Pharmacology COPY Flashcards
1
Q
Azathioprine s/e
A
Marrow suppression
Hepatotoxic
Diarrhoea and nausea
Pancreatitis
2
Q
Carbamazepine side effect
A
Carb - carbs make you Gain weight and hope your fat cos of a baby!
Maze - makes you dizzy, nausea, low Na
Pine - wish I had neutrophils (agranulocytosis and aplastic anaemia)
Rash most common (SJS in Chinese HLA)
Also decreases effect of OCP
3
Q
Valproate inhibits metabolism of some drugs causing toxicity
A
Phenobarbitone, phenytoin, lamotrigine
Pancreatitis, LfTs, alopecia, weight gain
4
Q
Topiramate side effects
A
To Lose Weight
Nephrolithiasis, glaucoma, weight loss
5
Q
Lamotrigine increased by
A
Valproate and decreased by CMZ
Rash SJs
6
Q
Vigabactrin side effect
A
V=Visual field loss, reduced night vision (permanent)
7
Q
Brachial plexus at what level causes horners
A
T1
8
Q
Bell’s palsy loss of taste where
A
Anterior tongue
9
Q
SE interferon
A
Flu like, BM suppression, alopecia
10
Q
SE ribavirin
A
Haemolytic anaemia, teratogenic
11
Q
SE of cyclosporine
A
Hirsutism most common
Renal HTN Liver toxicity GI upset Tremor Parasthesias Gingival hyperplasia
Calcineurin inhibitor (stops IL2)
12
Q
Hydroxychloroquine monitoring
A
Eye 6 monthly
13
Q
PK
A
Dose to achieve concentration
14
Q
PD
A
Concentration-response relationship
15
Q
Steady state is
A
Rate in = rate out
(Reached after 5 half lives)
a drug infused at a constant rate reaches about 94% of steady state after 4 half lives
16
Q
Beta lactam pr scribing important principle
A
Time above MIC
17
Q
Aminoglycosides mechanism of action
A
Inhibition of protein synthesis
18
Q
Thiopentone mechanism of action
A
Potentiates action of GABA
19
Q
Ketamine and neonate
A
Neuronal apoptosis and long term memory deficits
20
Q
Stilboesterol long term effect
A
Vaginal carcinoma
21
Q
Tetracycline long term effect
A
Teeth staining
22
Q
Neuroleptic malignant syndrome
A
a life-threatening, neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs. Symptoms include high fever, sweating, unstable blood pressure, stupor, muscular rigidity, and autonomic dysfunction
23
Q
ACEi cough mediated by
A
Bradykinin
24
Q
NO mechanism of action
A
SM relaxation by up regulation cGMP
25
Codeine path enzyme required
CYP2D6
26
CYP450 inhibitors and inducers
Inhibitors only MAC (macolides, antifungals, CCB - verapamil, diltiaem) and grapefruit juice
Inducers all the others
RASS (rifampicin, anti-seizure - phenobarb, phenytoin, carbamazepine, St. John's wort)
27
Ondansetron
Serotonin 5HT-3 antagonist
28
Reversal drug for benzo
Flumazenil
29
Statins
Statins areHmG-CoA reductase inhibitors
30
MMF/metformin/SSRI most common se
GI disturbance
31
Valproate and phenytoin in pregnancy effects
Valproate NTD
| Phenyt fetal hydantoin syndrome
32
Pancuronium does it cross placenta
No - used in LsCS
33
Bioavailability worked out wth
AUC
34
Rituximab mechanism of action
Anti CD20 antibody
35
Citalopram ECG change
Prolonged QT
36
Mechanism of action of methylphenidate and amphetamine
Block reuptake of dopamine
37
Mechanism of action of atomoxetine
Selective NA reuptake inhibitor
Blocks transporter and blocks reuptake ofNA
38
Prevelance OCD
1%
39
Pimecrolimus classification and s/e
Celcineurin inhibitor (immune mediated anti inflammatory)
Burning and increase infection
Not atrophy
40
Main concerning side effect of propranolol
Hypoglycaemia
41
Sirolimus
mTOR inhibitors (inhibits cell growth and angiogenesis)
42
Omalizumab
Anti IgE antibody
43
UVA or B used
B because A is risk skin ca
44
Sotalol side effects
Bradycardia, lethargy, QT prolonged
45
Flecainide side effects
Tingling, constipation, blurred vision, monitor blood levels
46
Side effect digoxin
Hypokalaemia
47
Frusemide action site
Loop diuretic acting on loop of henle
48
Thiazides diuretic site of action
Proximal and distal tubules
49
Spironolactone site of action
Aldosterone antagonist acts on distal tubule
50
Contraindication to diuretics, b blocker, acei, calcium channel blocker
Diuretics - gout
Beta blocker - asthma, diabetes
Ace inhibitors - pregnancy, bilateral renal artery stenosis, high potassium
Calcium channel blocker- heart block
51
Drug that can worsen pulm HTN
Contraceptives
52
Statins mechanism of action
HMG-CoA reductase inhibitors
53
Statins side effects
```
Commonly GI/headache/myalgia
Sleep disturbed and nightmares
Memory loss
Myopathy
Interstitial lung disease
Deranged lfts
CK up
Rhabdo
```
54
Other treatments apart from statins (2)
```
Nicotinic acid (B3) imcreases HDL cholesterol
Ezetimibe is cholesterol absorption inhibitor
```
55
Other than tamiflu what can you use > 5 year olds?
Zanamavir is another neuraminidase inhibitor, delivered as an inhaled powder by rotadisk. It is active against influenza A and B, sometimes even for strains resistant to Oseltamivir. It is licensed for children >5years. Treatment dose is 2 x 5mg inhalations twice daily for 5 days; prophylaxis dose is 2x 5mg inhalations once daily for 10 days.
Tamiflu reduces sx by 1 day
56
AED highest risk SJS
LTG
57
AED in pregnancy
Lamotrigine
58
AED mostly renal excreted
Levetiracetam and gabapentin
59
Halve digoxin dose if prescribed with
Amiodarone
60
Sotalol must monitor
QT interval
61
Stimulants in ADHD mechanism of action
Methyphenidate and amphetamine
– Block reuptake of dopamine
Amphetamine
– Increases dopamine release
Atomoxetine
– Blocks transporter and blocks reuptake of
noradrenalin
62
Tacrilomus SE
Burning topically
tremor, renal impairment, hyperglycaemic conditions, diabetes mellitus, hyperkalaemia, infections, hypertension and insomnia.
Can check levels
63
MMF most common side effect
GI
64
Name three teratogens in pregnancy
Carbamazepine (Nt defect)
Valproate (nt defect)
MTX (CNS defects)
Carbimazole (hypothyroidism) so PTU preferred
Quinine (deafness)
Toluene (similar to fetal alcohol syndrome)
Misoprostol (moebius sequence with facial paralysis)
Steroid ? Cleft
65
Warfarin teratogenic effect
Nasal hypoplasia
66
Cyclophosphamide adverse effects
Gametogenesis affected
Increased risk secondary tumours (DNA damaged)
Haemorrhaging cystitis
67
Bleomycin side effect
```
Pulmonary toxicity (fibrosis usually dose related and delayed
)
```
68
Vinca alkaloids bind to tubulin in M phase and inhibits mitosis
Side effects
Neurotoxic (peripheral neuropathy)
| Intrathecal vincristine fatal
69
CisPLATINUM and carboPLATINUM side effects
Dose related ototoxicity and renal toxicity
| Neurotoxic
70
What drug can worsen liver failure in underlying metabolic disease
Sodium valproate
71
Infliximab mechanism of action
Neutralises TNFa by binding to it and stopping it attaching to receptors
72
Vasopressin in vwd mechanism
Increases release of vwf from endothelial cells
73
Pulmozyme (dornase alfa) mechanism of action
Hydrolyses DNA in mucus (recombinant human deoxyribonuclease I)
74
Isotrenitoin in pregnancy causes
Facial, ear, heart deformities
75
Methotrexate 80% excrete by? And what can interfere and cause toxicity
Renal
| Aciclovir, allopurinol, PPI some abx
76
Ribavirin side effect
Haemolytic anaemia
77
Thromboxane is a powerful vasodilator or vasoconstrictor
Vasoconstrictor
78
Antidiuretic hormone mechanism
Inserts aquaporins into apical membrane
79
ACEi side effects
Risk hyperkalaemia
80
Paracetamol overdose physiology
Broken into toxic metabolite by cytochrome p450 and binds to glutathione
81
Most likely condition to respond to SSRI
Anxiety
82
Oral rehydration contains starch for
Fermentation
| And ORT with zinc reduces diarrhoea too
83
C peptide level to see
Amount of insulin
84
The drugs that most commonly cause SJS/TEN are:
Sulfonamides: cotrimoxizole;
Beta-lactam: penicillins, cephalosporins
Anti-convulsants: lamotrigine, carbamazepine, phenytoin, phenobarbitone
Allopurinol
Paracetamol/acetominophen
Nevirapine (non-nucleoside reverse-transcriptase inhibitor)
Nonsteroidal anti-inflammatory drugs (NSAIDs) (oxicam type mainly)
85
Second generation H1 receptor antagonists effectively relieve most of the symptoms of allergic
rhinoconjunctivitis.
Which one of the following symptoms is least effectively relieved?
A. Nasal congestion.
B. Nasal itch.
C. Ocular tearing.
D. Rhinorrhoea.
E. Sneezing.
A
86
The cough associated with the use of angiotensin-converting enzyme (ACE) inhibitors is mediated through
Bradykinin
87
Non competitive antagonist
non-competitive antagonist binds to a receptor irreversibly and cannot be displaced by an agonist
88
Clearance formula
CL = Vd * Ke/half life
[Ke = elimination constant=0.7]
CL = volume of distribution/half life
CL in L/h (check units!)
89
Half life formula
t1/2 = Vd/CL
| Check units
90
What is high first pass metabolism
| What route isn't first pass metabolised
1: when drug uptake by Gut into liver system before goi into blood and high amount metabolised so minimal active drug in system
2: nasal
91
Volume of distribution is
theoretical volume that would be necessary to contain the total amount of an administered drug at the same concentration that it is observed in the blood plasma.
The distribution of drug in body or plasma after dose
92
Which anti epileptic is most teratogenic
Valproate
| But others include CMZ, phenobarbital and phenytoin
93
Tricyclics overdose Tx
Sodium bicarbonate
94
Rituximab mechanism of action
Inhibits CD20
95
G6PD drugs to avoid (3)
Nitrofurantoin
Methylene blue
Rasburicase
Primaquine
96
On antipsychotics and present with fever, coma, rigid muscles and autonomic dysfunction
Called?
Neuroleptic malignant syndrome
97
First order kinetics
K is a constant and first order kinetics the same fraction or percentage is eliminated at a rate (therefore a log)
98
What drug can go into zero order kinetics
Phenytoin
| Aspirin can bind to platelets no upregulation receptors
99
Bioequality of a drug percent
AUC and peak conc Cmax 80-125%
100
Red man syndrome with what drug
Vancomycin (related to rate of administration)
101
Carbamazepine genetics HIGH risk SJs
Asian carbamazepine HLAB1502 HIGH risk SJS
102
Renal stones SE
Topirimate
103
Tachyphylaxis is
The more drug you add it becomes less effective
104
sotalol mechanism and SE
(blocks potassium
channels, can cause bradycardia and lethargy and prolongs QT),
105
Flecinide SE
Blurred vision, tingling, constipation
Need trough levels
106
Drugs causing prolonged QT
AAA TakesCare of your Ford Engine
```
Antihistaminics
Anticholinergics
Antiarrythmics (specially Quinidine and Sotalol)
TCAS
Fluoroquinolones
Erythromycin
```
```
antibiotics (erythromycin, clarithromycin, cotrimoxazole),
antifungal agents (fluconazole), antiprotozoal agents, antihistamines
(selected), antidepressants (tricyclics), antipsychotics (haloperidol,
risperidone, chlorpromazine), antiarrhythmic drugs, lipid lowering
```
107
Gum hyperplasia, ataxia, hirsute, nystagmus what drug
Phenytoin
108
Cyclizine and metoclopramide mechanism of action
```
Cyclizine = H1 receptor antagonist
Met = dopamine receptor antagonist
```
109
Thioliazines and metformin action
Increase sensitivity to insulin
Metformin also suppresses liver glucose production
110
Sulfonylurea (gliclazide) action
Increased secretion
111
Exposed valproate teratogen risk NTD
1-2%
112
Carbimazole mechanism of action
Blocking iodisation and coupling of tyrosine molecules on thyroglobulin
113
Diazoxide mechanism of action
potent openers of the K+ ATP channels present on the insulin producing beta cells of the pancreas.
114
Valproate SE
```
V.A.L.P.R.O.A.T.E
Vomiting
Alopecia/ammonia
Liver toxicity
Pancreatitis/ Pancytopenia
Retention of fats (weight gain)
Oedema (peripheral oedema)
Anorexia
Tremor
Enzyme inhibition
```
115
Codeine metabolism
Glucuronidation by CYP2D6 to morphine
116
selumetinib
Is an inhibitor of mitogen-activated protein kinases.
Trial for plexiform neurofibromas
117
crisaborole
It is a phosphodiesterase-4 inhibitor, mainly acting on phosphodiesterase 4B (PDE4B), which causes inflammation.[6] Chemically, crisaborole is a phenoxybenoxaborole.[6] It contains a boron atom that helps penetrate the skin and is essential for its binding activity.[8] Inhibition of PDE4B appears to suppress the release of tumor necrosis factor alpha (TNFα), interleukin-12 (IL-12), IL-23 and other cytokines, proteins believed to be involved in the immune response and inflammation.[6]
118
Atypical hemolytic uremic syndrome (aHUS) is caused by alternative complement pathway dysregulation, leading to systemic thrombotic microangiopathy (TMA) and severe end-organ damage. Which drug now approved and what is its mechanism of action?
eculizumab, a terminal complement inhibitor
119
Cotrimoxazole mechanism of action
sulfamethoxazole -> inhibits bacterial synthesis of dihydrofolic acid
trimethoprim -> blocks production of tetrahydrofolic acid
120
Octreotide is an analogue of
Somatostatin
121
Leveteracetam SE
Somnolence
Irritability
122
L asparginase mechanism
Breaks down asparginase which cancer cell needs to live
123
L asparginase SE
Allergy
Coagulopathy
Pancreatitis
124
Busulphan SE
Pulmonary fibrosis
Sz
VOD
Hyperpigmentation
Causes DNA cross
Inking to prevent replication
125
Cytarabine mechanism
Adds sugar onto nucleotide in S phase (synthesis of DNA)
126
Number of puffs in an inhaler
200
127
MgSO4 protects against CP by
Blocks NMDA receptor on glial cell preventing injury and free radicals and dilates
128
Cotrimoxazole works by
Inhibiting dihydrofolate
129
Fosfomycin targets?
Gram positive including MRSA and anaerobes
130
Ivacoftor is a drug for?
Modulates GSS1D potentiates molecule to surface
Kalydeco similar and is in trial phase
131
Dornase Alfa also called
Pulmozyme
132
What drug with abx neonatal sepsis reduces death
Pentoxifyline
133
Drug for Frederick ataxia
Idebenone (coQ10 variant)
134
Transenamic acid mechanism
Fibrinolytic inhibitor
135
Eculizumab action
Blocks C5 splitting/activation
136
Rituximab mechanism
Against CD20 found on B cells (triggers cell death)
137
Fanconi anaemia hypersensitive to what drug
Cisplatin (DNA cross linker)
| Chromosome fragile
138
Drug for Dravet and Lennox-gastault
Dravet - stiripentol
LG - rufinamide
DRACULA SHOULD STRIP PENT HOUSE
LG FUELS THE ROOF IN A MIND
139
Treatment c diff mild-mod and severe
Metronidazole
| IV vancomycin
140
What drugs delay renal clearance MTX (4)
Allopurinol
Aciclovir
Antibiotics
PPI
141
How does cholestyramine work and indications and side effects
Binds bile acids
High cholesterol ileum not working and itch
Side effect constipation and haemorrhoids
142
Diazoxide side effect? (2)
Hairy
| Water retention
143
Phenytoin mechanism of action
Sodium channel
144
Erythromycin prokinetic effect mediated by
Motilin
145
Eculizamab inhibits?
C5 activation
