Pharmacology Flashcards
P450 Inducers
PCBRASS- increases drung metabolism, reducing effects of medications:
* Phenytoin
* Carbamazepine
* Barbiturates
* Rifampicin
* Alcohol- chronic use
* Sulfonlyureas
* Smoking
* St John’s wort
P450 inhibitors
OAKK DEVICES- reduces drug metabolism, increases drug action:
* Omeprazole
* Amiodarone
* Allopurinol
* Ketoconazole
* Disulfiram
* Ethanol
* Valporate (sodium)
* Isoniazind
* Ciprofloxacin
* Erythromycin, clarithromycin
* Sulphonamides- e.g. sulfadiazine, sulfamethoxazole
5 Cs of agranulocytosis
- Carbamazepine, valporate, phenytoin
- Carbimazole
- Co-trimoxazole, cephalosporins
- Clozapine
- Cytotoxics (e.g. methotrexate)
Aches, Cramps, Dizzines, and PalPItations
Drugs that cause hypomagnasaemia
- Aminoglycosides (gentamicin)
- Cisplatin
- Diuretics- furosemide, bumetainide
- PPIs- omeprazole, lasoprazole (by decreasing intestinal absorption of magnesium)
Drugs that cause impaired glucose tolerance
DiaBetic Nick’s Sugar InTolerance
* Diuretics
* Beta blockers
* Nictoninic acid
* Steroids
* IFN-alpha
* Tacrolimus/ciclosporin
OH BETA!
Side effects of beta-blockers
- Orthostatic Hypotension
- Bronchospasm/wheeze
- Erectile dysfunction
- Trouble sleeping and bad dreams
- AV block, arrhythmias
Drugs that increase risk of urinary retention
Terminate DAN’s Output:
* Tricyclic antidepressants- amitriptyline
* Disopyramide
* Anticholinergics- atropine
* NSAIDs
* Opiates
Drugs that cause pulmonary fibrosis
NE SCARs:
* Nitrofurantoin
* Ergot-derived dopamine R agonists (bromocriptine, cabergoline, pergolide)
* Sulfasalazine
* Cytotoxics (bleomycin)
* Amiodarone
* Rheumatoid drugs- methotrexate
Drugs that cause photosensitivity
FAST
* FLuroquinolone (quinolones)
* Amiodarone
* Sulfonamide/Sulfonylureas/nSAIDs
* Thiazide diuretics/Tetracyclines (doxycyline)
Drugs that cause thrombocytopaenia
Quinine
Quinidine
Co-trimoxazole
Vancomycin
Side effects of amiodarone
BITCH of a medication:
* Blue slate skin
* Interstitial lung disease
* Thyroid- hypo/hyperthyroidism
* Corneal microdeposits- can be dazzeled by headlights at night
* Hepatotoxicity
Monito TFTs and LFTs. Need CXR prior to treatment
Side effects of quinolones e.g. ciprofloxacin
Tenodon tear/rupture
Lowers seizure threshold
Lengthens QT interval
Drugs to avoid in pregnancy
- Abx
- Tetracyclines- teeth discolouration
- Trimethoprim and suphonamides- affect folate metabolism (increase neural defects)
- Gentamicin
- Quinolones- ciprofloxacin
- ACEis/ARBs
- Statins
- Warfarin
- Sulfonylureas
- Retinoids
- Caution with AEDs
- Lamotrigine and levetiracetam considered the safest
- Valporate, topiramate, phenytoin, carbamazepine, phenobarbital all increase risk of teratogenesis
Signs of digoxin toxicity
Confusion, N&V, yellow-green vision, bradycardia
Precipitaed by hypokalaemia, renal failure, drugs: amiodarone, verapamil, diltiazem, spironolactone, thiazides
Drugs that can cause pancreatitis
DPP-4 inhibitors (-gliptins), azathioprine, sodium valoporate, steroids, thiazide diuretics, sulfanamides, GLP-1 mimetics (exanatide/liraglutide)
SEs of sulfonylureas
Gliclazide, glimepiride
Hypoglycaemia
Weight gain
SEs of thiazolinidediones
Bladder cancer, weight gain, fluid retention, liver impairment (need to monitor LFTs)
CIs: heart failure, active/previous bladder cancer or uninvestigted macroscopic haematuria, hepatic impairment
SEs of metformin
Weight loss
GI upset/diarrhoea (can be trialled on modified release)
Lactic acidosis
CI in eGR <30
SEs of DPP-4 inhibitors
-gliptins
Weight neutral/do NOT cause weight gain- may be preffered in obese patients
Pancreatitis
SEs of SGLT-2 inhibitors
Dapagliflozins
Weight loss
Risk of UTI, genital infections
* Can cause euvolaemic DKA
* Fournier’s gangrene
SEs of GLP-1 mimetics
Weight loss
N+V, renal impariment
Severe pancreatitis , can cause chronic pancreatitis
SEs of spironolactone
Hyperkalaemia, gynaecomastia. (If K+ >4.5 should give alpha/beta blocker for hypertension)
Causes of hypokalaemia
Thiaizide and loop diuretics
Cushing’s syndrome
Conn’s syndrome (primary hyperaldosteronism_
Magnesium deficiency
SEs of lithium
Fine tremor, hypothyroidism, N+V, nephrogenic diabetes inspidius
OD: coarse tremor, ataxia, hyperreflexia- Tx IV 0.9% NaCl fluid resuscitation
