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Antibiotics > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Orlistat (Indications?)

A
  • Age 18-75
  • BMI of 28 or more w/ risk factors
  • BMI of 30 or more
  • -
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2
Q

Orlistat (How does it work)

A

Lipase inhibitor (reduces absoprtion of dietary fat)

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3
Q

Orlistat (Contraindications)

A

Chronic Malabsorption syndrome
Cholestasis
Breastfeeding

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4
Q

Which SSRI can affect/cause HTN?

A

Venlafaxine

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5
Q

What is Malarone and what are the side effects?

A

Anti-malarial containing a combination of atovaquone and proguanil.

**Side effects: GI upset, headaches, skin rash, mouth ulcers **

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6
Q

What is Mefloquine and what are the side effects?

A

Antimalarial drug.

**Side effects: Dizziness, Sleep disturbances (Insomnia, vivid dreams) and neuropsychiatric disturbance (anxiety, depression, panic attacks, hallucinations)
**
Contraindicated in epilepsy

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7
Q

What is chloroquine and what are the side effects?

A

Antimalarial
Rarely used now

Side effects: Headache
Contraindicated in epilepsy

SAFER OPTION TO USE IN PREGNANCY - but high levels of resistance

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8
Q

Antimalarials in pregnancy

A

If travel cannot be avoided:
- Chloroquine can be taken
- Proguanil: folate supplementation (5mg od) should be given

Malarone (atovaquone + proguanil): the BNF advises to avoid these drugs unless essential. If taken then folate supplementation should be given
mefloquine: caution advised
doxycycline is contraindicated

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9
Q

Lithium side effects

A

Nausea/vomiting, diarrhoea
Fine tremor
Weight gain

Nephrotoxicity - polyuria
Thyroid enlargement (can cause hypothyroid)
Hyperparathyroidism + hypercalcaemia
IIH

ECG: T wave flattening/inversion
Leucocytosis

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10
Q

Lithium monitoring
- When should lithium levels be checked
- How often monitorng when starting/dose change
- How often once stable and what other blood tests?

A

Lithium levels should be checked 12 hours post-dose

Lihtium levels should be done weekly after starting and after each dose change until concentrations stable

Lithium levels should normally be checked every 3 months
TFT and renal funciton should be checked every 6 months

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11
Q

Precipitants for lithium toxicity?

A

Dehydration
Renal failure
Drugs - Metronidazole, ACE-I, NSAIDs, Thiazide diuretics (MANT)

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12
Q

Features of lithium toxicity?

A

Coarse tremor
Hyperreflexia
Acute confusion
Polyuria
Seizure
Coma

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13
Q

Management of lithium toxicity?

A

Mild-moderate - IV fluids
Severe - Haemodyalisis
Sodium bicarbonate is sometimes used.

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14
Q

Methotrexate side effects?

A

Mucositis
Myelosuppression
Pneumonitis (typically 1 year after trt)
Pulmonary fibrosis
Liver fibrosis
May affect fertility

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15
Q

Methotrexate contraindications

A

Pregnancy (Teratogenic)
- Women should avoid pregnancy for at least 6 months after treatment stopped
- Men should use contraception for 6 months after treatment

Breastfeeding
Active Infeciton
**Immunodeficinecy **

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16
Q

Methotrexate monitoring?

A

FBC, U&Es, LFTs at start and every 2 weeks until dose stable for 6 weeks (also at dose increases)

Then check monthly for 3 months and then 3 monthly

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17
Q

Sulphasalazine - Indications?

A

IBD, RA

18
Q

Sulphasalazine - Side effects

A

Rashes
Oligospermia
Headache
Heinz body anaemia
Megaloblastic anaemia
Lung fibrosis

19
Q

Sulphasalazine - Pregnancy/breastfeeding?

A

Thoeretical risk of neonatal haemolysis in third trimester
Adequate folate supplements should be given

Also theoretical risk of neonatal haemolysis through breastfeeding

20
Q

Pioglitazone - Contraindications

A

Heart Failure
Bladder Cancer/uninvestigated haematuria
Hepatic impairment

21
Q

Pioglitazone - what is it?

A

**Thiazolidinedione **
They are agonists to the PPAR-gamma receptor and reduce peripheral insulin resistance.

22
Q

Pioglitazone - Side effects

A

Weight gain

Liver impairment: monitor LFTs

Fluid retention - therefore contraindicated in heart failure. The risk of fluid retention is increased if the patient also takes insulin

Increased risk of fractures

Increased risk of bladder cancer

23
Q

Dapagliflozin - what type of medication + how does it work?

A

SLGT-2 inhibitor
Reversibly inhibit sodium-glucose co-transporter 2 (SGLT-2) in the renal proximal convoluted tubule to reduce glucose reabsorption and increase urinary glucose excretion.

24
Q

Dapagliflozin/SGLT-2 - side effects

A

Urinary and genital infection (secondary to glycosuria).

Fournier’s gangrene has also been reported

Normoglycaemic ketoacidosis

Increased risk of lower-limb amputation: feet should be closely monitored

25
Q

Dapagliflozin - contraindications?

A

DKA
Active foot disease (Skin ulceration/osteomyelitis)
Renal/hepatic impairment

26
Q

Exenatide? - Type

A

GLP-1 agonist

27
Q

Exenatide - Contraindications

A

Ketoacidosis
Pancreatitis
Renal/Hepatic impairment
Severe GI disease (IBD/gastroparesis)

28
Q

Exenatide - Side effects

A

Weight loss
Nausea/vomiting
Pancreatitis
Renal impairment
Cardiac - AV block, sinus tachycardia
SKin rash

29
Q

Methylphenidate - weight monitoring?

A

Every 3 months in children 10 or less

3 months then 6 months after treatment started, and every 6 months thereafter in everyone aged over 10

30
Q

Methylphenidate - height monitoring frequency?

A

Every 6 months in children and young people

31
Q

Methylphenidate - BP/HR monitoring

A

Before and after each dose change
Routinely every 6 months

32
Q

Methylphenidate - what aspects need to be monitored?

A

Weight, height, BP/Pulse

33
Q

Digoxin - MOA?

A

Decreases conduction through the atrioventricular node which slows the ventricular rate in atrial fibrillation and flutter

Increases the force of cardiac muscle contraction due to inhibition of the Na+/K+ ATPase pump.

34
Q

Digoxin toxicity - precipitating factors?

A

LOW - Pot, Mg, albumin, temp, thyroid

High - Calcium, sodium

Drugs - Amiodarone, Qunidine, Verapamil, Diltiazem, Spironolactone (Drugs that cause hypokalaemia - thiazides + loop)

35
Q

Digoxin toxicity - features?

A

Generally unwell
- Lethargy, nausea & vomiting, anorexia, confusion,

Yellow-green vision

Arrhythmias (e.g. AV block, bradycardia)

Gynaecomastia

36
Q

Leflunomide - Contraindications/cautions

A

Pregnancy - the BNF advises: ‘Effective contraception essential during treatment and for at least 2 years after treatment in women and at least 3 months after treatment in men (plasma concentration monitoring required’

Caution should also be exercised with pre-existing lung and liver disease

37
Q

Triptans - side effects

A

Dyspnoea
Flushing
Fatigue
Sensations of tingling/hot/cold

38
Q

Triptans - contraindications

A

IHD
HTN
MI
CVA - TIA/Stroke

39
Q

Gynaecomastia - Drug causes?

A

Got DISCO Fever
- GnRH ag - goserelin
- Digoxin
- Isoniazid
- Spiro
- Cimetidine
- Omeprazole/ oestrogens
- Finasteride

40
Q

Tinnitus - Drug Causes?

A

Aspirin/NSAIDs
Aminoglycosides
Loop diuretics
Quinine

Antibiotics (4 decks)

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