Pharmacology Flashcards
How do the following antibiotics work:
Macrolides
Penicillin
Metronidazole
Cephalosporins
Quinolones
Tetracyclines
Nitrofurantoin
Trimethoprim
Macrolides - peptidyltransferase inhibitor, to dow ith protein synthesis
Penicillin - betalactamase inhibitor which disrupts cell wall
Metronidazole - inhibits nucleic acid synthesis by generating radicals
Cephalosporins - betalactamase inhibitor which disrupts cell wall
Quinolones - DNA gyrase inhibitor
Tetracyclines - binds to the 30S subunit of ribosomes which prevents stuff attaching
Nitrofurantoin - damages DNA by generating reactive intermediaries
Trimethoprim - dihydrofolate reductase inhibitor
What type of antibiotic is erythromycin
Macrolide
What type of drug is ciprofloxacin
Quinolone
What type of drug is doxycycline
tetracycline
What are the features of fetal warfarin syndrome?
What are people treated with during pregnancy?
V-PLANTS
Ventriculomegaly
Pectus carinatum
Laryngomalacia
Agenesis of corpus callosum
Nasal bridge hypoplasia
Telybrachydactyly
Short stature
Causess FWS in 5% of fetuses exposed during week 6-12 pregnancy.
Converted to LMWH during pregnancy - an exception can be mechanical heart valve
What is the teratogenic effect of metronidazole
lactose intolerance
What is the teratogenic effect of ACE-i/ARBs
KIDNEY STUFF (and lung)
Renal dysgenesis
Oligohydramnios (not producing any wee)
Renal failure
IUGR
Pulmonary atresia
What is the teratogenic effect of tetracyclines
MOUTH
Yellow teeth
Cleft palate
What is the teratogenic effect of Carbimazole
GUT AND SKIN
Omphalocele
Choanal altresia
Aplasia cutis - no skin
What is the teratogenic effect of sodium valproate AND lithium
cardiac effects
What is the teratogenic effect of gentamicin
ototoxicity
What are the doses for prophylactic for LMWH: enoxaparin, dalteparin
Enoxaparin
50-90 40mg
90-130 mg 60mg
130-170mg 80mg
170mg 0.6mg/kg
Dalteparin
50-90 5000IU
90-130 mg 7500IU
130-170mg 10,000IU
170mg 75 u/kg
Which morphine receptors do the following act on:
Strong opioids
Co-codamol
THEY ARE AGONISTS
Strong ones: morphine/fentanyl/methadone: MU receptors
Mu but also kappa and delta
LIDOCAINE
How does it work?
What is the half life?
What is the maximum dose with and without adrenaline?
It blocks fast voltage gated sodium channels
Half life is 2 hours, metabolised by the liver
Maximum dose without adrenaline is 3mg/kg
Maximum dose with adrenaline is 7mg/kg
How do all the antiemetics work?
They INHIBIT STUFF
REMEMBER H1 and D2
Promethazine and cyclizine - Histamine H1 antagonist
Ondansetron - serotonin antagonist
Prochlorperazine and metoclopramide - Dopamine D2 antagonist
How does ranitidine work?
Blocks H2 receptors
What are the receptors on the gastric parietal cells
Which is the most significant receptor?
H2 receptors
Gastrin receptors
Acetylcholine receptors
Most significant = H2
What are the options for antenatal steroids
2x betamethasone 12mg 12-24h apart
4x dexamethsone IM 6mg
What are the side effects of the following cardiac medications:
ACE-i
Loop diuretics
CCBs
BBs
ACE-i:
- Dry cough
- Sometimes renal impairment but rare
Loop diuretics
- Low Salts - Na/Mg/Ca/Mg
- Postural hypotension
CCBs
- Peripheral swelling
BBs
- Bronchosmasp
- Abnormal glycaemic control
- Cold fingers and toes
Which of the antiemetics can you not give to <20 year olds and why
Metoclopramide
Can lead to oligogyric crisis
How do you reverse morphine OD
Naloxone
How do you reverse benzo OD
Flumazenil
How do you reverse warfarin OD
Vitamin K/octiplex
How do you reverse heparin OD
Protamine
How do you reverse paracetamol OD
Parvolex
N-acetylcysteine
How does clomiphene induce ovulation
Blocks the oestrogen receptors in the hypothalamus to block the negative feedback loop. This means GnRH is still produced –> LH and FSH from AP –> ovulation
What are the benefits of antenatal corticosteroids for the mum
NONE
When are antenatal steroids given?
For risk of PTB vaginally up to 34+6
For PCB up to 38+6
Which of the antifungals works by inhibiting squalene epoxidase
Terbinafine!
Im no_t been fine_ I’m squealing!!!
With Warfarin, what are the target INRs for the following:
PE
AF
Mitral valve replacement
PE and AF 2-3
Mechanical valve 2.5-3.5
Mechanical valve 3.0-4.0 if has PE despite Warfarin
What is the first line therapy for N&V in early pregnancy
Cyclizine or promethazine or prochlorperazine
What is the mechanism of action of tamoxifen
What cancers does it help?
Or increase the risk of?
What does it do to bone density?
What about gynaecomastia?
What about lactation?
Who cant have it?
Oestrogen antagonist in breast tissue
Partial agonist in endometrial tissue - therefore increases risk of endometrial Ca
It improves bone density
It is a treatment for gynaecomastia
It inhibits lactation
CANT HAVE IT:
- Personal or family history of VTE
Give some examples of SERMs
How do they work
Clomiphene - blocks oestrogen receptors in hypothalamus to block negative feedback
Tamoxifen - blocks oestrogen receptors in breast tissue but agonist in endometrial tissue
How much more potent is fentanyl in comparison to morphine
100x more potent!
When do you restart warfarin following birth
SAFE in breastfeeding.
Restart 5-7 dys after birth
How do Imodazole antifungals work?
What are examples?
They bind to the phosphlipids in the cell wall which elads to lack of ergosterol
