and if resistant then give glucagon

30
Q

Causes of an oculogyric crisis?

A

antipsychotics
metoclopramide
postencephalitic Parkinson’s disease

31
Q

Lithium toxicity features?

A

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

32
Q

Features of hypocalcaemia?

A

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

33
Q

What kind of drugs are histamine 2 antagonists?

A

Antacids

34
Q

Example of a GABA antagonist?

A

Flumazenil

35
Q

Mechanism of action of standard heparin?

A

Activates antithrombin III. Forms a complex that inhibits thrombin, factors Xa, IXa, Xia and XIIa

36
Q

Statins monitoring?

A

LFT

37
Q

AceI monitoring

A

U and Es

38
Q

Amiodarone monitoring

A

TFTs and LFTs

39
Q

Methotrexate monitoring

A

FBC, LFT and U and Es

40
Q

Azathioprine monitoring?

A

FBC and LFT

41
Q

Neuropsychiatric drug monitoring?

A

Lithium level, TFT and U and E

42
Q

Sodium valporate monitoring?

A

LFT

43
Q

Glitazones monitoring?

A

LFTs

44
Q

Type of immune reaction in N-acetylcysteine?

A

Anaphylactoid reaction
Non-IgE mediated mast cell release

45
Q

Adverse effects of metformin?

A

gastrointestinal upsets are common (nausea, anorexia, diarrhoea), intolerable in 20%
reduced vitamin B12 absorption - rarely a clinical problem
lactic acidosis with severe liver disease or renal failure

46
Q

What reverses a heparin OD?

A

Protamine sulphate

47
Q

Indications for verapamil

A

Angina, hypertension, arrhythmias

Highly negatively inotropic

Should not be given with beta-blockers as may cause heart block

48
Q

Indications for dilitiazem?

A

Angina, hypertension

Less negatively inotropic than verapamil but caution should still be exercised when patients have heart failure or are taking beta-blockers

49
Q

Indications for nifedipine, amlodipine or felodipine (dihydropyridines)

A

Hypertension, angina, Raynaud’s

Affects the peripheral vascular smooth muscle more than the myocardium and therefore do not result in worsening of heart failure but may therefore cause ankle swelling

Shorter acting dihydropyridines (e.g. nifedipine) cause peripheral vasodilation which may result in reflex tachycardia

50
Q

Ciclosporin adverse effects?

A

nephrotoxicity
hepatotoxicity
fluid retention
hypertension
hyperkalaemia
hypertrichosis
gingival hyperplasia
tremor
impaired glucose tolerance
hyperlipidaemia
increased susceptibility to severe infection

51
Q

When is diclofenac contraindicated?

A

ischaemic heart disease
peripheral arterial disease
cerebrovascular disease
congestive heart failure (New York Heart Association classification II-IV)

52
Q

Ethylene glycol toxicitiy management?

A

Fomepizole

53
Q

Mneumonic for TB side effects

A

RIPE ONGO
Rifampicin-Orange secretions
INH- Neuropathy
Pyrazinamide- Fout
Etahmbutol-Optic neuritis

54
Q

Contraindications for flecainide?

A

post myocardial infarction
structural heart disease: e.g. heart failure
sinus node dysfunction; second-degree or greater AV block
atrial flutter

55
Q

How often should digoxin be monitored?

A

Not routinely except in suspected toxicity

56
Q

Treating roseascea where flyshing is predominant symptom?

A

Topical brimonidine

Year 4 Final (39 decks)

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