Pharmacology Flashcards
Drugs that cause corneal opacities?
amiodarone
indomethacin
Adverse effects of gentamicin?
Otoxcity and nephrotoxicity
What should be given if present 8-24 hours after paracetemol OD?
Acetylcysteine
Mneumonic for inducers of cytochrome P450s
‘Barbs funny mom refuses greasy carbs - still smokes and drinks’
Barbiturates
Phenytoin
Modafinil
Rifampicin
Griseofulvin
Carbamazepine
St Johns Wort
Smoking
Alcohol (chronic)
Allopurinol and azathioprine interaction
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
First line for insecticide posoning?
Atropine
First line for OD on iron tablets?
Desferrioxamine
First line for drinking antifreeze?
Fomepizole
Recommended adrenaline dose in cardiac arrest?
10ml 1:10,000 IV or 1ml of 1:1000 IV
What hapens in terms of metabolic and respiratory acidosis/alkalosis in salicylate overdose?
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.
What can peripheral neuropathy in isoniazid be prevented with?
Pyridoxine
Ciclosporin side effects
nephrotoxicity
hepatotoxicity
fluid retention
hypertension
hyperkalaemia
hypertrichosis
gingival hyperplasia
tremor
impaired glucose tolerance
hyperlipidaemia
increased susceptibility to severe infection
(Notice how everything is increased)
Best antibiotic for bacterial sore throat if pencillin allergic?
Clarithromycin
Quinolones adverse effect?
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
Side effects of veramapril?
Heart failure, constipation, hypotension, bradycardia, flushing
What are phoshodinesterases used in?
used in the treatment of erectile dysfunction.
P450 inhibitors (low enzyme activity) mneumonic
Sodium valproate
Isoniazid
Cimetidine
Ketofluconazole
Fluconazole
Alcohol (acute) / amiodarone
Chloramphenicol
Erythromycin
Sulphonamides
Ciprofloxacin
Omeprazole
Metronidazole
Theophylline definitive management?
Haemodialysis
Causes of low magnesium
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’
Adverse effects of finasteride?
impotence
decrease libido
ejaculation disorders
gynaecomastia and breast tenderness
Side effects of viagra?
visual disturbances: blue discolouration and non-arteritic anterior ischaemic neuropathy
nasal congestion
flushing
gastrointestinal side-effects
headache
priapism
First line for tricyclic overdose?
IV bicarbonate
Contraindications to metformin?
CKD
May cause lactic acidosis if taken during period where tissue hypoxia
Iodine containing X-ray contrast mediaq
What teratogen is lithium associated with?
Ebstein’s anomaly
Adverse effects of macrolides?
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
Mechanism of action of metformin?
acts by activation of the AMP-activated protein kinase (AMPK)
increases insulin sensitivity
decreases hepatic gluconeogenesis
may also reduce gastrointestinal absorption of carbohydrates
What is ethylene glycol?
Type of alcohol used as coolant or antifreeze
Serotonin syndrome mneumonic
STEAM
SSRI
Tramadol
Ectasy
Amphemtamines
MAOI
Management of a beta blocker OD?
Atripine and if resistant then give glucagon
Causes of an oculogyric crisis?
antipsychotics
metoclopramide
postencephalitic Parkinson’s disease
Lithium toxicity features?
coarse tremor (a fine tremor is seen in therapeutic levels)
hyperreflexia
acute confusion
polyuria
seizure
coma
Features of hypocalcaemia?
paraesthesia
tetany
seizures
arrhythmias
decreased PTH secretion → hypocalcaemia
ECG features similar to those of hypokalaemia
exacerbates digoxin toxicity
What kind of drugs are histamine 2 antagonists?
Antacids
Example of a GABA antagonist?
Flumazenil
Mechanism of action of standard heparin?
Activates antithrombin III. Forms a complex that inhibits thrombin, factors Xa, IXa, Xia and XIIa
Statins monitoring?
LFT
AceI monitoring
U and Es
Amiodarone monitoring
TFTs and LFTs
Methotrexate monitoring
FBC, LFT and U and Es
Azathioprine monitoring?
FBC and LFT
Neuropsychiatric drug monitoring?
Lithium level, TFT and U and E
Sodium valporate monitoring?
LFT
Glitazones monitoring?
LFTs
Type of immune reaction in N-acetylcysteine?
Anaphylactoid reaction
Non-IgE mediated mast cell release
Adverse effects of metformin?
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
What reverses a heparin OD?
Protamine sulphate
Indications for verapamil
Angina, hypertension, arrhythmias
Highly negatively inotropic
Should not be given with beta-blockers as may cause heart block
Indications for dilitiazem?
Angina, hypertension
Less negatively inotropic than verapamil but caution should still be exercised when patients have heart failure or are taking beta-blockers
Indications for nifedipine, amlodipine or felodipine (dihydropyridines)
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
Ciclosporin adverse effects?
nephrotoxicity
hepatotoxicity
fluid retention
hypertension
hyperkalaemia
hypertrichosis
gingival hyperplasia
tremor
impaired glucose tolerance
hyperlipidaemia
increased susceptibility to severe infection
When is diclofenac contraindicated?
ischaemic heart disease
peripheral arterial disease
cerebrovascular disease
congestive heart failure (New York Heart Association classification II-IV)
Ethylene glycol toxicitiy management?
Fomepizole
Mneumonic for TB side effects
RIPE ONGO
Rifampicin-Orange secretions
INH- Neuropathy
Pyrazinamide- Fout
Etahmbutol-Optic neuritis
Contraindications for flecainide?
post myocardial infarction
structural heart disease: e.g. heart failure
sinus node dysfunction; second-degree or greater AV block
atrial flutter
How often should digoxin be monitored?
Not routinely except in suspected toxicity
Treating roseascea where flyshing is predominant symptom?
Topical brimonidine
