Pharmacology Flashcards
What are the indications for alpha blockers?
BPH
Hypertension
Doxazosin and Tamsulosin
What are 4 side effects of alpha blockers?
Postural hypotension
Drowsiness
Dyspnoea
Cough
When should caution be taken in a patient taking an alpha blocker?
Cataract surgery
Due to intraoperative risk of floppy iris syndrome
What is the mechanism of action of aspirin?
Antagonist of COX1 and COX2 which make prostaglandins, prostacyclin and thromboxane
Blocking thromboxane A2 in platelets = reduced ability to aggregate
What are the indications for aspirin use?
First line for ischaemic heart disease
No longer recommended for following an ischaemic stroke (clopi is instead)
Which drugs does aspirin potentiate?
Oral hypoglycaemics
Warfarin
Steroids
What is the mechanisms of action of Ciclosporin?
Immunosuppressant
Decreases clonal proliferation of T cells by reducing IL-2 release
Give 5 indications for cyclosporin use
After an organ transplant
Rheumatoid Arthritis
Ulcerative Colitis
Psoriasis
Pure red cell aplasia
What 5 adverse effects of cyclosporin?
INCREASES EVERYTHING - hyperkalaemia, HTN, hypertrichosis, gingival hyperplasia, hyperlipidaemia
Nephrotoxic and hepatotoxic
Impaired glucose tolerance
Tremor
More susceptible to infection (but not myelotoxic)
Give 6 examples of drugs that can cause agranulocytosis
4Cs = carbimazole, clozapine, carbamazepine, chloramphenicol
2Ms = mirtazapine and methotrexate
What should be monitored in a patient taking a statin and when?
LFTs
Baseline, 3 months and 12 months
What should be monitored in a patient taking an ACE inhibitor and when?
U&E
prior to treatment
after increasing dose
at least annually
What should be monitored in a patient taking Amiodarone and when?
TFT, LFT, U&E, CXR prior to treatment
TFT, LFT every 6 months
What should be monitored in a patient taking Methotrexate and when?
FBC, U&E, LFT before treatment
repeat weekly until stable
Every 2-3 months
GIVE 3 indications for methotrexate
Incomplete miscarriage/ medical TOP
RA
psoriasis
Take once a week along with folic acid
Give 4 adverse effects of methotrexate
Teratogenic - avoid pregnancy for at least 6 months after treatment stops (men and women)
Fibrosis - lung and liver
Myelosuppression
Mucositis
What should be monitored in a patient taking Azothioprine and when?
FBC, LFT before treatment
FBC weekly for the first 4 weeks
FBC, LFT every 3 months
What is the method of action of methotrexate?
Competitively inhibits Dihydrofolate Reductase (DHFR) which forms tetrahydrofolate = folic acid
Folic acid needed for DNA synthesis so inhibits DNA synthesis
What is the method of action of Azathioprine?
Inhibits purine synthesis = inhibits DNA synthesis
What are some general and life threatening adverse effects of Azathioprine?
General - nausea, dizziness, myalgia
Life-threatening - myelosuppression, agranulocytosis, neutropenia, increased risk of cancer and infection, pancreatitis
What should be monitored in a patient taking Lithium and when?
TFT, U&E prior to treatment
Lithium levels weekly until stabilised then every 3 months
TFT, U&E every 6 months
What are 5 adverse effects of lithium use?
Hypothyroidism
Nephrotxic
Fine tremor
T wave inversion
Weight Gain
What are the signs of lithium toxicity?
Coarse tremor
Hyperreflexia
Acute confusion
Seizure > coma
What can precipitate lithium toxicity?
Basically anything that messes with the kidneys
Dehydration/renal failure/ thiazides/ acei/ NSAIDs
What should be monitored in a patient taking Sodium Valproate and when?
LFTs and FBC before treatment
LFTs periodically during first 6 months
What is the MOA of sodium valproate?
Increases GABA activity
What are 5 adverse effects of sodium valproate use?
Nausea and weight gain
P450 INHIBITOR
Teratogenic
Thrombocytopenia
Pancreatitis
Which drug can cause cataracts?
Steroids
Which drugs can cause corneal opacities?
Amiodarone
Indomethacin
Which drugs can cause optic neuritis? (3)
Ethambutol
Amiodarone
Metronidazole
Which drugs can cause retinopathy? (2)
Chloroquine
Quinine
