General

Question 1

How does lactulose treat hepatic encephalopathy?

Answer 1

Lactulose helps trap the ammonia (NH3) in the colon. It does this by using gut flora to acidify the colon, transforming the freely diffusible ammonia into ammonium (NH4+) which can no longer diffuse back into the blood.

Question 2

Which diuretic is used in heart failure?

Answer 2

Loop diuretic ie frusemide

Question 3

What is frusemide?

Answer 3

Loop diuretic

Acts on the thick ascending limb of loop of Henle

Causes K+ loss due to increased Na+ in collecting duct (actions of aldosterone)

Question 4

What are some indications for infliximab?

Answer 4

UC

Crohn’s

Question 5

What is dilantin?

Answer 5

Anti-convulsant for management of complex partial seizures and generalised tonic-clonic seizures

Question 6

What is the mechanism of action and effect of benzodiazepines?

Answer 6

Potent inhibitor of GABA in the CNS

Antianolytic, sedative, hypnotic, muscle relaxant, antiepileptic

Question 7

What is the mechanism of action of metoclopramide?

Answer 7

Blocks dopamine receptor (and when given at higher doses) serotinin receptors in the chemoreceptor trigger zone in the CNS

Enhances the activity of ACh in the gut to increase motility

Question 8

What are the names of some non-dihydropyridine calcium channel blockers?

Answer 8

Verapamil

Diltiazem

Question 9

Which diuretic is used in HTN?

Answer 9

Thiazides

Question 10

What type of drugs rapamil?

Answer 10

Non-dihydropyridine calcium channel blocker

Question 11

What is targin?

Answer 11

Oxycodone/Naloxone opioid analgesic

Oxycodone is pain relief

Naloxone reduces opioid-induced euphoria & constipation

Question 12

What is ototoxic mean?

Answer 12

Toxic to the ear - specifically the cochlea or auditory nerve

Question 13

What is the normal dose of oxycodone for pain relief?

Answer 13

5mg

Question 14

What type of drug is diltiazem?

Answer 14

Non-dihydropyridine calcium channel blocker

Question 15

What is spirolactone?

Answer 15

K-sparring diuretic > aldosterone receptor antagonist

Question 16

What is the indication for colchicine?

Answer 16

Mainly gout - pain relief

Question 17

What type of drug is nifedipine? Indications? Side effects?

Answer 17

Dihydropyridine calcium channel blocker (peripheral vasodilator)

HTN, angina

Peripheral oedema that doesn’t respond to diuretics

Question 18

What dose of naloxone is used to reverse opioid overdose? What pharmakinetic factor must be considered?

Answer 18

0.4 to 2mg initial, repeated every 2-3mins until reversal (to a maximum of 10mg)

The duration of action of naloxone is shorter than opioids, must monitor patient

Question 19

What is the mechanism of action of infliximab?

Answer 19

Inhibitor of TNF-alpha

Question 20

What is the normal dose of ibuprofen for pain relief?

Answer 20

400mg

Question 21

Which are the centrally acting calcium channel blockers, dihydropyridines or non-dihydropyridines

Answer 21

Non-dihydropyridines

Question 22

What is the names of some dihydropyridine calcium channel blockers?

Answer 22

Nifedipine

Amlodipine

Question 23

What is novorapid?

Answer 23

Fast-acting insulin analog

Question 24

What is Tazocin?

Answer 24

A combination of the beta-lactam piperacillin and beta-lactamase inhibitor tazobactam

Commonly indicated in patients with hospitally acquired pneumonia/septicaemia

Question 25

What is the method of action and indication of methotrexate?

Answer 25

Inhibition of folic acid Acute lymphoblastic leukaemia

Question 26

What is the triple whammy effect of NSAIDs, diuretics, and ACEIs?

Answer 26

NSAIDs block prostaglandin production, prostaglandin provides tonic vasodilation of afferent renal arterioles ACEI block angiotensin II, which exerts tonic vasoconstriction of efferent arterioles Diuretics reduce plasma volume and renal plasma flow = Reduction in GFR = renal damage

Question 27

What is celecoxib?

Answer 27

An NSAID used for some arthritis

Question 28

What type of drug is isosorbide mononitrate?

Answer 28

A nitrate used in the treatment of angina Dilates blood vessels

Question 29

What are the side effects of prednisolone?

Answer 29

Weight gain Increased insulin resistance Proximal muscle weakness Hirsutism Striae Increased BP Immunosuppression Impaired wound healing Easy of bruising Osteoporosis Menstrual changes Steroid madness, euphoria

Question 30

What is lactulose indicated for?

Answer 30

Chronic constipation Hepatic encephalopathy

Question 31

What is the mechanism of action of calcium channel blockers?

Answer 31

Inhibit the slow inward calcium current in cardiac arteriolar muscle cells, reducing contractility, SA activity, AV node conduction and vascular tone Can be vascularly selective - dihydropyridine CCBs \> arteriolar vasodilation \> reduce afterload Or cardiac and vascular selective with negative inotropic and chronotropic properties \> used for arrhythmias and angina

Question 32

What is the mechanism of action of colchicine?

Answer 32

Inhibits mitotic spindle formation \> inhibits neutrophil migration, chemotaxis, adhesion and phagocytosis \> reduces inflammatory response to urate crystals

Question 33

What are some side effects of amiodarone?

Answer 33

Pulmonary fibrosis Thyrotoxicosis or hypothyroid Vision changes - yellow vision, reversible

Question 34

What is the usual dose of paracetamol for pain relief?

Answer 34

1g, QID (4 times per day)

Question 35

What type of drug is amlodipine?

Answer 35

Dihydropyridine calcium channel blocker (peripheral vasodilator)

Question 36

What type of drug is midazolam?

Answer 36

A benzodiazepine

Question 37

What is Fentanyl?

Answer 37

Synthetic opioid analgesic

Question 38

What are the 3 system you worry about when giving NSAIDs?

Answer 38

Renal: Renal toxicity Cardiac: Fluid retention GIT: Ulcers

Question 39

What is a oculogyric crisis? Which drugs cause it?

Answer 39

A dystonic reaction to certain drugs that causes a prolonged involuntary upward gaze of the eye - Dopamine D2 antagonists - Neuroleptics - Antihistamines