Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MEDICINE NEW > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What pain killer has a dangerous interaction with lithium, in terms of it’s excretion?

A

NSAIDs- competes for active transport out the kidneys so less lithium excreted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What type of laxative should be given for those on morphine?

A

Stimulant laxative- ie senna

As opioids reduce motility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the danger of giving SSRIs (like citalopram) with antiplatelet drugs?

A

Seratonin is a mild antiplatelet, slightly increases risk of bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What needs to be on a controlled drug prescription?

A

On all prescriptions: Name + address, Dr name + address, signed

Drug name + strength + preparation
Dose + frequency
Total number of tablets/volume given
Written in numbers and words

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why is tramadol different in mechanism to other opioids?

A

Acts on seratonin and noradrenergic receptors unlike other opioids so can lower seizure thresholds (avoid in epileptic patients) and puts at risk of seratonin syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Drugs causing urinary retention:

A 
Anticholinergics (antipsychotics, antidepressants, respiratory gents)
Anaesthetic agents
Analgesia- morphine
Alpha-adrenoreceptor agonists (hypertension)
Anti-inflammatories
Anxiolytics (benzodiazepines)
Antihistamines
Alcohol
Antihypertensive- Ca channel blockers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which antibiotics may have cross-reactions with penicillins, causing anaphylactic reactions is pen-allergic?

A

Carbopenems (meropenem)

Cephalosporin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which antibiotic causes tendontis?

A

Ciprofloxacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What antibiotics put patients at higher risk of C Diff infections?

A

Ciprofloxacin

Cephalosporin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the problem with giving nitrofurantoin in a patient with a low GFR <30?

A

Doesn’t get excreted enough into the urine to become concentrated and give a therapeutic dose, so patient gets subtherapeutic dose if clearance is poor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What’s the difference between spironolactone, eplerenone compared to amiloride?

A

All work as aldosterone pathway antagonists, but spironolactone acts on the receptor and amiloride acts on the ENaC channel directly.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which UTI antibiotic causes high potassium?

A

Trimethoprim- blocks ENaC channels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Side effects of steroids

A

Diabietes, Hypertension
Cushing’s, Addisonian crisis

Osteonecrosis, osteoporosis
Proximal myopathy
Pancreatitis, infection

Cataracts, glaucoma
Buffalo hump, acne, striae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which receptors does tamulosin act on?

A

Alpha 1 antagonist
Benign prostatic hyperplasia

Prevent smooth muscle constriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are beta 1 + beta 2 agonists used for?

A

Dobutamine- beta 1 agonism (raise BP in very sick patients)

Salbutamol- beta 2 agonism (asthma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which drugs can cause constipation:

A 
Opiates
Ca-channel antagonists
Antidepressants, antiepileptics 
Iron/calcium supplements
Diuretics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Causes of gynaecomastia

A 
D - Digoxin
I - Isoniazid
S - Spironolactone
C - Cimetidine
O - Omeprazole/Oestrogens
M - Methyldopa
T - Tricyclic antidepressants
V - Verapamil
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What features on the U+Es/FBC indicate there is a CKD rather than AKI?

A

Anaemia

Low calcium, high phosphate (no vit D, so low calcium absorption and lack of phosphate excretion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Signs of Digoxin toxicity:

A

Fatigue + confusion
N+V
Yellow vision

Bradycardia or tachycardia, AV block every kind of dysarrhythmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Drug causes of lung fibrosis:

A 
BAN MS
Bleomycin- chemo
Amiodarone
Nitrofurantoin long term- chronic UTI
Methotrexate
Sulfasalazine, rarely statins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What happens in Gilbert’s disease?

A

Bilirubin normally conjugated by liver, so it is water sluble and can be secreted into bile and the duodenum.

Gilbert’s reduced activity of gluconryltransferase- less conjugation of bilirubin so it isn’t excreted into urine (unconjugated bilirubin is insoluble), can get jaundice from high bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Vincristine SE (chemo)

A

Peripheral neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How does Isoniazid cause peripheral neuropathy?

A

Vit B6 deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which immunosuppressant causes ulcerative stomatitis (inflammation of gum linings)

A

Methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Drug causes of long QT syndrome

A

SHAME AT

SSRIs
HAloperidol
Methadone
Erythromicin
Amiodarone
Tricyclic antidepressants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which beta blocker prolongs QT interval?

A

Sotolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Name the mechanism of the following Parkinson’s drugs:

  1. Ropinirole
  2. Rasagiline
  3. Entacapone
  4. Benzhexol
A
  1. Dopamine agonist (also pramipexole)
  2. MAO-B inhibitor, reduces DA breakdown at presynaptic terminal (also selegiline)
  3. COMT inhibitor, reduces DA breakdown in synapse and on postsynaptic terminal
  4. Anticholinergic, reduces tremor by decreasing muscle activation by nAChR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How does N-acetylcysteine help prevent damage in a paracetamol overdose?

A

The body runs out of glutathione to be conjugated with a toxic paracetamol metabolite, so the metabolite builds up.
However NAC provides more glutathione so the metabolite may be neutralised before it can cause any toxic damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Summarise the renin angiotensin system effects

A

Renin (juxtaglomerular cells-kidney) converts Angiotensinogen (from liver) into Angiotensin I
Which is converted into Angiotensin II by ACE (lungs)

AT-II vasoconstricts arterioles, increases ADH and prompts aldosterone secretion (from adrenals)

Aldosterone increases ENaC expression (more Na+, less K+)

30
Q

What effect would thiazide diuretics have on calcium levels?

A

Thiazides raise Ca+ levels
By blocking Na/Cl cotransporter there’s less Na in tubular cells.
On the side of the cell near capillaries (not the luminal side) there’s a transporter that swaps 3Na into the tubular cell for every Ca it moves out of the cell and into the interstitium.

Less Na in the cell, more active transporter, more Ca moved into capillaries

31
Q

How does Clopidogrel and Dipyridamole prevent platelet aggregation?

A

The resting state of platelets in maintained by a cAMP-activated calcium channel that causes efflux of Ca+ from the platelet keeping intracellular levels low, preventing activation.

Dipyridamole inhibits phosphodiesterase to maintain cAMP levels and keep Ca+ inside low
Clopidogrel inhibits the ADP receptor, this receptor would otherwise inhibit adenyl cyclase and break down cAMP

32
Q

How does N-acetylcysteine help prevent damage in a paracetamol overdose?

A

The body runs out of glutathione to be conjugated with a toxic paracetamol metabolite, so the metabolite builds up.
However NAC provides more glutathione so the metabolite may be neutralised before it can cause any toxic damage

33
Q

Summarise the renin angiotensin system effects

A

Renin (juxtaglomerular cells-kidney) converts Angiotensinogen (from liver) into Angiotensin I
Which is converted into Angiotensin II by ACE (lungs)

AT-II vasoconstricts arterioles, increases ADH and prompts aldosterone secretion (from adrenals)

Aldosterone increases ENaC expression (more Na+, less K+)

34
Q

What effect would thiazide diuretics have on calcium levels?

A

Thiazides raise Ca+ levels
By blocking Na/Cl cotransporter there’s less Na in tubular cells.
On the side of the cell near capillaries (not the luminal side) there’s a transporter that swaps 3Na into the tubular cell for every Ca it moves out of the cell and into the interstitium.

Less Na in the cell, more active transporter, more Ca moved into capillaries

35
Q

How does Clopidogrel and Dipyridamole prevent platelet aggregation?

A

The resting state of platelets in maintained by a cAMP-activated calcium channel that causes efflux of Ca+ from the platelet keeping intracellular levels low, preventing activation.

Dipyridamole inhibits phosphodiesterase to maintain cAMP levels and keep Ca+ inside low
Clopidogrel inhibits the ADP receptor, this receptor would otherwise inhibit adenyl cyclase and break down cAMP

36
Q

Main side effect issue that needs to be monitored with ciclosporin?

A

Nephrotoxicity

Check creatinine every two weeks for first 3 months of treatment

37
Q

Receptors that tramadol exerts an effect on?

A 
Mu-opioid R agonist
SSRI + 5-HT R antagonist
Noradrenaline reuptake inhibitor
NMDA R antagonist
NACh R antagonist
Muscarinic ACh R antagonist
38
Q

Which opioids can precipitate serotonin syndrome?

A

Fentanyl and Tramadol

39
Q

1st line antiemetic in pregnancy?

A

Antihistamine like cyclizine antiemetic

More experience, no evidence or teratogenicity

40
Q

Preferred anti-emetic for chemo?

A

Visceral and chemoreceptor trigger zone nausea is mediated by serotonin and dopamine.

5-HT strongly involved in chemo-nausea so
Metoclopramide

41
Q

What situation is metoclopramide less useful for?

A

Post-op nausea, for some reason despite it being a anti-dopaminergic agent it works less well?

Good for chemo-induced nausea though

42
Q

Which antiemetics can cause

  1. Prolonged QT
  2. Parkinsonian side effects
  3. Worsening of bowel obstruction
A
  1. 5-HT antagonists and DA antagonists like ondansetron (5-HT) and metoclopramide (DA)
  2. DA antagonists (prochlorperazine, metoclopramide, NB domperidone doesn’t cross BBB, less likely to cause)
  3. DA antagonists (increases gut motility)
43
Q

Hierarchy of Rx in type 2 diabetes?

A

Diet
Metformin
Add sulfonylura (gliclazide) or DPP-4 inhibitor (sitagliptin) or glitazone
Triple therapy or insulin

(No glitazone if LVF)

44
Q

How does Rx of COPD differ depending on whether they have an FEV >50% or below 50%?

A

All get a short acting b-agonist or anti-muscarinic

Mild/moderate >50% = LABA or LAMA, then add steroid, then all 3 (stepwise approach)

Sever <50% = LAMA or LABA + steroid, then all 3 (jumps a step)

45
Q

When would you give HRT via the vaginal route rather than transdermally?

A

For urogenital atrophy associated with the menopause

46
Q

What is the benefit of giving HRT cyclically, continuously or without progesterone?

A

No progesterone- increased risk of endometrial cancer only indicated for hysterectomy patients

Cyclical HRT- still have periods (given if patient is still having periods)
Continuous HRT- no periods (only appropriate if post-menopausal + no periods in 1 year)

47
Q

Name some common SSRIs, SNRIs and TCAs:

A

Depression Rx

1st: SSRIs- Fluoxetine, Citalopram, Sertraline, Paroxetine
2nd: SNRIs- Venlafaxine, Duloxetine
3rd: TCAs- Amitriptyline

48
Q

1st line drug for high triglycerides in isolation (no raised cholesterol/LDLs)?

A

Fibrates- gemofibrozil, ciprofibrate, fenofibrate

Act in liver to reduce cholesterol synthesis, reducing vLDL secretion and increasing uptake from blood, increasing HDL plasma levels

Not to be used with statins

49
Q

Drug causes of hypocalcaemia:

A

HypO:

Someone has CALled, loop over to the phone, pick up the phen

Loop diuretics
Bisphosphonates
Phenytoin

50
Q

Drugs affected by cyp450:

A

COWEST

Ciclosporin
Oral contraceptives
Warfarin
Epileptics
Statins
Theophylline
51
Q

Causes of hyperkalaemia:

A

N SAID:Tri have Tact in the Cycles of Parin UREA

NSAID, Trimethoprim, Tacrolimus, Ciclosporin, Heparin, Sulphonylurea

ACEi, K+ sparing

52
Q

Causes of agranulocytosis:

A

Carbamazepine
Colchicine
Carbimazole
Clozapine

53
Q

Causes of liver fibrosis:

A

MAMI

Methotraxate
Amiodarone
Methyldopa
Isoniazid

54
Q

Causes of gynaecomastia

A

DISCO MTV:

Digoxin
Isoniazid
Spironolactone
Cimetidine
Oestrogen

Methotrexate
TCAs
Verapamil

55
Q

Causes of Long QT:

A 
Macrolide
Antipsychotic
TCAs
Histamine
SSRI
56
Q

SIADH:

A

Carbamazepine

SSRIs

57
Q

Causes of neuropathy

A

MICE NAP

Methotrexate
Isoniazid
Ciclosporin
Ethanol
Nitrofurantoin
Amiodarone
Phenytoin/Penicillamine
58
Q

Indications for anti-digoxin antibody:

A

Dangerous arrhythmias: VT, VF, 3rd degree heart block
K+ above 6
Digoxin above 7.8ng/mL 6 hours later

59
Q

Antidote for arsenic?

A

Dimercaprol

60
Q

Drug causes of diarrhoea:

A

COT (babies poo):
Colchicine
Orlistat
Theophylline

61
Q

Antidepressant that particularly may cause constipation?

A

Tricyclics- anticholinergic effects

Also watch out for oxybutinin, given for urge incontinence

62
Q

Drug causes of lupus?

A

HIP
Hydralazine
Isoniazid
Procainamide (sodium channel blocker antiarrhythmic)

63
Q

How does suxamethonium work?

A

Partial agonist of acetylcholine receptors, depolarises the post-synaptic membrane
Rapidly inactivated using plasma cholinesterases

SEs: high K+, muscle pains post-op

64
Q

What are the two mechanisms of neuromuscular blockers used in surgery and how are they reversed?

A

Partial ACh receptor agonists- depolarise post-synaptic membrane
(suxamethonium)

Competitive antagonists of AChR- compete with ACh at the neuromuscular junction
(Rocuronium, sugammadex, vecuronim, atracurium)

65
Q

Which antibiotics are safe to prescribe to patients with porphyrias?

A

Penicillins only pretty much.

66
Q

Which drugs can displace sodium valproate and digoxin from protein-carriers in the blood?

A

NSAIDs

Aspirin

67
Q

Which drugs cause oesophageal irritation, and what are the two mechanisms by which they do this?

A

Direct inflammation: alendronic acid, tetracycline, sando-K

Lowering oesophageal tone: nitrates, Ca channel blockers

68
Q

Which immunomodulator drugs are associated with the following side effects:

A. Pancreatitis
B. Oligozoospermia

A

A. Azathioprine or mercaptopurine (it’s prodrug)

B. Sulfasalazine

69
Q

Rx of Whipple’s disease?

PAs + macrophages

A 
Gram positive bacteria, trophyerma whipplei
Causes
1. Malabsorption
2. Arthropathy
3. CNS disease + cerebellar signs

Rx: ceftriaxone- crosses BBB
Long term- trimethoprim or doxycycline

70
Q

Rx of constipation and order of medication trials:

A
  1. Lifestyle and drug reconciliation
  2. Stimulant laxative- senna
    • Osmotic- movicol or lactulose
    • Glycerine suppository
  5. Phosphate enema
  6. Manual evacuation

MEDICINE NEW (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions