Drugs Flashcards
(184 cards)
1
Q
Why would Pyroxidine be prescribed?
A
Prevent side effect of Isoniadzid (peripheral neuropathy)- TB mediation
2
Q
What are the side effects of Phenytoin?
A
Gingival hyperplasia, peripheral neuropathy, lymphadenopathy
3
Q
How does Memantine work?
A
NMDA antagonist - second line treatment for alzheimers
4
Q
What enzyme needs to be tested prior to started Aziothiarpine? and what is Azathioprine used for?
A
TPMT levels prior to staring treatment. Azathioprine is used to induce remission in Crohns
5
Q
Side effects of calcium channel blockers? eg Amlodipine
A
Ankle swelling
6
Q
What is the reversal agent for Dabigitran (DOAC)?
A
idarucizumab
7
Q
What is the reversal agent for Heparin?
A
protamine sulfate
8
Q
What are some examples of anti musclarinics used in urge incontinence?
A
First line: Oxybutanin. Second line: tolterodine
9
Q
What monitoring is required with use of Amiodarone?
A
LFTS/ TFTS/ U+Es 6 monthly. ECG every 12 months
10
Q
What type of antibiotic is Clarithryomycin and what is a side effect?
A
Macrolide. Side effect is VT (torsades de points)
11
Q
What morphine drugs can be used in patients with CKD 4 (palliative care)?
A
Alfentanil, oxycodone, buprenorphine, fentanyl
12
Q
How does Gliclazide work?
A
ATP dependent K channels on pancreatic beta cells
13
Q
What is a side effect of nicorandil?
A
Ulceration including anal ulceration
14
Q
What monitoring is required for Hydroxychloroquine?
A
Ophthalmology referral prior to commencing treatment. Need annual visual check
15
Q
What is a side effect of Co-amoxiclav?
A
Can cause cholestasis- elevated bilirubin/ itching
16
Q
What are the side effects of Cisplatin?
A
Hypomagnesium, ototoxicity and peripheral neuropathy
17
Q
What are the side effects of Methotrexate?
A
Bone marrow suppression, liver fibrosis, lung fibrosis.
18
Q
What are the side effects of Doxorubcin?
A
Cardiomyopathy
19
Q
What would a side effect of long term oral trimethoprim for acne be?
A
Depress haemopoetisis
20
Q
What type of drug is Losartan ?
A
ARB
21
Q
What drugs can cause hypercalcaemia?
A
Thiazide drugs eg Bendroflumethazide or calcium containing antiacids
22
Q
What type of drug is Carvedilol?
A
B blocker. Used post MI
23
Q
What type of drug is Gliclazide and what are some of the side effects?
A
Sulphonylurea.
SI include weight gain and hypoglycaemia
24
Q
What type of drug is Bumetanide? and what is the side effect?
A
Loop Diuretic
Ototoxicity
25
What are SGLT1 inhibitors associated with/ side effects?
Necrotising fascititis of the perineum
Normoglycaemic ketoacidosis
UTIs
26
What monitoring does Amiodarone need?
TFT, LFT, U&E, CXR prior to treatment
TFT, LFT every 6 months
27
What monitoring does Sodium Valporate need?
LFT, FBC before treatment
LFT 'periodically' during first 6 months
28
What monitoring does Glitazones need?
LFT before treatment
LFT 'regularly' during treatment
29
What is the antibiotic for cellulitis if allergic to penicillin?
Clarithromycin
30
What medications can cause gingival hyperplasia?
phenytoin, ciclosporin, calcium channel blockers
31
What condition can gingival hyperplasia be seen in?
AML
32
Clozapine is an example of which type of drugs?
Atypical antipsychotic
33
What is the management for acute prostatitis?
Ciprofloxacin
34
What are the monitoring requirements for statins?
LFTs at baseline, 3 months and 12 months
35
How does varenicline work?
Parial nicotinic agonist
36
What is an example of an SGLT2 drugs for diabetes?
Dapagliflozin
37
What are side effects of calcium channel blockers?
Headaches/ flushing/ ankle oedema
38
What are some examples of calcium channel blockers?
Amlodipine
39
What is a side effect of Doxorubacin?
Cardiomyopathy / Cardiotoxicity
40
Erythromycin is contraindicated in which 3 drugs?
amiodarone, warfarin and simvastatin
41
Side effect of long term PPI (Omeprazole)
Osteoporosis and fractures increase fracture risk, hyponatraemia
42
What drug can cause duptenyrns contracture?
Phenytoin
43
What is an example of aminoglycoside?
Gentamicin, neomycin
44
Which diabetic medication is contraindication in heart failure?
Pioglitazone- can cause fluid retention and therefore bad in HF
45
What antibiotic for a dental abcess?
Amoxicillin
46
What are the side effects of Finasteride?
Gynaecomastia/ decreased libido/ ejaculation disorders
47
What is the dose of rectal diazepam for seizures (in community)
10mg rectal diazepam
48
Side effect of Pioglitazone?
Fluid retention
49
Which drugs can precipitate lithium toxicity?
NSAIDs, Diuretics, ACE/ARB
50
Side effects of Amiodarone?
Pulmonary fibrosis, corneal deposits, photosensitivity reactions, derangement in liver function tests and TFS
51
Treatment of Campylobacter enteritis
Clarithryomycin
52
What is an example of a selective serotonin reuptake inhibitors?
SSRI = citalopram/ fluoxetine
53
What drugs are contraindicated with an SSRI?
Warfarin, Aspirin, NSAIDs, Triptans, MAO inhibitors.
54
What drug can cause a blue tinge to vision?
Sildenafil
55
What drug interacts with levothyroxine?
IRON!
56
What drugs can cause urinary retention?
Amitriptylline, anticholingerics (oxybutanin), NSAIDs, opioids
57
Donepezil
-What type of drug
- Indication
- Side effect/ CI?
acetylcholinesterase inhibitor
Indicated for Alzheimers
Side effect: Insomnia/ Bradycardia
58
Agranulocytosis is a side effect of which drug?
Carbamazepine
59
Side effect of Varenicline?
Nictonic receptor parital agonist
Side effect) nausea/ insomnia
60
What blood test needs to be done prior to starting TB treatment?
LFTs
61
Side effect of Benzodizepine drugs?
Anterograde amnesia
62
What type of drug is indapamide?
Thiazide like diuretic
63
What is the most common drug caused of Gynaecomastia?
Spironlactone
64
What is an example of a drug that can cause drug induced thrombocytopenia?
Quinine (others include NSAIDs, diuretics)
65
When should Metformin be held?
Recent MI, AKI, Sepsis (risk of lactic acidosis)
66
Campylobacter diarrhoea is treated with?
Clarithromycin
67
Clarithromycin interacts with which common drug?
Statins! increased risk of rhabdo
68
What drugs can precipitate digoxin toxicity?
Anything that causes hypokaemia eg loop diuretics, quinine, amiodarone, vermapril, diltazam, ciclosporin
69
What is Digoxin used for?
Rate control in AF
70
Important side effect of hydroxychloroquine?
**EYE TOXICITY**
71
Aspirin overdose is treated with?
Urinary alkalisation
Haemodialysis if severe.
72
Beta blocker overdose treated with?
Atropine first line
If doesn't respond then Glucagon
73
Side effect of ethabutamol
Optic neuritis- need to check visual acuity.
74
What type of drug is empagliflozin ?
Flozins are SGLT2 inhibitors
75
What is a side effect of empagliflozin ?
Increased frequency of UTIs due to renal excretion of glucose.
76
What drugs cause erythema nodosum?
penicillins, sulfonamides (such as sulfasalazine), and the combined oral contraceptive pill.
77
What drugs raise prolactin?
metoclopramide, domperidone, prochlorperazine
78
How does paroxetine work?
SSRI
79
What drugs can cause gynaecomastia?
Sprinolactone, goserelin, digoxin, finasteride.
80
Side effect of NSAIDS?
Cardiovascular events
81
What type of drug is Amitrptylline and what is the side effect?
Tricyclic Antidepressant
Side effect- Antimusclarinic effects eg dry mouth and blurred vision
82
Side effect of Cetrizine?
Anticholingeric effects if combined with other antimusclarinics
83
Side effects of Montelukast ?
Common- diarrhoea/ GI/ fever
Can also cause neuropsychiatric problems and sleep disorders.
84
What type of drug is Xylometazoline ?
Nasal decongestant. avoid in things like angle closure glaucoma
85
What antidepressant has a long half life and therefore increased risk of serotonin syndrome?
Fluoxetine ( long half life- can cause interactions for up to 5 weeks after stopping)
86
What type of drugs is Moclobemide?
MAO inhibitor for depression
87
What are some examples of Macrolide antibiotics? and what drug would need to be held when prescribing them?
'Mycins' Erthyromycin, clarithryomycin.
Hold statins!
88
LABA (long acting B agonist) for asthma must be prescribed alongside what?
LABA+ steroid inhaler. If LABA used without steroid can increase risk of exacerbations
89
How do propanolol and bisoprolol act on b receptors?
Bisoprolol is cardioselective (less problematic in astmatics) and propanolol works on all the beta receptors.
90
Which drugs interact with amiodarone?
Statin- simvastatin.
91
Amiodarone- side effects?
Slate grey appearance/ HYPO or HYPER thyroid!
Hypotension
Ocular involvement
"Amiodarone is a bitch"
Blue man
Intersitital lung disease
Thyroid (hypo/hyper)
Corneal
Hypotension
92
Side effects of Methylphenidate? (and use of this drug)
ADHD drug
Side effects- decreased appetite, dropping height centiles.
93
What drug increases risk of tendon injuries?
Ciprofloxacin!
94
Side effect of Clarithryomycin?
CVS events.
95
Side effect of Doxycycline?
Ototoxic/ Oesphagitis
96
Side effect of Pen V
Decreased platelet count - easy bruising
97
What is eflornithine used for?
To prevent excess hair growth on the face of women with PCOS
98
What is second line in BB overdose?
Glucagon (second line after atropine)
99
What are some examples of SSRI?
Fluoxetine/ Sertraline/ Citalopram
100
What SSRI for under 18's?
Fluxoxetine
101
Side effect of Nitrofurotin?
Jaundice
102
What drugs cause the side effect of gynaecomastia? (5)
1. Spirinolactone
2. Cimetidine
3. Zoladex
4. Finasteride
5. Calcium channel blockers
103
What drugs can cause tardive dyskinesia? (2)
1. Antipsychotics
2. Metoclopramide
104
What drug can cause rhabdomyolysis?
Statins
105
What drugs can cause erectile dysfunction?
Antihypertensives, Antidepressants, nicotine
106
What drugs can cause Jaundice?
Nitrofurotonin, Erythromycin, Isonidazid, Methydopa, Indomethocin and Salicytes
107
What are the side effects of Leflunomide?
Hypertension/ GI upset/ Hepatitis
108
What are the side effects of Sulphalazine?
Low sperm count/ mouth ulcers/ depression hepatitis
109
Side effect of Ethambutol
OPTIC NEURITIS!
110
What are the side effects of these cytotoxic agents -(toxicity bear)
Doxorubicin
Bleomycin
Cisplatin
Methotrexate
Vincristine/ Vinblatine
Cyclophosphamide
Doxorubicin- cardiotoxicity
Bleomycin- Lungs
Cisplatin- Ears and kidneys
Methotrexate- liver
Vincristine - Peripheral neuropathy
Cyclophosmaide- haemorraghic cystitis
111
Side effect of Acarbose (diabetic med)
Farting!
112
Side effect of Propanolol?
Cold fingers/ toes, tiredness, sleep disturbance
113
Side effects of Thiazide diuretics eg bendoflumethazide?
Impaired glucose tolerance
Hypokaemia
Hyponatraemia
Gout
Dehydration
Postural hypotension
114
What are some of the side effects of long term Nitrofuratoin?
Pulmonary fibrosis/ and its renally excreted so not for patients with eGFR less 45
115
What can omeprazole do to electrolytes?
Hypomagnesium/ Hyponatraemia
116
How is Dabigitran/ Rivaroxaban/ Apixiban excreted?
Dabigitran- Renal
Rivaroxban- Liver
Apixiban- fecal
117
What 2 SSRIs are most likely to cause discontinuation syndrome?
Paroxetine and Venlafaxine
118
What are the side effects of SSRI?
Increased thoughts of suicide
Hyponatraemia
GI bleeding
GI upset
Citalopram- INCREASED QT interval
119
What drugs cannot be co-prescribed with SSRIs? (5)
NSAIDS
Warfarin/ Heparin
Aspirin
Triptans
120
Clozapine toxicity presents how?
Hypersalivation/ drowsiness/ seizures and confusion (Remember clozapine= agranulocytosis)
121
What is a side effect of Carbamazepine?
Leucopaenia, thrombocytopenia and agranulocytosis
122
Common side effects of melatonin?
Odd dreams, arthralgia, increased risk of infection, pain
123
What is a normal QT interval?
430 in males
450 in females
124
Side effect of Mefloquine (malaria prophylaxis) and what patients is it contraindicated in?
Neuropsychiatric disorders.
Contraindicated in epilepsy/ GAD/ psychiatric disorders
125
What drugs can cause pancreatitis?
Thiazides/ Tetracyclines and Aziothioprine
azathioprine, mesalazine, didanosine, bendroflumethiazide, furosemide, pentamidine, steroids, sodium valproate
126
Mechanism of action Bromocriptine?
Dopamine Agonist
127
Mechanism of action of Proclorperazine ?
Dopamine R Antagonist
Side effect- muscle spasms, movement disorders.
128
How do Cabergoline (Dostinex) and Bromocriptine work?
Side effects?
Dopamine Receptor Agonist.
Side effect- rare= pulmonary fibrosis
Postural hypotension/ Hallunicaitons
129
What needs to be done prior to treatment with Cabergoline or Bromocriptine?
1. ESR,
2.creatinine
3.chest x-ray should be obtained prior to treatment
130
How does Procyclidine work? and what are its uses?
Anticholinergic
Used for Parkinsonism/ extrapyramidal side effects
131
What are each of these drugs?
- Clozapine
- Chlorpromazine hydrochloride
- Carbamazepine
Clozapine- Atypical Antipsychotic. (Aganulocytosis)
Chlorpromazine hydrochloride - Schizophrenia, N+V in pal care.
Carbamazepine- Antieplieptic
132
What condition do ACE inhibitors need to be prescribed carefully?
Renal artery stenosis. Avoid ACE inhibitors if bilateral renal artery stenosis.
133
Octreotide- what is it used for and what is a side effect?
Used for carcinoid tumours
Side effect- gall stones!
134
What SSRIs to avoid with Tamoxifen?
Avoid fluoxetine and paroxetine
135
Side effect of Thiazide like diuretics?
Hyponatraemia
Hypokaemia
136
Side effects of these Rheumatoid Arthritis drugs:
Sulphasalazine
Leflunomide
Hydroxychloroquine
Gold
'MABs'
Gold
Penicillamine
NSAIDs
Sulphasalazine- oligospermia, rashes.
Leflunomide - HTN, liver disease, fibrosis
Hydroxychloroquine- eye checks!
Gold- proteinuria
'MABs'- Reactivation of TB
Penicillamine- proteinuria/ exacerbation of myasthenia graves
NSAIDs - bronchospasm/ peptic ulceration
137
When does the BNF suggest gradual reduction in steroids?
- If 40mg Prednisone for more than a week
- More than 3 weeks of treatment
- Repeated courses of steroids
138
What are the drug causes of galactorrhea? (Raised prolactin =3)
Metoclopramide
Phenothiazines eg: Levomepromazine
Haloperidol
139
What is a side effect of Atenolol? (beta blockers in general)
Raynauds
Hypoglycaemia in diabetics
Exacerbate psoriasis
140
Withdrawing a patient from Benzodiazepines- what is the schedule?
Switch to an equivalent dose of DIAZEPAM
Reduce in steps about 2-3mg each 2-3 weeks
141
What are the side effects of Flozins sglt2 inhibitors?
Euglycaemic ketosis
Increased risk of foot amputation
Urine infections due to glycosuria
142
Side effect of Pioglitazone (Thiazolidinediones)
1. Fluid retention (CI in heart failure)
2. Weight gain
3. Liver impairment
4. BLADDER CA.
143
What are the 2 drugs used for opioid dependence?
How do you switch from one to another?
Buprenorphine and Methadone
Stop methadone and restart Buprenorphine when withdrawal symptoms start.
144
Doxycycline (tetracycline) contraindicated in which patient groups? (3)
pregnancy - tooth abnormalities
Myasthenia Gravis - increase muscle weakness
Lupus - exacerbate
145
What drugs can cause dyspepsia?
NSAIDS
Steroids
SSRIs
Digoxin
Viagra
146
What antiemetic for gastric stasis/ functional bowel obstruction?
Metoclopramide
147
What antiemetic for metabolic causes of N+V?
Haloperidol eg hypercalcaemia or renal failure
148
Cyclizine is used for which types of N+V?
Motion sickness
Raised ICP
Mechanical bowel obstruction
149
What eGFR would you avoid Apixiban?
eGFR 15 or below avoid apixiban
150
What to remember about Amlodipine and simvastatin?
Max dose of Simvastatin is 20mg when coprescribed with Amlodipine
151
3 drug of gingival hyperplasia
Phenytoin
CCB (Amlodipine/ Nifedipine)
Ciclosporin
152
Side effects of Digoxin?
YELLOW VISION (Xanthopsia)
Arrhythmias
153
Side effect of Adenosine ?
Flushing, Bronchospasm, chest discomfort
154
What antihypertensive is contraindicated in Gout?
Thiazide like diuretics
155
What are the main ototoxic drugs?
Aminoglycosdies (Gentamicin)
Loop diuretics
Salicylates
156
Palliative care- what drug is first line in Agitation and confusion?
Haloperidol
157
Lithium and Digoxin Toxicity
- Precipating factors
- Classic Presentation
- Treatment
Lithium
Precipitating: ACE/ ARB. NSAIDS. Thiazide like diuretics
Presentation: Hyperreflexia/ Coarse tremor
Mx) Fluid resus. Haemodialysis if severe.
Digoxin
Precipitating: HYPOkaleamia
Presentation: Arrythmias/ Yellow green vision
Mx) Digibind ( digoxin specific antibody fragments)
158
What may antifreeze be referred to?
Ethylene Glycol
159
Antidote to antifreeze/ ethylene glycol?
Fomepizole
(traditionally ethanol used)
Haemodialysis
160
Poisioning from methanol would be from ingestion of what?
Windscreen wash
Liquids used in distilling
161
Antidotes to the following (common ones)
Beta blockers
Paracetamol
Salyciliates
Benzodiazepines
TCAs
Methanol
Organophosphate insecticide
Beta blockers : Atropine/ Glucagon if resistant
Paracetamol: Charcoal if 1hr/ NAC/ Liver transplant
Salyciliates: 1. Urinary alkinsation 2. Haemodialysis
Benzodiazepines : Flumezanil
TCAs: IV Bicarbonate/ Dialysis
Methanol: Fomepeziole (same as antifreeze)
Organophosphate insecticide: Atropine (same as BB)
162
What are the antidotes to the following:
Iron
Lead
Carbon monoxide
Cyanide
Iron - Desferrioxamine
Lead - Dimercaprol
Carbon monoxide - 100% O2
Cyanide- Hydroxycobalamin
163
How does COCAINE use present?
Most things go up
Hypertension/ Hyperreflexia/ Hypertonia/ Tachycardia
Psychotic episodes/ Anxiety
Treatment is with Benzodiazepines eg: coronary artery spasm
164
How does ecstasy ( MDMA) use present and management in toxicity?
HYPONATRAEMIA
Anxiety/ agitation/ hypertension/ Rhabdomyaysis/ Tachycardia
Mx) Dantrone if severe - if not supportive.
165
Barbituates- overdose would present how and management?
eg Thiopentone is a medically used barbiturate.
Present with Reduced GCS/ Reduced respiratory drive
MX) Activated charcoal/ haemodialysis
166
How would cannabis use present?
Can present with psychotic symptoms
Cyclical vomiting syndrome ( relieved with hot shower)
Gynaecomastia
167
How would GHB use present?
(opposite to amphetamines)
Respiratory depression
168
What is the antidote to Benzodiazepine overdose?
Flumenazil
169
What is the antidote to TCAs overdose?
IV Bicarbonate/ Dialysis
170
What is the antidote for organophosphate poisoning?
Atropine
171
What is the antidote for Digoxin/ Lead/ Cyanide?
Digoxin: Digibind
Lead: Dimercaprol
Cyanide: Hydroxycobalamin
172
What analgesia for shingles related pain? Post herpetic pain?
Amitriptylline
173
What 2 drugs can increase saliva production?
Clozapine/ Neostigmine
174
What are some drug causes of erectile dysfunction?
Finasteride
BB eg Atenolol
Thiazide diuretics eg indapamide
TCA antidepressants eg Amitriptylline
175
Side effect of Beta Blockers?
Erectile dysfunction
176
Drugs that cause erectile dysfunction?
BB
Spirnolactone
Thiazide diuretic
Finasteride
Digoxin
177
What is an example of a Tetracycline and what are the side effect?
Tetracyclines eg Minocycline
Caution-- can exacerbate lupus!!
Can also cause facial pigmentation
178
What are some examples of phenothiazines?
chlorpromazine hydrochloride, prochlorperazine,
179
Apart from orange secretions what are the other side effects of Rifamicin?
N+V
Thrombocytopenia
Diarrhoea
Leukpenia
180
Side effects of Orlistat and when should it be used?
BMI over 28 with risk factors
OR BMI over 30
Side effects: flactulance/ fecal incontinence
**Pancreatic lipase inhibitor**
181
Tamoxifen - uses (2)
Increases risk of?
Cannot use in which patient groups?
Side effects
Tamoxifen - used for ER + breast ca in pre menopausal women
- treatment of gynaecomastia
Increases risk of VTE/ Endometrial ca.
Cannot use in breastfeeding or pregnancy
Side effects: N+V/ HOT FLUSHES
182
Is Erythromycin safe in pregnancy?
Yes
183
Side effects of Stains
Myositis
Altered LFTs
GI side effects (rarely pancreatitis)
Rarely ILD
184
What are the side effects of Carbamazapine?
Ataxia, Diplopia, Dizzyness
