Clinical Pharmacology, Therapeutics and Toxicology Flashcards Preview

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Flashcards in Clinical Pharmacology, Therapeutics and Toxicology Deck (22)
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1
Q

what is the drug in anti-freeze

A

ethylene glycol

2
Q

features of ethylene glycol poisoning

A

stage 1: similar to alcohol, confusion, ataxia, slurred speech

2: metabolic acidosis with high anion gap and high osmolar gap. Also tachycardia and hypertension
3: acute renal failure

3
Q

Mx of ethylene glycol poisoning

A

fomepizole (alcohol dehydrogenase inhibitor)
used to use alcohol
haemodialysis in refractory cases

4
Q

role of somatostatin

A

inhibits GH, glucagon and insulin release

5
Q

indications for octreotide

A
acute variceal haemorrhage 
acromegaly
carcinoid syndrome (flushing, diarrhoea, restrictive cardiomyopathy)
post pancreatic surgery
VIPomas
refractory diarrhoea
6
Q

features of carcinoid syndrome

A

flushing
diarrhoea
restrictive cardiomyopathy

secondary to carcinoid tumours (neuroendocrine)

7
Q

Side effects of ciclosporin

A

everything increased

BP, fluid, gums, hair, K, glucose

8
Q

drugs with zero-order kinetics:

A
metabolism independent of reactant concentration
phenytoin
salicylates
heparin
ethanol
9
Q

how common is a deficiency of hepatic N-acetyltransferase?

which drugs are affected by this?

A
50% PISHD
Procainamide (1a antiarrhythmic)
Isoniazid
Sulfasalazine
Hydralazine (vascular smooth m relaxant)
Dapsone
10
Q

effect of macrolides on other medications

A

macrolides (erythromycin, clarithromycin, azithromycin)
macrolides inhibit P450 enzymes which metabolise statins, significantly increasing risk of myopathy and rhabdomyolysis therefore stop statins whilst on macrolides

11
Q

mechanism of action of bezafibrate

SE

A

PPAR-alpha agonist, increasing lipoprotein lipase expression.
SE: myositis, cholestasis, pruritis

12
Q

ECG changes of TCA overdose

A

sinus tachy
wide QRS
prolonged QT interval

13
Q

how long do you have to take steroids for before needing osteoporosis prophylaxis

A

prednisolone 7.5mg or equivalent for >3months

14
Q

how long may it take for finasteride to work?
mechanism of action
SE

A

can be up to 6 months
5-alpha reductase inhibitors (blocks testosterone -> DHT)
SE: ED, decreased libido, ejaculation problems, gynaecomastia

15
Q

Mx of Beta blocker OD

A

atropine and glucagon
glucagon is positively ionotropic and decreases renal vascular resistance
If above fails then pacing

16
Q

adverse features of cocaine use

A

Cardiac: MI, tachy or brady, HTN, QRS widening and QT prolongation, aortic dissection
Neuro: seizures, hypertonia, hyperreflexia, mydriasis
psych: agitation, psychosis, hallucinations
other: hyperthermia, metabolic acidosis, rhabdomyolysis

17
Q

Cocaine
Mechanism of action
Mx

A

D, NA, and 5HT reuptake inhibitor
Mx: Benzos
BZD + GTN (if chest pain, PCI if MI)
BDZ + sodium nitroprusside (if HTN)

18
Q

features of paracetamol OD

A

n&v

24 hrs later: RUQ pain, jaundice, encephalopathy

19
Q

causes of gingival hyperplasia

A

ciclosporin
calcium channel blockers
phenytoin
AML

20
Q

Mx of cyanide poisoning

A

IV hydroxycobalamin
Dicobalt edetate
inhaled amyl nitrite, IV sodium nitrite (oxidises Fe2 to Fe3, forming methaemoglobin which binds to cyanide)
thiosulphate also used to metabolise cyanide

21
Q

What is the mode of action of ciprofloxacin?

A

Bacterial DNA gyrase inhibitors.

22
Q

What is the mechanism of action of trimethoprim

A

bacterial folate synthesis inhibitor