Pharmacology Finals Flashcards
Dosage of Adrenaline in Anaphylaxis
0.5ml/500mcg 1:1000 IM
Dosage of Adrenaline in Cardiac arrest
10ml 1:10,000 IV or 1ml of 1:1000 IV
Alcohol Overuse mx
benzodiazepines for acute withdrawal
disulfram: promotes abstinence - negative reactions if taken CI: psychosis and IHD
acomprosate - reduces cravings
Naltrexone (trying to quit) - is an opiate blocker that makes alcohol less enjoyable and less rewarding
Allopurinol Mechanism
interactions
Xanthine oxidase inhibitor
Interacts with Azathioprine (Crohns) - leads to azathioprine toxicity
Alpha Blockers SE
postural hypotension
drowsiness
dyspnoea
cough
Amiodarone (used in Broad complex QRS typically) SE
Thyroid dsyfunction - hypo and hyper
Pulmonary Fibrosis
Liver Fibrosis
Photosensitvity
Slate Grey Appearance of skin
Can contribute to Digoxin toxicity
Aspirin Mechanism
COX 1 and COX 2 inhibitor
CI Drugs in Pregnancy
This - Trimethoprim
Working - Warfarin
Thing - Tetracyclines
Can - Ciprofloxacin
Really - retinoid
Suck - Sulfonylurea - Gliciazide
Sometimes - Statin
+ All Anti-epileptic drugs - carbamezpine, valproate, phenytoin
Caustic substance ingestion mx
A to E
Endoscopy
Urgent upper GI surgical referral if signs of perforation present (surgical emphysema, mediastinal widening on chest x-ray)
High dose IV PPI
Drugs causing Pulmonary Fibrosis
O -
M - Methotrexate
A - Amiodarone
N - Nitrofurantoin
Drugs causing Urinary Retention
NOT A Drop
Nsaids
Opioids
TCAs - amitryptyline
Anticholinergics
Disopyramide
Drugs causing photosensitvity
Tans
Thiazide/Tetracycline
Amiodarone
NSAIDS
Sulfonylurea
SALicyLATe poisoning features
AL - Respiratory Alkalosis
LAT - Metabolic Acidosis (due to raised lactate)
Mx of Salicylate poisoning
Activated charcoal
urinary alkalinization with intravenous sodium bicarbonate
Indications for haemodialysis
seizures
coma
metabolic acidosis resistant to treatment
Mx of Serotonin syndrome
supportive including IV fluids
benzodiazepines
chlorpromazine
Features of TCAoverdose
mx
3 D’s - Dry mouth, dilated pupils, wiDened QRS
IV bicarbonate
Drugs promoting lithium toxicity
MAD
Metronidazole
ACEi/ARB
Diclofenac(NSAIDS)/Diuretics
Features of lithium toxicity
coarse tremor (a fine tremor is seen in therapeutic levels)
hyperreflexia
acute confusion
polyuria
seizure
coma
Mx of Lithium toxicity
mild-moderate toxicity may respond to volume resuscitation with normal saline
haemodialysis may be needed in severe toxicity
features of opioid misuse
rhinorrhoea
needle track marks
pinpoint pupils
drowsiness
watering eyes
yawning
Opioid overdose mx
Opioid dependence mx
EX: Heroin, morphine, oxycodone etc
Emergency management of opioid overdose
IV or IM naloxone: has a rapid onset and relatively short duration of action
methadone or buprenorphine (compliance monitored via urinalysis)
Ecstasy mx
Management
supportive
dantrolene may be used for hyperthermia if simple measures fail
Ecstasy Poisoning Features
“all hyper except sodium”
Hyperthermia
Hypertension
Tachy
Rhabdomyolosis
Hyponatraemia - KEY
LSD tx
should be first managed with supportive reassurance in a calm, stress-free environment. If ineffective, benzodiazepines are the medication of choice.
supportive care
antipsychotics if severe and longterm
LSD toxicity symptoms
Drug-induced psychosis
n+v
pyrexia
tachy
hypertension
hyperthermia
Colchicine SE
Diarrhea, nausea,
Cocaine mechanism
cocaine blocks the uptake of dopamine, noradrenaline and serotonin
Cocaine effects
agitation
psychosis
hallucinations
Seizures
coronary artery spasm
Cocaine mx
benzodiazepines
Neuroepileptic malignant syndrome tx
IV fluids and stop antipsychotic
Why does alcohol make you thirsty
inhibits ADH secretion
Important side effect of Herception(Trastsumab)
Cardiac Toxicity - Heartceptin - so these patients need cardiac monitoring via echocardiogram
Monitoring In amiodarone
Before starting - CXR
Every 6 months - LFTs, TFTs
Omeperazole SE (4)
Increased risk of C.difficile infections
Osteoporosis
Increased risk of fractures
Hypocalcaemia and Hypomagnesia
Digoxin Toxicity features
generally unwell, lethargy, nausea & vomiting
yellow-green vision
arrhythmias (e.g. AV block, bradycardia)
gynaecomastia
G to remember - gynaecomastia and green vision
Predisposing factors to Digoxin toxcity
hypokalaemia
Hypothermia
renal failure
Mx of digoxin toxicity
Digibind
Omepreazole SE
Hyponatraemia
Hypomagnesia
osteoporosis - increased risk of fractures
c.difficile infections
