Pharmacology

Question 1

What eye condition can steroids cause?

Answer 1

Cataracts

Question 2

What eye condition can amiodarone cause?

Answer 2

Vortex keratopathy

Question 3

What visual symptoms can Vigabatrin cause?

Answer 3

Visual field loss including blurred vision, oscillopsia, tunnel vision and difficulty in navigation. Visual acuity is preserved.

Question 4

What visual symptoms can Carbamazepine cause?

Answer 4

Abnormal colour perception and reduced contrast sensitivity

Question 5

What visual symptoms can Levetiracetam cause?

Answer 5

Diplopia

Question 6

What eye condition can Topiramate cause?

Answer 6

Closed angle glaucoma

Question 7

What visual symptoms and signs can Sodium Valproate cause?

Answer 7

Abnormal colour perception and altered visual evoked potentials

Question 8

What is the mechanism of action of cyanide?

Answer 8

Cyanide causes the inhibition of the enzyme cytochrome oxidase c which is an essential part of the mitochondrial electron transfer chain (ETC). It therefore interferes with the basic process of cellular respiration, preventing the formation of ATP and causing rapid cell death

Question 9

What is the mechanism of sarin gas and related agents?

Answer 9

Inhibition of the enzyme acetylcholinesterase, causing levels of acetylcholine to build up in the nervous system causing prolonged sustained contraction of the diaphragm

Question 10

What is the mechanism of action of arsenic?

Answer 10

Inhibition of the enzyme pyruvate dehydrogenase which is necessary for the conversion of pyruvate to acetyl CoA. This also interferes with the basic process of cellular respiration, as pyruvate formed during glycolysis cannot be changed to acetyl CoA to enter the Kreb’s cycle

Question 11

What is the mechanism of action of Abatacept?

Answer 11

Abatacept is a cytotoxic lymphocyte antigen 4 (CTLA 4) homologue - licensed for RA treatment

Question 12

What is the mechanism of action of Adalimumab, etanercept, infliximab, golimumab, and certolizumab

Answer 12

Adalimumab, etanercept, infliximab, golimumab, and certolizumab are anti-TNF alpha agents.

Question 13

What is the mechanism of action of Rituximab?

Answer 13

Rituximab is an anti-CD 20 antibody - licensed for RA treatmen

Question 14

What is the mechanism of action of Anakinra?

Answer 14

Anakinra is an anti-IL 1 antibody.

Question 15

What TB medication is most likely to cause toxic optic neuropathy?

Answer 15

Ethambutol is a well-recognised cause of toxic optic neuropathy. Early features include loss of colour vision and complaints of dimness of vision.

Question 16

What medications can cause methaemoglobinaemia?

Answer 16

Phenacetin
Sulphonamides
Dapsone
Primaquine
Lidocaine
Procaine
Benzocaine.

Question 17

Side effects of isoniazid?

Answer 17

Hepatitis, peripheral neuritis (pyridoxine given prophylactically) and a systemic lupus erythematosus (SLE)-like syndrome

Question 18

List antihistamines in order of generation (first / second) and in order of sedation effect.

Answer 18

First gen:
chlorpheriramine, diphenhydramine, Cyproheptadine

Second gen:
cetirizine and levocetirizine are more sedating than loratadine and desloratadine, and possibly more sedating than fexofenadine (which is the active metabolite of terfenadine and does not appear to have the same arrhythmogenic effects as terfenadine)

Question 19

What is the treatment for Serotonin Syndrome?

Answer 19

Cyproheptadine