Pharmacology Flashcards
Why do corticosteroids increase the levels of blood glucose?
As they oppose the action of insulin and stimulate hepatic gluconeogenesis.
What are the medications used to control rate in patients with atrial fibrillation?
beta-blockers
(a common contraindication for beta-blockers is asthma)
calcium channel blockers
digoxin
What is the medication of choice for human and animal bites?
Co-amoxiclav
Penicillin allergy = doxycycline + metronidazole
What are the return to school rules for a diagnosis of impetigo?
Patients may return to school or work when they are no longer contagious which is when all lesions have crusted over or 48h after treatment starts.
Why is atropine indicated for inferior MI associated heart block or bradycardia?
This is because AV (atrioventricular) block and bradyarrhythmias are usually transient (hours to days) when caused by inferior myocardial infarction (MI).
What investigation must be carried out before flecanide is administered and why?
Echocardiogram.
Flecanide is contraindicated in structural heart disease ischaemic heart disease.
Desferrioxamine is an example of…
An iron chelator
What is the mechanism of action of rocuronium?
Non-depolarising agent which causes antagonism of nicotinic acetylcholine receptors in the motor end plate. This causes skeletal muscle relaxation.
Which group of anaesthetic agents are patients with myasthenia gravis more sensitive to?
Non-depolarising agents as patients with myasthenia gravis have fewer nicotinic acetylcholine receptors due to autoimmune mediated destruction.
Phenytoin and NSAIDs are two medications that are known to precipitate TENS, name 4 more.
sulphonamides
allopurinol
penicillins
carbamazepine
What is the treatment dose of adrenaline for anaphylaxis?
0.5mg - 0.5ml 1:1000 IM
What medication can be used as an alternative to bisphosphonates to prevent pathological fractures in patients with an eGFR of less than 30?
Denosumab
Which antigen receptor does Rituximab act against?
CD20 (B lymphocyte antigen receptor)
What are the sx of digoxin toxicity? What findings would be seen on ECG?
General malaise, confusion, lethargy, bradycardia, vomiting and nausea.
Down-sloping ST depression (commonly called ‘reverse tick’ sign) and flattened or inverted T waves.
Why can thiazide diuretics exacerbate digoxin toxicity?
Digoxin toxicity can be exacerbated by thiazide diuretics, as they can cause hypokalemia. This happens because digoxin normally binds to the ATPase pump on the same site as potassium. Low potassium levels, means that there are more binding sites for digoxin, increasing its effect which is inhibitory, leading to bradycardia and its consequences.
…………… and gabapentin are first-line for spasticity in multiple sclerosis.
Baclofen
What is the role of inotropes in the treatment of pulmonary oedema on a background of severe left ventricular dysfunction?
Promote increased cardiac contractability and support blood pressure whilst diuresis is ongoing.
Baclofen and ………………. are first-line for spasticity in multiple sclerosis
gabapentin
What is the class and mechanism of action of Sitagliptin?
DDP4-inhibitor
Reduce the peripheral breakdown of incretins.
What abnormality can be seen on an FBC of a patient taking glucocorticoids?
Neutrophilia
With older patients on many anti-hypertensives with normal BP readings which is the most appropriate medication to STOP first?
ACEi
ARB
Thiazide Diuretics
CCB
Beta Blockers
Thiazide
Indications for corticosteroid treatment for sarcoidosis are…
parenchymal lung disease, uveitis, hypercalcaemia and neurological or cardiac involvement
What medication has only been demonstrated to improve mortality in patients with NYHA class III or IV heart failure who are already taking an ACE inhibitor
Spironolactone
What is the mechanism of action of metformin?
Its primary mechanism of action involves decreasing hepatic gluconeogenesis and increasing peripheral insulin sensitivity
Retro-orbital headache, fever, facial flushing, rash, thrombocytopenia in returning traveller is suggestive of which infection?
Dengue fever
What will the results of an iodine test show for a patient with Graves Disease?
An increase in the homogenous uptake
What medication can be used as prophylaxis for cluster headaches?
Verapamil
What medication is used to combat chemotherapy induced nausea and vomiting?
Ondansetron
What class of medications are triptans?
Serotonin agonists
What is the antidote for reversing respiratory depression caused by magnesium sulphate?
Calcium gluconate
What can be given as an alternative to atropine for a patient with symptomatic bradycardia?
Adrenaline infusion or isoprenaline
Nifedipine causes ……………….. which may result in ……………….
peripheral vasodilation
reflex tachycardia
Teeth discolouration is one of the adverse effects of tetracyclines, name 3 more.
photosensitivity
angioedema
black hairy tongue
What are the four drugs used to treat TB and which one can cause optic neuritis?
Pyrazinamide
Ethambutol
Isoniazid
Rifampicin
Ethambutol
Clinical features of digoxin toxicity*:
GIT: nausea, vomiting, a…………., diarrhoea
Visual: b……….. v…………., yellow/green discolouration, h……….
CVS: palpitations, syncope, d……………
CNS: confusion, dizziness, d……………., fatigue
anorexia
blurred vision, haloes
dyspnoea
delirium
What is the antidote for digoxin toxicity?
Digoxin-specific antibody fab fragments (Digibind).
What baseline tests must be done before the administration of amiodarone? Why?
LFTs - can cause raised liver enzymes, need baseline.
TFTs - can cause hypo or hyper
U+Es - risk of hypokalaemia need baseline K+
CXR - pulmonary fibrosis risk
What is the dose for rectal diazepam in an adult used for a seizure?
10mg
What test should be done for a patient before starting them on a biologic?
CXR - as they can cause reactivation of TB.
What tests should done before starting and monitored during taking:
venlafaxine
citalopram
sertraline
BP
ECG - QT prolongation
U+Es - hyponatraemia
