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AKT > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Family history of DVT and HRT

A

does not contraindicate HRT but should be taken into consideration
transdermal preparations are preferred as a first line

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2
Q

What does 1% of lidocaine mean?

A

there is 1g in 100ml (or 10mg/1ml)

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3
Q

Digoxin toxicity

A

Nausea + yellow/green vision

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4
Q

Acne vulgaris and pregnancy, which med is contraindication?

A

topical isotretinoin are strongly contraindicated in pregnancy

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5
Q

Motion sickness meds

A

hyoscine > cyclizine > promethazine

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6
Q

Ciclosporin SE

A

everything is increased - fluid, BP, K+, hair, gums, glucose

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7
Q

Drugs causing lung fibrosis

A

amiodarone
cytotoxic agents: busulphan, bleomycin
anti-rheumatoid drugs: methotrexate, sulfasalazine
nitrofurantoin
ergot-derived dopamine receptor agonists (bromocriptine, cabergoline, pergolide)

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8
Q

medications that may exacerbate heart failure

A

thiazolidinediones - pioglitazone is contraindicated as it causes fluid retention
verapamil - negative inotropic effect
NSAIDs/glucocorticoids - should be used with caution as they cause fluid retention
low-dose aspirin is an exception - many patients will have coexistent cardiovascular disease and the benefits of taking aspirin easily outweigh the risks
class I antiarrhythmics
flecainide (negative inotropic and proarrhythmic effect)

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9
Q

P450 enzyme inducers

A 
PC BRAS
Phenytoin
Carbamazepine
Barbiturates
Rifampicin
Alcohol
St John's Wort
Griseofulvin
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10
Q

Carbon monoxide poisoning features

A 
headache: 90% of cases
nausea and vomiting: 50%
vertigo: 50%
confusion: 30%
subjective weakness: 20%
severe toxicity: 'pink' skin and mucosae, hyperpyrexia, arrhythmias, extrapyramidal features, coma, death
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11
Q

PDE 5 inhibitors (e.g. sildenafil) contraindication

A

nitrates and nicorandil
hypotension
recent stroke or myocardial infarction (NICE recommend waiting 6 months)

**avoid alpha-blockers for 4 hours after sildenafil

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12
Q

SE of amiodarone on thyroid

A

Hypothyroidism + thyrotoxicosis

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13
Q

adrenaline doses in anaphylaxis and cardiac arrest

A

anaphylaxis: 0.5ml 1:1,000 IM

cardiac arrest: 10ml 1:10,000 IV or 1ml of 1:1000 IV

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14
Q

Side-effects of common drugs: antibiotics

Amoxicillin
Co-amoxiclav
Flucloxacillin
Erythromycin
Ciprofloxacin
Metronidazole
Doxycycline
Trimethoprim
A

Amoxicillin Rash with infectious mononucleosis
Co-amoxiclav Cholestasis
Flucloxacillin Cholestasis (usually develops several weeks after use)
Erythromycin Gastrointestinal upset
Prolongs QT interval
Ciprofloxacin Lowers seizure threshold
Tendonitis
Metronidazole Reaction following alcohol ingestion
Doxycycline Photosensitivity
Trimethoprim Rashes, including photosensitivity
Pruritus
Suppression of haematopoiesis

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15
Q

Main indication for HRT

A

control of vasomotor symptoms such as flushing

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16
Q

Inhibitors of the P450 system

A 
antibiotics: ciprofloxacin, erythromycin
isoniazid
cimetidine,omeprazole
amiodarone
allopurinol
imidazoles: ketoconazole, fluconazole
SSRIs: fluoxetine, sertraline
ritonavir
sodium valproate
acute alcohol intake
quinupristin
17
Q 
Side-effects of diabetes drugs
Metformin
Sulfonylureas
Glitazones
Gliptins
A 
Metformin	Gastrointestinal side-effects
Lactic acidosis
Sulfonylureas	Hypoglycaemic episodes
Increased appetite and weight gain
Syndrome of inappropriate ADH secretion
Liver dysfunction (cholestatic)
Glitazones	Weight gain
Fluid retention
Liver dysfunction
Fractures
Gliptins	Pancreatitis
18
Q

opioid detoxification

A

methadone or buprenorphine

19
Q 
When to check the blood level of meds for monitoring/suspected toxicity.
Lithium
Ciclosporin
Digoxin
PHenytoin
A

Lithium - 12 hours post dose
Ciclosporin - immediately before dose
Digoxin - at least 6 hours post dose
Phenytoin - immediately before dose

20
Q

Metformin and impaired renal function

A

metformin is contraindicated in eGFR < 30

21
Q

Drug causes of urticaria

A

aspirin
penicillins
NSAIDs
opiates

22
Q

PDE-5 inhibitors + which condition could cause priaprism

A

sickle cell disease

23
Q

Azithromycin ear SE

A

hearing loss and tinnitus

24
Q

Digoxin toxicity precipitating factors

A

Diltiazem, verapamil

amiodarone, spironolactone

25
Q

Contraindication in any form of CVS disease

A

Diclofenac

26
Q 
Side-effects of anti-hypertensives
ACEi
Bendroflumethiazide
CCB
Beta-blockers
Doxazosin
A 
ACE inhibitors	• Cough
• Hyperkalaemia
Bendroflumethiazide	• Gout
• Hypokalaemia
• Hyponatraemia
• Impaired glucose tolerance
Calcium channel blockers	• Headache
• Flushing
• Ankle oedema
Beta-blockers	• Bronchospasm (especially in asthmatics)
• Fatigue
• Cold peripheries
Doxazosin	• Postural hypotension
27
Q

Amiodarone and eye

A

Corneal opacities

28
Q

Drugs to avoid in renal failure

A

antibiotics: tetracycline, nitrofurantoin
NSAIDs
lithium
metformin

29
Q

Drugs relatively safe in renal failure

A

antibiotics: erythromycin, rifampicin
diazepam
warfarin

30
Q

Iodine-containing x-ray contrast media such as CT with contrast, which med should be stopped and how long

A

metformin should be discontinued on the day of the procedure and for 48 hours thereafter

31
Q

Alcohol misuse and depression

A

Treat alcohol misuse first, many recovered after that.

Treat depression if it persists for 3-4 weeks

32
Q

Ecstasy poisoning

A

neurological: agitation, anxiety, confusion, ataxia
cardiovascular: tachycardia, hypertension
hyponatraemia
hyperthermia
rhabdomyolysis

33
Q

Macrolides such as erythromycine and clarithromycin and ECG

A

long QT

34
Q

Metformin and MI

A

Metformin should be stopped following a myocardial infarction due to the risk of lactic acidosis. It may be introduced at a later date.

35
Q

Mefloquine and mental health issues

A

mefloquine should not be used in patients with a history of anxiety, depression schizophrenia or other psychiatric disorders

36
Q

St John’s Wort and SSRI

A

Can use serotonin syndrome

37
Q

Drugs contra indicated in pregnancy

A

tetracyclines
aminoglycosides
sulphonamides and trimethoprim
quinolones: the BNF advises to avoid due to arthropathy in some animal studies

Other drugs
ACE inhibitors, angiotensin II receptor antagonists
statins
warfarin
sulfonylureas
retinoids (including topical)
cytotoxic agents

AKT (16 decks)

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