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Pharmacology > Miscellaneous > Flashcards

Miscellaneous Flashcards

1
Q

Give 2 examples of PPIs

A

Omeprazole

Lansoprazole

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2
Q

Give an example of an H2 antagonist

A

Ranitidine

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3
Q

List some contraindications for the use of ‘triptans’ e.g. in migrane

A

IHD, coronary spasm, uncontrolled HTN, SSRIs, recent lithium use

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4
Q

Give 2 side effects of ‘triptans’ e.g. in migraine

A

Arrhythmias ± angina

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5
Q

List some side effects of amitriptyline

A

Drowsiness
Dry mouth
Decreased vision

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6
Q

Give 2 examples of shortest acting insulins

A

NovoRapid

Humalog

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7
Q

How quickly would you expect a short acting insulin such as NovoRapid or Humalog to take to reach it’s peak? How long will it last?

A

Reaches peak in 1-2 hours

Lasts about 4 hours

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8
Q

When do you need to administer a short-acting insulin such as NovoRapid or Humalog?

A

Immediately with meals - either just before or just after

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9
Q

How quickly would you expect a relatively short acting insulin such as Actrapid or Humulin to take to reach it’s peak? How long will it last?

A

Reaches peak in 2-3 hours

Lasts about 8 hours

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10
Q

When do you need to administer a relatively quick acting insulin e.g. Act rapid or Humulin?

A

20-30 minutes before food

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11
Q

Give an example of a biguanide

A

Metformin

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12
Q

Give an example of a sulphonylurea

A

Gliclazide

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13
Q

Give an example of a DPP-4 inhibitor

A

Sitagliptin

Linagliptin

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14
Q

Give an example of a GLP-1 analogue

A

Liraglutide

Exenatide

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15
Q

Side effects of sulphonylureas

A

Weight gain

Hypoglycaemia

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16
Q

Which 2 types of drug may increase the hypoglycaemic effect of sulphonylureas?

A

Warfarin

Fluconazole

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17
Q

Give 3 examples of anti cholinesterase drugs given in Alzheimer’s dementia

A

Donepezil
Rivastigmine
Galantamine

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18
Q

What is cholestyramine?

A

Bile acid sequestrant - it binds bile to prevent it’s reabsorption.

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19
Q

Give a use of cholestyramine

A

Symptomatic relief of itching in primary biliary cholestasis

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20
Q

What is Creon and when it is used?

A

Pancreatic enzyme supplementation (lipase, protease, amylase). Used in chronic pancreatitis.

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21
Q

Name 2 drugs which cause gynacomastia

A

Spironolactone

Digoxin

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22
Q

List 4 drugs which will cause hyperkalaemia

A

Amiloride
Losartan
Ramipril
Spironolactone

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23
Q

What is meant by a drug interaction?

A

When the effect of drug A alters the effect of drug B

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24
Q

List 3 drugs with a narrow therapeutic index

A

Phenytoin
Insulin
Digoxin

25
Q

Which 2 features of a drug will make an possible interaction clinically significant?

A

Narrow therapeutic index (e.g. phenytoin, digoxin, insulin)

Steep dose response curve

26
Q

Give 2 drugs which slow gastric emptying

A

Opiates

Atropine

27
Q

Give a drug which speeds up gastric emptying

A

Metoclopramide

28
Q

Give 2 examples of drugs which are bound to something else in the small intestine, thus slowing their absorption

A
  • Tetracycline antibiotics e.g. doxycycline binds to calcium (e.g. in milk)
  • Warfarin binds to cholestyramine
29
Q

Drug B is a cytochrome P450 enzyme inducer. Drug A is metabolised by cP450. Will drug B increase or decrease the effect of drug A?

A

Drug B will decrease the effect of Drug A.

cP450 inducers increase metabolism by cP450 thus inactivating the initial drug.

30
Q

Drug B is a cytochrome P450 enzyme inhibitor. Drug A is metabolised by cP450. Will drug B increase or decrease the effect of drug A?

A

Drug B will increase the effect of Drug A.

cP450 inhibitors decrease metabolism by cP450 thus increasing the effect of the initial drug.

31
Q

Which 2 drugs are the exception to the rule of cytochrome p450 activity?

A

Paracetamol

Clopidogrel

32
Q

True / False: Cytochrome p450 induction has an immediate effect

A

False - Induction happens slowly as it requires production of more enzyme. Cytochrome p450 inhibition happens immediately.

33
Q

What effect do macrolides have on warfarin? Why?

A

Macrolides are cytochrome p450 inhibitors so they potentiate warfarin, thus increasing the INR

34
Q

Why should the dose of a statin be lowered when taken with a calcium channel blocker e.g. verapamil?

A

Calcium channel blockers are cytochrome p450 inhibitors, thus increasing the effect of statin. It’s important to monitor this and lower the statin dose as necessary.

35
Q

List some drugs which inhibit cytochrome p450 enzymes

A 
Macrolides (erythromycin, clarithromycin)
Cimetidine
Ciprofloxacin
Isoniazide
Sodium valproate
Verapamil
Grapefruit juice
Anti-fungal '-azoles'
36
Q

List some drugs which induce cytochrome p450 enzymes

A 
Phenytoin
Carbamazepine
Phenobarbitone
Rifampicin
Griseofulvin
Smoking
Alcohol
37
Q

Explain why a patient taking carbamazepine may show an initial benefit from the drug, followed by a deterioration in their symptoms.

A

Carbamazepine is an inducer of cytochrome p450, but it is also metabolised by cytochrome p450 enzymes. Initially the patient feels the beneficial therapeutic effects of the drug, but as more cytochrome p450 enzymes are made by induction, more carbamazepine will be metabolised leading to a deterioration in symptoms.

38
Q

A patient has a one-off binge drinking session and takes a paracetamol overdose. They have no prior hx of EtOH excess. Why might they be protected from paracetamol toxicity?

A

Acute alcohol consumption causes cytochrome p450 inhibition. Chronic alcohol consumption causes cytochrome p450 induction. In the acute setting, where there is no prior history of alcohol excess, cytochrome p450 enzymes are inhibited so paracetamol breakdown will not be at dangerous levels. If this patient was a chronic abuser of alcohol, their levels of c. P450 will be high and so paracetamol would be broken down to toxic metabolites very rapidly, making overdose very dangerous.

39
Q

Give 4 factors which influence renal excretion of a drug

A

Protein binding
Tubular secretion
Glomerular filtration rate
Urinary pH

40
Q

List 2 examples of drugs which alter the tubular excretion of another drug, changing their activity

A

Probenecid (previously used for gout) inhibits renal tubular secretion of penicillins and AZT, increasing their concentration in the plasma

NSAIDs decrease the renal tubular secretion of thiazide and loop diuretics, thus preventing them from getting to the site of action

41
Q

List the side effects of steroids.

A 
Diabetes
Hypertension
Cushing's syndrome
Stomach ulcers
Osteoporosis
Osteonecrosis
Proximal myopathy
Pancreatitis
Cataracts
Glaucoma
Infection
Euphoria
Buffalo hump
Striae
Acne
Addisonian crisis on withdrawal
42
Q

List some side effects of carbimazole

A

Agranulocytosis

43
Q

Which drugs may cause agranulocytosis?

A

The 4 ‘C’s

Carbamazepine
Carbimazole
Colchicine
Clozapine

44
Q

What type of drug is warfarin?

A

Vitamin K antagonist

45
Q

List some side effects of ciclosporin

A

Renal toxicity
Hyperkalaemia
Gum hypertrophy

46
Q

List some side effects of azathioprine

A

Infections
Pancreatitis
Liver toxicity
Bone marrow suppression

47
Q

Which drugs might cause dyspepsia?

A 
NSAIDs - aspirin
Steroids
Calcium channel blockers
Nitrates
Bisphosphonates
Theophyllines
48
Q

What are the side effects of H2 antagonists used in peptic ulcer disease?

A

Nausea, diarrhoea, constipation, headache, rash

49
Q

What are the side effects of PPIs?

A

Headaches, abdominal pain, diarrhoea, Clostridium difficile infections

50
Q

How do you determine whether H. pylori eradication has been successful?

A

Urea breath test after 4 weeks

51
Q

Give an example of a dopamine antagonist anti-emetic

A

Metoclopramide
Domperidone
Prochloperazine

52
Q

Give an example of a 5-HT3 antagonist anti-emetic

A

Ondansetron

53
Q

When might you used a 5-HT3 antagonist anti-emetic?

A

Nausea and vomiting associated with cytotoxic chemotherapy or radiotherapy

54
Q

Which drugs can cause constipation?

A 
Opiates
Calcium channel blockers e.g. verapamil
Anticholinergics e.g. tricyclic antidepressants
Iron
Lithium
55
Q

List the 4 types of laxatives and give an example for each

A

Bulk forming e.g. isphagula husk, bran
Osmotic e.g. lactulose, magnesium salts
Stimulants e.g. Senna
Stool softeners e.g. arachis oil

56
Q

List some drugs which may cause oesophagitis

A 
Alendronate
Sando-K
Amlodipine
Isosorbide mononitrate
Tetracycline
57
Q

List some drugs which cause constipation

A

Co-codamol
Verapamil
Oxybutinin
Ferrous sulphate

58
Q

List some drugs which cause drug-induced lupus

A 
Procainamide
Minocycline
Hydralazine
Isoniazid
Phenytoin

Pharmacology (7 decks)

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