Pharmacology

Question 1

Fomepizole moa

Answer 1

competitive inhibition of alcohol dehydrogenase

Question 2

Drugs causing tendinopathy

Answer 2

Quinolones, commonly cipro and steroids

Question 3

P450 inducers

Answer 3

CRAP GPs =inducer=decrease INR

Carbamazepine
Rifampicin
Alcohol ‘Chronic’
Phenytoin
Griseofulvin.
Phenobarbital
Sulphonylurea

Question 4

P450 inhibitors

Answer 4

SICK FACES.COM=Inhibitor=increase INR

Sodium Valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Alcohol ‘Acute’
Chloramphenicol
Erythromycin / Macrolides
Sulphonamide
Ciprofloxacin
Omeprazole
Metronidazole

Question 5

Drugs causing urticaria

Answer 5

NAPPY rash (to remember urticaria)
Nsaid
Aspirin
Penicillin
o(PY)iates

Question 6

ABG picture in salicylate poisoning

Answer 6

Mixed met acidosis with resp alkalosis

Question 7

N acetyl cystine moa

Answer 7

Acts as a precursor to glutathione to replenish stores to conjugate the active metabolite N-acetyl-B-benzoquinone imine

Question 8

COCP relation with cancer

Answer 8

Combined oral contraceptive pill
increased risk of breast and cervical cancer
protective against ovarian and endometrial cancer
reduced risk of colorectal cancer

Question 9

Drugs with zero order kinetics

Answer 9

Drugs exhibiting zero-order kinetics
phenytoin
salicylates (e.g. high-dose aspirin)
heparin
ethanol

Question 10

Drugs causing photosensitivity

Answer 10

SCANTy clothing causes sunburn
Sulphonamides
Ciprofloxacin
Amiodarone
NSAIDS
TetracYclines/thiazides

Question 11

King’s college criteria for liver transplantation post pcm overdose

Answer 11

Arterial pH < 7.3, 24 hours post-ingestion

OR

Prothrombin time > 100 seconds AND
Creatinine > 300 µmol/l AND
Grade III or IV encephalopathy

Question 12

Features of quinine toxicity

Answer 12

Quinine toxicity (cinchonism) presents with myriad ECG changes, hypotension, metabolic acidosis, hypoglycaemia and classically tinnitus, flushing and visual disturbances. Flash pulmonary oedema may occur

Question 13

Opiod dependence management

Answer 13

Methadone, buprenorphine
methadone complete agonist of mu receptor
buprenorphine partial agonist of mu receptor, kappa receptor antagonist

Question 14

Rash + eosinophilia + fever / deranged lfts

Answer 14

DRESS syndrome - severe reaction to medication

Question 15

Drugs that can be cleared with haemodialysis

Answer 15

Drugs that can be cleared with haemodialysis - mnemonic: BLAST
Barbiturate
Lithium
Alcohol (inc methanol, ethylene glycol)
Salicylates
Theophyllines (charcoal haemoperfusion is preferable)