Pharmacology Mix Flashcards
Most serious toxicity work sodium valproate
Hepatic toxicity (necrotic Process)
Can cause thrombocytopenia
Acute cellulitis of leg. What bacteria to treat
Hemolytic streptococcus
Antibiotic responsible for warfarin interaction
Ciprofloxacin
Anticonvulsant drug with least teratogenic risk
Lamotrigine
(Carbamazepine is in middle, valproate is the worse)
Absolute risk is only 4-5%
Most likely adverse of verapamil at therapeutic dose
Constipation
Which antipsychotic most likely to cause extraoyramidal effects
Flupentixol (first generation)
Atypical cause less
Which is most likely adverse event of leukotriene antagonists
Effective in one third
Step 4
Once a day
One bad adverse event (church Strauss (eosinophilic vasculitis which can be fatal)
Right answer: used in exercise or cold induced asthma
If patient presented with af within 6 hours
Then do DC cardioversion as best initial option
Cancer patient prescribed morphine. What other treatment would you give
Antiemetic: hyoscine (not useful in this case,)
Laxative: co-danthramer
Cancer chemo that causes severe hair loss and hemorrahgic cystitis
Cyclophosphamide
Patient with hypertension and heart failure develop a increased breathlessness after adding one of these drugs
Verapamil (because inotrope negative (and kronotrope negative)
Most likely adverse effect of ciclosporin
Hypertension
75 year old recovers from cdiff. What to give her again?
Metronidazole 2 weeks
80 y old patient drowsy with lOw potassium sodium and high urea. Most likely cause
Excessive treatment with loop diuretics
Alcoholic:///confusion ataxia macrocytosis
Give thiamine
Regarding copd
Long term oxygen therapy is indicated in presence of pulmonary hypertension
Recently: inhaled steroids no significant place in therapy
Side effects of low Molecular weight heparin
Thrombocytopenia
Osteoporosis
Most effective on Post prandial hyperglycemia
Acarbose
Treatment of very high triglycerides (biggest risk can cause acute pancreatitis)
Fenofibrate
In diabetic ketoacidosis
Blood glucose should be reduced to 10 mol/l within 24 hours
Iv bicarb avoided
Prophylactic antibiotics not given
Total boys potassium is depleted
Total fluid deficit is much higher than 3 litre
Diarrhea as a side effect of
Misoprostol (synthetic prostaglandin analogue)
Potentially dangerous combination with sildenafil causing hypotension
Isosorbide mononitrate
Dangerous combination of fluoxetine with which of the drugs
Phenelzine (imao serotonin syndrome)
Which antifungal drug inhibitor of cyp450
Ketoconazole
Phase 2 Metabolic reaction
Glucuronidation
Phase 2 are adding molecules too small molecules
Phase 1: deanination, hydrolysis, reduxrion
Hepatic drug metabolism in babies
Similar to adults
In old
Glomerular filtration rate lower than at age of 20
Initial treatment of generalised tonic clinic seizure it’s
Diazepam
Adverse effect of carvimazole
Neutropenia
Know type I diabetes found unconscious
What to give without knowing anything Else
50 ml glucose 20% solution via rapid intravenous injection
Most likely to cause ventricular dysrythmias in overdose
Imipramine (tricyclics)
Most likely to cause significant hypoglycemia
Gliclazide
First line treatment in immunocompromierd pneumocystis
Co-trimoxazole
52 year old with t2m
Normal renal function with proteinuria
What antihypertensive to give
Acei
Arb
How long to wait before starting enoxaparin after acute stroke
2 months
Diclofenac and warfarin interaction
Increased activity of warfarin because diclofena displace warfarin from plasma protein. Other interaction is that Diclofenac has antiplatelet action that will increase of bleeding with warfarin
Beta blocker and calcium channel blocker
To avoid because of risk of hypotension…bradycardia
If vancomycin given too fast
Red man syndrome
Iatrogenic causes of gout
Thiazide
Cytotoxic drugs
Pyrazinamide
Hyoscine
Antiemetic
Anticholinergic / antimuscarinic
Causes constipation
NSAIDs in head traum
Can cause cerebral edema
Combination of acyclovir and lisinopril
Can cause aki
If alki, what drugs to withheld
Some gliptins and metformin.
Symptoms of lithium toxicity
Ataxia
Dysarthria
Tremor
Muscle twitching
…
Diclofenac and lithium?
Increased lithium toxicity because Diclofenac reduce renal clearance of lithium
Frusemide
Non steroids
Gliclazide problem
Weight gain because increase insulin secretion
Gliptins don’t increase weight
Pioglitazone
What biochemical test to look for when assessing paracetamol toxicity
Clotting: pt, inr
Digitoxin
Cardiac glycoside used in renal impairment (contrary to digoxin)
Drug used to treat bradycardia caused by increased vagal tone
Atropine
Drug used to terminate Svt and should be used with caution in asthma
Adenosine
High dose loop diuretcs like frusemide
Hearing loss
Inner ear…
ccb and beta blockers
To avoid because of risk of bradycardia (even syndrome) and hypotension
Enoxaparin and warfarin
If INR > 2, then stop heparin
If bradycardua (slow af) and digoxin
Stop digoxin
Howe to calculate prn dose of morphine sulfate
Usually calculated as one sixth of the total daily dose
In acute mi, regarding GTN
Try sublingual spray before infusion
Alcohol and warfarin
Acute alcohol intoxication: enzyme inhibition
Chronic excess: enzyme induction
1 % solution
= 1 g / 100 ml
What time to give acei
Night because risk of orthostatic hypotension
First treatment for New onset af (more than 48 hours)
Ccb or beta blockers before considering digoxin
Treatment for diabetes type 2 in bmi 18 and creatinine more than 150
Don’t give metformin
Gliclazide
Vancomycin: ae and precautions
Ototox
Nephrotox
So check creatinine before starting to adjust dose
What to do before starting statins
Check serum ALT
Sodium and lithium
Sodium depletion can increase the risk of lithium toxicity and patients are advised to avoid making changes in their diet…
Initiation of methotrexate treatment
No baseline chest xray
Don’t start if liver enzymes abnormal
Before starting olanxapine
Check hyperglycemia
Ecg only if patient with cardiovascular disease
Edrophonium
Short acting cholinestetase inhibitor that is used in diagnosis of myasthenia gravis
Gentamicin monitoring
One hour peak serum concentration should be 3-5 mg/l
If inr > 8
Give iv vitamin k and stop warfarin and restart when less than 5
Treatment for paroxysmal AT that may cause intermittent clauducation
Sotalol
Treatment of hypercalcemia
Saline
Biphosphonates
Frusemide (increase calcium secretion),
not thiazides (increase absorption): used in calcium stones
Patient with gi hematemesis
Telepressin
Dmard used to treat inflammatory arthritis. That can cause reversible azoospermia and bone marrow suppression
Sulfasalazine
Ttt for mild systemic lupus erythematosus that requires regular ophthalmic review to check for the development of retinopathy
Hydroxychloroquine
Bromocriptine
Barely used now in Parkinson as they can cause vascular fibrosis
Drug that inhibits iconoclast mediated…
Rituximab
Side effects of dmards
- Sulfasalazine- marrow suppression, oligospermia, hepatitis
- Gold- nephrotic syndrome, marrow suppression
- Penicillamine- disturbance of taste, nephrotic syndrome, myasthenia
- Chloroquine- retinopathy, tinnitus
- Steroids- diabetes, truncal obesity; azathioprine- marrow suppression
- Cytotoxic drugs eg methotrexate- hepatic toxicity, marrow suppression
- Newer immunosuppressants eg leflunomide- marrow suppression
- Tumour necrosis factor antagonists eg infliximab- infusion reactions including anaphylaxis, infections including re-activation of TB
