Pharmacology Flashcards
Family history of DVT and HRT
does not contraindicate HRT but should be taken into consideration
transdermal preparations are preferred as a first line
What does 1% of lidocaine mean?
there is 1g in 100ml (or 10mg/1ml)
Digoxin toxicity
Nausea + yellow/green vision
Acne vulgaris and pregnancy, which med is contraindication?
topical isotretinoin are strongly contraindicated in pregnancy
Motion sickness meds
hyoscine > cyclizine > promethazine
Ciclosporin SE
everything is increased - fluid, BP, K+, hair, gums, glucose
Drugs causing lung fibrosis
amiodarone
cytotoxic agents: busulphan, bleomycin
anti-rheumatoid drugs: methotrexate, sulfasalazine
nitrofurantoin
ergot-derived dopamine receptor agonists (bromocriptine, cabergoline, pergolide)
medications that may exacerbate heart failure
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)
P450 enzyme inducers
PC BRAS Phenytoin Carbamazepine Barbiturates Rifampicin Alcohol St John's Wort Griseofulvin
Carbon monoxide poisoning features
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
PDE 5 inhibitors (e.g. sildenafil) contraindication
nitrates and nicorandil
hypotension
recent stroke or myocardial infarction (NICE recommend waiting 6 months)
**avoid alpha-blockers for 4 hours after sildenafil
SE of amiodarone on thyroid
Hypothyroidism + thyrotoxicosis
adrenaline doses in anaphylaxis and cardiac arrest
anaphylaxis: 0.5ml 1:1,000 IM
cardiac arrest: 10ml 1:10,000 IV or 1ml of 1:1000 IV
Side-effects of common drugs: antibiotics
Amoxicillin Co-amoxiclav Flucloxacillin Erythromycin Ciprofloxacin Metronidazole Doxycycline Trimethoprim
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
Main indication for HRT
control of vasomotor symptoms such as flushing
Inhibitors of the P450 system
antibiotics: ciprofloxacin, erythromycin isoniazid cimetidine,omeprazole amiodarone allopurinol imidazoles: ketoconazole, fluconazole SSRIs: fluoxetine, sertraline ritonavir sodium valproate acute alcohol intake quinupristin
Side-effects of diabetes drugs Metformin Sulfonylureas Glitazones Gliptins
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
opioid detoxification
methadone or buprenorphine
When to check the blood level of meds for monitoring/suspected toxicity. Lithium Ciclosporin Digoxin PHenytoin
Lithium - 12 hours post dose
Ciclosporin - immediately before dose
Digoxin - at least 6 hours post dose
Phenytoin - immediately before dose
Metformin and impaired renal function
metformin is contraindicated in eGFR < 30
Drug causes of urticaria
aspirin
penicillins
NSAIDs
opiates
PDE-5 inhibitors + which condition could cause priaprism
sickle cell disease
Azithromycin ear SE
hearing loss and tinnitus
Digoxin toxicity precipitating factors
Diltiazem, verapamil
amiodarone, spironolactone
