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Finals > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Examples of P450 inhibitors

A 
Abx - ciprofloxacin, erythromycin
Omeprazole
Amiodarone
Allopurinol
SSRIs
Sodium valproate
Acute alcohol intake
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2
Q

Examples of P450 inducers

A

Antiepileptics
Phenobarbitone
Rifampicin
Chronic alcohol

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3
Q

C/Is for diclofenac

A

IHD
PAD
CVD
CCF

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4
Q

Causes of drug-induced urinary retention

A

TCAs
Anticholinergics
Opiods
NSAIDs

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5
Q

Drugs causing gout

A

Pyrazinamide
Loop diuretics
Thiazides

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6
Q

Give some drugs that cause nephrotoxicity

A

Lithium
Aminoglycosides
Ciclosporin

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7
Q

What LFT changes would make you stop a statin?

A

If transaminases rose and persisted at 3x upper limit of ref range

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8
Q

Class of drugs responsible for hearing loss

A

Loop diuretics

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9
Q

1st line HTN drug in DM

A

ACEi

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10
Q

SEs of CCB

A

Headache
Flushing
Ankle oedema

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11
Q

Main indications for alpha blockers

A

HTN and benign prostatic hyperplasia

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12
Q

Ideal statin drug and dose prescribed as primary prevention of CVD

A

Atorvastatin 20mg

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13
Q

SE of metformin when eGFR <30

A

Lactic acidosis

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14
Q

Two SEs of ACEi

A

Cough

Hyperkalaemia

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15
Q

4 SEs of bendroflumethiazide

A

Gout
Hypokalaemia
Hyponatraemia
Impaired glucose tolerance

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16
Q

3 SEs of B-blockers

A

Bronchospasm
Fatigue
Cold peripheries

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17
Q

Site of action of bendroflumethiazide

A

Proximal DCT

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18
Q

Outline the classes of antiarrhythmics and their mechanism of action

A 
1a - blocks Na, inc AP duration
1b - blocks Na, dec AP duration
1c - blocks Na, no effect on AP
II - B-antagonists
III - blocks K
IV - CCB
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19
Q

Examples of 1a antiarrhythmics

A

Quinidine

Procainamide

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20
Q

Example of a 1b antiarrhythmics

A

Lidocaine

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21
Q

Example of a 1c antiarrhythmics

A

Flecainide

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22
Q

Examples of class II antiarrhythmics

A

Propranolol
Atenolol
Bisoprolol

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23
Q

Examples of class III antiarrhythmics

A

Amiodarone

Sotalol

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24
Q

Examples of class IV antiarrhythmics

A

Verapamil

Diltiazem

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25
Q

Uses of alpha agonists

A

Alpha 1: decongestants

Alpha 2: glaucoma

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26
Q

Uses of alpha antagonists

A

BPH

HTN

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27
Q

Uses of B1 agonists

A

Inotropes (dobutamine)

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28
Q

Examples of B1 antagonists

A 
Non-selective = propranolol
Selective = bisoprolol, atenolol
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29
Q

Uses of B2 agonists

A

Bronchodilators (salbutamol)

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30
Q

Examples of B2 antagonists

A

Non-selective B-blockers - propranolol

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31
Q

Uses of dopamine agonists

A

Parkinson’s

Prolactinoma

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32
Q

Uses of dopamine antagonists

A

Schizophrenia (haloperidol)

Anit-emetics (metoclopramide)

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33
Q

Example of GABA agonist

A

BZDs

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34
Q

Example of GABA antagonist

A

Flumazenil

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35
Q

Example of a histamine-1 antagonist

A

Loratadine

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36
Q

Use of histamine-2 antagonists

A

Antacids (ranitidine)

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37
Q

Use of muscarinic agonists

A

Glaucoma

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38
Q

Examples of muscarinic antagonists

A

Atropine (for brady)
Bronchodilator (ipratropium)
Urge incontinence

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39
Q

Examples of nicotinic agonists

A

Nicotine

Depolarising muscle relaxants (sux)

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40
Q

Examples of nicotinic antagonist

A

Non-depolarising muscle relaxant (atracurium)

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41
Q

Mechanism of action of fondaparinux

A

Activates antithrombin III

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42
Q

What pH disturbance might you see when too much NaCl is given?

A

Hyperchloraemic acidosis

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43
Q

SEs of clozapine

A 
Weight gain
Excessive salivation
Agranulocytosis
Neutropenia
Myocarditis
Arrhythmias
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44
Q

SE of sildenafil

A

Headaches

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45
Q

Mechanism of action of statins

A

Dec intrinsic cholesterol synthesis (via HMG-CoA)

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46
Q

Anti-TB drug associated with peripheral neuropathy

A

Isoniazid

47
Q

Class of drug to inc gastric motility

A

Dopamine antagonist - metoclopramide

48
Q

SEs of mirtazapine

A

Large inc appetite

Drowsiness

49
Q

Statin dose post-MI

A

Atorvastatin 80mg

50
Q

Condition worsened by thiazide diuretics

A

Gout

51
Q

When is a statin recommended in HTN?

A

When the QRisk is >20%

52
Q

Abx causing tendinitis and rupture?

A

Ciprofloxacin

53
Q

Tests before commencing amiodarone

A

TFT
LFT
U+E
CXR

54
Q

Diabetes drug causing cholestasis

A

Gliclazide

55
Q

SE more common in atypical vs typical antipsychotics

A

Weight gain

56
Q

SEs of ciclosporin

A

HTN
Fluid OL
Hyperkalaemia
Hyperglycaemia

57
Q

TB drug causing vision deterioration (particularly in colour vision)

A

Ethambutol

58
Q

Mode of action of orlistat

A

Pancreatic lipase inhibitor

59
Q

SEs of cocaine

A

CVS - MI, tachy, brady, HTN, broad QRS, QT prolong, aortic diss

Neuro - seizures, hypertonia, hyperreflexia

Psych - agitation, psychosis, hallucinations

Others - ischaemic colitis, hyperthermia, met acid, rhabdo

60
Q

Treatment of cocaine OD

A

BZDs

61
Q

Uses of B-blockers

A 
Angina
HTN
Antidysrhythmic
Post-MI
HF
62
Q

C/I of B-blockers

A

Severe asthma or COPD

Heart blocks

63
Q

Uses of ACEi

A

HTN
HF
Post-MI

64
Q

Uses of loop diuretics. What are the SEs?

A

HF

SEs - hyponat, hypokal, hypocalc, ototoxic

65
Q

Use of thiazide diuretics. SEs?

A

HTN (indapamide)
HF
SEs - hypokal, hypercalc, hypomag, inc urate

66
Q

Uses of vasodilators. SEs?

A

CCF
IHD
HTN

67
Q

Uses of CCB. SEs?

A

Promote coronary and peripheral vasodilation.

Used in HTN, angina and dysrhythmias

68
Q

Uses of digoxin. SEs?

A

Used to slow pulse in AF
Also +ve inotrope, so has role in CCF in sinus rhythm
SEs - arrhythmia, nausea, anorexia, yellow vision, gynaecomastia

69
Q

Which T2DM drug is C/I in HF

A

Pioglitazone

70
Q

Which CCB would you use in HTN if the pt is already on B-blocker?

A

Nifedipine (Verapamil is C/I when on B-blocker)

71
Q

2 drugs to avoid in WPW and why

A

Verapamil and digoxin (may precipitate VT or VF)

72
Q

Important side effect of flucloxacillin

A

Cholestasis

73
Q

Common side effect of erythromycin

A

GI upset

also cholestasis

74
Q

What advice would you give to a pt listed for endoscopy with regard to their PPI/H2 antagonist?

A

Stop taking omeprazole 2weeks before endoscopy

75
Q

What advice would you give to a pt currently taking aspirin 75mg OD who has a flare of gout?

A

Continue aspirin - no evidence that low dose aspirin increases urate levels

76
Q

Effect of amiodarone on thyroid

A

Hypothyroidism and thyrotoxicosis

77
Q

Medication to prevent alcohol withdrawal symptoms?

A

Chlordiazepoxide

78
Q

Monitoring required when starting statins

A

Baseline, 3m and 12m

79
Q

Mechanism of action of alteplase

A

Activates plasminogen to form plasmin

80
Q

ABx most likely to cause C Diff

A

Broad spec - clindamycin, cephalosporins, pen)

81
Q

Examples of macrolides

A

Erythromycin
Clarithromycin
Azithromycin

82
Q

Action of macrolides

A

Inhibiting bacterial protein synthesis by blocking translocation

83
Q

Adverse effects of macrolides

A

GI
Cholestatic jaundice
P450 inhibitor

84
Q

Common interactions of macrolides

A

Statins - stop them for duration of ABx therapy (inc risk rhabdo)

85
Q

Drug-induced SIADH

A

Carbamazepine
Sulphonylureas
SSRIs
Tricyclics

86
Q

Precipitating features of digoxin toxicity

A 
Hypokalaemia 
Inc age
Renal failure
MI
Hypomag, hypoalb, hypothermia
Hypothyroid
Hypercalc, hypernat
Acidosis
87
Q

Drugs that inc risk digoxin toxicity

A

Amiodarone
Verapamil and diltiazem
Spironolactone
Drugs that cause hypokal- thiazides and loop

88
Q

Monitoring for pts on methotrexate

A

FBC, LFT, U+E

89
Q

Monitoring for pts on amiodarone

A

TFT

LFT

90
Q

ABx that lower the seizure threshold and should therefore be avoided with sodium valproate

A

Ciprofloxacin

91
Q

Monitoring for pts on azathioprine

A

FBC

LFT

92
Q

First line therapy for C Diff

A

Metronidazole

93
Q

What is the most appropriate time for therapeutic monitoring of lithium levels

A

12hrs after last dose

94
Q

Side effects of ciclosporin

A 
Inc fluid
Inc BP
Inc K
Inc hair
Inc gums
Inc glucose
Hepatotoxicity
95
Q

Mechanism of action of nicorandil

A

Potassium channel activator

96
Q

Mechanism of action of finasteride (used in BPH)

A

5-alpha reductase inhibitor

Dec size of prostate

97
Q

Coming off SSRIs

A

Pt should remain on SSRIs for 6m after remission

Dose should be gradually reduced over 4wks

98
Q

ABx causing QT prolongation

A

Clarithromycin

99
Q

Most common cause of drug-induced angioedema

A

ACEi

100
Q

Site of action of furosemide

A

Ascending loop of Henle

101
Q

Drug that decreases the effect of adenosine

A

Aminophylline

102
Q

Drug that increases the effect of adenosine

A

Dipyridamole

103
Q

What medications should be avoided before a Urea breath test?

A

No Abx in past 4w

No PPIs in past 2w

104
Q

Anti-TB drug causing gout

A

Pyrazinamide

105
Q

Most important blood test in pts taking clozapine

A

FBC

106
Q

Examples of typical/first gen antipsychotics and their SEs

A

Chlorpromazine, haloperidol

SEs: extrapyramidal

107
Q

Examples of atypical/second gen antipsychotics and their SEs

A

Amisulpride, olanzapine, quetiapine, risperidone

SEs: lower risk EPSE, more metabolic (weight gain, hyperglycaemia, dyslipidaemia)

108
Q

Uses of BZDs

A 
Sedation
Hypnotic
Anxiolytic
Anticonvulsant
Muscle relaxant
109
Q

Side effects of BZDs

A

Anterograde amnesia (memory recall and creation of new memories is significantly impaired)

110
Q

Interactions with SSRIs

A

NSAIDS - if given together, give PPI
Warfarin/heparin - avoid SSRI, give mirtazapine
Triptans - avoid SSRI

111
Q

Who gets a statin?

A
  • everyone with CVD (stroke, TIA, IHD, PAD)
  • anyone with 10yr CV risk >10%
  • T1DM who were diagnosed >10yrs OR aged >40 OR established neuropathy
  • CKD if GFR<60
112
Q

Equivalent of 20mg prednisolone in hydrocortisone

A

Pred is 4x stronger

Therefore give hydrocortisone 20mg QDS

113
Q

Mechanism of action of bromocriptine

A

Dec prolactin by inc dopamine

114
Q

Management of EPSE of antipsychotics

A

Procyclidine

Finals (25 decks)

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