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Flashcards in Drugs Deck (175):
1

Give examples of H2 receptor antagonists

  • Ranitidine
  • Nizatidine
  • Famotidine
  • Cimetidine

1

What are the side effects of Ergometrine?

  • Nausea and vomiting
  • Arrhythmias including bradycardia
  • Hypertension
  • Tinnitus

2

What are the contra-indications of Oxytocin?

  • Hypertonic uterine contractions
  • Severe pre-eclampsia toxaemia
  • Severe cardiovascular disease

3

What are the Glycopeptide antibiotics used for?

Gram +ve bacteria (β-lactam resistant):

  • MRSA
  • Clostridium difficile
  • Prophylaxis before prosthetic implants - heart valves

4

Name examples of the 3rd generation of cephalosporins

  • Cefotaxime
  • Ceftazidime
  • Ceftriaxone

5

How does Metronidazole work?

It damages the DNA through reactive intermediates, therefore inhibiting DNA synthesis

5

How do the Macrolides work?

The bind to the 50S subunit of bacterial ribosomes and inhibit translocation

5

How do the Oxazolidinones work?

They bind to bacterial ribosomes and prevent the formation of 70S ribosome complex

5

Which compartment do colloids tend to stay in?

The intravascular space

6

What are the long acting β2 agonists (LABA) used in the treatment of COPD?

  • Salmeterol
  • Formoterol

7

Give examples of gastric stimulants.

  • Domperidone
  • Metoclopramide

7

How does Trimethoprim work?

It inhibits the dihydrofolate reductase enzyme

8

How do NSAIDs cause GIT mucosal damage?

  • They inhibit the prostaglandins
  • They directly irritate the gastric and duodenal mucosa

8

What are the indications for giving paracetamol?

  • Mild to moderate pain
  • Pyrexia

9

What are the 2nd generation of cephalosporins used for?

Against certain Gram -ve such as Haemophilus influenzae

9

How do the statins work?

  • They inhibit the HMG CoA-reductase, which is involved in the synthesis of cholesterol
  • This leads to a decrease in the levels of LDL cholesterol

9

What is the antidote for an iron overdose?

Desferrioxamine

10

What is the antidote for an opiate overdose?

Naloxone

11

What are the contra-indications of Aspirin use?

  • Hypersensitivity
  • Active peptic ulcer
  • Haemophilia
  • Bleeding disorders

12

What medications can Sucralfate interact with?

  • Digoxin
  • Antibiotics
  • Phenytoin

12

What is Metronidazole used for?

Anaerobic infections:

  • Bacterial vaginosis
  • Intra-abdominal infections/ abscesses
  • Abscesses of brain, liver, oral cavity
  • Aspiration pneumonia
  • Clostridium difficile colitis

Protazoal infections

  • Giardia
  • Prophylaxis in GI surgery

12

What are the side effects of Rifampicin?

  • Orange body secretions - stains contact lenses
  • Altered liver function

12

What are the side effects of the penicillins?

  • Hypersensitivity
  • Diarrhoea
  • Cholestatic jaundice - Flucloxacillin

13

How do antacids work?

They neutralise the acid produced by the stomach

13

How do the glycopeptide antibiotics work?

The inhibit the release of the building block unit of the cell wall from the cell membrane

This prevents the addition of new units to the peptidoglycan cell wall

14

Give examples of the Aminoglycosides

  • Gentamicin
  • Amikacin

14

What bacteria are the Marcolides useful against?

Gram +ve;

  • Staphylococci spp
  • Streptococci spp

Gram -ve:

  • Haemophilus influenzae
  • Legionella pneumophila
  • Mycoplasma

14

What is the treatment of aspiration pneumonia?

  • Cefuroxime
  • Metronidazole

15

What are colloids made up of?

They are solutions of partially dissolved large molecular weight chemicals (>30, 000kDa) and dissolved low molecular weight chemicals such as electrolytes in water

16

How does Rifampicin work?

It inhibits RNA polymerase preventing transcription of mRNA

18

Give examples of proton pump inhibitors (PPIs)

  • Omeprazole
  • Lansoprazole
  • Pantoprazole
  • Esomeprazole

18

What is the treatment of atypical pneumonia?

  • Clarithromycin
  • Rifampicin
  • Tetracycline

18

What are the side effects of Codeine?

  • Drowsiness
  • Constipation

19

What are the side effects of Tamsulosin?

  • Drowsiness
  • Hypotension
  • Syncope
  • GI disturbances
  • Erectile dysfunction

20

Which tissues do the Tetracyclines concentrate in?

Those undergoing calcification

21

What Dihydropyridine calcium channel blockers are used in the treatment of angina?

  • Amlodipine
  • Nifedipine
  • Felodipine

22

How does Sucralfate work?

It protects damaged mucosa.It stimulates local production of bicarbonates

22

What groups of are classified as beta-lactams?

  • Penicillins
  • Cephalosporins
  • Carbopenems

23

When is Metformin contra-indicated?

  • Ketoacidosis
  • Lactic acidosis

23

What are the MI-5 drugs?

  1. Aspirin
  2. Clopidogrel
  3. ACE-inhibitor (Ramipril)
  4. β-blocker (Bisoprolol)
  5. Statin (Simvastatin or Atorvastatin)

24

Name examples of the 2nd generation of cephalosporins

  • Cefaclor
  • Cefuroxime

25

What are the adverse effects possible with cephalosporins?

If a patient has a hypersensitive reaction to penicillins there is a 10% they will be allergic to cephalosporins

26

What are the side effects of Trimethoprim?

  • Folate deficiency
  • Rarely causes haematopoiesis depression

27

What bacteria are the Aminoglycosides used against?

  • Only work on aerobes
  • Pseudomonas and other Gram -ve bacilli
  • Staphylococci

29

When should Misoprostol not be given?

  • In pregnant women
  • Women of child bearing age

30

What are the side effects of the Oxazolidinones?

  • Haematopoietic disorders
  • Cheese reaction - It is a MAOI
  • Optic neuropathy

31

What are the 3 things found in Oral Rehydration Solution (ORS)?

  1. Water
  2. Sodium chloride
  3. Glucose

31

When are PPIs indicated for use?

  • Treatment of GU and DUs
  • Prevention and treatment of NSAID induced ulceration
  • H. pylori erdatication
  • Severe GORD
  • Oesophagitis
  • Zollinger-Ellison syndrome
  • Stress ulceration

33

Give some examples of alginates.

  • Simeticone
  • Sodium alginate

33

What is the antidote for cyanide poisoning?

  • 100% O2
  • Skin decontamination
  • Dicobalt edetate (Kelocyanor)
  • Hydroxocobalamine
  • Nitrites (Amyl nitrite) / Sodium thiosulphate

33

What is Carboprost used for?

Severe post-partum haemorrhage due to uterine atony in patients unresponsive to Ergometrine and Oxytocin

34

What is the mechanism of action of Ramipril?

  • It inhibits angiotensin converting enzyme (ACE) stopping the conversion of angiotensin I to angiotensin II
  • This prevents vasoconstriction and release of aldosterone

36

How do Domperidone and Metoclopramide work?

They increase peristalsis in the jejunum and duodenum, thought to be through activation of muscarinic receptors in the GIT

37

What is the method of action of Aspirin?

  • Irreversibly inhibits COX-1 and COX-2
  • This inhibits thromboxane A2 production
  • Leads to inhibition of platelet aggregation

38

What can occur if Macrolides are given IV?

Can cause phlebitis

38

What are the side-effects of Tetracyclines?

  • Irritation of gastric mucosa
  • Growth stunting due to incorporation into growing bones
  • Phototoxicity reaction

39

What are the side effects of Vancomycin?

  • Red man syndrome if given too quickly
  • Phlebitis if not diluted enough
  • Nephrotoxicity
  • Ototoxicity in the elderly

41

What are the side effects of the H2 receptor antagonists?

  • Diarrhoea
  • Headache
  • Constipation
  • Confusion
  • Hallucinations

42

Name examples of the 1st generation of cephalosporins

  • Cefadrine
  • Cefadroxil
  • Cefalexin

42

What does activation of the β2 receptor on bronchial smooth muscle cause?

Bronchodilatation

44

What are the side effects of Misoprostol?

  • Diarrhoea
  • Abdominal pain

45

When would Losartan be given?

If a patient had an intolerance to ACE inhibitors due to the dry cough or other side effects

46

Which of the penicillin antibiotics are penicillinase resistant, including those used in combination with other drugs?

  • Flucloxacillin
  • Amoxicillin if given with clavulanic acid - Co-amoxiclav
  • Piperacillin if given with Tazobactam

47

How does Sulphonamide work as an antibiotic?

It inhibits the dihydrofolate synthetase enzyme needed for folate synthesis in bacteria

48

What beta-blockers are used for the treatment of angina?

  • Bisoprolo
  • lAtenolol
  • Metoprolol
  • Carvedilol

49

What class of drug are Bisoprolol, Atenolol and Carvedilol?

Beta blockers

49

What is the antidote for a digoxin overdose?

Digoxin specific antibodies

50

Give an example of a glycopeptide antibiotic.

  • Vancomycin
  • Teicoplanin

50

What is Co-trimoxazole and when is it used?

It is both Trimethoprim and Sulfamethoxazole

Where it confers benefits over other treatments, such as Pneumocystis jiroveci pneumonia in AIDs and other immunocompromised people

51

What is the antidote for a β-blocker overdose?

Glucagon

52

What are the side effects of Aspirin?

  • GI irritation
  • GI haemorrhage
  • Bronchospasm

53

What are crystalloid solutions made up of?

They are solutions of dissolved low molecular weight chemicals such as glucose, or electrolytes in water

54

What are the 1st generation of Cephalosporins used for?

  • Skin infection
  • Soft tissue infections

54

The activation of which receptor causes bronchoconstriction?

Muscarinic receptor in bronchial smooth muscle

55

What are the muscarinic antagonists used in the treatment of COPD?

  • Ipratropium
  • Tiotropium

56

What are the bacteria that Tetracyclines are used against?

  • Staphylococci
  • Streptococci

Gram -ve bacteria

Certain strains of MRSA

Acne

Community acquired pneumonia

57

What effects do non-dihydropyridines have on the heart?

  • They prevent the influx of calcium in coronary artery smooth muscle, leading to vasodilatation
  • They also slow conduction through the AV node - rate limiting

58

What is the osmolality of UK ORS, and how does this help with rehydration?

Osmolality = 240mOsm/L

This is lower than the osmolality found in the body, so water will passively move from the lumen of the intestine into the body to rehydrate

59

How long do the SABA last for?

4-6 hours after inhalation

61

What are the side effects of Quinolones?

  • Reduction in seizure threshold
  • Tendon damage and/or rupture
  • Confusion and drowsiness
  • Arthropathy - not advised in under 18's

61

What is Varenicline used for?

It is used as an aid to quit smoking

63

How are the Aminoglycosides administered?

Only by IV

64

What is the method of action of Clopidogrel?

It irreversibly binds to P2Y12 components of adenosine receptor on platelet surface

66

When is Orlistat contraindicated?

  • Malabsorption disorders
  • Reduced gallbladder function
  • Pregnancy and breast feeding

67

What is the antidote for a benzodiazepine overdose?

Flumazenil

69

What medical conditions should loperamide not be given with?

  • Active colitis
  • Infective cause of diarrhoea
  • Antibiotic associated colitis

70

What are the contra-indications of Clopidogrel?

Active bleeding

70

What drug is given to induce labour?

Dinoprostone (PGE2)

71

What are the side effects of Sucralfate?

  • It can cause constipation
  • Bezoar formation with enteral feeds

72

How is 1 L of Hartmann's solution distributed amongst intravascular and interstitial compartments?

250ml in intravascular

750ml in interstitial fluid

73

What is the treatment of cavitation pneumonia?

  • Cefuroxime
  • Metronidazole
  • Flucloxacillin

75

How do the Quinolones exert an antibiotic effect?

They inhibit the DNA gyrase enzyme in the bacteria preventing the supercoiling of their DNA

76

What are the concentrations of Sodium and glucose in UK ORS?

  • Na - 60mmol/L
  • Glucose - 90mmol/L

77

What are the side effects of Ibuprofen?

  • Nausea
  • Dyspepsia
  • GIT ulceration and/or bleeding
  • Diarrhoea or constipation

78

What is loperamide used for?

  • Acute diarrhoea - symptomatic treatment used with rehydration
  • Chronic diarrhoea

78

Give examples of the Quinolones

  • Ciprofloxacin
  • Levofloxacin

78

What is the antidote for a paraquat overdose?

Fullers earth

80

What tissues are Quinolones good at penetrating?

  • Pus
  • Bone
  • CSF

82

What are the side effects of PPIs?

  • Rash
  • Headache
  • Diarrhoea
  • Nausea

83

What is the treatment of complicated pneumonia?

Cefuroxime + Clarithromycin

Augmentin + Clarithromycin

83

How does Tamsulosin work?

It is a α1-selective alpha blocker that causes relaxation of the smooth muscle in benign prostatic hyperplasia

85

How do the beta-lactam antibiotics work?

They covalently bind to penicillin-binding proteins to inhibit the final formation of cross links in the bacterial cell wall

86

What are the indications for H2 receptor antagonist use?

  • Treatment of GUs or DUs
  • GORD symptoms
  • High dose in Zollinger-Ellison syndrome

87

What are some of the side effects of Ipratropium?

  • Dry mouth
  • Blurred vision
  • GI disturbances
  • Glaucoma in susceptible people

88

How does Choloramphenicol work?

It inhibits transpeptidation on the ribsome

89

What are the side effects of Ramipril?

  • Dry cough
  • Hyperkalaemia
  • Renal impairment
  • Hypotension
  • Angioedema
  • Hepatic impairment

90

How do the Dihydropyridine calcium channel blockers exert their effect in angina?

They cause smooth muscle relaxation by inhibiting influx of Ca ions

This leads to relaxation of the coronary arteries and peripheral arteries

91

What is the antidote for paracetamol overdose?

N-acetyl cysteine

93

What Macrolide is destroyed in the stomach, so must the tablets must be enteric coated?

Erythromycin

94

What is Misoprostol used with?

NSAIDs - Arthrotec

95

What disease should Ramipril not be given with?

  • Renal artery stenosis
  • Severe aortic stenosis

96

How does Metformin work?

It decreases gluconeogenesis and increases peripheral utilisation of glucose

It can only work if there is endogenous insulin present

98

What is the effect of food on penicillins?

It delays their absorption

99

What are the 3rd generation of cephalosporins used for?

  • Lots of Gram -ve infections
  • Meningitis - Ceftriaxone
  • Ceftazidime - Pseudomonas

100

How do the Tetracycline antibiotics work?

The bind to the 30S subunit of the bacterial ribosome, and actively compete with tRNA for the A site

This competition inhibits tRNA from binding and therefore protein synthesis

101

How does food interact with the absorption of the Macrolides?

It decreases the absorption of Erythromycin and Azithromycin

It increases the absorption of Clarithromycin

103

What are the short acting β2 agonists (SABA) used in the treatment of COPD?

  • Salbutamol
  • Terbutaline

105

How loperamide exert its effect on the GIT?

It is a GI μ opioid receptor agonist causing decreased motility of the bowel and increased anal sphincter tone

106

What is the treatment of uncomplicated pneumonia?

Amoxycillin + Clarithromycin or Cephalosporin

108

What is Rifampicin used for?

  • Mycobacteria (TB) - always given with a 2nd (Isoniazid, Vancomycin)
  • Nasal carriage of Neisseria meningiditis
  • Staphylococci such as MRSA

110

What is Sucralfate used to treat?

  • Gastric and duodenal ulcers
  • Prophylaxis for stress ulcers

111

What is Tamsulosin used for?

Difficulty urinating due to benign prostatic hyperplasia

112

How long does the effect of LABAs last?

12 hours after inhalation

113

When are Oxazolidinones used?

Gram +ve bacteria:

  • MRSA
  • VSE
  • Other serious infections where other antibiotics have failed

114

What is Metformin used for?

It is mainly used for type II diabetes

115

When are Calcium channel blockers used for angina?

They are used as a 2nd line to beta blockers, or when beta blockers are contra-indicated

116

How do Aminoglycosides work?

The bind to the 30S subunit of bacterial ribosomes and cause a misreading of the codon on the mRNA

This results in a non-functional protein being produced

117

When is Ergometrine given in labour, and what does it do?

It is used in the 3rd stage of labour to help control post-partum haemorrhage

118

How does Orlistat work in the treatment of obesity?

It is an intestinal lipase inhibitor that prevents the digestion and absorption of dietary lipids

119

What are the side effects of the β2 agonists?

  • Tremor
  • Hypokalaemia
  • Tachycardia

120

What is an example of an Oxazolidinone?

Linezolid

121

Give examples of the Tetracyclines

 

  • Tetracycline
  • Doxycycline

122

Give some examples of antacids.

  • Sodium bicarbonate
  • Magnesium & Aluminium salts (Gaviscon)

123

What are the side effects of Dinoprostone?

  • Nausea and vomiting
  • Uterine hypertonus
  • Pulmonary embolus
  • Low Apgar score

125

What bacteria are Pencillin V and Benzylpenicillin used for?

Gram -ve:

  • Cocci - Neisseria
  • Bacilli - Listeria monocytogenes

Gram +ve:

  • Cocci - Streptococcus pneumoniae
  • Spirochetes - syphilis

126

What are the side effects of Metoformin?

  • Anorexia
  • Nausea and vomiting
  • Diarrhoea
  • Abdominal pain

128

How do the H2 receptor antagonist work?

They reversibly and competitively bind to the H2 receptor which suppresses gastric acid secretion

They also inhibit gastrin and ACh mediated acid secretion

129

What is the antidote for a methanol overdose?

Ethanol

130

What is the first line treatment of angina?

  • Glyceryl Trinitrate (GTN)
  • Beta-blockers

131

Give examples of the Macrolides

  • Clarithromycin
  • Erythromycin
  • Azithromycin

133

Which metal ions can interfere with the absorption of the Quinolones?

  • Ca
  • Al
  • Mg
  • Zn
  • Fe

134

What are the side effects of the Macrolides?

  • Nausea, vomiting and diarrhoea - increased gastric motility
  • Liver dysfunction
  • Prolong QT interval
  • Statin-induced myopathy

136

Which of the pencillins is effective against Pseudomonas?

Peperacillin

137

What is Oxytocin (Syntocinon) used for?

  • To augment labour - stronger uterine contraction
  • Help control post-partum haemorrhage if given with Ergometrine

138

How do alginates work?

They increase the viscosity of the stomach content, and may produce a "raft" to reduce symptoms of GORD

138

How does Varenicline work?

It is a selective nicotine partial agonist

139

What are the contra-indications of Ibuprofen?

  • Active GU or DU
  • Gastrointestinal bleeding

141

What happens to water in the cells when colloids are given?

It moves out of the cells into the intravascular space

142

What bacteria is Flucloxacillin used for?

Staphylococci

144

What are the side effects of loperamide?

  • Abdominal cramps
  • Dizziness
  • Drowsiness
  • Skin reactions - urticaria

145

When is Codeine given?

Mild to moderate pain

147

What non-dihydropyridine calcium channel blockers are used for angina?

  • Verapamil
  • Diltiazem

149

What can be a side effect of giving 0.9% NaCl?

It can lead to hyperchloraemic metabolic acidosis, which causes hyperkalaemia and multi-system pathology

150

What are the indications for giving Ibuprofen?

  • Pain
  • Inflammation
  • Fever

152

What are the main side effects of the antacids and alginates?

  • Constipation (aluminium)
  • Diarrhoea (magnesium)
  • Interact with other medications (antibiotics, enteric coated drugs etc).

153

Give examples of a statin?

  • Simvastatin
  • Atorvastatin

154

What class of drug is Ibuprofen?

It is a NSAID

155

What are the side effects of Clopidogrel?

  • GI irritation
  • GI haemorrhage

156

What muscarinic receptors that are blocked and cause bronchodilation?

M1 and M3

157

What are the 3rd line treatments for angina?

  • Potassium channel activators
  • Ivabradine

158

What class of drug are Losartan, Candesartan and Valsartan?

Angiotensin II receptor blockers

159

How do NSAIDs work?

The inhibit the activity of both COX-1 and COX-2, thereby inhibiting the production of prostaglandins and thromboxanes

161

What are the side effects of Orlistat?

  • Steatorrhoea
  • Feacal incontinence
  • Flatulence
  • Abdominal discomfort and pain

162

What are the side effects of the Aminoglycosides?

  • Ototoxicity - damage to CN VIII
  • Nephrotoxicity

163

What are the side effects of Metronidazole?

  • Rashes
  • Metallic taste
  • Extreme reaction if taken with alcohol

165

Which of the Macrolides has a similar spectrum to the Penicillin V?

Erythromycin

166

What bacteria are the Quinolones useful against?

  • Pseudomonas

Gram -ve:

  • E. coli
  • Klebsiella
  • Salmonella
  • Proteus
  • Campylobacter

Gram +ve

Anaerobes

168

What is Trimethoprim used for?

  • UTI's - treatment in high doses and prophylactic in lower doses
  • Enterococci
  • Certain Gram -ve bacteria

169

When should dinoprostone not be given to induce labour?

  • Active cardiac or pulmonary disease
  • Placenta praevia
  • Ruptured membranes
  • Multiple pregnancies

170

What class of drug is Codeine?

An Opioid

171

What is the antidote for carbon monoxide poisoning?

  • Removal from CO environment
  • 100% O2
  • Hyperbaric chamber

172

What are the side effects of statin?

  • Headache
  • Altered liver function
  • Myalgia

173

How does Misoprostol work?

It is a prostaglandin analogue

174

What is the maximum length of time an Oxazolidinone should be given for?

28 days

175

What are the contra-indications for Ergometrine?

  • 1st and 2nd stages of labour
  • Vascular or severe cardiac disease
  • Eclampsia