Pharmacology Flashcards
What electrolyte abnormalities precipitate digoxin toxicity?
MOST COMMONLY: hypokalaemia
Others:
Hypomagnesaemia
Hypercalcaemia
Hypernatraemia
How does MI management differ in those who have cocaine-induced MI?
Benzodiazepines (for coronary artery vasospasm)
What are the clinical features of organophosphate poisoning?
(mnemonic = SLUD)
Salivation
Lacrimation
Urination
Defecation/diarrhoea
cardiovascular: hypotension, bradycardia
also: small pupils, muscle fasciculation
What is the management of organophosphate poisoning?
Atropine
What are the features of carbon monoxide toxicity?
headache: 90% of cases
nausea and vomiting: 50%
vertigo: 50%
confusion: 30%
subjective weakness: 20%
severe toxicity: ‘pink’ skin and mucosae, hyperpyrexia, arrhythmias, extrapyramidal features, coma, death
What antibiotic may lower seizure threshold?
Quinolones e.g. Ciprofloxacin
When to avoid taking macrolides and why?
When on statins
Taking macrolides concurrently with statins significantly increases the risk of myopathy and rhabdomyolysis.
What are main side effects of amlodipine?
Headache, flushing and ankle oedema
What is the consequences of allopurinol and azathioprine use?
excessive myelosuppression and therefore increase the risk of neutropenic sepsis.
What is the consequences of allopurinol and cyclophosphamide use?
allopurinol reduces renal clearance, therefore may cause marrow toxicity
What is the consequences of allopurinol and Theophylline use?
allopurinol causes an increase in plasma concentration of theophylline by inhibiting its breakdown
What are the causes of drug-induced urinary retention?
1) tricyclic antidepressants e.g. amitriptyline
2) anticholinergics e.g. antipsychotics, antihistamines
3) opioids
4) NSAIDs
5) disopyramide
What is the use of sidenafil in neonates?
To treat pulmonary hypertension
What is the mechanism of action of aspirin?
Aspirin is a non reversible COX 1 and 2 inhibitor
What is the mechanism of action of finasteride?
5 alpha reductase inhibitor which converts testosterone into DHT
What is the most important factor for considering liver transplant after paracetamol OD?
arterial pH is the single most important factor according to the King’s College Hospital criteria for liver transplantation.
What to do if GI side effects of metformin?
Switch to MR metformin before trying second-line drug
What is the management of salicylate OD?
1) Charcoal (if within 1 hr)
2) urinary alkalinization with intravenous sodium bicarbonate
3) haemodialysis
What are the signs and symptoms of lithium toxicity?
Diarrhoea, vomiting, abdominal pain, coarse tremor, weakness, seizures, muscle twitches and blurred vision
What medications are contraindications to prescribing sildenafil?
nitrates and nicorandil
What is the characteristic feature of ecstasy(MDMA) use?
hyperthermia, with body temperatures often exceeding 39ºC
What are important adverse effects of aminoglycosides (e.g. gentamicin)?
ototoxicity
nephrotoxicity
What medication can cause a blue tinge to vision?
blue vision: Viagra/sildenafil (‘the blue pill’)
What medication can cause a yellow-green tinge to vision?
Digoxin
What are the adverse effects of St John’s Wort?
1) profile in trials similar to placebo
2) can cause serotonin syndrome
3) inducer of P450 system, therefore decreased levels of drugs such as warfarin, ciclosporin. The effectiveness of the combined oral contraceptive pill may also be reduced
What antibiotics can cause prolonged QT interval?
Macrolides (e.g. azithromycin, erythromycin)
When is diclofenac contraindicated?
Diclofenac is now contraindicated with any form of cardiovascular/cerebrovascular disease
What is a common side effect of tamoxifen?
Hot flushes
What is the 1st and 2nd line management of beta blocker overdose?
1st: atropine
2nd: glucagon
What medication can be prescribed alongside TB treatment to decrease the risk of peripheral neuropathy?
Pyridoxine- a form of vitamin B6
