pharmacology Flashcards
ace inhbitors side effects
Side-effects:
* cough
occurs in around 15% of patients and may occur up to a year after starting treatment
thought to be due to increased bradykinin levels
* angioedema: may occur up to a year after starting treatment
* hyperkalaemia
* first-dose hypotension: more common in patients taking diuretics
indapamide side effects
Thiazide diuretics can cause hypercalcaemia and hypocalciuria
A 61-year-old man with peripheral arterial disease is prescribed simvastatin. What is the most appropriate blood test monitoring?
LFTs at baseline, 3 months and 12 months. might also do fasting lipid profile
SSRI use during third trimester - risk of
SSRI use during third trimester - risk of persistent pulmonary hypertension of the newborn
Cautions and contraindications ACE
Cautions and contraindications
* pregnancy and breastfeeding - avoid
* renovascular disease - may result in renal impairment
* * aortic stenosis - may result in hypotension
* hereditary of idiopathic angioedema
* specialist advice should be sought before starting ACE inhibitors in patients with a potassium >= 5.0 mmol/L
ACE interactions
patients receiving high-dose diuretic therapy (more than 80 mg of furosemide a day)
* significantly increases the risk of hypotension
Rivaroxaban and apixaban can be reversed by
Rivaroxaban and apixaban can be reversed by andexanet alfa
which antibiotics should be avoided in in pregnant or breastfeeding women and in children younger than 12 years of age
Oral tetracyclines should be avoided in pregnant or breastfeeding women and in children younger than 12 years of age
which TB drug affects vision?
Ethambutol is associated with optic neuropathy and development of colour blindness. It should be discontinued if these symptoms develop.
are statins fine to take in pregnancy?
No
Pregnancy is a contraindication to statin therapy
which treatment for UTIs should be avoided in the first trimester?
Trimethoprim is teratogenic in the first trimester and should be avoided during pregnancy
the preferred antiplatelet for secondary prevention following stroke
Clopidogrel is the preferred antiplatelet for secondary prevention following stroke
A 45-year-old female complains of lower back pain, constipation, headaches, low mood, and difficulty concentrating.
Her presentation is likely due to which of the following medications?
Long-term lithium use can result in hyperparathyroidism and resultant hypercalcaemia
Patients with type I diabetes and a BMI > 25 should be considered for…in addition to insulin
Patients with type I diabetes and a BMI > 25 should be considered for metformin in addition to insulin
he antibiotic of choice for cellulitis in pregnancy if the patient is penicillin allergic
Erythromycin is the antibiotic of choice for cellulitis in pregnancy if the patient is penicillin allergic
features of lithium toxicity
coarse tremor (a fine tremor is seen in therapeutic levels)
hyperreflexia
acute confusion
polyuria
seizure
coma
additional:
blurred vision
episodes of syncope
intermittent palpitations and fleeting chest pain
very lightheaded
regular monitoring with methotrexate:
Methotrexate may cause hepatotoxicity - monitor LFTs
as well as FBC and U and Es
Aromatase inhibitors (e.g. anastrozole) may cause
Aromatase inhibitors (e.g. anastrozole) may cause osteoporosis
Clindamycin treatment is associated with a high risk of
C. difficile so look out for watery diarrhea and cramping abdo pain
Statins MOA
Statins inhibit HMG-CoA reductase, the rate-limiting enzyme in hepatic cholesterol synthesis
decreases intrinsic cholesterol synthesis
statins interact with which common medication?
Statins + erythromycin/clarithromycin (macrolide) - an important and common interaction
For a person < 80, with stage 1 hypertension, only treat medically if
For a person < 80, with stage 1 hypertension, only treat medically if: diabetic, renal disease, QRISK2 >10%, established coronary vascular disease, or end organ damage
Bleeding on dabigatran? Can use… to reverse
Bleeding on dabigatran? Can use idarucizumab to reverse
For type 2 diabetics requiring treatment, metformin is contraindicated in those with
For type 2 diabetics requiring treatment, metformin is contraindicated in those with eGFR < 30
first line rate control in AF if asthmatic
diltiazem
A 20-year-old female presents to the emergency department following overdose of a substance. She explains she has tinnitus and appears very anxious and sweaty. You are asked to perform an arterial blood gas (ABG). What are the most likely results on the ABG?
overdose of salicylates: symptoms of tinnitus, anxiety and (sweaty) diaphoresis.
typically presents with a respiratory alkalosis initially due to hyperventilation, followed by a metabolic acidosis due to lactic acid accumulation
A 55-year-old woman with a history of rheumatoid arthritis (RA) presents with a urinary tract infection (UTI). Her RA is managed with methotrexate, for which she has a co-prescription of folic acid supplements. The doctor is considering a drug prescription to manage the patient’s UTI. She has no known drug allergies.
What medication should be avoided?
Co-trimoxazole contains trimethoprim and therefore should never be prescribed with methotrexate
Which drugs has been associated with an increased risk of atypical stress fractures of the proximal femoral shaft?
Bisphosphonate so alendronate
