misc

Question 1

how does bupropion work?

Answer 1

nicotine antagonist
dopamine, Na reuptake inhibitor

Question 1

how does varenicline work?

Answer 1

aka champix

nicotine partial agonist - helps with withdrawal

Question 2

side effects/ cautions/contraindications of bupropion and verenicline?

Answer 2

neither can be used in preg/ breast feeding

bupropion - not in patients with epilepsy

varenicline - caution in patients with depression.

other side effects of verenicline include - nausea, constipation, headache, vivid dreams

Question 3

how much do blinking and laryngoscopy raise intraocular pressure by?

Answer 3

blinking - 10mmHg
laryngoscopy - 30 to 40 mmHg

Question 4

how does rise in CVP cause increase in intraocular pressure?

Answer 4

via episceral vessels

Question 5

what is pilocarpine and when is it relatively contraindicated?

Answer 5

muscarinic agonist
Can cause bronchospasm and is relatively contraindicated in asthma.

Used in glaucoma and to increase saliva in those with xerostomia

Question 6

how do B blockers work in glaucoma?

Answer 6

decrease aqueous humour production

Question 7

which anti-emetic can increase intraocular pressure?

Answer 7

metoclopramide - via dopamine receptors

Question 8

how does latanoprost effect intraocular pressure?

Answer 8

Latanoprost is a prostaglandin analogue and is thought to break extracellular matrix, decreasing resistance to the outflow of aqueous humour.

Question 9

how does sux increase intraocular pressure?

Answer 9

Suxamethonium increased IOP, probably as a result of increased choiroidal blood volume.

even when fasciculations are removed, still increases ocular pressure hence thought to be above mechanism

Question 10

what is the basic chemical structure for histamine?

Answer 10

basic molecule

imidazole ring with amino acid side chain

produced from histadine via decarboxylation

Question 11

which histamine receptor is found in CNS?

Answer 11

H1

Question 12

what type of GPCR is H1 and H2?

Answer 12

H1 - Gq
H2 - Gs

Question 13

when are antihistamines indicated in anaphylaxis?

Answer 13

indicated as second-line after adrenaline and steroids

Question 14

what is the receptor mechanism for antihistamines?

Answer 14

inverse agonists - stabilise inactive state of H1

Question 15

which generation antihistamine is chlorphenamine?

Answer 15

first generation

Question 16

can loratidine cross BBB?

Answer 16

not as sedating first generation but still mild sedating effects

(second generation)

Question 17

what protein binding is chlorphenamine?

Answer 17

70%

Question 18

what is the bio oral availability of cyclizine?

Answer 18

high - 80%
similar dose IV and oral

Question 19

how is fexofenadine excreted?

Answer 19

mostly in faeces unchanged.

Question 20

how is epoprostenol given in resp disease? what does it do?

Answer 20

When nebulised, it acts as a specific pulmonary vasodilator at ventilated alveoli, reducing V/Q mismatch

Question 21

how does aminophylline act?

Answer 21

inhibition of phosphodiesterase - intracellular enzyme

Question 22

give an example of leukotriene receptor antagonist? when are they used?

Answer 22

Montelukast, zafirlukast, and pranlukast

chronic asthma, no effects in acute

Question 23

what asthma drug is churg straus a side effect of?

Answer 23

montelukast - rare

Question 24

what is the mechanism of terbutaline?

Answer 24

short acting b2 agonist

Question 25

how much prednisolone is given in acute asthma?

Answer 25

40-50mg

Question 26

what is the protein binding of acetazolamide in plasma?

Answer 26

70%

Question 27

what chemical are thiazides related too?

Answer 27

sulphonamides

Question 28

what is the function of triamterene?

Answer 28

Triamterene blocks elective Na+ channel on the collecting duct luminal membrane

Question 28

how does spironolactone affect digoxin?

Answer 28

reduces clearance hence increases levels

Question 29

what does furosemide do to calcium?

Answer 29

lower it

Question 30

which diuretic worsens diabetes?

Answer 30

thiazides.

Question 31

what type of receptor is the oxytocin receptor?

Answer 31

GPCR

Question 32

what does oxytocin do to diuresis?

Answer 32

anti-diuretic effects

Question 33

what does ergometrine do to SVR and coronary vessels?

Answer 33

increases systemic vascular resistance coronary spasm risk

Question 34

what is the route of delivery of carboprost?

Answer 34

IM - 250ug every 15 mins up to 2mg NOT IV

Question 35

what are the symptoms of hyperMg at 4mM and 6mM plasma conc?

Answer 35

Muscle weakness and bradycardia are seen at a plasma concentration of 6 mmol/L. 4 mmol/L is associated with hyporeflexia, nausea and slurred speech.

Question 36

what are the functions of oestrogen and progesterone on uterus towards term?

Answer 36

Progesterone keeps the uterus in functional quiescence oestrogen causes the myometrium to become activated - which involves upregulation of oxytocin and prostaglandin receptors

Question 37

which hormone causes uterine involution?

Answer 37

oxytocin

Question 38

can oxytocin cross the placenta?

Answer 38

yes

Question 39

what does oxytocin do to the CVS?

Answer 39

Oxytocin reduces SVR, causes transient hypotension and reflex tachycardia.

Question 40

how is oxytocin metaboliseD?

Answer 40

Oxytocin is metabolised by the liver and by plasma oxytocinases.

Question 41

which uterine agent is contraindicated in asthma?

Answer 41

carboprost

Question 42

what type of molecule is misoprostal

Answer 42

Misoprostol is a synthetic prostaglandin E2⍺ analogue

Question 43

what is the mechanism of ergometrine?

Answer 43

Ergometrine causes hypertension by the agonism of ⍺2 receptors.

Question 44

at what stage in PPH is carboprost used?

Answer 44

Carboprost should be used third line after oxytocin and Ergometrine (unless ergometrine is contraindicated).

Question 45

which inhalation agents have the most effect on uterus relaxation?

Answer 45

Sevoflurane and desflurane have a greater uterine relaxation effect than isoflurane.

Question 46

what is atosiban?

Answer 46

Atosiban is an oxytocin receptor antagonist used second line as tocolysis in pre-term labour

Question 47

where is alcohol absorbed?

Answer 47

20% in stomach 80% in duodenum

Question 48

which liver enzyme does chronic alcohol induce?

Answer 48

CYP 2E1

Question 49

what does GORD do to alcohol breath test?

Answer 49

false positive

Question 50

1 unit of alcohol is equivalent to how much pure ethanol?

Answer 50

10ml

Question 51

what is the CIWA-Ar score?

Answer 51

measures alcohol withdrawal

Question 52

what is the most common arrhythmia seen in alcoholics?

Answer 52

AF

Question 53

which class of ilicit drug is codeine?

Answer 53

class B

Question 54

heroin may be cut with scopolamine, what does this do?

Answer 54

anti-cholinergic effects

Question 55

what can talc cause that is cut into ectasy ?

Answer 55

pulmonary granulomas

Question 56

what blood result finding can be seen with cocaine?

Answer 56

thrombocytopenia

Question 57

which opiate receptors does heroin bind?

Answer 57

all of them

Question 58

at low doses what can cannabis do to MAC?

Answer 58

increase MAC at low doses canabis can be stimulatory in general acute canabis, reduces MAC

Question 59

which component of cigarette smoke is nicotine?

Answer 59

the particulate phase (not the gaseous phase)

Question 60

what is the half life of nicotine and how is it metabolised?

Answer 60

30 mins by CYP 450 metabolites are present for up to 20 hr

Question 61

what does nicotine do at high doses?

Answer 61

sedative and depressive effects

Question 62

how much greater is the affinity for CO to Hb than O2?

Answer 62

300 x

Question 63

what does smoking do for PONV and why?

Answer 63

reduces incidence upregulates CYP2E1 and hence quicker metabolism of anaesthetic agents

Question 64

how does varenicline work?

Answer 64

partial nicotinic agonist

Question 65

how does bupropion work?

Answer 65

nicotinic receptor antagonist with dopaminergic and adrenergic action

Question 66

Is gentamicin bacteriostatic or cidal? What type of antibiotic

Answer 66

Bacteriocidal Aminoglycoside