Pharmacology Flashcards
What S/E does lithium commonly cause
Nephrogenic diabetes insipidus
What main S/E does carbamazepine cause and what are other S/Es
SIADH
N + V
Drowsiness
Dizziness
Headache
How is nifedipine metabolised
CYP3A4 cytochrome P450 isoenzyme
What type of juice is contraindicated in drugs metabolised by the CYP34A P450 isoenzyme (such as nifedipine and simvastatin)
Grapefruit juice
It inhibits the enzyme
What is the pharmacological mechanism of tolterodine and what is this drug used for
Bladder instability
Muscarinic antagonist
What is the action of celecoxib and when would an example of this be used
Sodium retention by inhibiting secretion
Reduces risk of heterotopic ossification in patients post fracture and surgical fixation
Primary action of allopurinol
Inhibits urate production
In the context of a drug overdose, what does activated charcoal do
Reduce further absorption of overdosed substances
What strongly indicates a need for repeated oral activated charcoal administration
In cases where the drug circulates through the enterohepatic circulation
Major pharmacological mode of aspirin
cycloxygenase 1 and 2 inhibition
Causes of drug induced lupus
Hydralazine
Procainamide
Phenytoin
Ethosuximide
What can reduce the chance of tumour lysis syndrome pre chemotherapy
Pre hydration
Allopurinol or rasburicase (latter in high risk patients)
Treatment of mycoplasma
Clarithromycin
Doxycycline
Action of haloperidol
Chemoreceptor trigger zone
Drugs that act at the chemoreceptor trigger zone
Haloperidol
Promethazine
Domperidone
Mechanism of action of cyclizine
Blocks cholinergic pathways
S/e carbimazole
Nausea
Rash / Itchiness
Arthalgia
Alopecia
Agranulocytosis
Jaundice
What is carbimazole used to treat
Hyperthyroidism
Mechanism of action of terlipressin in hepatorenal syndrome
Decreases plasma renin activity
Features of phenytoin pharmacology
Has very high protein binding
(phenytoin levels measure both free and protein binded levels)
So is subject to slow elimination of the drug
Features of ethambutol toxicity
Hyperuricaemia
Visual disturbance (optic neuropathy - fundoscopy often normal)
What is indometacin
NSAID
What liver picture can augmentin cause
Obstructive
Treatment of hypertensive crisis
IV sodium nitroprusside
S/Es of long term use of phenyotin
Gum hypertrophy
Folate deficiency
Osteomalacia
Coarse facial features
Neuropathy
Aplastic anaemia (rarely)
Features of theophylline toxicity
Severe N + V
Seizures
Myoclonus
Hyperthermia
Rhabdomyolysis
AKI
S/E metoclopramide
Extrapyramidal effects (especially in children and young adults)
Hyperprolactinaemia
Tardive dyskinesia
Drowsiness
Restlessness
Diarrhoea
Depression
Neuroepileptic malignant syndrome
Rashes
Puritis
Oedema
Drug causes of galactorrhoea
Metoclopramide
Chlorpromazine
Haloperidol
a-methyldopa
Opioids
Fluoxetine
Ranitidine
Effects of rifampicin on INR and how
Lowers INR
Powerful enzyme inducer
Drugs that cause an increased INR
Ciprofloxacin
Metronidazole
Allopurinol
Cimetidine
What chemotherapy agents are known to promote the effects of radiation therapy
Dactinomycin
Metronidazole
5-fluorouracil
Gemcitabine
Cisplatin
Hydroxyurea
Paclitaxel
Mitomycin C
Topotecan
Treatment of bacterial overgrowth syndrome
Co-amoxiclav
How does azathioprine work
Inhibits purine synthase
Suppresses lymphocyte numbers and function
Drug interactions with statins
Macrolides
Antacid
Antifungals
Cyclosporin
Nicotinic acid
Fibrate therapy
Against which receptor does rituximab have its main activity
CD20
Antibiotics that work by disruption of bacterial wall synthesis or intergrity
Penicillins
Cephalosporins
Carbapenems
Vancomycin
Antibiotics that work by disruption of bacterial ribosome function
Tetracyclines
Gentamicin
Erythromycin
Clarithromycin
Clindamycin
Chloramphenicol
Antibiotics that work by disruption of nucleic acid synthesis
Folate synthesis - TMP and sulfoxamethazole
Ciprofloxacin
Rifampicin (RNA polymerase)
Causes of drug induced hepatitis
Fenofibrate
Methyldopa
Carbamazepine
Nitrofurantoin
Isoniazid
Treatment of enteomeaba histolytica
Metronidazole
S/Es ciclosporin
Hyperuricaemia
Hypertrichosis
Gum hypertrophy
Mechanism of action of warfarin
Vitamin K antagonist
How does LMWH work
Activates antithrombin III which binds to and inhibits factor Xa
How does dalbigatran work
Direct thrombin inhibitor
How does rivaroxaban / edoxaban / apixaban work
Inhibits activated factor Xa
anti-emetic to be used in intracranail disease
cyclizine
anti-emetic to be used in vestibular / movement induced vomiting
cyclizine
anti emetic used in gastric stasis
metoclopramide
anti emetic used in drug induced vomiting
haloperidol
anti emetic used in metabolic induced vomiting
haloperidol
anti emetic to be used in pregnancy
Promethazine
Treatment of beta blocker overdose
Consider activated charcoal if wihtin one hour
IV sodium bicarb if
- QRS > 120
- Hypotension not responsive to fluids
IV glucagon in scenarios where refractory to fluid resuscitation and atropine
Features of cyanide poisoning
Cherry red skin
Bitter almond odour on breath
Treatment of mild cyanide poisoning
IV sodium thiosulphate
Treatment of moderate cyanide poisoning
IV hydroxoycobalamin
Treatment of severe cyanide poisoning
IV hydroxycobalamin +/- IV sodium thiosulphate
Treatment of ethylene glycol ingestion
fomepizole or ethanol
S/E amiodarone
Photodermatitis
Greyish blue discolouration on sun exposed areas
Hypo or hyperthyroidism
S/E ciclosporin
Chronic interstitial nephritis
Mechanism of action of flecanide
Slows the upstroke of the action potential
How does tamoxifen work
Functions as a selective oestrogen receptor modulator
S/Es rifampicin
N + V / diarrhoea
Loss of apetitie
Bodily fluids turn orange
S/Es isoniazid
Transaminitis
Peripheral neuropathy
Which anti-TB drugs increase the risk of gout
Pyrazinamide
Ethambutol
Mechanism of action of clopidogrel
ADP receptor inhibitor
Mechanism of action of Dipyridamole
Phosphodiresterase inhibitor
1st line treatment for both acute and chronic schizophrenia
Risperidone
