Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Drugs > I M Ar 2 > Flashcards

I M Ar 2 Flashcards

(149 cards)

Start Studying
1
Q

Amiodarone mechanism

A

Blocks sodium, calcium, potassium channels

Antagonism of a/b adrenergic receptors

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

Amiodarone adverse effects during IV infusion

A

Hypotension

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

Amiodarone adverse effects when taken chronically

A

Pneumonitis, bradycardia, hepatitis, photo sensitivity, thyroid abnormalities

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

Who shouldn’t take amiodarone

A

Severe hypotension
Heart block
Thyroid disease

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

Amiodarone interactions

A

Increase plasma conc of digoxin, diltiazem, verapamil

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

Prescription of amiodarone needs

A

Senior involvement (f1 not on own)

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

Amiodarone for cardiac arrest

A

300mg followed by flush

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

If repeated IV of amiodarone indicated how is it administered? Why?

A

Central line

Peripheral can cause phlebitis

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

Why should you not copy the preceding dose on prescription of amiodarone

A

May be a loading dose

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

ACEi egs

A

Ramipril, lisinopril, perindopril

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

ACEi uses

A

Hypertension
Chronic heart failure / ischemic heart disease
Diabetic nephropathy / CKD with pronteinuria

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

Mechanism of ACEi

A

Presents conversion of angiotensin I -> II

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

ACEi adverse effects

A

Hypotension (can be profound after first dose)
Dry cough
Hyperkalaemia
Cause / worsen renal failure (especially with renal artery stenosis)
Rarely - angiodema , anaphylaxis

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

Wh should not get ACEi

A

Renal artery stenosis
Acute kidney injury
Pregnant / breastfeeding
Chronic kidney disease (use lower dose)

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

ACEi interactions

A

Avoid potassium elevating drugs

NSAIDs -> increas risk of renal failure

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

How are ACEi prescribed - dose

A

Usually around 2.5mg daily titrated up to 10mg over few weeks

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

Dose of ramipril for heart failure / neohropathy

A

1.25mg daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What to tell patients getting ACEi

A 
Dizzy - especially after first dose 
Dry cough 
Tell someone if allergic signs 
Avoids NSAIDs eg ibuprofen 
Will need blood test monitoring
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What should be checked before starting ACEi

A

Electrolytes and renal functions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Angiotensin receptor blockers egs

A

Losartan, candesartan, irbesartan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

ARBs uses

A

Hypertension
Chronic heart failure / ischemic heart disease
Diabetic nephropathy / CKD with pronteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

ARBs mechanism

A

Block action of angiotensin II on AT1 receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

ARBs adverse effects

A

Hypertension (especially first dose)
Hyperkalaemia
Renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Why do ARBs not cause a dry cough

A

Do not affect ACEi (involved in bradykinin metabolism )

-> also less likely to cause angiodema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Who should not get ARBs
Renal artery stenosis Acute kidney injury Pregnant / breastfeeding CKD - use lower doses
26
ARBs interactions
Don't use with potassium elevating drugs | Risk of renal failure with NSAIDs
27
Prescription on ARBs
50mg orally daily titrated up
28
Losartan in heart failure
Start on 12.5mg daily
29
What to tell patients getting ARBs
Dizziness Will need blood test monitoring Avoid taking NSAIDs
30
What should be checked before starting ARBs
Electrolytes and renal function
31
In what ethnic group are ARBs preferable to ACEi
Black African / Caribbean as risk of angiodema is 5x higher then general population with ACEi
32
SSRIs egs
Citalopram Fluoxetine Sertraline Escitalopram
33
SSRIs uses
Moderate - severe depression (mild if other treatments fail) Panic disorder OCD
34
SSRIs mechanism
Inhibit neuronal reputable of serotonin
35
Why are SSRIs generally preferred to tricyclics
Fewer adverse effects and less dangerous in overdose
36
SSRIs adverse effects
``` GI upset, weight / appetite disturbance Hypersensitivity Suicidal thoughts Lower seizure threshold Can prolong QT interval -> arrythmias Increase risk of bleeding Serotonin syndrome ```
37
What is serotonin syndrome
Autonomic hyperactivity Altered mental state Neuromuscular excitation
38
When should you be cautious of precribing SSRIs
Epileptics Peptic ulcer disease Young people Hepatic impairment (as metabolised)
39
Which drugs should not be given with SSRIs ? Why?
Monoamine oxidase inhibitors (also increase serotonin -> serotonin syndrome risk) Drugs that prolong QT interval eg. Antipsychotics Carful with aspirin / NSAIDs (due to bleeding risk)
40
Prescribing SSRIs (citalopram)
20mg orally daily increased as needed
41
What to tell patient getting SSRIs
May need psychological therapy for longer term benefits Carry on with SSRIs for 6 months after feel better Not to stop suddenly -> tummy upset, flu like symptoms
42
Which SSRIs have fewer interactions
Citalopram and escitalopram
43
Tricyclics egs
Amitriptyline | Lofepramine
44
Tricyclics indications
Moderate - sever depression when SSRIs don't work | Neuropathic pain
45
Tricyclics mechanism
Inhibit neuronal reuptake of serotonin and noradrenaline
46
Tricyclics mechanism which causes adverse effects
Block muscarinic, H1, A1/2, D2 receptors
47
Triclyclics adverse effects ? (Receptor blocked)
Dry mouth, constipation, urinary retention, blurred vision (antimuscarinic). Sedation, hypotension (a1/H1). Arrythmias, ECG changes. Convulsions, hallucinations, mania. Breast changes sexual dysfunction, extra pyramidal eg tremor / dyskinesia (dopamine)
48
Sudden withdrawal of tricyclics causes
GI upset, flu like
49
Who should tricyclics be used with caution
Elderly, CV disease, epilepsy, constipation, prostatic hyper trophy, raised intraoccular pressure
50
Which drugs should not be given with tricyclics
Mono amine oxidase inhibitors
51
Amytriptyline dose for neuropathic pain? Depression?
10mg at night | 75mg daily
52
What needs to be thought about when prescribing tricyclics
Very dangerous in overdose -> prescribe small quantity at a time
53
What to tell patients getting tricyclics
Takes a few weeks for symptom improvement May need psychological therapy Keep taking for 6 months after better Don't stop suddenly
54
Amiodarone uses
Tachyarrythmias (usually when other treatments none suitable)
55
What to tell patients getting tricyclics
Will improve symptoms over a few weeks. May need psychological therapy for long term benefits. Keep taking for 6months after symtoms improve Don't stop treatment suddenly -> flu like withdrawal
56
Venlafaxine and mirtazepine uses
``` Major depression (SSRIs not effective) generalised anxiety disorder (venlafaxine only) ```
57
Mechanisms of venlafaxine and mirtazapine
Increase availability of monoamines for neurotransmisson
58
Venlafaxine and mirtazapine adverse effects
GI upset CNS effects - headache, abnormal dreams, convulsions.... Less common - hyponatraemia, serotonin syndrome
59
Venlafaxine and mirtazapine sudden withdrawal ->
GI upset and flu like symptoms
60
Venlafaxine and mirtazapine caution with who?
Elderly, hepatic /renal impairment, Cv disease (Venlafaxine associated with arrythmias)
61
Venlafaxine and mirtazapine interactions
SSRIs -> serotonin syndrome
62
Prescribing venlafaxine and mirtazepine
Low dose titrated up V - 37.5 twice daily up to 375 daily M- 15mg daily up to 45
63
Venlafaxine and mirtazapine tell patients
Improve symptoms over a few weeks May need psychological therapy Keep taking for 6 months after improvement Not stop taking suddenly
64
Egs of d2 receptor antagonists (antiemetics)
Metoclopramide , domperidone
65
What is the main receptor in the chemoreceptor trigger zone
D2
66
D2 antagonist uses
Nausea and vommiting - especially in reduced gut motility
67
D2 antagonists adverse effects
Diarrhoea (as promoted gastric emptying) Short term - acute dystonic reaction Extra pyramidal symptoms
68
D2 antagonist - who is more likely to get extra pyramidal symptoms
Children and young adults
69
Prokinetic effects of d2 antagonists mean they are contraindicated in who
GI obstruction / perforation
70
Risk of extra pyramidal symtoms increases with metoclopramide and what other class
Antipsychotics (same mechanism)
71
Metoclopramide antagonises effect of what drugs (contraindicated)
Dopaminergic agents for Parkinson's
72
Starting dose for metoclopramide and domperidone
10mg three times daily
73
Eg of h1 antagonist antiemetics
Cyclizine, cinnarizine, promethazine
74
H1 antiemetics uses
Nausea and vommiting - especially with motion sickness or vertigo
75
H1 antagonist antiemetics mechanism
Block h1 receptors in vomiting centre and communication with vestibular system
76
H1 antiemetics adverse effects
Drowsiness Dry throat and mouth Tachycardia (palpitations)
77
Warnings with h1 antagonist antiemetics
``` Prostatic hyper trophy (antimuscarinic may lead to retention) Hepatic encephalopathy (due to sedation) ```
78
Eg of phenothiazines (antiemetics)
Prochlorperazine | Chlorpromazine
79
Phenothiazines uses
Nausea and vomiting especially with vertigo | Psychotic disorders
80
Phenothiazines mechanism
Mostly by d2 antagonist in vomiting centre and vestibular system
81
Phenothiazines adverse effects
``` Drowsiness Postural hypotension Extrapyramidal symptoms Short term - acute dystonic reaction QT prolongation ```
82
Who should not get phenothiazines
Sever liver disease - never Prostatic hyper trophy - retention Elderly
83
Which drugs interact with phenothiazines
Any that prolong QT | Antipsychotics, amiodarone , Ciproflaxacin, macrolides, quinine, SSRIs
84
Egs of 5HT-3 antagonists
Ondansetron, granisetron
85
5HT3 antagonists mechanism
High amount of 5ht3 receptors in chemoreceptor trigger zone. Serotonin also key transmitter in gut
86
5ht3 antagonists warning
Prolong QT interval at high doses | Avoid other drugs that do this
87
Drugs that prolong QT
Antipsychotics, amiodarone , Ciproflaxacin, macrolides, quinine, SSRIs, phenothiazines, 5ht3 antagonists
88
Prescription of ondansetron
4-8mg every 12 hours
89
Antiemetics potential for morning sickness as minimal risk to baby
Ondasetron
90
Antifungals egs
Nystatin, clotrimazole, fluconazol
91
What is found in fungal membranes but not human cells and therefore target of antfungals
Ergosterol
92
Nystatin / clotrimazole adverse effects
Local irritation where applied
93
Fluconazole adverse effects
GI upset, headache, hepatitis | Rarely - prolonged QT
94
Fluconazole contraindications
NEVER in pregnancy - malformations | Liver disease / renal impairment
95
Interactions with fluconazole
Any metabolised by P450 (as inhibits) | Drugs that prolong QT
96
Eg of drugs metabolised by p450
Phenytoin, carbamazepine, warfarin, diazepam, simvastatin, sulphonyureas
97
How is nystatin usually prescribed
Oral suspension for oral candidiasis | Cream for skin infections
98
How is clotrimazole prescribed? What for ?
Cream | Tinea (ringworm ), candidia
99
H1 antagonist uses
Allergies Relieve pruritus, urticaria Anaphylaxis (after adrenaline) Nausea and vomiting
100
Antihistamines eg
Cetirizine, loratadine, fexofenadine, chlorphenamine
101
Which cells release histamine
IgE
102
Which antihistamine causes some sedation? Why do others (2nd gen) not ?
Chlorphenamine | Others don't cross blood brain barrier
103
Who should not get get chlorphenamine
People with severe liver disease
104
Eg of anti motility drugs
Loperamide, codeine phosphate
105
Anti motility used to treat
Diarrhoea
106
Anti motility mechanism
Agonist of opioid u receptors in GI. | So transit of bowel contents + increase anal sphincter tone
107
When should loperamide not be used
Acute UC / C. difficile as increases risk of mega colon. | Dysentery - as likely bacterial infection
108
Usual dose of loperamide
4mg followed by 2mg after each lose stool
109
What to tell patient getting loperamide
Treats diarrhoea but not underlying cause
110
Eg of bronchodilator muscarinics
Ipatropium, Tiotropium, glycopyrronium
111
Uses of bronchodilators
COPD p, asthma
112
Mechanism of bronchodilators
Competitive inhibitor of acetyl choline | -> reduce smooth muscle tone / secretions
113
Bronchodilators adverse effects
Dry mouth
114
Bronchodilators caution in
Patients susceptible to angle-closure glaucoma
115
Which bronchodilators are short acting / long
Short - ipatropium | Long - tiotropium / glycopyrronium
116
What needs to be monitored with bronchodilators
Inhaler technique
117
Anti muscarinics for GI / cardio uses egs
Atropine, hyoscine butyl bromide, glycopyrronium
118
What is atropine used to treat
Bradycardia
119
First line treatment for IBS
Hyoscine butyl bromide
120
What is used to treat copious respiratory secretions
Hyoscine butyl bromide
121
Mechanism of GI / cV antimuscarinics
Competitive inhibitor of acetyl choline | Increase heart rate, reduce smooth muscle tone, reduce secretions
122
Adverse effects of GI / cv antimuscarinics
Tachycardia, dry mouth, constipation, urinary retention, blurred vision, drowsiness and confusion
123
Who should antimuscarinics be cautious with
Susceptible to angle-closure glaucoma | Arrythmias
124
Preciption of atropine for bradycardia
300-600 micrograms every 2 minutes until acceptable heart rate
125
Antimuscarinics for IBS prescription
10mg 8 hourly (hyoscine butyl bromide )
126
GU antimuscarinic egs
Oxybutynin, tolterodine, solifenacin
127
Which receptor are GU antimuscarinics selective (ish) for
M3 - promotes bladder relaxation
128
Adverse effects of GU antimuscarinics
Dry mouth, tachycardia, constipation, blurred vision
129
When should GU antimuscarinics be avoided
Never in UTI | Cautious in elderly, angle-closure glaucoma, arrythmias, urinary retention
130
What should be done before prescribing antimuscarinics for urge incontinence
Adequate bladder training
131
Eg of first gen antipsychotics
Haloperidol, chlorpromazine, prochlorperazine
132
1antipsychotics uses
Psychomotor agitation, schizophrenia , bipolar, nausea and vomiting
133
Mechanism of 1antipsychotics
Block post synaptic d2
134
3 dopaminergic pathways in CNS
Mesolimbic / mesocortical - midbrain and limbic / frontal cortex. Nigrostriatal - substantia nigra and corpus striatum (basal ganglia). Tuberohypophyseal - hypothalamus and pituitary
135
Main drawback / adverse effect of 1antipsychotics ? Which pathway ?
Extrapyramidal effects - movement abnormalities from blockade of d2 in nigrostriatal
136
Types of Extrapyramidal in 1antipsychotics
Acute dystonic reactions - Parkinsonism movements / spasms. Akathisia - state of inner restlessness. Neuroleptic malignant syndrome - confusion, autonomic disregulation and pyrexia (life threatening) Tardive dyskinesia - (late onset) pointless repetitive movements eg. Lip smacking
137
Which Extrapyramidal symptom may not stop after stopping treatment
Tardive dyskinesia
138
Adverse effects of 1amtipsychotics
Extrapyramidal | Drowsiness, hypotension, QT prolongation, erectile dysfunction, hyperprolactinaemia
139
When should you be cautious of 1antipsychotics
Elderly - start lower dose Dementia Parkinson's - due to Extrapyramidal
140
Drug interactions with 1 antipsychotics
Any that prolong QT
141
Second gen antipsychotics egs
Quetiapine, olanzapine, risperidone, clozapine
142
2antipsychotic uses
Psychomotor agitation Schizophrenia Bipolar
143
Mechanism of 2antipsychotics
Block post synaptic d2 receptors
144
Main adverse effect of 2antipsychotics
Metabolic disturbance - weight gain, diabetes
145
2antipsychotic adverse effects
Sedation, Extrapyramidal, metabolic disturbance, prolong QT, sexual dysfunction / breast symptoms
146
Clozapine specific adverse effect
1% agranulocytosis (deficiency of neutrophils | Myocarditis
147
Clozapine not used in which patients
Neutropenia | Severe heart disease
148
2antipsychotics caution in ?
Cv disease
149
2antipsychotics interactions
Should not be combined with dopamine blocking antiemetics / drugs that prolong QT

Drugs (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions