Pharmacology Flashcards
What is the adverse effect of long term nitrofurantoin use and how does this present/appear on imaging?
Pulmonary fibrosis. Alveolar infiltrates on CXR affecting both upper and lower lobes.
Which antidepressant has the shortest half life?
Venlafaxine (SNRI) - half life of 4-7 hours. Therefore more likely to cause withdrawal symptoms, and so is weaned over months.
Which antidepressant has the longest half life?
Fluoxetine. 4-6 days. More dangerous in overdose and needs to be cross-tapered very slowly.
How long is citalopram’s half life?
Around 36 hours
How long is mirtazapine’s half life?
20-40 hours
How long is sertraline’s half life?
22-36 hours
What are the features of clozapine toxicity?
Drowsiness, hyperthermia, confusion, hypersalivation and seizures
Which antipsychotic carries a risk of agranulocytosis?
Clozapine
What are the indication and adverse effects of melatonin in children?
Only licensed for insomina in autism. Adverse effects are odd dreams, headaches, arthralgia and altered behaviour.
What advice do you give when switching from norethisterone to COCP?
7 day period of condom use required
What advice to give when switching from desogestrel to COCP?
No additional contraceptive required
Which contraceptive is linked to liver pathology? And which liver pathologies are associated?
Oestrogen containing ones. Small increased risk of cholestasis, adenoma, gallstones and HCC. They are contraindicated in those with existing HCC.
What is the contraindication for yellow fever vaccine?
Anaphylactic egg allergy
What is mefloquine used for and what are its adverse effects?
Anti-malarial. Associated with neuropsychiatric effects - abnormal dreams, insomnia, A+D, suicidal ideation and psychosis. CI in those with GAD, depression and epilepsy.
Which antibiotic is and antifolate and therefore should not be used with methotrexate?
Trimethoprim. Can cause bone marrow suppression when used together.
What is topiramate used for? And what are cautions to be aware of?
Migraine prophylaxis and epilepsy. Reduces efficacy of contraceptives and increases risk of cleft lip and palate. IUD should be used in those of child bearing age.
What are some dose considerations with mirtazapine?
At lower dose (15mg) it acts on histaminergic receptors, causing tirednesss. At higher dose this effect is lost, and it only acts on serotoninergic and noradrenergic receptors.
What are adverse effects of macrolide antibiotics?
QT prolongation, GI effects and cholestatic jaundice. They are P450 inhibitors and so statins should be held.
Cautions and contraindications with diclofenac?
MHRA warning regarding CV events with diclofenac. Absolutely contraindicated with hypertension, diabetes and hypercholesterolaemia. Iburprofen and naproxen are safer and as effective.
What are the adverse effects of furosemide?
Ototoxicity, nephrotoxicity (including acute interstitial nephritis)
Adverse effect of aspirin?
Ototoxicity
Which drugs can cause drug-induced lupus?
Chlorpromazine, methyldopa, hydralazine, isoniazid, D-penicillamine and minocycline.
Which drugs cause drug induced psoriasis?
Beta blockers, ACEi, lithium, HCQ, NSAIDs and amoxicillin.
What is bromocriptine and what are its adverse effects?
Ergot-derived dopamine receptor agonist. Associated with pulmonary, retroperitoneal and pericardial fibrosis. Baseline echo, ESR, Cr and CXR are recommended before commencing.
