Pharmacology Flashcards

1
Q

Digoxin toxicity Fx

A

yellow/ green vision
nausea
confusion
arrythmia - av block, brady
gynaecomastia

take levels 6 hours after last dose

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2
Q

Digoxin toxicity precipitating factors

A

hypoKal
renal failure
heart failure
Amiodarone
verapamil
diltizaem
spirinolactone

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3
Q

Causes of hypoMAG

A

Diuretics
PPIs
TPN
diarrhoea
HypoK
HyperCal

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4
Q

Inducers of P450 (therefore reduce INR)

A

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

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5
Q

Inhibitor of P450 (increases INR)

A

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

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6
Q

Lithium toxicity precipitating factors

A

dehydration
renal failure
drugs - thiazides, ACEi/ ARB, NSAIDs, metronidazole

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7
Q

Reasons for HRT for Premature Ovarian Insufficiency

A

CVD
Osteoporosis
cognitive impairment

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8
Q

Serotonin syndrome Fx

A

sweating
tremor
confusion
tachycardia
hypertension
dilated pupils
hypERreflexia + Clonus

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9
Q

Neuroleptic malignant syndrome Fx

A

Symptoms gradual over days
bradykinesia
hyporeflexia
hypotension
rigidity

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10
Q

Macrolides (eg Clarithromycin, azithromycin) SE

A

Prolonged QT
GI upset
Cholestatic jaundice
P450 inhib
Azithro - hearing loss + tinnitus

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11
Q

Oculogyric crisis Fx

A

Agitated
clenched jaw
eyes deviated upwards

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12
Q

Oculogyric crisis causes

A

antipsychotics
metoclopramide
Parkinsons disease

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13
Q

Urticaria causes (medications)

A

aspirin
penicillin
NSAIDs
opiates

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14
Q

Amiodarone monitoring

A

CXR one off initially
TFT, LFT every 6 months

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15
Q

Lithium toxicity Fx

A

Coarse tremor (fine tremor in therapeutic levels)
hyperreflexia
confusion
seizures

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16
Q

Isoniazid SE

A

Peripheral neuropathy - prevent with Pyridoxine (Vit B6)
hepatitis, agranulocytosis
P450 inhib

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17
Q

Mefloquine contraindication

A

Mental health disorders - can exacerbate MH symptoms

18
Q

Statin monitoring

A

LFT at baseline, 3 and 12 months

19
Q

Lithium monitoring

A

TFT, UE prior to treatment, and every 6 months
Lithium levels weekly until stable, then every 3 months

20
Q

Rifampicin SE

A

hepatitis
orange secretions
P450 inducer

21
Q

Ciclosporin SE

A

Everything is increased - fluid, bp, K, hair, gums, glucose

22
Q

What renal function do you consider to change metformin

A

creatinine > 130
eGFR <45
if eGFR <30 - Metformin is contraindicated and must be switched

Metformin should no be started after episode of hypoxia eg MI, AKI, sepsis

23
Q

Reactivation of Tb SE

A

Etanercept
Infliximab
Adalimumab

24
Q

Gold SE

A

Proteinuria

25
Q

Oligospermia SE of what medication

A

Sulfasalazine

26
Q

Hydroxychloroquine SE

A

Retinopathy
Corneal deposits

27
Q

What groups should have daily Vit D supplements

A

pregnant and breastfeeding women
Children 6months - 5 years. Unless taking fortified milk
Adults >65yo
Not exposed to the sun eg housebound patients

28
Q

ACEi monitoring

A

UE
baseline, every change in dose, yearly

29
Q

Methotrexate monitoring

A

FBC, UE, LFT
baseline, weekly until stable, then 3 monthly

30
Q

Azathioprine monitoring

A

FBC, LFT baseline
FBC weekly first 4 weeks
FBC, LFT every 3 months

31
Q

Drug induced impaired glucose tolerance (6)

A

thiazides, furosemide (less common)
steroids
tacrolimus, ciclosporin
interferon-alpha
nicotinic acid
antipsychotics

32
Q

Medications contraindicated in pregnancy

A

Antibiotics
tetracyclines - Doxycycline
aminoglycosides - Gentamicin
sulphonamides and trimethoprim
quinolones - ciprofloxacin

Other drugs
ACE inhibitors, angiotensin II receptor antagonists
statins
warfarin
sulfonylureas
retinoids (including topical)
cytotoxic agents

33
Q

Flucloxacillin SE

A

Cholestatis
Hepatitis

34
Q

Ciprofloxacin SE

A

reduce seizure threshold

35
Q

Sodium valproate monitoring

A

LFT, FBC baseline
LFT every 6 months

36
Q

ALS adrenaline doses
anaphylaxis
cardiac arrest

A

anaphylaxis: 0.5mg - 0.5ml 1:1,000 IM
cardiac arrest: 1mg - 10ml 1:10,000 IV or 1ml of 1:1000 IV

37
Q

Contraindication to Disulfiram (for alcohol detox)

A

Cardiac failure
Cerebrovascular disease
Psychosis/ suicide risk

38
Q

Contraindication to Acamprostate (for alcohol detox)

A

liver impairment
renal impairment

39
Q

Contraindication to Bupropion (for smoking cessation)

A

Seizures
eating disorders
pregnancy
bipolar

40
Q

Contraindication to Varenicline (for smoking cessation)

A

Depression
Suicidal thoughts

41
Q

Alcohol detox medication

A

Disulfiram - increases alcohol sensitivity - makes person sick if drinks alcohol

Acamprosate - reduces cravings

42
Q
A