Pharmacology Flashcards
1
Q
Possible interactions of salbutamol?
A
-Corticosteroids: high doses of both drugs increase risk of hypokalaemia -Loop/thiazide diuretics: increase risk of hypokalaemia -Theophylline: increase risk of hypokalaemia
2
Q
Why is omperazole bad in ca diagnosis?
A
May mask symptoms of stomach ca
3
Q
Thiazides SEs?
A
hypokalaemia, hyperuricaemia, hyperglycaemia, increased lipids
3
Q
Names of some calcium channel blockers?
A
Diltiazem, amilodipine, verapamil
3
Q
Indications of mesalazine?
A
Mild-moderate UC Maintenance of remission RA
4
Q
Cautions in paracetamol?
A
Hepatic/renal impairment, chronic alcohol abuse
4
Q
Drug class of salbuatmol?
A
Beta 2 agonist
5
Q
Class of loperamide?
A
Anti-diarrhoeal agent
6
Q
Contraindications of warfarin?
A
Haemorrhagic stroke Significant bleeding Within 72 hours of surgery, 48 hours pospartum Pregnancy (1st and 3rd trimesters) Drugs with increased risk of bleeding
6
Q
Statins metabolised by …?
A
CYP450
7
Q
Indications of prednisolone?
A
Suppression of allergic/inflammatory disorders IBD Asthma Rheumatoid disease Immunosuppression (leukaemia, transplant)
8
Q
Interactions or morphine?
A
Hypnotics - enhances sedative effect
9
Q
Metformin + cimetidine?
A
Inhibits renal elimination
10
Q
Class of senna?
A
Laxative
11
Q
Action of isosorbide mononitrate?
A
Potent relaxer of smooth muscle (vascular) - dilate both arteries and veins. Venous dilatation pools blood in the peripheries leading to a decrease in venous return, central blood volume and ventricular filling volumes and pressures. BP usually declines secondary to decrease in CO. Dilate epicardial coronary arteries.
11
Q
Action of clopidgorel?
A
Prevents platelet aggregation. Metabolised by CYP450 to metabolite which selectively inhibits binding of adenosine diphosphate to platelet P2Y12 receptor, and subsequent ADP mediated activation of GPiib/iiia complex.
11
Q
Indications of metformin?
A
TII DM
12
Q
Class of prednisolone?
A
Corticosteroid
13
Q
Interactions of levodopa?
A
Anaesthetics - increased risk of dysrhythmias MAOIs - risk of HTN crisis (withdraw L-dopa 2wks prior to starting MAOIs) Neuroleptics - block dopamine receptors
13
Q
Class of phenytoin?
A
Anti-convulsant
13
Q
Mechanism of mesalazine?
A
Released 5-aminosalicylate acid in the bowel Unknown mechanism
14
Q
Action of streptokinase?
A
Activation of endogenous fibrinolytic system - initiated by formation of streptokinase-plasminogen complex. Converts plasminogen to plasmin = fibrinolytic.
14
Q
Conta indications of morphine?
A
Severe respiratory disease Increased ICP and head injury Undiagnosed acute abo Acute alcohol intoxication Hepatic failure
15
Q
Interactions of codeine?
A
Alcohol - enhanced hypotensive/sedative effects Metoclopramide - antagonise effects of metoclopramide on GI activity Cimetidine - inhibits opioid metabolism
16
Drug class of paracetamol?
Non-opidioid analgesia and antipyretic
16
ACE-i and PSDs?
Risk of severe hyperkalaemia
17
Main side effect of statins?
Rhabdomyolysis
17
Side effects of insulin?
Hypoglycaemia, weight gain
18
Indications of statins?
Hypercholesterolaemia Cardiovascular prevention
19
Ferusomide causes increased risk of cardiac toxicity with what drugs? and why?
Antipsychotics, antiarrythmics, cardiac glycosides - ferusomide-induced hypokalaemia.
19
Interactions of thyroxine?
Warfarin - increased effect of warfarin
19
Action of carbimazole?
Decreased production of thyroid hormones (T3 and T4). Inhibition of enzyme thyroid peroxidase which is necessary for thyroid hormone synthesis
19
Mechanism of gaviscon?
Weak alkalis neutralise stomach acid. Alginate component increases stomach content viscosity to reduced acid reflux
19
Thiazide and lithium?
Increased toxicity
21
Contraindications of ferusomide?
Severe hypokalaemia/hyponatraemia
22
Mechanism of morphine?
Mimics endogenous opioids, acting on opioid receptors in the dorsal horn, periaquedutal grey matter and midline raphe nuclei
22
Indications of omeprazole?
GORD Dyspepsia Oesophagitis Gastric/duodenal ulcers H.pylori eradication Zollinger-Ellison syndrome
23
Side effects of alendronate?
Oesophageal reactions, abdo pain and distension, GI disturbances
24
Indications of thyroxine?
Hypothyroidism
25
Action of enoxaparin?
Binds to anti-thrombin III leading to inhibition of coagulation factors IIa and Xa.
26
Side effects of loperamide?
Abdominal cramps Dizziness/fatigue Skin reactions (urticaria)
27
Class of thyroxine?
Thyroid hormone
27
Indications of alendronate?
Post-menopausal osteoporosis. Corticosteroid-associated osteoporosis. Paget's disease.
27
Class of vitamin D?
Vitamin
27
Indications of loperamide?
Acute diarrhoea Chronic diarrhoea (adults)
28
Bad effect of O2 in COPD?
Respiratory arrest
29
Indications of nitrates?
Angina pectoris
30
How does salbutamol work?
Adrenergic beta receptor stimulant with a selective effect on the beta 2 receptors of the bronchi, which produces bronchodilatation
31
Indications of codeine?
Mild-moderate pain Diarrhoea Cough suppression
31
Indications of ipratropium bromide?
Reversible bronchospasm associated with chronic obstructive pulmonary disease (COPD) and chronic asthma.
32
Gentamycin and loop diuretics?
Renal failure risk
33
Indications of ranitidine?
Benign/gastric duodenal ulcers Chronic episodic dyspepsia GORD
33
Interactions of cimetidine?
CYP450 INHIBITOR
34
Mechanism of diclofenac?
Reversible inhibition of COX-1 and COX-2 enzymes Decreased prostaglandin synthesis
35
Mechanism of levodopa?
Crosses blood brain barrier and is converted by enzyme dopa carboxylase. Replaces deficient dopamine in basal ganglia.
36
Indications of carbimazole?
Hyperthyroidism
36
Contraindications of calcium?
Conditions associated with hypercalcaemia and hypercalciuria (some malignancy)
38
Action of digoxin?
Inhibits Na+K+ATPase - increase in intraceullar calcium. Positive inotropic effect (increased force of contraction), negative chronotropic effect (decreased rate of contraction). Increases vagal input, decreases sympathetic drive. ESSENTIALLY - slows ventricular rate in sinus rhythm and AF.
38
Class of lamotrigine?
Anti-convulsant
39
Contraindications of diclofenac?
Aspirin/NSAID hypersensitivity Severe heart failure Caution:elderly patients
40
B blockers contraindications
Asthma, uncontrolled HF, bradycardia, hypotension, 2/3rd degree heart block
40
Contra-indications of sodium valproate?
Hepatic dysfunction (metabolised/excreted by liver), porphyria
40
Indications for morphine?
Severe pain, acute pulmonary oedema due to HF, intractable cough in pallative care
42
Thiazide diuretics action?
Act on early segments of distal tubule - inhibit NaCl reabsorption. Excretion of Cl-, Na+ and H20 - and K+ and H+
42
Drug class of carbimazole?
Anti-thyroid
44
Contraindications of PSDs?
Hyperkalaemia, anuria, Addison's disease
45
Side effects of aspirin?
Increased bleeding tendency, dyspepsia
45
Action of gliclazide?
Stimualtes insulin production by binding to sulphonylurea receptors and blocking ATP-dependent potassium channels in pancreatic beta cells. Causes depolarisation and insulin release. Inhibits gluconeogenesis.
46
Mechanism of senna?
Hydrolysed in colon to produce anthracine glycoside derivatives. Directly stimulate myenteric plexus = smooth muscle activity and defecation
48
Adverse event associated with enoxaparin?
Haemorrhages
49
Side effects of omeprazole?
GI disturbances, headache
50
Interactions of omeprazole?
CYP450 INHIBITOR
51
Drug class of levodopa?
Dopamine precursor
51
Class of metformin?
Biguanide
52
Contraindications of digoxin?
Hypetrophic obstructive cardiomyopathy Supraventricular arrythmias associated with an accessory AV pathway (wolff parkinson white syndrome) Complete/second degree heart block
53
Rampiril contraindications?
Bilateral renal artery stenosis, hepatic/renal impairment, pregnancy/breastfeeding
55
Digoxin indications?
CCF SVT AF
57
Indications of ferusomide?
Pulmonary oedema, CCF, antihypertensive treatment
57
ACE-i and metformin?
enhance hypoglycaemic effect
58
Interactions of carbamazapine?
CYP450 INDUCER Cimetidine, erythromycin, diltiazem, isoniazid, verapamil: inhibit metabolism of carbamezapine Corticosteroids, cyclosporin, phenytoin: decreased effect of carbamazepine
59
Class of insulin?
Peptide hormone
60
Class of diclofenac?
NSAID
61
Interactions of alendronate?
Antacids - decreased absorption of alendronate
62
Side effects of codeine?
Nausea and vom, constipation, dry mouth, biliary spasm
62
Possible interactions of ipratropium bromide?
-Avoid with clarithromycin/erythromycin - ↑ risk of side effects with antidepressants - ↓effect of sublingual nitrates (due to dry mouth)
63
Interactions of diclofenac?
ACE-i - increased risk of renal impairment SSRIs - increased risk bleeding B-blockers/calcium channel blockers - NSAIDs antagonise hypotensive effects
64
Class of sodium valproate?
Anti-convulsant
65
Interactions of insulin?
B-blockers: mask warning signs of hypoglycaemia which are mediated by sympathetic NS
67
Side effects of ACE-i?
Hyperkalaemia, impaired renal function, profound hypotension, persistent dry cough.
67
Mechanism of phenytoin?
Alters transmembrane movement of Na+/K+ by blocking voltage-gated Na+ channels. Prevents spread of epileptic discharges
69
Bad interactions of PSDs?
ACE-i - because ACE-i inhibits aldosterone secretion too Drugs known to cause hyperkalaemia NSAIDs Digoxin Noradrenaline
70
Contra-indications of streptokinase?
Existing or recent internal haemorrhage, intracranial neoplasm, recent head trauma, acute pancreatitis, uncontrollable hypertension, simultanous treatment with oral anticoagulants, severe liver or kidney damage, recent surgery.
70
Indications for warfarin?
Prophylaxis of systemic embolism in patients with rheumatic heart disease and atrial fibrillation Prophylaxis after insertion of prosthetic heart valves Prophylaxis and treatment of venous thrombosis and pulmonary embolism TIA
72
Indications of metoclopramide?
Nausea and vomiting, GOR
73
Class of masalazine?
Aminosalicylates
74
Mechanism of alendronate?
Inhibits osteoclast-mediated bone reabsorption. For optimal activity enough vitamin D and calcium are needed to promote normal bone development.
76
B blockers action?
Block B adrenoreceptors in heart and intestinal SM. Reduced contractility of heart and reduced cardiac output
77
Side effects of diclofenac?
GI discomfort and disturbance Bleeding/ulceration Renal failure
78
Side effects of salbuatmol?
Tremor, tachycardia
78
Class of ranitidine?
H2 antagonist
80
Contraindications of nitrates?
MI with low filling pressures, hypertrophic/obstructive cardiomyopathy, aortic/mitral stenosis, severe anaemia, raised ICP
81
Thiazide and PPI?
Hyponatraemia
82
Indications of carbamazapine?
Generalised tonic-clonic seizures, partial seizures, trigmeinal neuralgia/chronic neurogenic pain, bipolar prophylaxis
83
Side effects of gliclazide?
Hypoglycaemia, weight gain
85
Ramipril indications?
HF, hypertension, diabetic nephropathy, prophylaxis of cardiovascular events
86
Why should prednisolone be withdrawn slowly after long term treatment?
Risk of acute adrenal crisis
86
Contraindications of mesalazine?
Renal impairment
88
Indications for clopidogrel?
MI, stroke or established peripheral arterial disease. Acute coronary syndrome. Prevention of thromboembolic events in AF, where treatment with vitamin K antagonists not appropriate.
89
What is amiodarone?
Anti-dysrhythmic
89
Class of carbamezapine?
Anti-convulsant
90
Interactions of digoxin?
Amiodarone/propfenone/quinidine - antiarrythmics increase risk of toxicity Ca channel blockers - increase risk of toxicity Diuretics - hypokalaemia can increase risk of toxicity
90
Interactions of calcium?
Ciprofloxacin/tetracycline: decreased absorption with calcium salts Diuretics - increased risk of hypercalcaemia
92
Metabolism of warfarin?
CYP450 system - INR variable depending on interaction with other substances
94
Action of calcium channel blockers?
Stops inward displacement of calcium ions. Reduces myocardial activity, systemic vascular tone may be diminished.
95
Calcium channel blocker that is a P450...?
Diltiazem - inhibitor!
96
Class of morphine?
Opiate
98
Indications of phenytoin?
Epilepsy (all except absence seizures) Trigeminal neuralgia
99
Side effects of senna
Abdo cramps, diarrhoea
100
Possible interactions of ACE-i?
Potassium supplements/PSDs - hyperkalaemia Loop diuretics - profound first dose hypotension NSAIDs - increased risk of renal damage
100
Paracetamol overdose?
Hepatic necrosis, renal failure
101
Class of metoclopramide?
Antiemetics (dopamine antagonist)
102
Why is metformin treatment of choice in TII DM?
Decreases appetite
104
Action of amiodarone?
1. Prolongation of myocardial cell-action potential duration and refractory period 2. Non-competitive alpha and beta adrenergic inhibition Prolongs the duration of the action potential of all cardiac fibres.
106
Indications of gliclazide?
Type II DM (only if residual B cell activity as needs endogenous insulin)
107
CP450 inhibitors?
Some Certain Silly Compounds Annoyingly Inhibit Enzymes, Grrrrr Sodium valproate Ciprofloxacin Sulphonamide Cimetidine/omeprazole Antifungals, amiodarone Isonazid Erythromycin Graprefruit juice
108
Class of gaviscon?
Antacid
109
Interactions of gliclazide?
Chloramphenicol/cotrimoxazole/sulphonamides - increased hypoglycaemic effects of gliclazide Fluconazole - increased plasma concentration of gliclazide
109
CYP450 substrates?
Warfarin COCP Theophylline Corticosteroids Tricyclics Pethidine Statins
111
Contraindications of amiodarone?
Sinus bradycardia and SA heart block. Evidence of history of thyroid dysfunction. Pregnancy/lactation
112
Indications for insulin?
DM I/II Ketoacidosis Hyperglycaemic hyperosmotic non-ketoic coma Emergency treatment of hyperkalaemia
113
Contra indications of vit D?
Hypercalcaemia, metastatic calcification
113
Drugs with narrow therapeutic range?
Guys With Large Dongles Totally Make Perfect Internet Connections Gentamycin Warfarin Lithium Digoxin Theophylline Methotrexate Phenytoin Insulin Ciclosporin
114
Action of sodium valproate?
Increased GABA content of the brain by inhibiting GABA transaminase enzyme, preventing GABA re-uptake. Decreased concentration of aspartate, an excitatory neurotransmitter
115
Possible interactions of prednisolone?
-Phenytoin: ↓ effect of prednisolone -Rifampicin: ↓ effect of prednisolone
117
Side effects of meoclopramide?
Acute dystonic reactions
118
Contraindications of omeprazole?
Liver disease Breast feeding/prego
119
Contraindications of carbamazapine?
Bone marrow depression, AV node conduction abnormalities, porphyria
120
Indiactions of gaviscon?
Symptomatic relief of: Gastric/duodenal ulcers GORD Non ulcer dyspepsia
122
Contra-indications of alendronate?
Abnormalities of oesophagus (stricture) Hypoglycaemia Renal impairment Prego/breastfeeding
123
Action of potassium sparing diuretics?
Act on distal nephron, where K+ homeostasis controlled. PSDs reduce Na+ reabsorption by either antagonising aldosterone (spironolactone) or blocking Na+ channels (amiloride). Causes electrical potential across tubular epithelium to fall, reducing driving force for K+ secretion.
124
How to reverse effects of morphine?
Naloxone - rapid acting opioid antagonist.
126
Calcium channel blockers indications?
Angina, hypertension, raynaud's, SVT, prophylaxis for cluster headache
128
Action of warfarin?
Vitamin K antagonist - inhibits formation of clotting factors II, VII, IX and X
129
Indications of amiodarone?
Treatment of severe rhythm disorders not responding to other therapies. Tachycarrythmia associated with Wolff-Parkinson-White Atrial flutter and fibrillation All types of tachyarrythmia of paroxysmal nature
131
Indications of vitamin D?
Vitamin D deficiency Insufficient exposure to light, insufficienct dietary intake, osteoporosis, GI malabsorption, chronic liver disease/renal impairment
133
B blockers indications?
Hypertension, angina, arrythmias, migraine prophylaxis
135
Action of aspirin?
Inhibits platelet aggregation. Inhibits cyclo-oxygenase - pharmacological effects due to inhibition of cyclo-oxygenase products such as thromboxanes, prostaglandins and prostacyclin.
137
Contraindications of insulin?
Renal impairment
138
Contraindications of gliclazide?
Ketoacidosis Pregnancy/breastfeeding Elderly patietns with hepatic/renal impairment susceptible to hypoglycaemia
140
Interactions of phenytoin?
CYP450 INDUCER Amiodarone, aspirin, cimetidine, diltiazem, nifedipin - increased plasma concentration of phenytoin
141
Contra-indications?
ACUTE ULCERATIVE COLITIS Abx associated colitis Dysentery
143
Mechanism of insulin?
Lowers plasma glucose by: - Stimulated glucose transport into fat and muscle cells - Stimulating glycogen synthesis - Inhibiting gluconeogenesis and lipolysis
144
Mechanism of prednisolone?
-Inhibits phospholipase A2 activity = decreased arachidonic acid production -Arachidonic acid = precursor for prostaglandin and leukotriene synthesis = anti-inflamm. effect -decreased B and T lymphocyte response to antigens = immunosuppressive effect
146
Contraindicaitons of carbimazole?
Prego/breastfeeding
148
Side effects of calcium?
GI disturbances Bradycardia Arrythmias
149
Statins and clarithromycin?
Dunno
150
Mechanism of metformin?
Not fully understodd, requires presence of insulin as it is an insulin sensitising agent. Increased peripheral glucose utilisation and decreased gluconeogenesis. Inhibits glucose absorption from GI tract.
151
Contra indications of codeine?
Acute respiratory depression Paralytic ileus Conditions associated with raised ICP and head injury (interferes with pupil response vital for neuro obs)
152
Contraindications of metformin?
Breastfeeding/prego Conditions predisposing to lactic acidosis (hepatic/renal impairment, severe HF, infection, dehydration)
153
Thiazides interactions?
Serum lithium conc may be increased NSAIDs may blunt diuretic action and increased risk of nephrotoxicity OCP may blunt diuretic action
154
Interactions of metoclopramide?
Lithium - Increased risk of extrapyramidal adverse effects NSAIDs - increased absorption of NSAIDs, increasing their effects
155
Indication of ARBs?
Alternative to ACE-i in hypertension/HF/diabetic nephropathy.
156
Indications for enoxaparin?
Prophylaxis of thromboembolic disorders of venous origin - surgery Treatment of venous thromboembolic disease presenting with DVT, PE or both. Treatment of unstable angina and acute ST segment non-Q wave MI.
157
Side effects of mesalazine?
GI effects inc. diarrhoea, nausea, vomiting, abdo discomfort
158
Class of omeprazole?
Proton pump inhibitor
159
Elimination of omeprazole?
80% renal, 20% faecal
161
Mechanism of paracetamol/
Weak inhibitor of COX enzymes = decreased prostaglandin and thromboxane synthesis Tissue specificity for CNS giving antipyretic/analesic effects with little anti-inflammatory action
162
Mechanism of ipratropium bromide
inhibit parasympathetic nerve impulses by selectively blocking the binding of the neurotransmitter acetylcholine to its receptor in nerve cells. The nerve fibers of the parasympathetic system are responsible for the involuntary movements of smooth muscles present in the gastrointestinal tract, urinary tract, and lungs. Ipratropium bromide is an antimuscarinic agent affecting muscarinic acetylcholine receptors. Affecting only receptors at the bronchi it inhibits mucous secretion.
163
Indications for aspirin?
Secondary prophylaxis following MI. Unstable angina and cerebral TIA
164
Class of alendronate?
Bisphosphonaste
165
Indications of diclofenac?
Inflammatory diseases, pain, pyrexia, acute gout
167
Contraindications of levodopa?
Closed angle glaucoma, drug induced parkinsonism
168
Contraindication of aspirin?
With methotrexate, haemophilia, renal/hepatic impairment, nasal polyps associated with asthma.
169
Indications of sodium valproate?
Epilepsy (all types)
170
Side effects of morphine?
Nausea, vom, drowsiness, constipation, dry mouth, respiratory depression, dependence, hallucinations, micturition difficulty, headahce, palpitations
172
Indications of streptokinase?
Treatment of acute myocardial infarction within 12 hours of onset
173
Mechanism of omeprazole?
Inhibits gastric acid secretion by dose dependent inhibition of proton pump of gastric parietal cells (blocks H+/K+ pump ATPase enzyme in parietal cells)
174
Indications of levodopa?
Idiopathic PD, parkinsonism
175
Indications for PSDs?
Oedema and ascites in cirrhosis, nephrotic syndrome, oedema in CCF, resistant hypertension, Conn's syndrome.
176
Side-effects of ferusomide?
Hypokalaemia, hyperuricaemia (gout), hyperglycaemia (CI in T2DM), ototoxic
177
Class of calcium?
Mineral
178
Possible interactions of ARBs?
PSDs, potassium supplements - hyperkalaemia NSAIDs - attenuation of antihypertensive effect, deterioration of renal function.
179
Contra-indications of salbutamol?
Hyperthyroidism, cardio disease, arrhythmias (susceptibility QT-interval prolongation), hypertension. Caution = diabetes (risk of ketoacidosis in IV).
181
Interactions of paracetamol?
Coumarins - increased anticoagulant effect Carbamezapine - increased paracetamol metabolism
182
Interactions of metformin?
Alcohol - increased risk of lactic acidosis Corticosteroids - antagonise hypoglycaemic effect
183
Effective antidote for paracetamol overdose?
N-acetylcysteine
184
Class of ipratropium bromide?
Anticholinergic
184
CP450 inducers?
CRAPS Carbamazepine Rifampicin bArbituates Phenytoin St John's Wort
185
Contraindications of senna
Intestinal obstruction
187
Indications of lamotrigine?
Partial seizures Primary/secondary generalised tonic-clonic seizures Lennox-Gastaut syndrome seizures Trigeminal neuralgia
188
Example of a cardiac glycoside?
Digoxin
189
Mechanism of ranitidine?
Competitively inhibit histamine actions at all H2 receptors, mainly inhibiting gastric acid scretions. Inhibits histamine/gastrin-stimulated secretions
190
What is ferusomide?
Loop diuretic
192
Interactions of sodium valproate/
Neuroleptics - decreased effects TCAs - decreased effects Anticonvulsants - 2 or more together gives increased effects and sedation
193
Indications of senna?
Constipation
195
Side effects of ranitidine?
Diarrhoea, GI/LFT disturbances, headache/dizziness/fatigue. rash
196
Indications of salbutamol?
Symptomatic treatment of reversible bronchoconstriction due to bronchial asthma and chronic obstructive pulmonary disease (COPD) including chronic bronchitis and emphysema.
197
Contraindictions of metoclopramide?
Parkinsonism, 1st 3-4 days following GI surgery, intestinal obstruction
198
Contra-indications of clopidogrel?
Severe liver impairment Active pathological bleeding (peptic ulcer, intracranial haemorrhage)
199
Does metformin cause hypoglycaemia?
No
201
Side effects of thyroxine?
Hyperthyroidism
202
Action of statins?
HMG CoA-reductase inhibitor
203
Class of codeine?
Opiate
204
Statins and amiodarone?
Increased statin conc therefore rhabdomyolysis
205
Mechanism of loperamide?
Acts on opioid U receptors in myenteric pleuxs. Inhibits Ach release = inhibits peristalsis
206
Enoxaparin contraindications?
bacterial endocarditis Active gastric or duodenal ulcer
207
Side effects of prednisolone?
bruising, hirsutism, moon-face, HTN, weight gain/oedema, impaired glucose tolerance
208
Action of ARBs?
Block angiotensin II receptors so have properties similar to ACE-i, but don't inhibit breakdown of bradykinin so doesn't produce perisistent dry cough.
209
Action of ferusomide?
Inhibit NaCl reabsorption in thick ascending loop of Henle.
210
Interactions of vit D?
Carbamezepine/phenytoin - increased vit D requirements Diuretics - increased risk of hypercalcaemia
211
Indications of paracetamol?
Mild-moderate pain, pyrexia
212
Side-effects of ipratropium bromide?
Dry mouth, Nausea, Headache, Constipation, Tachycardia, Palpitation, Urinary retention
213
Action of rampiril?
Inhibits conversion of angiotensin 1 to angiotensin 2, increases bradykinin --\> peripheral vasodilatation.
214
Thiazides indications?
HF, hypertension
215
Mechanism of thyroxine?
Mimics endogenous thyroxine. Increased oxygen consumption of metabolically active tissues
216
Indications of calcium?
Calcium deficiency; Increased requirements in children, prego and lactation. Decreased absorption in elderly. Double recommended dose needed in osteoporosis to prevent bone loss.
217
Interactions of gaviscon?
Decreased absorption of ACE inhibitors, antibacterials, digoxin, iron Increased excretion of lithium
218
Mechanism of metoclopramide?
Blocks dopamine receptors in chemoreceptor trigger zone in brain stem. Increased rate of gastric/duodenal emptying by relaxing pyloric sphincter, increased lower oesophageal sphincter tone
219
Mechanism of carbamezapine?
Increased GABA-mediated inhibitory transmission in the CNS. Decreased electrical excitability of cell membranes by blocking Na+ channels
220
Possible interaction of nitrates?
Hypotensive effect increased if used with phosphodiesterase type-5 inhibitors (e.g. sildenafil) --\> life threatening cardiovascular complications
221
Class of gliclazide?
Sulphonylurea
