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PHRM3011 > Drugs > Flashcards

Drugs Flashcards

1
Q

MOA of varenicline?

A

It is a partial nicotinic acetylcholine agonist. It reduces the withdrawal effects and reduces rhe peasure associated with smoking

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2
Q

Brand name of verenicline?

A

Champix

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3
Q

Name 2 precription drug opens for smoking cessation

A

Varenicline and buproprion

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4
Q

Explain how buproprion assists in smoking cessation. How effective is it?

A

Works by inhibiting the neuronal uptake of noradrenaline and dopamine (dopamine = reward and pleasure)
About as effective as NRT

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5
Q

Name the thrombolytic drug used in stroke?

A

Alteplase

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6
Q

Dosage regime for alteplase for STEMI?

A

10mg bolus, then 50mg over first hour and 40mg for next 2 hours. (<1.5mg/kg if less than 65kg)

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7
Q

Aspirin dosage for ischaemic strokes?

A

300mg given within 48 hours. Not within 24 hours of alteplase

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8
Q

Orlistat dose?

A

120mg three times a day (taken with main meals). Can be taken up to one hour after meal. Do not take dose if you skip meal or meal has no fats.

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9
Q

Hydrochlorothiazide dose?

A

12.5 - 25 mg each day in the morning

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10
Q

MOA of hydrochlorothiazide in HT?

A

Peripheral dilation (not used for diuretic effects at these low doses)

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11
Q

Enalapril MOA?

A

Inhibit conversion of angiotensin 1 into angiotensin 2 by inhibiting ACE. Prevents Ang2 from causing vasoconstriction, aldosterone release, etc

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12
Q

2 important side effects of ACE inhibitors (-pril)?

A

Cough and angioedema

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13
Q

Which functions should be tested prior to starting an ACE-I and 1-2 weeks after?

A

Renal function and electrolyte levels

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14
Q

Important counselling points for ACE-Is?

A

Might feel dizzy + orthostatic hypotension. And need to stop potassium Supps

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15
Q

Which ACE inhibitor is dosed twice daily instead of once?

A

Captopril. Start at 12.5mg bd, up to 50mg bd

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16
Q

Perindopril starting vs maintenance dose?

A

5mg once daily, up to 10mg once daily.

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17
Q

Ramipril vs perindopril dosing?

A

Ramipril starts at 2.5mg once daily, up to 5mg with max of 10mg
Perindopril starts at 5mg but also has max of 10mg.

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18
Q

Aspirin dose post MI?

A

300mg stat

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19
Q

Ticagrelor dosage post MI?

A

Loading dose = 180mg, then 90mg BD for at least 12 months in combo with low dose aspirin

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20
Q

Clopidogrel dose post MI? (Loading + maintenance)

A 
Loading = 300mg 
Maintenance = 75mg once daily with low dose aspirin
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21
Q

Dabigatran dose in AF stroke prevention?

A

150mg bd. Reduce to 110 bd if CrCl is low.

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22
Q

What dose of dabigatran is used if CrCl is below 30?

A

None. It needs to be avoided

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23
Q

Rivaroxaban dose in AF stroke prevention?

A

20mg once daily.

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24
Q

Dose adjustment consideration for Rivaroxaban?

A

If CrCl is 15-50, use 15mg daily instead of 20.

If below 15, do not use.

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25
Q

Apixaban dosage for AF stroke prevention?

A

5mg twice daily.

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26
Q

When would the dose of apixaban need to be reduced?

A

If patient weight is less than 60kg, if over 80 years old or if serum creatinine is high.
Reduce dose to 2.5mg BD if patient has 2 of these

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27
Q

Starting dose for warfarin?

A

5mg once daily for 2 days, then adjust based on INR

28
Q

Target INR for warfarin?

A

2-3

29
Q

Which patients would need more frequent INR monitoring? Normal monitoring = every 4 weeks

A

If at high risk of bleeding, if taking other drugs, if high alcohol consumption

30
Q

MOA of digoxin?

A

Slows conduction at the AV node by increasing PSNS and decreasing SNS. Also increases calcium levels which increases force of contraction

31
Q

Use of digoxin in renal impairment?

A

Will need dose reduction (depends on creatinine clearance)

32
Q

Loading dose of digoxin? And why would it be needed

A

250-500 mcg every 4-6 according to response.

Used for rapid control of ventricular rate in AF

33
Q

Maintenance dose of digoxin?

A

125-250 mcg once daily.

Needs to be reduced for elderly

34
Q

Is monitoring required for digoxin?

A

Yes, concentration monitoring to ensure pt is in steady state - because it has a low therapeutic index

35
Q

Why should electrolyte disturbances be corrected before starting anti-arrhythmic treatment?

A

Because these disturbances increase the risk of arrhythmias

36
Q

Should amiodarone be used with caution in patients with renal or hepatic impairment?

A

Hepatic.

Reduced hepatic function = less metabolism, accumulation of drug and hepatotoxicity

37
Q

Major precautions for beta blocker use?

A

Renal impairment, asthma, diabetes, pregnancy + breastfeeding

38
Q

Atenolol dose?

A

25-50mg once daily. Reduce in renal impairment

39
Q

Beta blocker ADRs?

A

sludge BBB

40
Q

Bisoprolol dose titration?

A

Initial = 1.25mg daily for 1 week

Slowly increase until at 10mg daily for maintenance.

41
Q

Carvediol dosage? Initial + maintence

A 
Initial = 12.5mg daily for 2 days 
Maintenance = 25mg once daily
42
Q

Metoprolol dosing?

A

50-100mg daily. In one or two doses.

43
Q

Site of action of beta blockers in AF?

A

Slows conduction at AV node

44
Q

Heparin dose for VTE prevention?

A

5000 units injected SC, 2 or 3 times daily for 7-10 days after the surgery

45
Q

Heparin ADRs?

A

HITS

Bleeding, bruising at injection site, allergic reaction

46
Q

Enoxaparin dose for VTE prevention in surgical patients

A

20mg SC injection once a day for 7-10 days

47
Q

Enoxaparin ADRs?

A

Bleeding, bruising at injection site, hyperkalaemia

HITS

48
Q

Enoxaparin in renal impairment?

A

Will require dose reduction

49
Q

ADRs of ticagrelor?

A

Bleeding, skin reactions (itchy rash)

Raised uric acid levels (gout aggregation)

50
Q

Clopidogrel ADRs?

A

GI ulcer, bleeding, itchy rash, angioedema

51
Q

Diltiazem drug class?

A

Non-dihydropyridine calcium channel blocker.

52
Q

Monitoring required for diltiazem?

A

None

53
Q

Diltiazem ADR?

A

Bradycardia, AV block, worsened arrhythmia, nausea, headache, hypotension

54
Q

Verapamil class?

A

Non-dihydropyridine CCB

55
Q

Amlodipine class?

A

Dihydropyridine CCB

56
Q

Which CCB class is more selective for the heart?

A

Non-dihydropyridine

57
Q

Side effects of non-dihydropyridine CCBs?

A

Reduced cardiac contractility and conduction

58
Q

Side effects of dihydropyridine CCBs?

A

Due to peripheral vasodilation=

Headaches, oedema, flushing, dizziness, nausea

59
Q

Atorvastatin dose?

A

10-80mg once daily

60
Q

Atorvastatin ADRs?

A

Sleep disturbances, myalgia, rhabdomyolysis, renal failure

61
Q

Monitoring required for statins?

A

Monitor aminotransferase (ALT -liver function) and CK levels (testing for muscle degradation)

62
Q

Simvastatin dose?

A

10-40 mg once daily

63
Q

Class of drugs with rhabdomyolysis as a potential ADR?

A

Statins.

Rhabdomyolysis = muscle breakdown

64
Q

Rosuvastatin dose?

A

Most potent.

5-20 mg once daily. 40mg max with specialist supervision

65
Q

Comment on renal impairment and statin use

A

Renal impairment increases the risk of myopathy and rhabdomyolysis. Start at low dose and monitor renal function and CK levels regularly

66
Q

Irbesartan dose?

A

150mg once daily (up to 300 if necessary)

PHRM3011 (17 decks)

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