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MRCOG part 1 > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

How do the following antibiotics work:

Macrolides
Penicillin
Metronidazole
Cephalosporins
Quinolones
Tetracyclines
Nitrofurantoin
Trimethoprim

A

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

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2
Q

What type of antibiotic is erythromycin

A

Macrolide

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3
Q

What type of drug is ciprofloxacin

A

Quinolone

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4
Q

What type of drug is doxycycline

A

tetracycline

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5
Q

What are the features of fetal warfarin syndrome?

What are people treated with during pregnancy?

A

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

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6
Q

What is the teratogenic effect of metronidazole

A

lactose intolerance

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7
Q

What is the teratogenic effect of ACE-i/ARBs

A

KIDNEY STUFF (and lung)

Renal dysgenesis
Oligohydramnios (not producing any wee)
Renal failure

IUGR
Pulmonary atresia

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8
Q

What is the teratogenic effect of tetracyclines

A

MOUTH

Yellow teeth
Cleft palate

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9
Q

What is the teratogenic effect of Carbimazole

A

GUT AND SKIN

Omphalocele
Choanal altresia
Aplasia cutis - no skin

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10
Q

What is the teratogenic effect of sodium valproate AND lithium

A

cardiac effects

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11
Q

What is the teratogenic effect of gentamicin

A

ototoxicity

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12
Q

What are the doses for prophylactic for LMWH: enoxaparin, dalteparin

A

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

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13
Q

Which morphine receptors do the following act on:

Strong opioids

Co-codamol

A

THEY ARE AGONISTS

Strong ones: morphine/fentanyl/methadone: MU receptors

Mu but also kappa and delta

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14
Q

LIDOCAINE

How does it work?
What is the half life?
What is the maximum dose with and without adrenaline?

A

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

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15
Q

How do all the antiemetics work?

A

They INHIBIT STUFF

REMEMBER H1 and D2

Promethazine and cyclizine - Histamine H1 antagonist

Ondansetron - serotonin antagonist

Prochlorperazine and metoclopramide - Dopamine D2 antagonist

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16
Q

How does ranitidine work?

A

Blocks H2 receptors

17
Q

What are the receptors on the gastric parietal cells

Which is the most significant receptor?

A

H2 receptors
Gastrin receptors
Acetylcholine receptors

Most significant = H2

18
Q

What are the options for antenatal steroids

A

2x betamethasone 12mg 12-24h apart

4x dexamethsone IM 6mg

19
Q

What are the side effects of the following cardiac medications:

ACE-i
Loop diuretics
CCBs
BBs

A

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

20
Q

Which of the antiemetics can you not give to <20 year olds and why

A

Metoclopramide

Can lead to oligogyric crisis

21
Q

How do you reverse morphine OD

A

Naloxone

22
Q

How do you reverse benzo OD

A

Flumazenil

23
Q

How do you reverse warfarin OD

A

Vitamin K/octiplex

24
Q

How do you reverse heparin OD

A

Protamine

25
Q

How do you reverse paracetamol OD

A

Parvolex
N-acetylcysteine

26
Q

How does clomiphene induce ovulation

A

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

27
Q

What are the benefits of antenatal corticosteroids for the mum

A

NONE

28
Q

When are antenatal steroids given?

A

For risk of PTB vaginally up to 34+6

For PCB up to 38+6

29
Q

Which of the antifungals works by inhibiting squalene epoxidase

A

Terbinafine!

Im no_t been fine_ I’m squealing!!!

30
Q

With Warfarin, what are the target INRs for the following:

PE
AF
Mitral valve replacement

A

PE and AF 2-3

Mechanical valve 2.5-3.5

Mechanical valve 3.0-4.0 if has PE despite Warfarin

31
Q

What is the first line therapy for N&V in early pregnancy

A

Cyclizine or promethazine or prochlorperazine

32
Q

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?

A

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

33
Q

Give some examples of SERMs

How do they work

A

Clomiphene - blocks oestrogen receptors in hypothalamus to block negative feedback

Tamoxifen - blocks oestrogen receptors in breast tissue but agonist in endometrial tissue

34
Q

How much more potent is fentanyl in comparison to morphine

A

100x more potent!

35
Q

When do you restart warfarin following birth

A

SAFE in breastfeeding.

Restart 5-7 dys after birth

36
Q

How do Imodazole antifungals work?

What are examples?

A

They bind to the phosphlipids in the cell wall which elads to lack of ergosterol

MRCOG part 1 (16 decks)

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