Pharmacology

Question 1

What to do if there has been a drug error

Answer 1

• Assess pt vital signs, general stability (neurological)
• Report to nurse coordinator and Dr
• Continue to monitor vitals
• Assess drug half life to determine how long it will take to metabolise
• Document according to hospital policy

Question 2

(Aricept)

Donepezil

Indication, drug cass, mechanism, effect, route, s/e

Answer 2

• Oral acetylcholinesterase inhibitor, that blocks the enzymatic breakdown of ACh, enhancing cholinergic function that is lost in alzheimers & responsible for many symptoms
• S/e: diarrhoea, muscle cramps, N/V, fatigue, insomnia

Question 3

Largactil

Chlorpromazine

Indication, drug class, mechanism of action, effect, route, s/e

Answer 3

• Phenothiazine antipsychotic (oral) for short term management of agitation and behavioural disturbances in delirium and dementia
• D2 receptor antagonist, inhibiting dopamine transmission and alleviating symptoms (not fully understood)
• S/E: post HoTN, ECG changes, drowsiness, dry mouth, dystonia (anticholinergic effects)

Question 4

Serenace

Haloperidol

Indication, drug class, mechanism of action, effect, route, s/e

Answer 4

• Antipsychotic (oral, IV) used for acute confusion, hallucinations, delusions in delirium, schizophrenia and acute alcoholism
• High affinity dopamine antagonist that blocks the postsynaptic dopamine transmission
• Increased dopamine turnover (reduced concentration), reduced symptoms
• S/E: HoTN, tachycardia, dystonia, drowsiness

Question 5

Oxybutynin

Answer 5

Oral
Urinary antispasmodic drug - enuresis & detrusor overactivity
Inhibit muscarinic action of acetylcholine on bladder SM

SE: palpitations, tachy, constipation, dizziness

Question 6

Amoxicillin-Clavulanic acid (Augmentin Duo)

Answer 6

Oral penicilin antibiotic for UTI infections
Has bactericidal effect on sensitive organisms during active multiplication
SE: N, D, headache

Question 7

Cephalexin

Answer 7

Oral cephalosporin antibiotic for genitourinary infections including acute prostatitis (streptococci, E. coli)
Work by inhibiting bacterial wall synthesis
SE: N

Question 8

Frusemide

Answer 8

Loop diuretic (oral, IV)
Potent inhibitor of Na and Cl at ascending limb of loop of Henle, & convoluted tubules
* Better for oedema as this transporter absorbs more Na than others in the nephron

Adverse: electrolyte imbalance (hyponatraemia, hypokalaemia, hypermagnasemia) - serum levels must be monitored

Question 9

Hydrochlorothiazide

Answer 9

Thiazide diuretic (oral)
Inhibit absorption of Na and Cl in the proximal segment of the distal convuluted tubule
Excrete water, Na, Cl, K, Mg but decrease excretion of uric acid and Ca
* Less potent for oedema but first choice for HTN
Can cause hyperglycaemia

Question 10

Amiloride, spironolactone

Answer 10

K-sparing diuretic
Act on distal tubules and collecting ducts with reduced diuretic capacity BUT spare K excretion therefore are used in combination with other diuretics

Question 11

Enalipril

Drug class, route, pharmacodynamics/kinetics, dosage, half life, s/e

Answer 11

• Oral ACE inhibitor - antihypertensive
• Dose: 10-40mg, 5mg initial
• Inhibits enzymatic conversion of angiotensin I to II (vasoconstrictor) to lower BP (suppresses RAAS)
• Rapid liver metabolism
• Half life = 11h
• S/E: headache, dizziness, fatigue, ACE cough, low BP

Question 12

Maxalon

Metaclopramide

Answer 12

Class: dopamine receptor antagonist/antiemetic
Route: Oral, IM, IV antiemetic/antinausea
Indication: GORD, N/V
Action: blocks the action of dopamine in the chemoreceptor trigger zone
Effect: Empty the stomach and increase intestinal motility

Question 13

Buscopan

Hyoscine butylbromide

Answer 13

Class: anticholinergic/antispasmodic
Route: Oral/IV/IM
Indication: cramps, stomach pain
Action: Muscarinic receptor antagonist & anticholinergic
Effect: Reduces tone and peristalsis in GI smooth muscle

Question 14

Prednisolone

Answer 14

Class: Synthetic corticosteroid
Route: oral
Indication: arthritis, asthma, autoimmune disorders
Action: blocks immune and inflammatory mediators
Effect: anti-inflammatory and immunosuppressive activity

Question 15

Tramadol

Answer 15

Opioid analgesic for moderate to severe pain
Binds my opioid receptions and inhibits reputable of serotonin and NA

Question 16

Tazocin (Piperacillin-Tazobactam)

Drug class, route, mode of action, side effects

Answer 16

Class: broad spectrum penicillin AB
Route: IV
Mode of action: inhibits septum and cell wall synthesis (piperacillin) & inhibits beta-lactamases that cause penicillin resistance (tazobactam)
SE: rash, diarrhoea, N/V, phlebitis

Question 17

Ventolin

Salbutamol

Drug class, route, mode of action, side effects

Answer 17

Class: bronchodilator
Route: inhalation
Mode: SA b2 adrenoreceptor agonist that causes bronchial SM dilation
SE: tachy, HoTN, headache

Question 18

Pulmicort

Butenoside

Drug class, route, mode of action, side effects

Answer 18

Class: corticosteroid preventer
Route: inhalation
Mode: anti-inflammatory
SE: sore throat, oral thrush

Question 19

Paracetomol

Drug class, route, mode of action, side effects, overdose & tx

Answer 19

Class: simple analgesia and antipyretic
Route: oral or IV
Mode: p-aminophenol derivative that causes analgesic and antipyretic activity
SE: rare, dyspepsia, nausea, allergy
Overdose: 10-15g, causes vomiting, abd pain, HoTN, sweating, colvulsions, resp dep, cyanosis, coma, liver damage and tubular nerosis, jaundive, hypoglycaemia, metabolic acidosis (half life 1-3h)
Treatment: IV acetylcystene 20%