Transition block: pharmacology

Question 1

Which drugs are used for secondary prevention of an MI?

Answer 1

ACE-i
B-blocker
statin
anti-platelet

Question 2

Name some drug causes of hyperkalaemia

Answer 2

ACE-i

Question 3

Which drug can not be used in combination with clopidogrel?

Answer 3

omeprazole

Question 4

Which drugs are nephrotoxic?

Answer 4

ACE-i
NSAIDs
Cyclosporin
Diuretic
Aminoglycosides
Allopurinol
Methotrexate
spironolactone

Question 5

What does

a) clopidogrel irreversibly block?
b) aspirin irreversibly block?

Answer 5

a) platelet ADP receptors to reduce aggregation

b) cyclo-oxygenase-1

Question 6

What is first order elimination kinetics?

Answer 6

elimination rate is proportional to drug concentration

Question 7

What is the volume of distribution in a highly lipophilic drug?

Answer 7

high

- they dissolve into fat so there is less in plasma

Question 8

How do you calculate the loading dose?

Answer 8

volume of distribution x target concentration

Question 9

How do you calculate the Vd?

Answer 9

dose/ plasma concentrationA

Question 10

How do you calculate the loading dose?

Answer 10

volume of distribution x target concentration ( if oral this is all divided by the oral bioavailability)

Question 11

Viagra + what causes collapse?

Answer 11

nitrate

Question 12

Which medications exacerbate gout?

Answer 12

furosemide

Question 13

Which drug interacts with simvastatin?

to cause what?

Answer 13

grapefruit juice due to cytochrome P450 which metabolises

muscle inflammation and rhabdomyolysis

Question 14

Treatment options for acute gout

Answer 14

colchicine
naproxen
oral prednisolone 
intra-articular steroid  (not regularly done)
intra-muscular steroid

Question 15

Which 3 drugs cause tripple whammy in acute renal failure?

Answer 15

naproxen
ACE-i
diuretic

Question 16

SE of colchicine

Answer 16

vomiting, nausea, diarrhoea

Question 17

patient on an anti-coagulant should avoid which type of analgesia

Answer 17

NSAIDs due to risk of GI bleed

Question 18

How long should warfarin be withdrawn for before surgery?

Answer 18

5 days

Question 19

How does warfarin work?

Answer 19

blocks vitamin K reductase so factors 2,7,9 and 10 can’t be carboxylated

Question 20

What is the half-life of warfarin?

Answer 20

long + variable

approx 40hr

Question 21

What is the target INR for warfarin?

Answer 21

2. 5
3. 5 (if venousthromboembolism while on anticoagulant)

can have 0.5 variation ie. 2-3/ 3-4

Question 22

Treat significant paracetamol overdose

Answer 22

IV N-acetylcysteine

Question 23

Which drug is given if a patient becomes hypotensive after a spinal anaesthetic?

Answer 23

ephedrine (both alpha and beta adrenoceptor)

• works on alpha1 receptors to cause vasoconstriction and bring up the bp
• increases release of noradrenaline

Question 24

How does spinal anaesthesia cause hypotension?

Answer 24

blockade of sympathetic transmission causing vasodilation