Drugs, mechanisms, side effects

Question 1

What kind of drug is bromocriptine?

Answer 1

A dopamine agonist

Question 2

What is bromocriptine used to treat?

Answer 2

As a dopamine agonist it is used to treat hyperprolactinaemia, acromegaly, Parkinson’s disease

Question 3

What is the effect of bromocriptine on breast milk production?

Answer 3

As a dopamine agonist it inhibits breast milk production by inhibiting prolactin release

Question 4

What kind of drug is cabergoline?

Answer 4

A dopamine agonist

Question 5

What is the indication for giving cabergoline?

Answer 5

Cabergoline is a dopamine (D2 receptor) agonist used in early phase parkinsons, or progressive phase in combination with levodopa, it also is used in hyperprolactinaemia and for breast milk suppression

Question 6

What is the impact of cabergoline on breast milk production?

Answer 6

Due its effect as a D2 receptor agonist, it inhibits prolactin and thereby suppresses breast milk production

Question 7

What is the most common GI side effect with bromocriptine?

Answer 7

Due to its Dopamine agonist effects - it causes nausea and vomiting

Question 8

What kind of drug is domperidone?

Answer 8

A peripheral dopamine D2 receptor ANTAGONIST

Question 9

What is the clinical indication for domperidone?

Answer 9

Treatment of nausea and vomiting by increasing gastric motility, particularly useful in Parkinson’s disease as it does not cross the blood brain barrier (unlike metoclopramide)

Question 10

How does domperidone effect breast milk production?

Answer 10

As a D2 receptor antagonist, domperidone can increase breast milk production by limiting inhibition of prolactin by dopamine

Question 11

What are the differences between heroin and morphine?

Answer 11

Diamorphine is a pro-drug of morphine
It is more lipophilic and therefore crosses the BBB more easily than morphine
It is more potent than morphine

Question 12

How much more potent is fentanyl than morphine?

Answer 12

100 times more potent

Question 13

What is the mechanism of action for lidocaine?

Answer 13

Blocks FAST voltage-gated sodium channels, preventing depolarisation

Question 14

What are the indications for lidocaine use?

Answer 14

Local anaesthetic and treatment of ventricular tachycardias (slows the heart rate)

Question 15

Which class of anti-arrhythmic is lidocaine?

Answer 15

Class- 1b

Question 16

What is the mechanism of action for class 1 anti-arrhythmic?

Answer 16

Sodium channel blockade

Question 17

What is the mechanism of action for class 2 anti-arrhythmic?

Answer 17

Beta blockade

Question 18

What is the mechanism of action for class 3 anti-arrhythmic?

Answer 18

Calcium channel blockade

Question 19

What is the mechanism of action for class 4 anti-arrhythmic?

Answer 19

Potassium channel blockade

Question 20

What is the max dose of lidocaine without adrenaline?

Answer 20

3mg/kg

Question 21

What is the max dose of lidocaine with adrenaline?

Answer 21

7mg/kg

Question 22

If there is a 60kg woman, what is the max dose in ml that you can give of 1% lidocaine?

Answer 22

Max dose =3mg/kg therefore 180mg
1% solution = 1000mg in 100ml = 10mg in 1ml
Therefore Max dose = 18ml

Question 23

What are the ECG changes with lidocaine toxicity?

Answer 23

Widened PR and QRS

Question 24

What are the main symptoms of lidocaine toxicity?

Answer 24

Circumoral paraesthesia
Tinnitus
Blurred vision
Leading to seizures, loss off conscious, cardiorespiratory compromise

Question 25

What is the active metabolite of tramadol?

Answer 25

Desmetramadol

Question 26

Which receptors does tramadol effect?

Answer 26

Mu opioid receptors, serotonin re-uptake inhibitor, noradrenaline re-uptake inhibitor, nicotinic acetylcholine receptor antagonist, M1 and M3 muscarinic acetylcholine receptor antagonist

Question 27

Which drugs increase the risk of osteoporosis?

Answer 27

Steroids and heparin

Question 28

What is the mechanism of action for paroxetine?

Answer 28

SSRI which also inhibits re-uptake of norephinephrine

Question 29

What is the role of paroxetine treatment in menopause?

Answer 29

SSRI with norepinephrine reuptake inhibitor activity which can be used to treat hot flushes

Question 30

What is the mechanism of action for Ullipristal Acetate?

Answer 30

Second generation selective progesterone receptor modulator - directly binds to progesterone receptors.

Question 31

What is the impact of halothane on the liver?

Answer 31

It can cause a halothane induced hepatitis

Question 32

What is the impact of halothane on the heart?

Answer 32

Reduced cardiac output, an atropine sensitive bradycardia, risk of arrythmia

Question 33

Which drugs are loop diuretics?

Answer 33

Furosemide Bumetanide Torsemide

Question 34

What kind of drug is metolazone?

Answer 34

A Thiazide diuretic

Question 35

Where in the kidney do k+ sparing diuretics act?

Answer 35

Distal convoluted tubule

Question 36

What kind of drug is amiloride?

Answer 36

A Potassium sparing diuretic

Question 37

What kind of drug is triamterene?

Answer 37

A potassium sparing diuretic

Question 38

Why might morphine cause bronchospasm?

Answer 38

Histamine release

Question 39

How might a change in potassium effect digoxin?

Answer 39

HYPO-kalaemia might cause digoxin toxicity

Question 40

Which chemotherapy drug is typically known for causing haemorrhagic cystitis?

Answer 40

Cyclophosphamide

Question 41

Which chemotherapy drug is typically known for causing peripheral neuropathy?

Answer 41

Vincristine

Question 42

What kind of drug is cyclophosphamide?

Answer 42

An alkylating agent

Question 43

What kind of drug is cisplatin?

Answer 43

An alkylating agent

Question 44

What kind of drug is carboplatin?

Answer 44

An akylating agent

Question 45

What kind of drug is paclitaxel?

Answer 45

An alkaloid

Question 46

What kind of drug is vincristine?

Answer 46

An alkaloid

Question 47

What is the mechanism of action of letrozole?

Answer 47

An aromatase inhibitor - inhibits oestrogen synthesis

Question 48

Which medications are associated with hirsuitism?

Answer 48

Phenytoin and sodium valproate