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Miscellaneous Flashcards

(58 cards)

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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

Study These Flashcards
A

Phenytoin
Insulin
Digoxin

25
Which 2 features of a drug will make an possible interaction clinically significant?
Narrow therapeutic index (e.g. phenytoin, digoxin, insulin) | Steep dose response curve
26
Give 2 drugs which slow gastric emptying
Opiates | Atropine
27
Give a drug which speeds up gastric emptying
Metoclopramide
28
Give 2 examples of drugs which are bound to something else in the small intestine, thus slowing their absorption
- Tetracycline antibiotics e.g. doxycycline binds to calcium (e.g. in milk) - Warfarin binds to cholestyramine
29
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?
Drug B will decrease the effect of Drug A. cP450 inducers increase metabolism by cP450 thus inactivating the initial drug.
30
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?
Drug B will increase the effect of Drug A. cP450 inhibitors decrease metabolism by cP450 thus increasing the effect of the initial drug.
31
Which 2 drugs are the exception to the rule of cytochrome p450 activity?
Paracetamol | Clopidogrel
32
True / False: Cytochrome p450 induction has an immediate effect
False - Induction happens slowly as it requires production of more enzyme. Cytochrome p450 inhibition happens immediately.
33
What effect do macrolides have on warfarin? Why?
Macrolides are cytochrome p450 inhibitors so they potentiate warfarin, thus increasing the INR
34
Why should the dose of a statin be lowered when taken with a calcium channel blocker e.g. verapamil?
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
List some drugs which inhibit cytochrome p450 enzymes
``` Macrolides (erythromycin, clarithromycin) Cimetidine Ciprofloxacin Isoniazide Sodium valproate Verapamil Grapefruit juice Anti-fungal '-azoles' ```
36
List some drugs which induce cytochrome p450 enzymes
``` Phenytoin Carbamazepine Phenobarbitone Rifampicin Griseofulvin Smoking Alcohol ```
37
Explain why a patient taking carbamazepine may show an initial benefit from the drug, followed by a deterioration in their symptoms.
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
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?
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
Give 4 factors which influence renal excretion of a drug
Protein binding Tubular secretion Glomerular filtration rate Urinary pH
40
List 2 examples of drugs which alter the tubular excretion of another drug, changing their activity
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
List the side effects of steroids.
``` 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
List some side effects of carbimazole
Agranulocytosis
43
Which drugs may cause agranulocytosis?
The 4 'C's Carbamazepine Carbimazole Colchicine Clozapine
44
What type of drug is warfarin?
Vitamin K antagonist
45
List some side effects of ciclosporin
Renal toxicity Hyperkalaemia Gum hypertrophy
46
List some side effects of azathioprine
Infections Pancreatitis Liver toxicity Bone marrow suppression
47
Which drugs might cause dyspepsia?
``` NSAIDs - aspirin Steroids Calcium channel blockers Nitrates Bisphosphonates Theophyllines ```
48
What are the side effects of H2 antagonists used in peptic ulcer disease?
Nausea, diarrhoea, constipation, headache, rash
49
What are the side effects of PPIs?
Headaches, abdominal pain, diarrhoea, Clostridium difficile infections
50
How do you determine whether H. pylori eradication has been successful?
Urea breath test after 4 weeks
51
Give an example of a dopamine antagonist anti-emetic
Metoclopramide Domperidone Prochloperazine
52
Give an example of a 5-HT3 antagonist anti-emetic
Ondansetron
53
When might you used a 5-HT3 antagonist anti-emetic?
Nausea and vomiting associated with cytotoxic chemotherapy or radiotherapy
54
Which drugs can cause constipation?
``` Opiates Calcium channel blockers e.g. verapamil Anticholinergics e.g. tricyclic antidepressants Iron Lithium ```
55
List the 4 types of laxatives and give an example for each
Bulk forming e.g. isphagula husk, bran Osmotic e.g. lactulose, magnesium salts Stimulants e.g. Senna Stool softeners e.g. arachis oil
56
List some drugs which may cause oesophagitis
``` Alendronate Sando-K Amlodipine Isosorbide mononitrate Tetracycline ```
57
List some drugs which cause constipation
Co-codamol Verapamil Oxybutinin Ferrous sulphate
58
List some drugs which cause drug-induced lupus
``` Procainamide Minocycline Hydralazine Isoniazid Phenytoin ```

Pharmacology (7 decks)

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