Clinical pharmacology

Question 1

Give examples of macrolides

Answer 1

Erythromycin, azithromycin, clarithromycin

Question 2

What is the MOA of macrolides?

Answer 2

Reversible inhibition of 50S subunit ribosome

Question 3

Give example of tetracycline

Answer 3

Doxycycline

Question 4

MOA of tetracyclines + aminoglycosides

Answer 4

Inhibit 30S subunit of ribosome

Question 5

Aminoglycoside examples

Answer 5

Gentamycin

Question 6

How are aminoglycosides nephrotoxic?

Answer 6

Cause acute tubular necrosis

Question 7

Examples of quinolones

Answer 7

Ciprofloxacin

Question 8

SEs of quinolones

Answer 8

Lowers seizure tershold

tendon damage + rupture

Question 9

What group of patients must you avoid quinolones in and why?

Answer 9

G6PD deficiency –> haemolytic reaction

Question 10

P450 inhibitors

Answer 10

allopurinol
amiodarone
ketoconazole
sodium valproate
omeprazole
fluoxetine
ciprofloxacin
acute alcohol intake
isoniazid
erythromycin
cimetidine
ritonavir
fluconazole
sertraline

Question 11

P450 inducer

Answer 11

carbamazepine
smoking
chronic alcohol intake
phenytoin
phenobarbitone
rifampicin
St John's Wort

Question 12

Drugs safe in breastfeeding

Answer 12

antibiotics: penicillins, cephalosporins, trimethoprim
endocrine: glucocorticoids (avoid high doses), levothyroxine*
epilepsy: sodium valproate, carbamazepine
asthma: salbutamol, theophyllines

psychiatric drugs: tricyclic antidepressants, antipsychotics** (clozapine avoid)

hypertension: beta-blockers, hydralazine
anticoagulants: warfarin, heparin

digoxin

Question 13

Drugs to avoid in breast feeding

Answer 13

antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides

psychiatric drugs: lithium, benzodiazepines

aspirin
carbimazole
methotrexate
sulfonylureas
cytotoxic drugs
amiodarone

Question 14

Drugs causing pancreatitis

Answer 14

Steroids
Thiazides
Sodium valproate
Azathioprine

Question 15

Amiodarone adverse effects

Answer 15

Hypo/hyperthyroid (as contains iodine)
Liver toxicity
Lung fibrosis

Question 16

What to monitor with amiodarone therapy?

Answer 16

LFTs

TFTs

Question 17

What precipitates digoxin toxicity?

Answer 17

HYPOKALEMIA

Drugs (verapamil, amiodarone, diltiazem, drugs that cause hypokalaemia), hypothermia, hypothyroid

Question 18

MoA sildenafil

2 contraindications for sildenafil

Answer 18

Phosphodiesterase Type 5 inhibitor (cause vasodilation through an increase in cGMP leading to smooth muscle relaxation in blood vessels)

CI’s: Nitrates + nicorandil

Question 19

Drug causes of gingival hyperplasia

give some other causes

Answer 19

phenytoin
ciclosporin
calcium channel blockers (especially nifedipine)

AML

Question 20

MOA Flecainide

Answer 20

Sodium channel blocker

Class 1c

widening of the QRS complex and prolongation of the PR interval

Question 21

What is phase I of drug metabolism?

Answer 21

Oxidation, reduction, hydrolysis

Question 22

What is phase 2 of drug metabolism?

Answer 22

Conjugation

Question 23

Examples of drugs that exhibit zero order kinetics?

Answer 23

Aspirin

Salicylates

Question 24

Dobutamine MoA

Answer 24

Beta 1 agonist

Question 25

What is a common side effect of verapamil?

Answer 25

Constipation

Question 26

What cancers does COCP increase and decrease risk of?

Answer 26

Increase: cervical + breast Decrease: endometrial + breast

Question 27

Examples of quinolones+MOA

Answer 27

Ciprofloxacin + levofloxacin Inhibit DNA synthesis

Question 28

What antiepileptic can cause agranulocytosis?

Answer 28

Carbemazapine

Question 29

What drugs can cause serotonin syndrome?

Answer 29

SSRIs and TRAMADOL!!!!1

Question 30

EXAM Q: How does digoxin work?

Answer 30

Inhibition of Na-K-ATPase pump Causes intracellular sodium accumulation

Question 31

Exam Q: tirofiban mechaniam of action

Answer 31

Glycoprotein IIb/IIIa receptor antagonists EAT: Eptifibatide, Tirofiban and Abciximab

Question 32

Drug

Answer 32

OMEPRAZOLE hepB vaccine isotretinoin