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yr 4 - passmed corrections > Drugs > Flashcards

Drugs Flashcards

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1
Q

Does LMWH require monitoring?

A

No

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2
Q

Does UH require monitoring?

A

Yes - APPT

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3
Q

Impact of quinolones on seizure threshold?

A

Lowers seizure threshold

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4
Q

Which CCB is the most highly negatively inotropic?

A

Verapamil

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5
Q

Mx of ethylene glycol toxicity (i.e. anti-freeze)?

A

Fomepizole

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6
Q

Mx of heparin-induced thrombocytopenia?

A

Anticoagulation can be provided by direct thrombin inhibitor e.g. argatroban

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7
Q

Mechanism of allopurinol?

A

Xanthine oxidase inhibitor

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8
Q

Why should allopurinol and azathioprine never be prescribed together?

A

Azathioprine is a prodrug, meaning it is metabolised to its active form, 6-mercaptopurine, which causes immunosuppression (prevents kidney rejection in this patient). The active 6-mercaptopurine is subsequently metabolised by xanthine oxidase to inactive uric acid which is excreted.

As allopurinol inhibits xanthine oxidase, the combination of the two drugs can lead to excessive myelosuppression and therefore increase the risk of neutropenic sepsis.

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9
Q

Name some drugs that can cause lung fibrosis

A
  • amiodarone
  • bleomycin
  • nitrofurantoin
  • ergot-derived bromine agonists e.g. bromocriptine, cabergoline
  • methotrexate
  • sulfalazine
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10
Q

Mx of organophosphate poisoning (e.g. insecticides)?

A

Atropine

Organophosphate poisoning causes inhibition of acetylcholinesterase –> bradycardia.

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11
Q

Mechanism of UH?

A

Activates antithrombin III

This then inhibits Xa, Ixa, Xia and XIIa

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12
Q

Mechanism of flecainide?

A

Sodium channel blocker

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13
Q

What is the most appropriate interval to leave before increasing the dose of metformin?

A

1 week

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14
Q

Mx of adrenaline induced ischaemia?

A

Phentolamine

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15
Q

What is the most appropriate way to assess the patient’s response to dalteparin (LMWH)?

A

Monitor anti-factor Xa levels.

This is because LMWH exerts its anticoagulant effect mainly by inhibiting Factor Xa.

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16
Q

What may be one of the earliest symptoms of aspirin overdose?

A

Tinnitus

17
Q

Can cocaine increase the risk of serotonin syndrome?

A

No

18
Q

When is IV magnesium sulphate indicated?

A

Mg <0.4 mmol/L

or tetany, arrhythmias or seizures

19
Q

How can nifedipine cause tachycardia?

A

Nifedipine causes peripheral vasodilation which may result in reflex tachycardia

20
Q

Effect of P450 enzyme inducers and inhibitors in paracetamol overdose?

A

The trick here is that the metabolite of paracetamol (NAPQI) is toxic, rather than paracetamol itself.

Therefore, if a drug inhibits P450 enzymes, it is PROTECTIVE in the case of paracetamol, as it prevents the enzymes from metabolising even more toxic NAPQI.

21
Q

How can digoxin affect appetite?

A

Can cause anorexia

22
Q

How does digoxin affect K+ levels?

A

Digoxin can cause HYPERkalaemia.

HYPOkalaemia can predispose to digoxin toxicity.

23
Q

Mx of digoxin OD?

A

Digibind (specific antibodies)

24
Q

What class of drug (as well as anticholinergics) can cause urinary retention?

A

Opioids e.g. codeine, tramadol, morphine

25
Q

Which TB drug can cause gout?

A

Pyrazinamide

26
Q

Mechanism of dobutamine (e.g. in cardiogenic shock)?

A

Beta-1 agonist

27
Q

Mechanism of depolarising muscle relaxants?

A

Nicotinic agonists

28
Q

How long after taking phenytoin should you measure levels?

A

Immediately before next dose

29
Q

What does the black triangle sign mean in the BNF?

A

Newly licensed drugs

30
Q

What does PoM mean in the bnf?

A

Prescription only medicine

31
Q

1st line for motion sickness?

A

1) Hyoscine
2) Cyclizine
3) Promethazine

32
Q

How does St Johns Wort affect P450 system?

A

Inducer

33
Q

Effect of amiodarone on P450?

A

Inhibitor

34
Q
A

yr 4 - passmed corrections (36 decks)

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