Pharmacology

Question 1

S/E of the CCB that is most likely to precipitate pulmonary oedema in a pt with known CHF?

Answer 1

Verapamil
S/E - HF, constipation, hypotension, bradycardia, flushing

Question 2

Mx organophosphate insecticide

Answer 2

Atropine

Question 3

A/E Gentamicin - amino glycoside

Answer 3

Ototoxocity
Nehrototoxicity - accumulates in renal failure. Toxicity secondary to acute tubular necrosis

Do not take in myasthenia graves

Question 4

When to give NAC in paracetamol overdose

Answer 4

Plasma paracetamol conc above 100mg/L at 4hrs and 15mg/L at 15hrs
Staggered overdose
Present 8-24hrs after more than 150mg/kg
>24hrs if jaundiced or hepatic tenderness r ALT above upper limit normal

Question 5

Common reaction to acetylcysteine - NAC and how to tx this

Answer 5

Anaphyloid reactions so given over 1 hour
Stop infusion and restart slower rate

Question 6

General first line mx for cocaien toxicity

Answer 6

Benzos

Question 7

CI to metformin

Answer 7

CKD
Ca be toxic in recent MIs (tissue hypoxia)
Idioine containing X ray contrast media
Alcohol abuse

Question 8

WHta measure signifies liver failure in paracetamol overdose

Answer 8

Elevated prothrombin time

Question 9

Most common drug associated with pulmonary fibrosis

Answer 9

Abs - nitrofurantoin
Amiodarone
Chemo - bleomycin
Methotrexate

Question 10

In paracetamol overdose, what is the the single most important prognostic factor

Answer 10

Arterial PH

Question 11

Induces of P450 system

Answer 11

antiepileptics: phenytoin, carbamazepine
barbiturates: phenobarbitone
rifampicin
St John’s Wort
chronic alcohol intake
griseofulvin
smoking (affects CYP1A2, reason why smokers require more aminophylline)

Question 12

Inhibitors of P450 system

Answer 12

antibiotics: ciprofloxacin, erythromycin
isoniazid
cimetidine,omeprazole
amiodarone
allopurinol
imidazoles: ketoconazole, fluconazole
SSRIs: fluoxetine, sertraline
ritonavir
sodium valproate
acute alcohol intake
quinupristin

Question 13

T2Diabetic with EGFR<30 but hbA1c 54 - what medication

Answer 13

Sitagliptin - metformin CI if egfr<30

Question 14

A.E amiodarone

Answer 14

Thyroid dysfunction - high and low
Cornea deposits
pulmonary fibrosis
Liver fibrosis
Peripheral neuropathy
Photosensitivity
Slate grey appearance
Thromboplbleitis
Bradycardia
Lengthens QT interval;

Question 15

ABG for salicylate overdose

Answer 15

Mixed primary respiratory alkalosis and metabolic acidosis

Question 16

How to monitor dalteparin levels

Answer 16

Anti Factor Xa levels

Question 17

BB overdose mx

Answer 17

Atropine
Glucagon

Question 18

N,V, confusion, yellow-green vision is most likely to indicate which medication toxicity

Answer 18

Digoxin

Question 19

MOA Digoxin

Answer 19

Inhibits Na+/K+ ATPase
Also stimulates vagus nerve

Question 20

Class of drug of Diltiazam and S/E

Answer 20

CCB
For angina/HTN

Hypotension, bradycardia, HF, ankle swelling

Question 21

Mx salicylate overdose

Answer 21

Supportive - IV bicarbonate

Question 22

Contraindication to sildenafil

Answer 22

Pts taking nitrates and related drugs like nicorandil
Hypotension
Recent stroke or MI

Question 23

S/E Sildenafil

Answer 23

Visual disturbances - blue discolouration, non arthritic anterior ischaemic neuropathy
Nasal congestion
Flushig
GI side effects
Headache
Priapism

Question 24

WHta medications can worsen glycaemia control in diabetics

Answer 24

Thizides
Steroids
Tacrloimus, ciclosporin
Interferon alpha
Nicotinic acid
Antipsychtoics

Question 25

What medications can worsen urinary retention

Answer 25

TCA
ANticholinergics
Opioids
NSAIDs
disopyramide

Question 26

WHta is monitored in statins

Answer 26

LFTs