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year 3 LIC > z - drugs > Flashcards

z - drugs Flashcards

1
Q

BB combination with verapamil (rate limiting CCB)

A

can potentially cause profound bradycardia and asystole

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2
Q

BB and asthma

A

contraindicated!

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3
Q

migraine prevention

A

propanolol or topiramate. propanolol in child brearing age females

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4
Q

bells palsy

A

prednisalone 1mg/kg for 10days prescribed within 72hours of onset +eye care

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5
Q

seizure

A

start antiepileptics following second seizure

focal - carbamazepine (not in absent!) or lamotragene
generalised - sodium valporate

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6
Q

preferred antiplatelet for secondary prevention following stroke/tia

A

clopidogrel

2nd line = aspirin in combo with modified release dipyridamole

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7
Q

severe cases of neuroleptic malignant syndrome

A

dantrolene

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8
Q

DVT/PE prophylaxis in nephrotic syndrome?

A

LMWH

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9
Q

pioglitizone

A

CI in bladder Ca (can cause it) and heart failure

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10
Q

treatment of nephrogenic DI

A

thiazides and low salt/protein diet (desmopressin in central DI)

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11
Q

ACEi/ARB as 1st line antihypertensive in…

A

<55 and T2DM (including afro-caribbean if T2DM)

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12
Q

ototoxicity associated with

A

loop diuretics

gentamicin

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13
Q

cataracts is a SE of which drug class?

A

corticosteroids

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14
Q

max dose of amlodipine

A

10mg

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15
Q

what needs to be considered when starting phenytoin?

A

cardiac monitoring. arrhythmic effects

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16
Q

drugs that increase the risk of GORD

A

tricyclincs, anti-cholonergics, nitrates

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17
Q

What is the most important advice to give to a patient starting carbimazole?

A

return for urgent medical review if develop any symptoms of infection. particularly sore throat or fever. are but serious side effect of carbimazole is agranulocytosis so patients must be counselled regarding this. If the patient develops any symptoms of an infection, particularly sore throat or fever then must seek urgent medical review and a FBC must be performed to check the neutrophil count

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18
Q

what is the prophalaxic treatment of spontaneous bacterial peritonitis?

A

oral ciprofloxacin or norfloxacin for people with cirrhosis and ascites with an ascitic protein of 15 g/litre or less until the ascites has resolved. or patients who have had an ep of SBP

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19
Q

uses of metoclopramide

A

anti-emetic and pro-kinetic:

  • GORD
  • gastroparesis in T2DM
  • often combined with analgesics to treat migraine

SE: extrapyramidal effects, tardive dyskinesia, Parkinson, hyperprolactinaemia

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20
Q

first line treatment for PBC

A

ursodeoxycholic acid

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21
Q

treatment for pruritis

A

cholestyramine

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22
Q

treatment of c,diff infection?

A

oral metronidazole for 14 days. if not improved then oral vancomycin

(both together is the treatment for v severe)

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23
Q

drug to prevent variceal bleeding?

A

propanolol

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24
Q

other than clindamycin what antibiotics can cause c.diff?

A

cephalosporins e.g. ceftriaxone, cefaclor

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25
Q

burn resusitation fluid if >15% SA covered

A

first 24hrs use parkland formula:

4ml x (total SA) x (body weight in kg)

50% in first 8 hours
50% in next 16 hours

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26
Q

treatment of thyrotoxicosis in pregnancy

A

ropylthiouracil is used in the first trimester of pregnancy in place of carbimazole, as the latter drug may be associated with an increased risk of congenital abnormalities. At the beginning of the second trimester, the woman should be switched back to carbimazole’

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27
Q

drugs common cause erectile dysfunction

A

SSRI’s and BB

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28
Q

treatment of SBP

A

IV cefotaxime

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29
Q

penacillamine is used in the Rx of?

A

Wilson’s disease. aids in the elimination of copper

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30
Q

management of hepatorenal syndrome

A

vasopressin analogues, for example terlipressin, have a growing evidence base supporting their use. They work by causing vasoconstriction of the splanchnic circulation
volume expansion with 20% albumin
transjugular intrahepatic portosystemic shunt

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31
Q

Offer prophylactic intravenous antibiotics for people with cirrhosis who have upper gastrointestinal bleeding

A

quinalone

inhibit DNA synthesis and are bactericidal in nature.
e.g ciprofloxacin; levofloxacin
SEs = tendon rupture, prolonged QT, lower seizure threshold in epileptics

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32
Q

what medications are key in the management of proteinuria?

A

ACEi/ARB

3mg/mmol if co-existent diabetes, an ACR >30 mg/mmol if co-existent hypertension or an ACR>70mg/mmol.
Therefore ramipril is the correct answer

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33
Q

treatment for constipation in children

A

advice on diet/fluids + movicol paediatric plan

macrogels if first line

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34
Q

what should you monitor in achild on methylphenidate for ADHD?

A

growth

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35
Q

what is the moa of loperamide?

A

μ-opioid receptor agonist which does not have systemic effects as it is not absorbed through the gut

reduce gastric motility through stimulation of opiod receptors

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36
Q

statins in pregnancy

A

STOP

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37
Q

treatment of prostatitis

A

fluroquinalone (ciprofloxacin) for 14days . consider testing for STI

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38
Q

treatment for itch

A

cholestyramine

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39
Q

non-sedating anti-histmaines

A

citirizine, loratidine, fexofenadine

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40
Q

anti-emetics used in pregnancy

A

1 - promethazine/cyclizine
2 - prochloperazine
3 - metoclopramide

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41
Q

anti-emetics ised post op

A

1 - ondansetron
2 - cyclizine
3 - prochloperazine

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42
Q

anti-emetic drug induces/ radiation

A

metoclopramide

43
Q

anti-emetic cytptoxic

A

triple therapy ondansetron, dexamethasone, apreptide +/- metoclopramide

44
Q

anti-emetic GI causes

A

metoclopramide

45
Q

motion sickness

A

1-hyocine

2-cyclizine

46
Q

vestibular disease

A

beta histine or cyclizine

47
Q

blood products in ruptured aaa

A

6 units crossmatched

48
Q

if pt has AF with stroke what long term medication should you start

A

doac.

300mg aspirin for 2 weeks then 75mg clopidogrel (and 80mg atorvostatin) if no AF

49
Q

treatment of infective exacerbation of COPD

A

prednisolone
amoxicillin, clarithromycin or doxycyclin

don’t use clarithro if prolonged QT

50
Q

what is the antibiotic prophylaxis used in copd

A

azithromycin

(usually 250 mg 3 times a week) for people with COPD if they do not smoke, have optimised non-pharmacological management and inhaled therapies, relevant vaccinations and (if appropriate) have been referred for pulmonary rehabilitation and experience frequent (typically 4 or more per year) exacerbations with sputum production

51
Q

drugs that can slow the progression of IPF

A

pirfenidone - antifibrotic and anti-inflammatory

nintedanib - monoclonal antibody

52
Q

first line management of COPD

A

inhaled salbutamol or ipratropium

53
Q

acute alcoholic hepatitis

A

prednisolone

54
Q

treatment of idiopathic intracranial htn

A

Acetazolamide

55
Q

whooping cough

A

erythromycin

56
Q

chlamydia psittici

A

1- doxy

2- erythromycin

57
Q

Qfever/ coxeilla

A

doxy

58
Q

legionella

A

levofoxacin or clarithromycin+rifampicin

59
Q

active or prophylactic treatment of pneumocysitis pneumonia

A

co-trimoxazole

60
Q

pseudomonas

A

ciprofloxacin

61
Q

treatment and SEs of active pulmonary TB

A

‘RIPE’

  • Rifampacin (body fluids orange)
  • Isoniazid (peripheral neuropathy: co-prescribe Pyridoxine (vitamin B6))
  • Pyrazinamide (can cause hyperuricaemia (high uric acid levels) resulting in gout/hepatitis/arthralgia)
  • Ehanbutol (colour blindness and reduced visual acuity. ON)

*Rifampacin/isoniazid/pyrazinamide can all cause hepatotoxicity

all 4 for 2 months. rifampacin and isoniazide for further 4

(SEs learn as ONGO - orange, neuropathy, gout, ON)

62
Q

drug that can reactivate TB

A

anti-TNF e.g. infliximab

63
Q

treatment of carcinoid syndrome

A

tumours that release serotonin into the system. octrotide - somatostatin analogue that helps decrease the secretion of seratonin

64
Q

prophylaxis in cluster headache

A

verapamil (CCB)

acute attacks = 100% O2 and SC triptan… triptans are CI in coronary heart disease as they can cause vasospasm

65
Q

CI in heart failure

A

non-hydropyridine CCB (verapamil and diltiazem)

66
Q

why might there be significant renal impairment after starting ACEi?

A

may occur if the patient has undiagnosed bilateral renal artery stenosis

Bilateral renal artery stenosis should always be considered in a patient with risk factors for, and evidence of, atherosclerotic vascular disease. In particular, if they are diagnosed later in life with hypertension and have an acute significant drop in renal function following the commencement of an ACE inhibitor

67
Q

cause of hallucination in PD

A

dopamine agonists

68
Q

advice when atarting sertraline

A

new antidepressant drug therefore less addictive
can take up to 3 weeks to feel benefit
can experience headache and nausea symptoms in first week of using it, nothing the second and you might think it is not working but you should start to feel benefits after the 3rd week. assess pt risk!! review in 2-3weeks. shouldnt be sedating but if you experience then get back in touch. expect to be on it for at least 3months

69
Q

azathioprine and colchicine together?

A

severe interaction causing bone marrow suppression (pancytopaenia)

70
Q

hydroxychloraquine SE

A

bulls eye retinopathy. all pts should have opthalmology assessment before commencing. +annual screening

71
Q

drug causes of drug induced lupus

A

procainamide

hydralazine

72
Q

paediatric constipation

A

(MSO)
Movicol (specific osmotic for pediatric)
Stimulant (eg.senna)
Osmotic (Eg.lactulose)

73
Q

statin and lft’s

A

can cause off lfts

74
Q

aye drop used to dilate pupil and relieve pn in uveitis and keratitis etc

A

cyclopentolate

atropine (anti-parasympathetic)

75
Q

mx of dresslers syndrome

A

aspirin (NSAID in pericarditis)

76
Q

steroids and fbc

A

cna cause increased WBCs, typically neutrophils

77
Q

treatment to prevent pathological fractures in bony mets

A

Bisphosphonates

denosumab if low gfr <30

78
Q

treatment of intestinal bacterial overgrowth ( diagnosed with hydrogen breath test)

A

rifaximin because rifaximin is poorly absorbed via the gastrointestinal tract therefore allowing a large dose of antibiotic to reach its intra-luminal target without systemically high concentrations. Moreover, there are low levels of rifaximin resistance in SIBO

Co-amoxiclav or metronidazole are also effective

79
Q

antidepressant of choice in child/adolescant

A

fluoxetine

80
Q

antidepressants first line after MI(safest)

A

sertraline

81
Q

co-prescribed with SSRI if pt taking nsaid

A

PPI

82
Q

antidepressant recommended if pt on warfarin or aspirin?

A

mirtazipine

83
Q

antibiotic for mycoplasma pneumonia

A

clarithromycin/erythromycin child and adult

doxycyclin older child and adult

84
Q

inhibitors of the p450 system (increase INR)?

A 
ciprofloxacin
erythromycin
isoniazid
cimetidine
omeprazole
amiodarone
allupurinol
fluconazole
SSRI
ritonavir
sodium valproate
acute alcohol intake
quinupristin
85
Q

inducers of the p450 system (drops INR; reduce effectiveness of COCP)?

A 
phenytoin
carbamazepine
phenobarbitone
rifampicin
st johns wort
chronic alcohol intake
griseofulvin
smoking
86
Q

moa of aspirin

A

non reversible COX 1 and 2 inhibitor

COX is responsible for prostoglandin, prostocyclin and thromboxane synthesis. blocking of thromboxane A2 formation in platlets reduces the ability of platelets to aggregate which has lead to the widespread use of low-dose aspirin in CVD.

clopidogrel is now 1st line following ischamic stroke or PAD.

87
Q

why dont prescribe doxycyclin to <12?

A

teeth discolouration

88
Q

SE of doxycyclin in adults?

A

sensitivity to light

89
Q

given in QRS prolongation associated with TCA OD

A

sodium bicarbonate - helps to reverse metabolic acidosis

90
Q

medication to avoid with ssri

A

triptans. risk of seratoinin syndrome

91
Q

dabigatran reversal agent

A

Idarucizumab

92
Q

antibiotics for PROM

A

erythromycin for 10 days

93
Q

thiazide diuretics and gout

A

contraindicated

94
Q

therapeutic cooling in neonates

A

Therapeutic cooling at 33-35 degrees attempts to reduce the chances of severe brain damage in neonates with hypoxic injury

95
Q

black carribean on CCB and needs next line?

A

add ARB>ACEi

96
Q

drug to avoid in HoCM

A

acei

97
Q

used to encourage closure of a patent ductus arteriosus

A

Indomethacin or ibuprofen

(PDA with no cyanosis - indomethacin
PDA with cyanosis - Prostaglandins/alprostadil)

98
Q

diclofenac is contraindicated in the following conditions…

A

ischaemic heart disease
peripheral arterial disease
cerebrovascular disease
congestive heart failure (New York Heart Association classification II-IV)

99
Q

treatment of Allergic bronchopulmonary aspergillosis

A

prednisolone

2nd line = itraconazole

100
Q

analgesia low back pain

A

Offer a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen or naproxen first-line, if there are no contraindications. An NSAID should be used at the lowest effective dose for the shortest possible time. Gastroprotective treatment should also be offered while an NSAID is being used.
If an NSAID is contraindicated, not tolerated, or ineffective, offer codeine with or without paracetamol, taking into account the risk of opioid dependence and adverse effects such as constipation.
Do not offer paracetamol alone for managing low back pain

101
Q

weight gain, constipation, lethargy on amioderone

A

can cause thyroid dysfunction (hypothyroid) due to high iodine contect

102
Q

cellulitis

A

fluclox

clarithromycin, erythromycin (pregnancy) or doxy

103
Q

cyclizine caution

A

heart failure

year 3 LIC (12 decks)

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