CPT Flashcards

1
Q

What effect will the i.v. rate of infusion have on plasma steady state?

A

It doesn’t effect it
(it will always take 4-5 half lives to reach state)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How do you work out the apparent volume of distribution?

A

Vd = dose/[drug in plasma]
Vd/ patient’s weight = apparent Vd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which reactions take place in phase I and phase II drug metabolism?

A

Phase I - Oxidation/Reduction
Phase II - Glucuronidation & Sulfation (conjugation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a reaction of both B Blockers and thiazide like diuretics?

A

Hypergylycaemia
Hyperlipidaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which anti-hypertensive can be used to treat gestational hypertension?

A

Labetalol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A deficiency in CYP2D6 will have what effect on codeine?

A

Decreased therapeutic effect, an increased dose may be needed
(codeine is a pro drug - it’s metabolised to morphine by CYP2D6)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Does HRT increase the risk of VTE?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which ion governs depolarisation (phase 0) in the SA node?

A

Calcium influx
(Na is ventricular AP not myocytes AP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some of the ways amiodarone work?

A

K channel blocker (primary)

Ca channel blocker
B blocker (non-competitive)
Na channel blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What effect does flecainide have?

A

Increases the P-R interval
Increases the AP duration
Slows the tissue conduction during phase 0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does digoxin work as an anti-arrhythmic?

A

via parasympathetic vagal tone
(blocks NA/K ATPase when used in HF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Loperamide’s mechanism of action?

A

Decreases peristalsis but increases segmental contractions
Increases transit time to allow more fluid to be removed from the faeces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Lactulose MOA?

A

Draws fluid into the bowel (osmotic laxative)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Macrogols MOA?

A

Limit loss of fluid into the bowel (osmotic laxative)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hyoscine hydrobromide MOA for motion sickness?

A

Blocks muscarinic ACh receptors
Blocks ACh at Central Trigger Zone via CN VIII
ADR is sedation which contributes to use of motion sickness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Cisplatin MOA?

A

Neurokinin 1 receptor antagonist
Prevents the action of substance P
Increases the effect of 5HT3 receptor antagonists
[CHEMO DRUG]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What effect do PPI have on warfarin and phenytoin?

A

PPIs inhibit CYP2C decreasing the metabolism of warfarin and phenytoin

18
Q

PPI MOA?

A

Irreversibly inhibit the H/K ATPase pump
Inhibit 90% of acid secretion
Could mask gastro-oesophageal cancer

19
Q

Which antihypertensive will exacerbate hyperkalaemia in patients taking heparin?

A

Spironolactone & Ramipril
(both inhibit aldosterone)

20
Q

Factors needed for a chemo regimen?

A

BMI
Liver function
Renal function
Performance status

21
Q

Warfarin MOA?

A

Competitively inhibits the oxidation of vit K by VKOR
(Limits the activation of factors II,VII,IX & X)

22
Q

A high Minimum Alveolar Concentration (MAC) indicates what?

A

Volatile anaesthetic is less potent
(MAC is 50% who fail to respond to surgical stimulus)

23
Q

Anaesthetic MOA?

A

Inhibition of NDMA glutamate receptors
Potentiate GABAa receptors

24
Q

Why would use a vasoconstricting agent with a local anaesthetic?

A

Decrease peak plasma conc of local anaesthetic
Decrease the minimum effective dose
Increase duration of anaesthesia

25
Which ADP receptor antagonist binds reversibly to the P2Y12 receptor?
Ticagrelor (binds to a different site than Clopidogrel/Prasugrel)
26
Aspirin MOA?
Irreversibly inhibits COX-1 and decreases TXA2 (limits platelet aggregation)
27
GLP-1 agonist (exenatide) MOA?
Increase insulin secretion Decrease glucagon secretion Decrease gastric emptying (promote weight loss)
28
Caution when prescribing glicazide for diabetes?
Can cause weight gain
29
Disease modifying antirheumatic drugs should...
Be considered in combination in severe rheumatoid disease
30
What should you be cautious of when prescribing a TNF inhibitor (e.g. adalimumab)?
Reactivation of TB (TNF is essential in granuloma formation)
31
Which prostanoids contribute to platelet aggregation?
PGI2 Inhibits platelet aggregation (I-I) TXA2 Assists platelet aggregation (A-A)
32
What happens if inhaled particles are too small or too large?
Too big - deposit in the mouth/oropharynx Too small - inhaled into alveoli and exhaled
33
What effect would grapefruit juice have on simvastatin?
Increase plasma conc of simvastatin CYP3A4 is inhibited by grapefruit juice CYP3A4 metabolises statins
34
Will liphophillic drugs cross the cell membrane and why?
Lipophillic drugs dissolve in the lipid membrane and penetrate the cell surface to cross membrane
35
What drug is given if a patient is unable to cope with a statin?
Ezetimibe (NPC1l1 inhibitor)
36
Flecainide MOA?
Increases action potential duration Slows tissue conduction during phase 0 Increases PR interval
37
Why are insulins made as soluble preperations?
To delay absorption from injection site
38
Loperamide MoA?
Decreases peristalsis but increases segmental contractions (more fluid can be removed)
39
Which anti-emetic is particularly useful in chemo induced N+V?
Neurokinin 1 receptor antagonist (aprepitant)
40
How do selegiline/rasagaline help in the management of parkinson's?
Inhibit MAO B metabolism of dopamine (prolongs action of L-dopa)
41
What are the 4 types of generalised seizure?
Tonic-clonic Myoclonic Absense Atonic