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MRCP Part 1 > Pharmacology & Toxicology > Flashcards

Pharmacology & Toxicology Flashcards

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1
Q

Causes of Hyperpyrexia (7)

A
  1. Salicylates *
  2. Ecstasy *
  3. Cocaine *
  4. Neuroleptic malignant syndrome
  5. Serotonin syndrome
  6. Thyroid storm
  7. Co poisoning *
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2
Q

3 Drugs casuse sensorineural deafness

A
  1. Lasix iv ( oral unlikely)
  2. Vancomycin iv
  3. Erythromycin iv
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3
Q

6 Drug induced impaired glucose tolerance

A
  1. Nicotinic acid ( Vit B3)
  2. Atypical antipsychotics ( olanzapine )
  3. Tacrolimus & cyclosporine
  4. Steroids
  5. Interferon alpha
  6. Thiazides & lasix

*NAT SIT

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4
Q

4 Drug causes of urticaria

A
  1. NSAIDS
  2. Opiates
  3. Penicillins
  4. ASA
  • NOPA
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5
Q

7 Drugs causing photosensitivity

A
  1. NSAIDS
  2. ACEi/ ARBs
  3. Sulfphonylureas
  4. Thiazides
  5. Amiodarone
  6. Psoralens
  7. Tetracycline, sulphonamide, cipro
  • NAS TAPT
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6
Q

3 Drug causes of gingival hyperplasia

A
  1. Cyclosporine
  2. Phenytoin
  3. CCB ( especially Nifedipine)

*CPC

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7
Q

5 Drug causing lung fibrosis

A
  1. Amiodarone
  2. Methotrexate & sulfasalazine
  3. Bleomycin & busulphan
  4. Nitrofurantoin
  5. Bromocriptine , cabergoline, pergolide
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8
Q

5 Drug induced urinary retention

A
  1. Disopyramide
  2. Opioids
  3. Tricyclic antidepressants
  4. Anticholinergics ( antipsychotics & antihistamine)
  5. NSAIDS
  • DO TAN
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9
Q

Drug induced pancytopenia

A
  1. Cytotoxics
  2. Antibiotics: trimethoprim, chloramphenicol
  3. Anti-rheumatic: Gold , penicillamine
  4. Carbimazole
  5. Phenytoin, carbamazepine
  6. Sulphonylureas
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10
Q

Drug causes of agranulocytosis

A
  1. Antithyroid drugs - carbimazole, propylthiouracil

2.Antipsychotics - atypical antipsychotics (CLOZAPINE)

3.Antiepileptics - carbamazepine

4.Antibiotics - penicillin, chloramphenicol, co-trimoxazole

5.Antidepressant - mirtazapine

6.Cytotoxic drugs - methotrexat

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11
Q

1 Drugs causing Cataracts

A

steroids

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12
Q

2 Drugs causing Corneal opacities

A

amiodarone
indomethacin

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13
Q

3 Drugs causing Optic neuritis

A

amiodarone

ethambutol

metronidazole

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14
Q

Drugs causing Retinopathy

A

chloroquine, quinine

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15
Q

Drugs causing blue discolouration and non-arteritic anterior ischaemic neuropathy

A

Sildenafil

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16
Q

Alcohol drinking management

A

Ora thiamine

Benzodiazepines for acute withdrawal

Disulfram

Acamprosate

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17
Q

Stages of Ethylene toxicity

A

Stage 1: symptoms similar to alcohol intoxication: confusion, dizziness, dysarthria

Stage 2: metabolic acidosis, high Anion Gap & high osmolar gap, tachycardia, HTN

Stage 3: AKI

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18
Q

Treatment of ethylene toxicity

A
  • fomepizole is preferred to ethanol
  • hemodialysis
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19
Q

Treatment of Methanol poisoning

A
  • fomepizole
  • hemodialysis
  • cofactor therapy with folinic acid to reduce ophthalmological complications
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20
Q

Ecstasy poisoning features

A

CNS: agitation, confusion , ataxia

CVS: tachycardia and HTN

Fever

Hypo Na

Rhabdomyolsis

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21
Q

Ecstasy poisoning management

A
  • supportive
  • dantrolene maybe used for fever if other simple measures fail
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22
Q

Carboxyhemoglobin level in non smoker

A

< 3 %

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23
Q

Carboxyhemoglobin level in smoker

A

< 10 %

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24
Q

Carboxyhemoglobin level in symptomatic

A

10-30 %

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25
Carboxyhemoglobin level in severe toxicity
> 30 %
26
in Carbon monoxide poisoning , ECG is useful to look for …..
Cardiac ischemia
27
Treatment of CO poisoning
- 100 % high flow O2 via Non rebreather mask - Minimum 6 hrs - Target SPo2 100 %
28
5 Indication of hyperbaric oxygen in CO poisoning
1. Level > 25 % 2. Pregnancy 3. Neurological signs 4. Myocardial ischemia 5. Arrhythmia
29
5 Features of Mercury poisoning
1. Visual field defects 2. Hearing loss 3. Irritability 4. Paraesthesia 5. RTA
30
2 Risk factors of Paracetamol overdose
1. Malnourished patients ( e.g anorexia nervosa) or patients who have not eaten for a few days 2. Hepatotoxic Drugs ( rifampicin, phenytoin, carbamazepine, chronic alcohol excess *** acute alcohol intake is not risk factor *** maybe protective
31
Acetyl cysteine is used in ttt of paracetamol overdose as it’s …….
It’s a precursor of glutathione and hence can increase hepatic glutathione production
32
Side effect of acetylcysteine ? And how to treat?
Anaphylactoid reaction - stop iv acetyl cysteine then restarting at slower rate
33
Criteria for liver transplant in paracetamol liver failure
1. PH < 7.3 , 24 hrs after ingestion Or 2. PT > 100 sec & creat > 300 & encephalopathy grade III or IV
34
Paracetamol overdose occurs when glutathione stores run out leading to ….
Increase NAPQI ( N acetyl p benzoquinone imine)
35
Fomepizole is an inhibitor of ….
Alcohol dehydrogenase
36
Confusion and pink mucosae
CO poisoning
37
Features of organophosphate poisoning
Salivation Lacrimation Urination Defecation Hypotension Bradycardia Small pupils Muscle fasciculation
38
Drugs that can be cleared with hemodialysis
BLAST 1. Barbiturates 2. Lithium 3. Alcohol ( methanol & ethylene glycol) 4. Salicylate 5. Theophylline ( charcoal hemoperfusion is preferred)
39
Drugs that can ( not ) be cleared with hemodialysis
1. Tricyclics & benzodiazepines 2. BB & digoxin 3. Dextropropoxyphene
40
BB overdose features & treatment
Hypotension Bradycardia HF Syncope Ttt: If bradycardia >> >atropine In resistant cases >>> glucagon
41
Treatment of organophosphate poisoning
- Atropine - pralidoxime
42
Salicylate overdose features
1. Mixed respiratory alkalosis and metabolic acidosis 2. Hyperventilation 3. Seizures and coma 4. Sweating and fever 5. Hyperglycemia and hypoglycemia 6. Tinnitus and lethargy
43
Salicylate overdose treatment
- ABC - Charcoal - Urinary alkalinization with iv NaHco3 - Hemodialysis
44
6 Indications for hemodialysis in Salicylate overdose
1. Serum concentration > 700 mg/l 2. Persistent metabolic acidosis 3. AKI 4. Pulmonary edema 5. Seizures 6. Coma
45
Cyanide poisoning features
Classical features: Brick red skin & Smell of bitter almonds Acute : hypoxia , hypotension, headache, confusion Chronic: ataxia, peripheral neuropathy, dermatitis
46
Cyanide poisoning management
- 100 % O2 - Iv hydroxocobalamin - combination of amyl nitrite , Na nitrite and Na thiosulfate
47
Botulinum toxin indications
1. Achalasia 2. Severe hyperhidrosis of the axillae 3. Hemifacial spasm 4. Blepharospasm 5. Spasmodic torticollis 6. Focal spasticity in cerebral palsy, hand& wrist disability associated with stroke
48
When should measure digoxin level If suspected digoxin toxicity
Within 8 -12 hrs of the last dose
49
Features of digoxin toxicity
Lethargy, confusion Nausea and vomiting and anorexia AV block , bradycardia Gynecomastia
50
Precipitating factors for digoxin toxicity
- Hypo K , Hypo Mg , Hypoalbuminaemia - hypothermia, hypothyroidism - hyper Ca , Hyper Na - renal failure, acidosis - myocardial ischemia - old age - drugs
51
Precipitating factors for digoxin toxicity ( drugs )
- amiodarone, Verapamil, diltilazem - quinidine - ciclosporin , spironolactone - drugs can cause Hypo K: thiazides, loop diuretics
52
Management of digoxin toxicity
1. Digibind 2. Correct arrhythmias 3. Monitor potassium
53
Treatment of lead toxicity
Dimercaprol , Ca edetate
54
Treatment of benzodiazepines overdose
1. Supportive care 2. Flumazenil ( can cause seizure) only with severe or iatrogenic overdose
55
Lithium toxicity occurs when the concentration level
> 1.5 mmol/L
56
Lithium toxicity maybe precipitated by
Dehydration Renal failure Drugs: thiazides, ACEi/ARBs , NSAIDS, Flagyl
57
Features of lithium toxicity
1. Coarse tremor ( fine tremor in therapeutic level ) 2. Hyperreflexia 3. Confusion , seizure , coma 4. Polyuria
58
Cocaine mechanism of action
Cocaine block the uptake of dopamine, noradrenaline and serotonin
59
Treatment of cocaine toxicity
- benzodiazepines first line - chest pain: benzodiazepines + glyceryl trinitrate, if MI >> PCI - HTN : benzodiazepines + Na nitroprusside - BB in cocaine induced cardiovascular problems
60
Early features of tricyclic overdose
- Dry mouth - dilated pupils , blurred vision - agitation - sinus tachycardia
61
4 features of severe poisoning in tricyclic overdose
- seizures, - coma - metabolic acidosis - arrhythmias
62
ECG changes in tricyclic overdose
- sinus tachycardia - widening of QRS - Prolongation of QT interval
63
In tricyclic overdose , Widening of QRS 1. > 100 associated with ……. 2. > 160 associated with ……
I. Seizures 2. VT
64
Treatment of tricyclic overdose
1. IV bicarbonate - first-line therapy for hypotension or arrhythmias - indications include widening of the QRS interval >100 msec or a ventricular arrhythmia 2. other drugs for arrhythmias
65
CCB side effects
- Headache - • Flushing • - Ankle oedema - Verapamil also commonly causes constipation
66
BB side effects
- Bronchospasm (especially in asthmatics) • - Fatigue -• Cold peripheries -• Sleep disturbances
67
Nítrates side effects
- Headache - • Postural hypotension • - Tachycardia
68
Nicorandil side effects
- Headache - • Flushing -• Anal ulceration
69
Drug causing yellow green tinge in vision
Digoxin
70
Classical hallmark of Quinine toxicity (cinchonism)
- Tinnitus, visual blurring - dry skin - arrhythmias - pulmonary edema - abdominal pain - hypoglycemia
71
Arrhythmias in Quinine toxicity due to…
Blockade of Na & K channels prolonging QRS & QT interval and these generate into ventricular tachyarrythmias or fibrillation causing death.
72
Hypoglycemia in Quinine toxicity due to
Quinine stimulates pancreatic insulin secretion
73
Quinine toxicity vs Aspirin poisoning
Difficult to distinguish so measure salicylate levels is important * tinnitus & deafness & visual defects are transient with Aspirin But permanent with quinine
74
Management of Quinine toxicity
- supportive with fluids , Inotropes - bicarbonate as needed - positive pressure ventilation for pulmonary edema
75
Iron tables overdose features
- Hypotension - Abdominal pain - Coffee ground vomiting & black stool - metabolic alkalosis 2ry to vomiting * iron table radio-plaque in X-ray or CT
76
Treatment of Iron tables overdose
- Gastric lavage with desferrioxamine into stomach to reduce further iron absorption - iv desferrioxamine at rate 15 mg/kg/hr is an initial ttt of choice and it’s important to start with it as soon as possible - hemodialysis - plasma exchange
77
Ethambutol  inhibits
the enzyme arabinosyl transferase which polymerizes arabinose into arabinan
78
Pyrazinamide converted by pyrazinamidase into ....
converted by pyrazinamidase into pyrazinoic acid which in turn inhibits fatty acid synthase (FAS) I
79
Which anti TB can cause gout ?
Pyrazinamide
80
Isoniazid inhibits .......
inhibits mycolic acid synthesis
81
Rifampicin inhibits .......
inhibits bacterial DNA dependent RNA polymerase preventing transcription of DNA into mRNA
82
Phenytoin levels do not need to be monitored routinely but  trough levels, immediately before dose  should be checked if:
adjustment of phenytoin dose suspected toxicity detection of non-adherence to the prescribed medication
83
Tacrolimus is a calcineurin inhibitor decreases clonal proliferation of T cells by .....
reducing IL-2 release
84
Which one of diabetes drugs can cause fluid retention
Glitazones
85
Which one of diabetes drugs can cause SIADH
Sulfonylureas
86
neuromuscular excitation hyperreflexia myoclonus rigidity autonomic nervous system excitation hyperthermia sweating altered mental state confusion Features of........?
Serotonin syndrome
87
Side effects of Quinolones
1. lengthens QT interval 2. tendon damage 3. Cartilage damage 4. lower seizure threshold
88
Contraindications of Quinolones
avoid in G6PD Pregnancy Breastfeeding
89
Amiloride blocks .....
the epithelial sodium channel in the distal convoluted tubule
90
Side-effects of PDE5 inhibitors
visual disturbances blue discolouration non-arteritic anterior ischaemic neuropathy nasal congestion flushing gastrointestinal side-effects headache priapism
91
Features of oculogyric crisis
restlessness, agitation involuntary upward deviation of the eyes
92
Causes of oculogyric crisis 
antipsychotics metoclopramide postencephalitic Parkinson's disease
93
Management of oculogyric crisis
cessation of causative medication if possible Iv  antimuscarinic: benztropine or procyclidine
94
somatostatin is released from .....1.... and inhibits .....2.......
1. D cells of pancreas 2. the release of growth hormone, glucagon and insulin
95
Side effects of Octreotide
gallstones (secondary to biliary stasis)
96
Management of Motion sickness
1. transdermal patch hyoscine 2. non-sedating antihistamines such as cyclizine or cinnarizine are recommended in preference to sedating preparation such as promethazine
97
Mechanism of action of Metformin
acts by activation of the AMP-activated protein kinase (AMPK) increases insulin sensitivity decreases hepatic gluconeogenesis may also reduce gastrointestinal absorption of carbohydrates
98
Metformin should be stopped  if 1. creatinine Or 2. eGFR
1. > 150 2. GFR < 30
99
Half life of iv Ig
3 weeks
100
Gentamicin can cause nephrotoxicity secondary to ......
secondary to  acute tubular necrosis
101
HMG CoA reductase inhibitors ?
Statins
102
Decreases cholesterol absorption in the small intestine?
Ezetimibe
103
Decreases hepatic VLDL secretion?
Nicotinic acid
104
Agonist of PPAR-alpha therefore increases lipoprotein lipase expressionMyositis, pruritus ?
Fibrates
105
Decreases bile acid reabsorption in the small intestine, upregulating the amount of cholesterol that is converted to bile acid ?
Cholestyramine
106
Activates antithrombin III. Forms a complex that inhibits thrombin, factors Xa, IXa, Xia and XIIa Which drug ?
Heparin
107
Activates antithrombin III. Forms a complex that inhibits factor Xa Which drug ?
LMWH
108
Heparin-induced thrombocytopaenia (HIT) is immune mediated - antibodies form against ......
complexes of platelet factor 4 (PF4) and heparin
109
Finasteride is an  inhibitor of......
5 alpha-reductase, an enzyme which metabolises testosterone into dihydrotestosterone.
110
Indications for Finasteride
benign prostatic hyperplasia male-pattern baldness
111
Finasteride & serum prostate-specific antigen
Finasteride causes decreased levels of serum prostate-specific antigen
112
sumatriptan is ....
a 5-HT1D receptor agonist
113
pizotifen & Methysergide & cyproheptadine are
a 5-HT2 receptor antagonist
114
extensive skin rash, high fever, and organ involvement,  Eosinophilia a and abnormal liver function tests.  Features of....?
DRESS
115
the diagnosis of DRESS syndrome conformed by ...
Skin biopsy
116
DRESS syndrome treatment
all medications that are a possible culprits to be stopped and supportive care started. Antihistamines, topical steroids  Systemic steroids may be started in severe cases where exfoliative dermatitis / pneumonitis / hepatitis is present. Occasionally immunosuppressants, intravenous immunoglobulin and plasmapheresis may be started
117
ergot-derived dopamine receptor agonists (bromocriptine, cabergoline, pergolide*) have been associated with
pulmonary, retroperitoneal and cardiac fibrosis.
118
4 Indications of dopamine receptor agonists 
Parkinson's disease prolactinoma/galactorrhoea cyclical breast disease acromegaly
119
4 Side effects of dopamine receptor agonists
nausea/vomiting postural hypotension hallucinations daytime somnolence
120
Ciclosporin is an immunosuppressant which decreases clonal proliferation of T cells by .......
reducing IL-2 release
121
Ciclosporin acts by binding to cyclophilin forming a complex which inhibits .......
calcineurin
122
11 Adverse effects of ciclosporin 
1. Nephrotoxicity 2. Hepatotoxicity 3. HTN 4. Fluid retention 5. impaired glucose tolerance 6. hyperlipidaemia 7. Hyperkalaemia 8. Tremor 9. gingival hyperplasia 10. increased susceptibility to severe infection 11. hypertrichosis ( excessive hair growth )
123
ciclosporin & cannabidiol
cannabidiol: may increase the concentration of ciclosporin
124
Allopurinol is
xanthine oxidase inhibitor
125
Patients at a high risk of severe cutaneous adverse reaction of allopurinol should be screened for
HLA-B *5801 allele
126
Allopurinol & Azathioprine
allopurinol can therefore lead to high levels of 6-mercaptopurine a much reduced dose (e.g. 25%) must therefore be used if the combination cannot be avoided
127
Allopurinol & Cyclophosphamide
allopurinol reduces renal clearance, therefore may cause marrow toxicity
128
Allopurinol & Theophylline
allopurinol causes an increase in plasma concentration of theophylline by inhibiting its breakdown
129
What is the Wolff-Chaikoff effect?
autoregulatory phenomenon where thyroxine formation is inhibited due to high levels of circulating iodide
130
Amiodarone-induced thyrotoxicosis Type 1 vs type 2 1. Goiter ? MANAGEMENT?
1. Goiter Type 1 present Type 2 absent 2. Management Type 1: Carbimazole or potassium perchlorate Type 2: Corticosteroids
131
Pathophysiology of Amiodarone-induced thyrotoxicosis Type 1
Excess iodine-induced thyroid hormone synthesis
132
Pathophysiology of Amiodarone-induced thyrotoxicosis Type 2
Amiodarone-related destructive thyroiditis
133
Cyclooxygenase is responsible for ............... synthesis. 
prostaglandin, prostacyclin and thromboxane synthesis. 
134
The blocking of thromboxane A2 formation in platelets reduces .............
the ability of platelets to aggregate 
135
Mechanism of action of Aspirin
Non reversible COX 1 and COX 2 inhibitor
136
6 Drugs which may precipitate attack of Acute intermittent porphyria
barbiturates halothane benzodiazepines alcohol oral contraceptive pill sulphonamides
137
Tamoxifen is a .......
Selective oEstrogen Receptor Modulator (SERM) which acts as an oestrogen receptor antagonist and partial agonist.
138
Tamoxifen is used for
management of oestrogen receptor positive breast cancer
139
4 Side effects of Tamoxifen
1. menstrual disturbance: 2. Hot flushes 3. VTE 4. endometrial cancer
140
Trastuzumab (Herceptin) is a monoclonal antibody directed against the  .........
HER2/neu receptor
141
Trastuzumab is used for...
It is used mainly in metastatic breast cancer although some patients with early disease are now also given trastuzumab.
142
Side effects of Trastuzumab
flu-like symptoms and diarrhoea are common cardiotoxicity * more  common when anthracyclines have also been used an echo is usually performed before starting treatment
143
Alpha-1
1. salivary secretion 2. hepatic glycogenolysis 3. relaxation of GI smooth muscle 4. vasoconstriction * SHRV
144
Alpha-2 adrenoceptors
mainly presynaptic: inhibition of transmitter release (inc NA, Ach from autonomic nerves) inhibits insulin platelet aggregation
145
Beta-1 adrenoceptors
mainly located in the heart increase heart rate + force
146
Beta-2
vasodilation bronchodilation relaxation of GI smooth muscle
147
Beta-3 adrenoceptors
lipolysis
148
phenylephrine is ...
Alpha-1 agonists
149
clonidine is
Alpha-2 agonists
150
dobutamine is
Beta-1 agonists
151
doxazosin is
alpha-1 blocker
152
tamsulosin is
alpha-2 blocker
153
phenoxybenzamine is
non-selective Alpha blocker
154
Management of accidental injection e.g. resulting in digital ischaemia
local infiltration of phentolamine
155
Types ( phases ) of Drug metabolism
phase I reactions: oxidation, reduction, hydrolysis phase II reactions: conjugation.
156
Antiarrhythmics: Vaughan Williams classification Class 4
CCB - Verapamil - diltiazem
157
Antiarrhythmics: Vaughan Williams classification Class 3
Potassium Chanel blockers - amiodarone - Sotalol - Ibutilide - Bretylium
158
Antiarrhythmics: Vaughan Williams classification Class 2
BB - Propranolol - Atenolol - Bisoprolol - Metoprolol
159
Antiarrhythmics: Vaughan Williams classification Class 1a
Block sodium channels Increases AP duration - Procainamide - Disopyramide - Quinidine *PDQ
160
Antiarrhythmics: Vaughan Williams classification Class 1b
Block sodium channels Decreases AP duration - Lidocaine - Mexiletine - Tocainide
161
Antiarrhythmics: Vaughan Williams classification Class 1c
Block sodium channels No effect on AP duration - Propafenone - Encainide - Flecainide *PEF
162
Contraindications of Flecainide
- post MI - structural heart disease: e.g. heart failure - sinus node dysfunction; second-degree or greater AV block - atrial flutter
163
Adverse effects of Flecainide
- negatively inotropic - bradycardia - proarrhythmic - oral paraesthesia - visual disturbances
164
Indications of Flecainide
- AFib - SVT associated with WPW
165
Actions of adrenaline on α adrenergic receptors:
inhibits insulin secretion by the pancreas stimulates glycogenolysis in the liver and muscle stimulates glycolysis in muscle
166
Actions of adrenaline onβ adrenergic receptors:
stimulates glucagon secretion in the pancreas stimulates ACTH stimulates lipolysis by adipose tissue
167
adrenaline doses - anaphylaxis - cardiac arrest
anaphylaxis: 0.5ml 1:1,000 IM cardiac arrest: 10ml 1:10,000 IV or 1ml of 1:1000 IV
168
increased risk of ........with combined oral contraceptive pill 
breast cancer   cervical cancer very small risk of  heart attacks  and  strokes
169
Metformin should be titrated slowly, leave at ........ before increasing dose
least 1 week
170
Avoidance of using hypotonic (0.45%) in paediatric patients - risk of ......
hyponatraemic encephalopathy
171
Drugs affected by acetylator status
Hydralazine Isoniazid Sulfasalazine Procainamide Dapsone *HI SPeeD
172
Drugs exhibiting zero order kinetics
Heparin Ethanol Phenytoin ASA
173
P450 enzymes inductors (7)
Smoking St John’s wort Chronic alcohol intake Carbamazepine Phenytoin Phenobarbitone Rifampicin GRiseofulvin
174
Lithium toxicity maybe precipitated by
Dehydration Renal failure Drugs - ACEi/ARBs - thiazides - NSAIDs - metronidazole
175
Levothyroxine acts via
Nuclear receptors
176
To give NaHCO3 in TCA overdose if (4)
PH < 7.1 QRS > 160 ms Arrhythmias Hypotension
177
Abciximab is
Glycoprotein IIb / IIIa receptor blocker
178
Cocaine can cause abdominal pain due to …..
Ischemic colitis
179
Pilocarpine is …….. agonist
muscarinic
180
P450 enzyme inductors …1…. Warfarin P450 enzyme inhibitors…2…. Warfarin
1. Reduce the effect of warfarin 2. Increase the effect of warfarin
181
Heparin activates …1?…. Which inhibits……2?.
1. Antithrombin III 2. Thrombin III & IX, X, XI, XII
182
MI 2ry to cocaine treated by
Iv benzodiazepines
183
Which One of Anti TB medications need adjustment In renal impairment?
Ethambutol
184
Cocaine in pregnancy can cause
Induce preterm labour
185
Local anesthetic toxicity can be treated with
Iv 20 % lipid emulsion
186
Ketamine is ……… receptor blocker
NMDA
187
What is the most common feature of CO poisoning?
Headache
188
What is The most common side effects of progesterone pills ?
Irregular vaginal bleeding
189
Sidenafil is contraindicated by nitrates and …..
Nicordanil
190
Enzymes are involved in phase I drug metabolism?
1. Alcohol dehydrogenase 2. Xanthine oxidase
191
Drug monitoring 1. Ciclosporin 2. Phenytoin 3. Digoxin 4. Lithium
1&2 immediately before the dose 3. 6 hours post dose 4. 12 hours post dose
192
Cyanide …… the enzyme cytochrome C oxidase
Inhibits
193
Which drug selectively blocks the epithelial Na transport channels ?
Amiloride
194
Adrenaline vs Glucose, lactate, K
Adrenaline induced hyperglycemia Hyperlactatemia Hypokalemia

MRCP Part 1 (17 decks)

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