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good paeds > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Azathioprine s/e

A

Marrow suppression
Hepatotoxic
Diarrhoea and nausea
Pancreatitis

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2
Q

Carbamazepine side effect

A

Carb - carbs make you Gain weight and hope your fat cos of a baby!

Maze - makes you dizzy, nausea, low Na

Pine - wish I had neutrophils (agranulocytosis and aplastic anaemia)

Rash most common (SJS in Chinese HLA)

Also decreases effect of OCP

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3
Q

Valproate inhibits metabolism of some drugs causing toxicity

A

Phenobarbitone, phenytoin, lamotrigine

Pancreatitis, LfTs, alopecia, weight gain

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4
Q

Topiramate side effects

A

To Lose Weight

Nephrolithiasis, glaucoma, weight loss

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5
Q

Lamotrigine increased by

A

Valproate and decreased by CMZ

Rash SJs

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6
Q

Vigabactrin side effect

A

V=Visual field loss, reduced night vision (permanent)

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7
Q

Brachial plexus at what level causes horners

A

T1

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8
Q

Bell’s palsy loss of taste where

A

Anterior tongue

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9
Q

SE interferon

A

Flu like, BM suppression, alopecia

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10
Q

SE ribavirin

A

Haemolytic anaemia, teratogenic

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11
Q

SE of cyclosporine

A

Hirsutism most common

Renal
HTN
Liver toxicity
GI upset
Tremor
Parasthesias 
Gingival hyperplasia

Calcineurin inhibitor (stops IL2)

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12
Q

Hydroxychloroquine monitoring

A

Eye 6 monthly

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13
Q

PK

A

Dose to achieve concentration

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14
Q

PD

A

Concentration-response relationship

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15
Q

Steady state is

A

Rate in = rate out

(Reached after 5 half lives)

a drug infused at a constant rate reaches about 94% of steady state after 4 half lives

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16
Q

Beta lactam pr scribing important principle

A

Time above MIC

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17
Q

Aminoglycosides mechanism of action

A

Inhibition of protein synthesis

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18
Q

Thiopentone mechanism of action

A

Potentiates action of GABA

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19
Q

Ketamine and neonate

A

Neuronal apoptosis and long term memory deficits

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20
Q

Stilboesterol long term effect

A

Vaginal carcinoma

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21
Q

Tetracycline long term effect

A

Teeth staining

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22
Q

Neuroleptic malignant syndrome

A

a life-threatening, neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs. Symptoms include high fever, sweating, unstable blood pressure, stupor, muscular rigidity, and autonomic dysfunction

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23
Q

ACEi cough mediated by

A

Bradykinin

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24
Q

NO mechanism of action

A

SM relaxation by up regulation cGMP

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25
Q

Codeine path enzyme required

A

CYP2D6

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26
Q

CYP450 inhibitors and inducers

A

Inhibitors only MAC (macolides, antifungals, CCB - verapamil, diltiaem) and grapefruit juice

Inducers all the others
RASS (rifampicin, anti-seizure - phenobarb, phenytoin, carbamazepine, St. John’s wort)

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27
Q

Ondansetron

A

Serotonin 5HT-3 antagonist

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28
Q

Reversal drug for benzo

A

Flumazenil

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29
Q

Statins

A

Statins areHmG-CoA reductase inhibitors

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30
Q

MMF/metformin/SSRI most common se

A

GI disturbance

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31
Q

Valproate and phenytoin in pregnancy effects

A

Valproate NTD

Phenyt fetal hydantoin syndrome

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32
Q

Pancuronium does it cross placenta

A

No - used in LsCS

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33
Q

Bioavailability worked out wth

A

AUC

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34
Q

Rituximab mechanism of action

A

Anti CD20 antibody

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35
Q

Citalopram ECG change

A

Prolonged QT

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36
Q

Mechanism of action of methylphenidate and amphetamine

A

Block reuptake of dopamine

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37
Q

Mechanism of action of atomoxetine

A

Selective NA reuptake inhibitor

Blocks transporter and blocks reuptake ofNA

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38
Q

Prevelance OCD

A

1%

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39
Q

Pimecrolimus classification and s/e

A

Celcineurin inhibitor (immune mediated anti inflammatory)
Burning and increase infection
Not atrophy

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40
Q

Main concerning side effect of propranolol

A

Hypoglycaemia

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41
Q

Sirolimus

A

mTOR inhibitors (inhibits cell growth and angiogenesis)

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42
Q

Omalizumab

A

Anti IgE antibody

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43
Q

UVA or B used

A

B because A is risk skin ca

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44
Q

Sotalol side effects

A

Bradycardia, lethargy, QT prolonged

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45
Q

Flecainide side effects

A

Tingling, constipation, blurred vision, monitor blood levels

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46
Q

Side effect digoxin

A

Hypokalaemia

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47
Q

Frusemide action site

A

Loop diuretic acting on loop of henle

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48
Q

Thiazides diuretic site of action

A

Proximal and distal tubules

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49
Q

Spironolactone site of action

A

Aldosterone antagonist acts on distal tubule

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50
Q

Contraindication to diuretics, b blocker, acei, calcium channel blocker

A

Diuretics - gout
Beta blocker - asthma, diabetes
Ace inhibitors - pregnancy, bilateral renal artery stenosis, high potassium
Calcium channel blocker- heart block

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51
Q

Drug that can worsen pulm HTN

A

Contraceptives

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52
Q

Statins mechanism of action

A

HMG-CoA reductase inhibitors

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53
Q

Statins side effects

A 
Commonly GI/headache/myalgia
Sleep disturbed and nightmares
Memory loss 
Myopathy
Interstitial lung disease
Deranged lfts 
CK up
Rhabdo
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54
Q

Other treatments apart from statins (2)

A 
Nicotinic acid (B3) imcreases HDL cholesterol 
Ezetimibe is cholesterol absorption inhibitor
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55
Q

Other than tamiflu what can you use > 5 year olds?

A

Zanamavir is another neuraminidase inhibitor, delivered as an inhaled powder by rotadisk. It is active against influenza A and B, sometimes even for strains resistant to Oseltamivir. It is licensed for children >5years. Treatment dose is 2 x 5mg inhalations twice daily for 5 days; prophylaxis dose is 2x 5mg inhalations once daily for 10 days.
Tamiflu reduces sx by 1 day

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56
Q

AED highest risk SJS

A

LTG

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57
Q

AED in pregnancy

A

Lamotrigine

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58
Q

AED mostly renal excreted

A

Levetiracetam and gabapentin

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59
Q

Halve digoxin dose if prescribed with

A

Amiodarone

60
Q

Sotalol must monitor

A

QT interval

61
Q

Stimulants in ADHD mechanism of action

A

Methyphenidate and amphetamine
– Block reuptake of dopamine
Amphetamine
– Increases dopamine release
Atomoxetine
– Blocks transporter and blocks reuptake of
noradrenalin

62
Q

Tacrilomus SE

A

Burning topically

tremor, renal impairment, hyperglycaemic conditions, diabetes mellitus, hyperkalaemia, infections, hypertension and insomnia.

Can check levels

63
Q

MMF most common side effect

A

GI

64
Q

Name three teratogens in pregnancy

A

Carbamazepine (Nt defect)
Valproate (nt defect)
MTX (CNS defects)

Carbimazole (hypothyroidism) so PTU preferred
Quinine (deafness)
Toluene (similar to fetal alcohol syndrome)
Misoprostol (moebius sequence with facial paralysis)
Steroid ? Cleft

65
Q

Warfarin teratogenic effect

A

Nasal hypoplasia

66
Q

Cyclophosphamide adverse effects

A

Gametogenesis affected
Increased risk secondary tumours (DNA damaged)
Haemorrhaging cystitis

67
Q

Bleomycin side effect

A 
Pulmonary toxicity (fibrosis usually dose related and delayed 
)
68
Q

Vinca alkaloids bind to tubulin in M phase and inhibits mitosis
Side effects

A

Neurotoxic (peripheral neuropathy)

Intrathecal vincristine fatal

69
Q

CisPLATINUM and carboPLATINUM side effects

A

Dose related ototoxicity and renal toxicity

Neurotoxic

70
Q

What drug can worsen liver failure in underlying metabolic disease

A

Sodium valproate

71
Q

Infliximab mechanism of action

A

Neutralises TNFa by binding to it and stopping it attaching to receptors

72
Q

Vasopressin in vwd mechanism

A

Increases release of vwf from endothelial cells

73
Q

Pulmozyme (dornase alfa) mechanism of action

A

Hydrolyses DNA in mucus (recombinant human deoxyribonuclease I)

74
Q

Isotrenitoin in pregnancy causes

A

Facial, ear, heart deformities

75
Q

Methotrexate 80% excrete by? And what can interfere and cause toxicity

A

Renal

Aciclovir, allopurinol, PPI some abx

76
Q

Ribavirin side effect

A

Haemolytic anaemia

77
Q

Thromboxane is a powerful vasodilator or vasoconstrictor

A

Vasoconstrictor

78
Q

Antidiuretic hormone mechanism

A

Inserts aquaporins into apical membrane

79
Q

ACEi side effects

A

Risk hyperkalaemia

80
Q

Paracetamol overdose physiology

A

Broken into toxic metabolite by cytochrome p450 and binds to glutathione

81
Q

Most likely condition to respond to SSRI

A

Anxiety

82
Q

Oral rehydration contains starch for

A

Fermentation

And ORT with zinc reduces diarrhoea too

83
Q

C peptide level to see

A

Amount of insulin

84
Q

The drugs that most commonly cause SJS/TEN are:

A

Sulfonamides: cotrimoxizole;
Beta-lactam: penicillins, cephalosporins
Anti-convulsants: lamotrigine, carbamazepine, phenytoin, phenobarbitone
Allopurinol
Paracetamol/acetominophen
Nevirapine (non-nucleoside reverse-transcriptase inhibitor)
Nonsteroidal anti-inflammatory drugs (NSAIDs) (oxicam type mainly)

85
Q

Second generation H1 receptor antagonists effectively relieve most of the symptoms of allergic
rhinoconjunctivitis.
Which one of the following symptoms is least effectively relieved?
A. Nasal congestion.
B. Nasal itch.
C. Ocular tearing.
D. Rhinorrhoea.
E. Sneezing.

A

A

86
Q

The cough associated with the use of angiotensin-converting enzyme (ACE) inhibitors is mediated through

A

Bradykinin

87
Q

Non competitive antagonist

A

non-competitive antagonist binds to a receptor irreversibly and cannot be displaced by an agonist

88
Q

Clearance formula

A

CL = Vd * Ke/half life
[Ke = elimination constant=0.7]
CL = volume of distribution/half life
CL in L/h (check units!)

89
Q

Half life formula

A

t1/2 = Vd/CL

Check units

90
Q

What is high first pass metabolism

What route isn’t first pass metabolised

A

1: when drug uptake by Gut into liver system before goi into blood and high amount metabolised so minimal active drug in system
2: nasal

91
Q

Volume of distribution is

A

theoretical volume that would be necessary to contain the total amount of an administered drug at the same concentration that it is observed in the blood plasma.

The distribution of drug in body or plasma after dose

92
Q

Which anti epileptic is most teratogenic

A

Valproate

But others include CMZ, phenobarbital and phenytoin

93
Q

Tricyclics overdose Tx

A

Sodium bicarbonate

94
Q

Rituximab mechanism of action

A

Inhibits CD20

95
Q

G6PD drugs to avoid (3)

A

Nitrofurantoin
Methylene blue
Rasburicase
Primaquine

96
Q

On antipsychotics and present with fever, coma, rigid muscles and autonomic dysfunction
Called?

A

Neuroleptic malignant syndrome

97
Q

First order kinetics

A

K is a constant and first order kinetics the same fraction or percentage is eliminated at a rate (therefore a log)

98
Q

What drug can go into zero order kinetics

A

Phenytoin

Aspirin can bind to platelets no upregulation receptors

99
Q

Bioequality of a drug percent

A

AUC and peak conc Cmax 80-125%

100
Q

Red man syndrome with what drug

A

Vancomycin (related to rate of administration)

101
Q

Carbamazepine genetics HIGH risk SJs

A

Asian carbamazepine HLAB1502 HIGH risk SJS

102
Q

Renal stones SE

A

Topirimate

103
Q

Tachyphylaxis is

A

The more drug you add it becomes less effective

104
Q

sotalol mechanism and SE

A

(blocks potassium
channels, can cause bradycardia and lethargy and prolongs QT),

105
Q

Flecinide SE

A

Blurred vision, tingling, constipation

Need trough levels

106
Q

Drugs causing prolonged QT

A

AAA TakesCare of your Ford Engine

Antihistaminics
Anticholinergics 
Antiarrythmics (specially Quinidine and Sotalol)
TCAS
Fluoroquinolones
Erythromycin
antibiotics (erythromycin, clarithromycin, cotrimoxazole), 
antifungal agents (fluconazole), antiprotozoal agents, antihistamines 
(selected), antidepressants (tricyclics), antipsychotics (haloperidol, 
risperidone, chlorpromazine), antiarrhythmic drugs, lipid lowering
107
Q

Gum hyperplasia, ataxia, hirsute, nystagmus what drug

A

Phenytoin

108
Q

Cyclizine and metoclopramide mechanism of action

A 
Cyclizine = H1 receptor antagonist
Met = dopamine receptor antagonist
109
Q

Thioliazines and metformin action

A

Increase sensitivity to insulin

Metformin also suppresses liver glucose production

110
Q

Sulfonylurea (gliclazide) action

A

Increased secretion

111
Q

Exposed valproate teratogen risk NTD

A

1-2%

112
Q

Carbimazole mechanism of action

A

Blocking iodisation and coupling of tyrosine molecules on thyroglobulin

113
Q

Diazoxide mechanism of action

A

potent openers of the K+ ATP channels present on the insulin producing beta cells of the pancreas.

114
Q

Valproate SE

A 
V.A.L.P.R.O.A.T.E
Vomiting 
Alopecia/ammonia
Liver toxicity
Pancreatitis/ Pancytopenia
Retention of fats (weight gain)
Oedema (peripheral oedema)
Anorexia
Tremor
Enzyme inhibition
115
Q

Codeine metabolism

A

Glucuronidation by CYP2D6 to morphine

116
Q

selumetinib

A

Is an inhibitor of mitogen-activated protein kinases.

Trial for plexiform neurofibromas

117
Q

crisaborole

A

It is a phosphodiesterase-4 inhibitor, mainly acting on phosphodiesterase 4B (PDE4B), which causes inflammation.[6] Chemically, crisaborole is a phenoxybenoxaborole.[6] It contains a boron atom that helps penetrate the skin and is essential for its binding activity.[8] Inhibition of PDE4B appears to suppress the release of tumor necrosis factor alpha (TNFα), interleukin-12 (IL-12), IL-23 and other cytokines, proteins believed to be involved in the immune response and inflammation.[6]

118
Q

Atypical hemolytic uremic syndrome (aHUS) is caused by alternative complement pathway dysregulation, leading to systemic thrombotic microangiopathy (TMA) and severe end-organ damage. Which drug now approved and what is its mechanism of action?

A

eculizumab, a terminal complement inhibitor

119
Q

Cotrimoxazole mechanism of action

A

sulfamethoxazole -> inhibits bacterial synthesis of dihydrofolic acid
trimethoprim -> blocks production of tetrahydrofolic acid

120
Q

Octreotide is an analogue of

A

Somatostatin

121
Q

Leveteracetam SE

A

Somnolence

Irritability

122
Q

L asparginase mechanism

A

Breaks down asparginase which cancer cell needs to live

123
Q

L asparginase SE

A

Allergy
Coagulopathy
Pancreatitis

124
Q

Busulphan SE

A

Pulmonary fibrosis
Sz
VOD
Hyperpigmentation

Causes DNA cross
Inking to prevent replication

125
Q

Cytarabine mechanism

A

Adds sugar onto nucleotide in S phase (synthesis of DNA)

126
Q

Number of puffs in an inhaler

A

200

127
Q

MgSO4 protects against CP by

A

Blocks NMDA receptor on glial cell preventing injury and free radicals and dilates

128
Q

Important drug cause of liver failure

A

PTU

129
Q

Cotrimoxazole works by

A

Inhibiting dihydrofolate

130
Q

Fosfomycin targets?

A

Gram positive including MRSA and anaerobes

131
Q

Ivacoftor is a drug for?

A

Modulates GSS1D potentiates molecule to surface

Kalydeco similar and is in trial phase

132
Q

Dornase Alfa also called

A

Pulmozyme

133
Q

What drug with abx neonatal sepsis reduces death

A

Pentoxifyline

134
Q

Drug for Frederick ataxia

A

Idebenone (coQ10 variant)

135
Q

Transenamic acid mechanism

A

Fibrinolytic inhibitor

136
Q

Eculizumab action

A

Blocks C5 splitting/activation

137
Q

Rituximab mechanism

A

Against CD20 found on B cells (triggers cell death)

138
Q

Fanconi anaemia hypersensitive to what drug

A

Cisplatin (DNA cross linker)

Chromosome fragile

139
Q

Drug for Dravet and Lennox-gastault

A

Dravet - stiripentol
LG - rufinamide

DRACULA SHOULD STRIP PENT HOUSE
LG FUELS THE ROOF IN A MIND

140
Q

Treatment c diff mild-mod and severe

A

Metronidazole

IV vancomycin

141
Q

What drugs delay renal clearance MTX (4)

A

Allopurinol
Aciclovir
Antibiotics
PPI

142
Q

How does cholestyramine work and indications and side effects

A

Binds bile acids
High cholesterol ileum not working and itch
Side effect constipation and haemorrhoids

143
Q

Diazoxide side effect? (2)

A

Hairy

Water retention

144
Q

Phenytoin mechanism of action

A

Sodium channel

145
Q

Erythromycin prokinetic effect mediated by

A

Motilin

146
Q

Eculizamab inhibits?

A

C5 activation

good paeds (19 decks)

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