pharmacology Flashcards
trimethoprim/sulfamethoxazole formulations use what ratio of dose between trimethoprim and sulfamethoxazole
1:5 ratio, so trimethoprim is less than sulfamethoxazole
(just remember trimethoprim has less letters)
usually its 4+20
denosumab - counselling points (5)
- 6 monthly dosing
- missing a dose by more than 4 weeks can lead to multiple spontaneous vertebral fractures
- if stopping, needs to be switched to a bisphosphonate
- can cause hypocalcaemia
- must maintain calcium and vit d status
oral bisphosphonates - counselling points (3)
- oral formulations can cause GI upset
- absorption reduced by food, antacids, calcium, magnesium and iron
- can cause osteonecrosis of the jaw - see dentist beforehand)
zoledronic acid - adverse effects (4)
transient influenza-like symptoms
uveitis (uncommon)
osteonecrosis of jaw
hypocalcaemia
valaciclovir
- indications and dosage regimen (3)
genital herpes - initial infection - 500mg BD for 5-10 days - recurrent infection - 500mg BD for 3 days - prophylaxis - 500mg OD recurrent cold sores - 2g every 12 hours, 2 doses shingles 1g PO TDS for 7 days
apixaban
- indications and dosage (3)
VTE prophlyaxis after hip/knee replacement
- 2.5mg BD, 10-14 days (knee) or 32-38 days (hip)
prophylaxis in AF
- 5mg BD
venous thromboembolism
- 10mg BD for 7 days, then 5mg BD for 3-6 months
indomethacin - PR suppository dose
100mg BD
pyridostigmine , neostigmine
- mode of action
- indications (2)
mode of action
- cholinergic
- inhibits cholinesterase enzymes -> more acetylcholine floating around to do neurotransmitting
indications
- myasthenia gravis
- reversing a neuromuscular blockade by neuromuscular blockers
suxamethonium
- mode of action
- indications (1)
acts like acetylcholine, neuromuscular blockade by binding to acetylcholine receptors
relax muscles during anaesthesia
atropine
- mode of action
- indications (2)
anticholinergic
bradycardia
blocks muscarinic side effects of neostigmine and pyridostigmine
hyoscine
- which version crosses blood-brain barrier
hyoscine hydrobromide crosses blood brain barrier
hyoscine
- which version is preferred in palliative care
- why
hyoscine butylbromide
less likely to cause CNS side effect
hyoscine butylbromide
- mechanism of action
- indication in pall care
- anticholinergic
- reduce secretions
lithium toxicity - presenting signs and symptoms
- GI (3)
- neuro (4 mild-mod, 3 severe)
- cardiac (2)
GI
- nausea
- vomiting
- diarrhea
neuro (mild to moderate) - tremors - hyperreflexia - dysarthria - ataxia neuro (severe) - confusion - coma - seizures
Cardiac
- QT prolongation
- hypotension
lithium toxicity - risk factors
- pmhx (3)
- pharm (1)
- personal (2)
pmhx
- nephrogenic diabetes insipidus
- hypothyroidism
- renal impairment
pharm
- new medications that affect renal fxn
personal
- age > 50
- poor hydration
medications that can exacerbate or precipitate gout attacks (3)
- thiazide diuretics
- loop diuretics
- cyclosporin
side effects of stimulants like dexamphetamine
GI (3) neuro (2) psych (2)
* rare x2
GI * appetite suppression * transient abdo pain * nausea on commencement neuro * headache on commencement * insomnia psych * emotional lability * irritability
rare
- priapism
- cardiac events
topical corticosteroids - low potency options
hydrocortisone 0.5%,
hydocortisone acetate 1%
desonide 0.05%
topical corticosteroids - moderate potency options
betamethasone dipropionate 0.05% cream betamethasone valerate 0.05% triamcinolone acetonide 0.1 methylprednisolone aceponate 0.1% clobetasone 0.05%
topical corticosteroids - high potency options
betamethasone dipropionate 0.05% ointment
betamethasone valerate 0.1%
mometasone furoate 0.1%
topical corticosteroids - superpotent
betamethasone dipropionate 0.05% in optimised vehicle
clobetasol propionate 0.05%
liver enzyme inducing anti-epileptic medications
Phenytoin
oxcarbazepine
carbamazepine
topiramate
common anti-epileptics that are not liver enzyme inducers
valproate lamotrigine gabapentin pregabalin levetiracetam
topical olopatadine
- what is it
- indication
- dosage
antihistamine eye drop
allergic conjunctivitis
1 drop BD to affect eyes
Hypertension Rx - ACE Inhibitor Rx -drug name, doses
ACE-I "prils" once daily - perindopril arginine 2.5-10mg od - perindopril erbumine 2-8mg OD - ramipril 2.5-10mg od - lisinopril 5-40mg daily - fosinopril 5-40mg daily
once daily or twice daily divided
- enalapril 5-40mg daily (2.5-20mg bd)
twice daily
- captopril 12.5-50mg BD
Hypertension Rx - ARB Rx -drug name, doses
ARB “sartans”
- candesartan 8-32mg od
- olmesartan 20-40mg od
- telmisartan 40-80mg od
- irbesartan 75-300mg od
Hypertension Rx - CCB - drug name, doses
dihydropyridine CCB - “pines”
- amlodipine 2.5-10mg od
- felodipine CR 5-20mg od
- Lercanidipine 10-20mg od
- Nifedipine 20-120mg od
CCB “others”
- diltiazem CR 180-360mg od
- verapamil 80-160mg bd/tds
- verapamil CR 180-480mg od
Hypertension Rx - Thiazide diuretics - drug name, doses
Thiazides
- hydrochlorothiazide 12.5-25mg od
- indapamide CR 1.5mg od
medications associated with hypertriglyceridaemia
- spironolactone
- thiazides
- beta blockers
- glucocorticoids
agranulocytosis in carbimazole
- when is it most likely to happen
- how to monitor for it
most likely in first 3 months
monitor for symptoms ie
- fever / sore throat / mouth ulcer / rash / fatigue / abdo pain / jaundice
