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MSRA > Pharmacology/ Therapeutics > Flashcards

Pharmacology/ Therapeutics Flashcards

1
Q

Donepazil
S/E (1)
CI (1)

A

SE
1. insomnia
CI
1. bradycardia

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2
Q

Name as many dopamine agonists as you can (7)

A
  1. Bromocriptine (SE cardiac fibrosis)
  2. Ropinirole
  3. Capergoline (SE cardiac fibrosis)
  4. Apomorphine
  5. Pramipexole
  6. Transdermal rotogitine
  7. Pergolide (SE cardiac fibrosis)

BRATCPP

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3
Q

Name 2 MAO B inhibitors

A
  1. Rasagaline

2. Selegiline

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4
Q

Name 2 COMT inhibitors

A
  1. Entacapone

2. Tolcapone

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5
Q

3 SE of DA

A
  1. Excessive sleepiness
  2. Hallucinations
  3. Impulse control
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6
Q

Triptans
SE (2)
CI (2)

A

SE

  1. Tingling
  2. Tightness/ heaviness throat and chest

CI

  1. IHD
  2. CVD
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7
Q

Long QT causes

A 
SSRIs
TCAs/ terfenadine
Ondansetron
Methadone/ MI/ myocarditis/ macrolides
Amiodarone
Chloroquine, ciprofloxacin
Hypothermia/ haloperidol 
Low K, Mg, Ca
Erythromycin
SAH
Sotalol

STOMACHLESS

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8
Q

Phenytoin

SE

A 
SE (PRANG HATDD)
Peripheral neuropathy 
Rash - toxic epidermal necrolysis
Ataxia
Nystagmus
Gingival hyperplasia 
Hirsutism 
Anaemia (megaloblastic)
Teratogenic 
Dizziness
Diplopia
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9
Q

Sodium valproate

SE

A 
WHAT PLANT 
Weight gain
Hepatotoxicity
Ataxia
Tremor
Thrombocytopaenia
Pancreatitis
Low Na
Alopecia
Nausea
Teratogenic
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10
Q

PPI S/E (4)

A
  1. Low sodium
  2. Low magnesium
  3. Clostridium difficile
  4. Osteoporosis
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11
Q

Sulphasalazine SE (2)

A
  1. Oligospermia

2. Pulmonary fibrosis

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12
Q

Name x3 5-ASA

A
  1. Sulphasalazine
  2. Mesalazine
  3. Olsalazine
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13
Q

AZT

SE (3)

A
  1. bone marrow depression
  2. pancreatitis
  3. increased risk of non-melanoma skin cancer
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14
Q

MTX

SE (5)

A
  1. Myelosuppression
  2. Mucositis
  3. Pneumonitis
  4. Pulmonary fibrosis
  5. Liver fibrosis
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15
Q

Hydroxychloroquine
S/E (1)
What investigations need to be done before and during taking this medication? How often?

A

Bulls eye retinopathy - can results in permanent visual loss

Baseline ophthalmological examination and annual screening

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16
Q

BishOsphOnates

SE (3)

A

OOO

  1. Osteonecrosis of jaw
  2. Oesophagitis
  3. Oeosophageal ulcers
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17
Q 
Prednisolone SE (5)
Hint: CHOICE
A
  1. Cushing’s
  2. Hirsutism+HTN+ hyperlipidaemia
  3. Osteoporosis, avascular necrosis femoral head,
  4. Impaired glucose tolerance, insomnia
  5. Cataracts
  6. Eating - weight gain

CHOICE

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18
Q

Mesalazine SE (2)

A
  1. Pancreatitis

2. Agranulocytosis

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19
Q

Leflunomide SE

What group of medication is it?

A

DMARD

  1. Liver impairment
  2. Interstitial lung disease
  3. Hypertension
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20
Q

Gold SE (1)

A

Proteinuria

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21
Q

Penicillamine SE (2)

A

Proteinuria

Exacerbation of myasthenia gravis

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22
Q

Etanercept SE (2)

A
  1. Demyelination

2. Reactivation of TB

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23
Q 
Thiazolidinediones 
MOA
Example
CI 
SE (4)
A 
Pioglitazone, reduces insulin resistance peripherally
CI: HF
1. Weight gain
2. Liver impairment 
3. Fluid retention 
4. Bladder cancer

PIogLItaZONE
Pio = pie = weight gain
LIver impairment
ZONE= transitional cell carcinoma = bladder ca

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24
Q

Lithium SE

A
  1. Diabetes insipidus
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25
Q

Finasteride SE (4)

A
  1. erectile dysfunction
  2. reduced libido
  3. ejaculation problems
  4. gynaecomastia
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26
Q

Anastrozole SE (3)

A
  1. Menopausal symptoms
  2. Osteoporosis
  3. Insomnia
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27
Q

Loop diuretics SE (4)

A
  1. Ototoxicity
  2. Gout
  3. Low calcium/ magnesium/ chloride/ sodium/ BP/ potassium
  4. Renal impairment
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28
Q

Carbimazole SE

A
  1. Agranulocytosis

2. Crosses the placenta - can only be used in small doses in pregnancy

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29
Q

Name six drugs that can cause gynaecomastia

A
  1. Spiro
  2. digoxin
  3. cannabis
  4. finasteride
  5. GnRH agonists e.g. goserelin, buserelin
  6. oestrogens
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30
Q

Name three medications that can cause raised prolactin

A
  1. metoclopramide
  2. domperidone
  3. haloperidol
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31
Q

Levothyroxine SE (4)

A
  1. hyperthyroidism: due to over treatment
  2. reduced bone mineral density
  3. worsening of angina
  4. atrial fibrillation
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32
Q

Tetracyclines

S/E:

A
  1. discolouration of teeth: therefore should not be used in children < 12 years of age
  2. photosensitivity
  3. angioedema
  4. black hairy tongue
33
Q

P450 enzyme inhibitors and inducers

What is the difference?

A

Inducers = breaks down other drugs more quickly

Inhibitors = leads to toxicity of other drugs, as prevents the breakdown

34
Q

Rifampicin
Inducer/ inhibitor
SE (2)

A

potent liver enzyme inducer
hepatitis
orange secretions

35
Q

isoniazid
inducer/ inhibitor
SE (3)

A

peripheral neuropathy - prevent with pyridoxine (Vitamin B6)
hepatitis
agranulocytosis
liver enzyme inhibitor

36
Q

pyrazinamide

SE (3)

A

hyperuricaemia causing gout
arthralgia, myalgia
hepatitis

37
Q

ethambutol

SE (1)

A

optic neuritis: check visual acuity before and during treatment

38
Q

Two antimalarials CI if has epilepsy

A

Chloroquine

Mefloquine

39
Q 
Isotretinoins SE (7)
Cannot be used which which medication and why?
A
  1. Teratogenic (use two forms of contraception)
  2. Dry skin/ eyes/ lips/ mouth
  3. Low mood
  4. Raised triglycerides
  5. Hair thinning
  6. Epistaxis
  7. Photosensitivity

Cannot be combined with tetracycline as risk of intracranial HTN

40
Q

CCB

SE

A
  1. Flushing
  2. Ankle oedema
  3. Headache
  4. Constipation
41
Q 
Monitoring
What drugs (3) will you need to monitor the LFTs?
A

Statins LFTs at baseline, 3 months and 12 months
Sodium valproate
Glitazones

42
Q

Monitoring

What drug will you need to monitor the U&E?

A

ACE
U&E prior to treatment
U&E after increasing dose
U&E at least annually

43
Q

Monitoring

TFT, LFT

A

Amiodarone
TFT, LFT, U&E, CXR prior to treatment
TFT, LFT every 6 months

44
Q

Monitoring

FBC, LFT, U&E

A

MTX
FBC, U&Es and LFTs before starting treatment and repeated weekly until therapy stabilised, thereafter patients should be monitored every 2-3 months’

45
Q

Monitoring

FBC, LFT

A

AZT
FBC, LFT before treatment
FBC weekly for the first 4 weeks
FBC, LFT every 3 months

46
Q

Monitoring

Level, TFT, U&E

A

Lithium
TFT, U&E prior to treatment
Lithium levels weekly until stabilised then every 3 months
TFT, U&E every 6 months

47
Q
  1. Headaches
  2. N&V
  3. Vertigo
  4. Confusion
  5. Weakness
  6. Pink skin and mucosae
A

CO poisoning

48
Q

CO poisoning Ix (2)

Mx

A

Venous or arterial blood gas
ECG

Mx

  1. 100% O2 non rebreather for 6 hours, target sats 100%
  2. Hyperbaric oxygen if severe (>30%)
49
Q

Overdose and poisoning: management

Paracetamol

A

activated charcoal if ingested < 1 hour ago
N-acetylcysteine (NAC)
liver transplantation

50
Q

Overdose and poisoning: management

Salicyclate

A

urinary alkalinization with IV bicarbonate

haemodialysis

51
Q

Overdose and poisoning: management
Opioid/opiates
Benzodiazepines

A

Naloxone

Flumezanil (supportive care only if not severe or iatrogenic)

52
Q

Overdose and poisoning: management

Tricyclic antidepressants

A

IV bicarbonate

53
Q

Overdose and poisoning: management

Lithium

A

mild-moderate toxicity: volume resuscitation with normal saline
haemodialysis may be needed in severe toxicity

54
Q

Overdose and poisoning: management
Warfarin
Heparin

A

Vitamin K, prothrombin complex

Protamine sulphate

55
Q

Overdose and poisoning: management
BB
Organophosphate insecticides

A

If bradycardic then atropine
in resistant cases glucagon may be used

atropine

56
Q

Overdose and poisoning: management
Ethylene glycol
Methanol poisoning

A
  1. fomepizole, an inhibitor of alcohol dehydrogenase
  2. Ethanol
  3. Haemodialysis
57
Q

Overdose and poisoning: management

Lead

A

Dimercaprol, calcium edetate

58
Q

Overdose and poisoning: management

Cyanide

A

Hydroxocobalamin; also combination of amyl nitrite, sodium nitrite, and sodium thiosulfate

59
Q

Quinolones
MOA (1)
CI (3)
SE (3)

A

inhibit topoisomerase II (DNA gyrase) and topoisomerase IV

CI pregnant, breasfeeding, G6PD

  1. Long QT
  2. Lowers seizure threshold
  3. Tendon damage/ rupture, increased risk if also taking steroids
60
Q 
Macrolides 
Cannot be used with? Why?
SE (2) 
Inhibitor/ inducer?
Azithro SE (2)
A

CI not to use with statins as macrolides are inzyme inhibitors therefore reduce breakdown of statins and increase risk of myopathy and rhabdomylysis.

  1. Long QT
  2. cholestatic jaundice

Azithromycin - hearing loss and tinnitus

61
Q

P450 inducers (therefore reduce efficacy of other drugs due to increased breakdown)

BullShit CRAP GPS

A 
Barbiturates
St John Warts
Carbamezapine
Rifampacin
Alcohol (chronic)
Phenytoin
Griseofluvin
Phenobarbitol
Sulfonylureas + smoking
62
Q

P4550 inhibitors (therefore increase toxicity risk)

SICKFACES.COM

A 
Sodium valproate
Isoniazid
Cipro
Ketoconazole
Fluconazole
Acute alcohol
Chloramphenicol
Erythro
Sulfonamides
Cimetidine
Omeprazole
Metronidazole
63
Q

Adrenaline doses in anaphylaxis and cardiac arrest

A

anaphylaxis: 0.5ml 1:1,000 IM

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

64
Q 
Mx alcohol
Acute withdrawal (2) 
To encourage abstinence (1) 
CI (2) 
Reduces craving, known to be a weak antagonist of NMDA receptors (1)
A 
Thiamine
Benzo
Disulfram - can cause severe reaction if also drinks ETOH
CI IHD, psychosis 
acamprosate
65
Q

Amiodorone SE (10) - name as many as you can

Drug interactions (2)

A
  1. Slate grey appearance
  2. Hypo/ hyperthyroidism
  3. Pulmonary fibrosis
  4. Liver fibrosis
  5. Corneal deposits
  6. Peripheral neuropathy
  7. Photosensitivity
  8. Long QT
  9. Thrombophlebitis
  10. Bradycardia

Warfarin - increases INR
Digoxin - increases digoxin levels

66
Q

Aspirin potentiates? (3)

A
  1. PO hypoglycaemics
  2. warfarin
  3. steroids
67
Q 
Diclofenac contraindications (4)
Should be switched to?
A
  1. ischaemic heart disease
  2. peripheral arterial disease
  3. cerebrovascular disease
  4. congestive heart failure

Naproxen or ibuprofen or topical diclofenac

68
Q

Name an inhibitor of 5 alpha-reductase
Indications (2)

SE (5)

A

Finasteride

benign prostatic hyperplasia
male-pattern baldness

  1. impotence
  2. decrease libido
  3. ejaculation disorders
  4. gynaecomastia
  5. breast tenderness
69
Q

Gentamicin is what type of abx?
Adverse effects (2)
CI (1)
Monitoring

A

Aminoglycoside
1. Ototoxicity
2. Nephrotoxicity
Myasthenia gravis

Peak and trough
Peak 1 hour post dose
Trough to be checked just before next dose due

If trough raised, interval should be increased
If peak raised, dose should be decreased

70
Q

Heparin
SE

Heparin-induced thrombocytopaenia (HIT) will occur after how long of use of heparin?

A
  1. bleeding
  2. thrombocytopenia
  3. osteoporosis/ risk of fractures
  4. hyperkalaemia

5-10 days

71
Q

Tamoxifen
MOA
SE (4)
How long is it used for?

A

oestrogen receptor antagonist and partial agonist

menopausal symptoms
VTE
endometrial cancer

5 years post tumour removal

72
Q

St John’s Wort is used in?

Inhibitor/ inducer

A

Mild-moderate depression

Inducer, therefore reduces effectiveness of warfarin/ ciclosporin/ COCP

73
Q

SE Metformin (2)

A

lactic acidosis

GI effects

74
Q

SE sulfonylureas (4)

A

Hypoglycaemic episodes
Increased appetite and weight gain
SIADH
Liver dysfunction (cholestatic)

75
Q

SE glitazones (4)

A

Weight gain
Fluid retention
Liver dysfunction
Fractures

76
Q

SE gliptins

A

Pancreatitis

77
Q

SE trimethoprim (3)

A

Rashes, including photosensitivity
Pruritus
Suppression of haematopoiesis

78
Q

SE metro

A

reaction after drinking ETOH

79
Q

SE Erythromycin

A

prolongs QT

MSRA (22 decks)

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