Pharmacology Flashcards
What type of diuretic is frusomide?
Loop
What electrolyte disturbance can an ACEI cause?
Hyperkalaemia (decreases absorption of sodium and increases retention of potassium)
What electrolyte disturbance can frusomide cause?
Hypokalaemia (as it is NOT a postassium sparing diuretic
What is the effect of bisoprolol on cardiac output?
Decreases CO
Does ramipril cause vasoconstriction or vasodilation?
Venous and arterial dilatation (blocks angiotensin II which is a vasoconstrictor)
What PPI should not be combined with clopidogrel?
Omeprazole
How is allopurinol excreted?
Renal - beware renal impairment
Do you need to be wary of simvastatin in renal failure?
It is metabolized largely by the liver but still isn’t recommended in SEVERE renal impairment
How is metformin excreted?
Excreted unchanged in the urine
How is the excretion of ramipril affected by renal impairment?
Significantly reduced
How is omeprazole metabolized?
Liver
In regards to a drug that exhibits first order kinetics administered by constant IV infusion, when is the steady state plasma concentration achieved?
When the rate of administration = the rate of elimination
How is time to steady state related to dose rate (first order kinetics)
It is independent of dose rate (will always take 5 half lives)
What happens to time to steady state if half life is reduced? (first order kinetics)
Time to stead state is reduced
How is time to steady state related to clearance? (first order kinetics)
Time to steady state decreases in proportion to clearance
How is the rate of elimination related to the plasma concentration (first order kinetics)
The plasma concentration drives the rate of elimination
What calculation can be done with apparent volume of distribution (Vd)
Loading dose
In first order elimination kinetics, how is the half life related to the dose?
It is independent of the dose until saturation
How is steady state plasma concentration related to dose rate?
Linearly related (dose doubles = steady state plasma concentration doubles (but not TIME to steady state))
How do you calculate a loading dose?
(Volume of distribution (litre per kg) x target plasma concetration (mg per litre)) / oral bioavailability
Then multiply all that by the weight of the patient in kg
Can also be estimated by Vd of drug:
LD = Vd x target plasma concentration / oral bioavailability
What does viagra do?
Vasodilates
What heart drug interacts with viagra?
Isosorbide mononitrate
What does isosorbide mononitrate do?
Vasodilator and decreases preload (reduces left ventricular work)
What medication might exacerbate gout?
Diuretics
What class of drug interacts with grapefruit juice?
Statins
The effectiveness of which drug out of the following may decrease in impaired renal function:
- Metformin
- Simvastatin
- Fruosemide
- Aspirin
- Bisoprolol
Fruosemide
What agents are used to treat acute gout?
NSAIDs, colchicine and steroids (oral, IM or intra-articular)
What are some things that might make you worried about giving NSAIDs
- Renal impairment (and LVF - combination causes glomerular filtration to become increasingly dependent on renal prostaglandins that, by vasodilatation, maintain adequate hydrostatic pressure within the glomerulus)
- Ongoing NSAID use
- ACEI and frusomide combination (might cause a triple whammy effect in someone with already bad kidney function and cause acute renal failure)
What drug would be used for osteoarthritic pain in a patient already taking warfarin for AF?
Paracetamol (don’t use NSAIDs)
How many days before surgery should warfarin be stopped?
5 days
What is the management for a paracetamol overdose?
IV N-acetylcysteine
What drug can be used after a patient becomes hypotensive after a spinal anaesthetic to bring the blood pressure up?
Ephedrine
What type of drug is cyclizine?
Histamine type 1 (H1) receptor antagonist
Is clonidone a hyper or hypotensive drug?
Hypotensive
What is the action of GTN?
Releases NO to cause vasodilatation
What is the action of ephedrine?
Causes release of noradrenaline and has some beta-receptor agonist activity
Can Vd exceed the total volume of the body?
Yes
