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Finals passmed > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What is the mechanism of action of cocaine?

A

Blocks uptake of dopamine, noradrenaline and serotonin

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2
Q

What is the first line management of cocaine induced MI?

A

Benzodiazepines + GTN

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3
Q

What is the mechanism of action of sildenafil?

A

Phosphodiesterase-5 inhibitors (enzyme that regulates blood flow in the penis and lungs)

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4
Q

What medications can cause hyperkalaemia if given with potassium-sparing diuretics?

A

ACE-I

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5
Q

What type of medication is amiloride?

A

Potassium-sparing diuretics

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6
Q

What immune changes can clozapine cause?

A

Neutropenia due to agranulocytosis

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7
Q

What immune cell changes can prednisolone cause?

A

Neutrophilia (promotes neutrophil maturation), reduced eosinophils

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8
Q

Give an example of a natural and a pharmacological mineralocorticoid

A

Aldosterone
fludrocortisone

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9
Q

Give an example of a natural and pharmacological glucocorticoid

A

Cortisol
Hydrocortisone, prednisolone

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10
Q

What are the features of a tricyclic overdose?

A

Convulsions, altered mental state, widened QRS, dilated pupils, dry, hot skin

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11
Q

What can be given in a TCA overdose?

A

Sodium bicarbonate

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12
Q

What can be given in a benzodiazepine overdose?

A

Flumazenil

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13
Q

What are the features of an benzodiazepine overdose?

A

hypotension, bradycardia, respiratory depression and coma

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14
Q

What medication can be used to reverse the effects of DOACs?

A

Andexanet alfa (modified factor Xa protein)

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15
Q

Which antibiotics lower the seizure threshold?

A

Quinolones - cipro and levofloxacin

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16
Q

What are the side effects of rifampicin?

A

Hepatitis, orange secretions, flu-like symptoms

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17
Q

What are the side effects of isoniazid?

A

Peripheral neuropathy, hepatitis, agranulocytosis

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18
Q

What are the side effects of ethambutol?

A

optic neuritis - and colour blindness (stop meds if this occurs)

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19
Q

What are the side effects of pyrazinamide?

A

hyperuricaemia, arthralgia, myalgia, hepatitis

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20
Q

What is the mechanism of action of metoclopramide?

A

dopamine agonist (reduces nausea), crosses BBB and causes hyperprolactinaemia

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21
Q

How do vasopressin analogues help in bleeding?

A

They cause vasoconstriction and increased systemic vascular resistance

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22
Q

What tests should be done before starting amiodarone?

A

TFT, LFT, U&E and CXR

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23
Q

What is the management of anaphylactic reaction to blood transfusion?

A

Transfusion termination, IM adrenaline, antihistamines, corticosteroids, bronchodilators and supportive care

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24
Q

What is the mechanism of action of alendronate?

A

It decreases osteoclastic bone resorption by binding to hydroxyapatite and causing apoptosis of osteoclasts

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25
Q

What is the action of 5-alpha reductase inhibitors?

A

block conversion of testosterone to dihydrotestosterone, can take time to improve prostate symptoms
(example - finasteride)

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26
Q

When does renal impairment occur in patients starting rampiril?

A

In those with bilateral renal artery stenosis

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27
Q

Give examples of some vitamin D analogues

A

Calcitriol and tacalcitol

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28
Q

Why are vitamin D analogues used in psoriasis?

A

They decrease cell division and differentiation, which decreases epidermalproliferation

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29
Q

Can you use topical vitamin D analogues in pregnant women?

A

NO

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30
Q

Which antiemetic is best for vertigo and dizziness?

A

Prochlorperazine

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31
Q

Which antiemetic is used to treat nausea and motion sickness?

A

Cyclizine or promethazine

32
Q

What do TNF-alpha inhibitors do?

A

Immunosuppression

33
Q

What side effect are you mainly worried about in those taking hydroxychloroquine?

A

Bull’s eye (central) retinopathy

34
Q

Which medications commonly cause gingival hyperplasia?

A

phenytoin, ciclosporin, CCB (nifedipine)

35
Q

What is the action of infliximab and etanercept?

A

TNF alpha inhibitor - for crohns or rheumatoid

36
Q

What is the action of imatinib?

A

tyrosine kinase inhibitor - For GI tumours and CML

37
Q

How long after taking digoxin should you measure blood concentration levels?

A

At least 6 hours after last dose

38
Q

How long after taking lithium should you measure blood concentration levels?

A

12 hours post-dose

39
Q

Which medications cause urinary retention?

A

opioids, tricyclics, anti-cholinergics and NSAIDs

40
Q

What are the side effects of ciclosporin?

A

^ fluid, BP, K+, hair, gums, glucose
nephrotoxicity and hepatotoxicity

41
Q

What is the characteristic symptom of digoxin toxicity?

A

yellowing of vision - xanthopsia, and reduced acuity (can get confusion, nausea and lethargy) and gynaecomastia

42
Q

What is the main adverse effect of hydroxychloroquine?

A

Bull’s eye retinopathy

43
Q

How does atropine work?

A

blocks parasympathetic action of the heart - increases HR and CO

44
Q

What type of anaemia does methotrexate cause?

A

megaloblastic macrocytic - due to folate deficiency

45
Q

Which calcium channel blockers are rate limiting and which are longer acting?

A

RL: verapamil or diltiazem
Longer acting: amlodipine, nifedipine

46
Q

Which other heart medication should not be prescribed with beta blockers?

A

Rate limiting CCBs such as verapamil

47
Q

How should bisphosphonates be taken?

A

with plenty of water while sitting or standing, on an empty stomach - at least 30 mins before breakfast, should be upright for 30 mins after taking

48
Q

What are some side effects of SGLT-2 inhibitors?

A

recurrent urine infections, necrotising fasciitis

49
Q

Name some somatostatin analogues

A

octreotide, lanreotide

50
Q

Name some cortisol synthesis inhibitors

A

ketoconazole, metyrapone

51
Q

What type of medication is indapamide?

A

thiazide-like diuretic

52
Q

What are the features of a type A drug reaction?

A

Augmented reactions - dose related, common, predictable, related to pharmacology, unlikely to be fatal

53
Q

What are the features of type B drug reactions?

A

B = Bizarre
not dose related, uncommon, unpredictable, not related to pharmacology, often fatal

54
Q

What are the features of a type C drug reaction?

A

Chronic
uncommon, related to cumulative dose

55
Q

What are the features of a type D drug reaction?

A

Delayed
uncommon, usually dose related, occurs after some time using the drug

56
Q

What are the percentages for common, very common, uncommon and rare reactions?

A

Very common > 10%
Common 1%-10%
Uncommon 0.1% - 1%
Rare 0.01% - 0.1%

57
Q

How does loperamide work?

A

It stimulates opioid receptors, but does not have systemic effects as is not absorbed through the gut

58
Q

What are pharmacodynamics?

A

The effect of a Drug on the body or on another drug

59
Q

What are pharmacokinetics?

A

The effect of the body on the drug

60
Q

What can be caused by cocomitant use of aminoglycosides and loop diuretics?

A

Ototoxicity - effects are additive

61
Q

What does Cytochrome P450 do?

A

It is involved in the metabolism and removal of drugs from the body

62
Q

Which common medications induce CY P450?

A

Anticonvulsants, corticosteroids, some antimicrobials, St John’s Wort, cigarette smoke

63
Q

What are some common inhibitors of CYPs?

A

Fluconazole, miconazole, erythromycin, grapefruit and cranberry juice, SSRIs, Omeprazole, erythromycin, ciprofloxacin

64
Q

When can you not use eGFR?

A

In under 18s and pregnant people
Or people who’s kidney function is changing rapidly

65
Q

When should you use creatinine clearance instead of eGFR?

A

-aged over 75
- on nephrotoxic drugs
- at extremes of muscle mass
- on medicine with a narrow therapeutic index
- on DOACs

66
Q

Which drugs should be stopped in AKI?

A

ACEi, ARBs, NSAIDs, contrast, aminoglycosides and diuretics

67
Q

What fluids should you use in AKI?

A

crystalloids - Hartmann’s unless hyperkalaemia
Sodium bicarbonate if serum bicarb < 20

68
Q

Which type of diuretic should be used in fluid overload in AKI?

A

Loop diuretics - furosemide

69
Q

Name some typical and atypical antipsychotics

A

typical: haloperidol, chlorpromazine
atypical: clozapine, risperidone, olanzapine

70
Q

What are the side effects experienced with typical antipsychotics?

A

Parkinsonism, acute dystonia (torticollis, oculogyric crisis), akathisia (severe restlessness), tardive dyskinesia (late onset abnormal, involuntary movements).
antimuscarinic, weight gain, raised prolactin

71
Q

What medication can be used to treat acute dystonia?

A

procyclidine

72
Q

How late can you take a POP without it being an issue?

A

desogestrel - 12 hrs
traditional POP - 3 hrs

73
Q

What medication should be started when taking an SSRI with an NSAID?

A

PPI

74
Q

Which drugs should you not take with an SSRI?

A
  • NSAIDS (okay with PPI), warfarin, heparin, aspirin, triptans (risk of SS), MAOIs (risk of SS)
75
Q

Which antibiotics should not be used in those with stage 4 kidney disease?

A

Tetracyclines like doxycycline

76
Q

What are the adverse effects of methotrexate?

A

pneumonitis
myelosuppresion
lung and liver fibrosis

77
Q

What should be co-prescribed with methotrexate?

A

5mg folic acid once weekly

Finals passmed (23 decks)

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