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Transition Block > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What type of diuretic is frusomide?

A

Loop

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2
Q

What electrolyte disturbance can an ACEI cause?

A

Hyperkalaemia (decreases absorption of sodium and increases retention of potassium)

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3
Q

What electrolyte disturbance can frusomide cause?

A

Hypokalaemia (as it is NOT a postassium sparing diuretic

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4
Q

What is the effect of bisoprolol on cardiac output?

A

Decreases CO

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5
Q

Does ramipril cause vasoconstriction or vasodilation?

A

Venous and arterial dilatation (blocks angiotensin II which is a vasoconstrictor)

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6
Q

What PPI should not be combined with clopidogrel?

A

Omeprazole

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7
Q

How is allopurinol excreted?

A

Renal - beware renal impairment

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8
Q

Do you need to be wary of simvastatin in renal failure?

A

It is metabolized largely by the liver but still isn’t recommended in SEVERE renal impairment

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9
Q

How is metformin excreted?

A

Excreted unchanged in the urine

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10
Q

How is the excretion of ramipril affected by renal impairment?

A

Significantly reduced

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11
Q

How is omeprazole metabolized?

A

Liver

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12
Q

In regards to a drug that exhibits first order kinetics administered by constant IV infusion, when is the steady state plasma concentration achieved?

A

When the rate of administration = the rate of elimination

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13
Q

How is time to steady state related to dose rate (first order kinetics)

A

It is independent of dose rate (will always take 5 half lives)

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14
Q

What happens to time to steady state if half life is reduced? (first order kinetics)

A

Time to stead state is reduced

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15
Q

How is time to steady state related to clearance? (first order kinetics)

A

Time to steady state decreases in proportion to clearance

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16
Q

How is the rate of elimination related to the plasma concentration (first order kinetics)

A

The plasma concentration drives the rate of elimination

17
Q

What calculation can be done with apparent volume of distribution (Vd)

A

Loading dose

18
Q

In first order elimination kinetics, how is the half life related to the dose?

A

It is independent of the dose until saturation

19
Q

How is steady state plasma concentration related to dose rate?

A

Linearly related (dose doubles = steady state plasma concentration doubles (but not TIME to steady state))

20
Q

How do you calculate a loading dose?

A

(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

21
Q

What does viagra do?

A

Vasodilates

22
Q

What heart drug interacts with viagra?

A

Isosorbide mononitrate

23
Q

What does isosorbide mononitrate do?

A

Vasodilator and decreases preload (reduces left ventricular work)

24
Q

What medication might exacerbate gout?

A

Diuretics

25
Q

What class of drug interacts with grapefruit juice?

A

Statins

26
Q

The effectiveness of which drug out of the following may decrease in impaired renal function:

  • Metformin
  • Simvastatin
  • Fruosemide
  • Aspirin
  • Bisoprolol
A

Fruosemide

27
Q

What agents are used to treat acute gout?

A

NSAIDs, colchicine and steroids (oral, IM or intra-articular)

28
Q

What are some things that might make you worried about giving NSAIDs

A
  • 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)
29
Q

What drug would be used for osteoarthritic pain in a patient already taking warfarin for AF?

A

Paracetamol (don’t use NSAIDs)

30
Q

How many days before surgery should warfarin be stopped?

A

5 days

31
Q

What is the management for a paracetamol overdose?

A

IV N-acetylcysteine

32
Q

What drug can be used after a patient becomes hypotensive after a spinal anaesthetic to bring the blood pressure up?

A

Ephedrine

33
Q

What type of drug is cyclizine?

A

Histamine type 1 (H1) receptor antagonist

34
Q

Is clonidone a hyper or hypotensive drug?

A

Hypotensive

35
Q

What is the action of GTN?

A

Releases NO to cause vasodilatation

36
Q

What is the action of ephedrine?

A

Causes release of noradrenaline and has some beta-receptor agonist activity

37
Q

Can Vd exceed the total volume of the body?

A

Yes

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