Transition block: pharmacology Flashcards
Which drugs are used for secondary prevention of an MI?
ACE-i
B-blocker
statin
anti-platelet
Name some drug causes of hyperkalaemia
ACE-i
Which drug can not be used in combination with clopidogrel?
omeprazole
Which drugs are nephrotoxic?
ACE-i NSAIDs Cyclosporin Diuretic Aminoglycosides Allopurinol Methotrexate spironolactone
What does
a) clopidogrel irreversibly block?
b) aspirin irreversibly block?
a) platelet ADP receptors to reduce aggregation
b) cyclo-oxygenase-1
What is first order elimination kinetics?
elimination rate is proportional to drug concentration
What is the volume of distribution in a highly lipophilic drug?
high
- they dissolve into fat so there is less in plasma
How do you calculate the loading dose?
volume of distribution x target concentration
How do you calculate the Vd?
dose/ plasma concentrationA
How do you calculate the loading dose?
volume of distribution x target concentration ( if oral this is all divided by the oral bioavailability)
Viagra + what causes collapse?
nitrate
Which medications exacerbate gout?
furosemide
Which drug interacts with simvastatin?
to cause what?
grapefruit juice due to cytochrome P450 which metabolises
muscle inflammation and rhabdomyolysis
Treatment options for acute gout
colchicine naproxen oral prednisolone intra-articular steroid (not regularly done) intra-muscular steroid
Which 3 drugs cause tripple whammy in acute renal failure?
naproxen
ACE-i
diuretic
SE of colchicine
vomiting, nausea, diarrhoea
patient on an anti-coagulant should avoid which type of analgesia
NSAIDs due to risk of GI bleed
How long should warfarin be withdrawn for before surgery?
5 days
How does warfarin work?
blocks vitamin K reductase so factors 2,7,9 and 10 can’t be carboxylated
What is the half-life of warfarin?
long + variable
approx 40hr
What is the target INR for warfarin?
- 5
- 5 (if venousthromboembolism while on anticoagulant)
can have 0.5 variation ie. 2-3/ 3-4
Treat significant paracetamol overdose
IV N-acetylcysteine
Which drug is given if a patient becomes hypotensive after a spinal anaesthetic?
ephedrine (both alpha and beta adrenoceptor)
- works on alpha1 receptors to cause vasoconstriction and bring up the bp
- increases release of noradrenaline
How does spinal anaesthesia cause hypotension?
blockade of sympathetic transmission causing vasodilation
