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MRCP part 2 > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

When to start NAC

A
  • staggered overdose
  • plasma concentration over 100 at 4 hours or 15 at 15 hours
  • more than 150mg/kg
  • symptomatic or raised ALT or raised INR >1.3
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2
Q

When to consider a liver transplant in paracetamol overdose

A

arterial pH <7.3 24 hours after ingestion
prothrombin time >100 seconds, creatinine >300 umol/l and grade III or IV encephalopathy

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3
Q

Common SE of NAC

A

Anaphylaxis

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3
Q

How long is an infusion of NAC

A

1 hour

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4
Q

MOA rifampicin

A

Inhibits bacterial DNA dependent RNH polymerase preventing transcription of DNA into mRNA

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5
Q

SE rifampicin

A

hepatitis, orange secretions, flu-like symptoms

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6
Q

MOA isoniazid

A

Inhibits mycolic acid synthesis

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7
Q

SE isoniazid

A

peripheral neuropathy (antidote pyridoxine vitamin B6), hepatitis, agranulocytosis

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8
Q

MOA pyrazinamide

A

Converted by pyrazinamidase into pyrazinoic acid which in turn inhibits fatty acid synthase

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9
Q

SE pyrazinamide

A

hyperuricaemia causing gout, arthralgia, myalgia

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10
Q

MOA ethambutol

A

inhibits the enzyme arabinosyl transferase which polymerises arabonise into arabian

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11
Q

SE ethambutol

A

Optic neuritis - have to check visual acuity before and at 3 months as well as renal function

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12
Q

TCA overdose symptoms

A

dilated pupils
dry mouth
seizure
coma

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13
Q

TCA overdose management

A

IV sodium bicarbonate

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14
Q

TCA ECG changes

A
  • sinus tachycardia
  • QT prolongation
  • QTc widening
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15
Q

Salicyclic overdose management

A
  • urinary alkalinization with IV bicarbonate
  • haemodialysis
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16
Q

Benzodiazepines overdose management

A

Flumazenil

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17
Q

Lithium overdose management

A

Normal saline resuscitation
Haemodialysis
Sodium bicarbonate

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18
Q

Warfarin overdose management

A

Vitamin K

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19
Q

Heparin overdose management

A

Protamine sulphate

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20
Q

Beta-blockers overdose management

A

If bradycardic will need atropine

21
Q

Ethylene glycol overdose management

A

Fomepizole

22
Q

Methanol overdose management

A

Fomepizole or haemodialysis

23
Q

Organophosphate insecticides overdose management

A

Atropine

24
Q

Digoxin overdose management

A

Digoxin specific antibody fragments

25
Q

Iron overdose management

A

Desferrioxamine

26
Q

Lead overdose management

A

Dimercaprol, calcium edetate

27
Q

Carbon monoxide poisoning managemenbt

A

Hyperbaric oxygen

28
Q

Cyanide poisoning management

A

Hydroxocobalamin; also combination of amyl nitrite, sodium nitrite, and sodium thiosulfate

29
Q

Ferrous sulphate overdose symptoms

A

RUQ pain
LFTs off
Diarrhoea
Vomiting

30
Q

Reversible SEs of anabolic steroids

A

Increased appetite
Gastrointestinal dysfunction
Mood swings
Anxiety
Acne
Oedema
Libido change
Scrotal pain
Erectile dysfunction
Menstrual irregularities

31
Q

Irreversible SEs of anabolic steroids

A

Hirsutism
Voice pitch changes
Male pattern baldness
Skin striae or keloid scarring
Chest pain
Clitoral hypertrophy
Short stature due to premature fusion of growth plates

32
Q

Bleomycin SE

A

Pulmonary fibrosis

33
Q

Drugs that cause lung fibrosis

A

amiodarone
cytotoxic agents: busulphan, bleomycin
anti-rheumatoid drugs: methotrexate, sulfasalazine
nitrofurantoin
ergot-derived dopamine receptor agonists (bromocriptine, cabergoline, pergolide)

34
Q

Serotonin syndrome symptoms

A

Fever
Rigidity
Reduced consciousness

35
Q

Serotonin syndrome onset of symptoms

A

Hours

36
Q

Serotonin Syndrome Management

A

Cyproheptadine

37
Q

NMS onset

A

Days

38
Q

NMS management

A

Dantrolene

39
Q

Methoxetamine symptoms

A

cerebellar ataxia
dissociation

40
Q

UTI antibiotic to avoid in CKD stage 3 or more

A

Nitrofurantoin

41
Q

Thallium poisoning symptoms

A

painful polyneuropathy
mood change
alopecia

42
Q

Thallium poisoning treatment

A

Oral prussian blue

43
Q

Cannabinoid toxicity symptoms

A

CNS: agitation, tremor, anxiety, confusion, somnolence, syncope, hallucinations, changes in perception, acute psychosis, nystagmus, convulsions and coma.

Cardiac: tachycardia, hypertension, chest pain, palpitations, ECG changes.

Renal: acute kidney injury.

Muscular: hypertonia, myoclonus, muscle jerking and myalgia.

Other: cold extremities, dry mouth, dyspnoea, mydriasis, vomiting and hypokalaemia

44
Q

UTI management pregnancy

A

Avoid trimethoprim in the first trimester
Avoid nitrofurantoin in the third trimester

45
Q

Cocaine toxicity drugs to avoid

A

Beta blocker as it can worsen vasoconstriction (benzodiazepines often used as treatment)

46
Q

Salicylic acid ABG findings

A

respiratory alkalosis and metabolic acidosis

47
Q

Is it normal for low or high sodium when giving IV Ig?

A

Hyponatraemia

48
Q

Risk of tramadol and SSRI

A

Serotonin syndrome

49
Q

Medication to avoid if taking aminophylline

A

Ciprofloxacin

50
Q

Drugs that cause an increase in the number of epileptic fits

A

alcohol, cocaine, amphetamines
ciprofloxacin, levofloxacin
aminophylline, theophylline
bupropion
methylphenidate (used in ADHD)
mefenamic acid

MRCP part 2 (1 decks)

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