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drugs > miscellaneous > Flashcards

miscellaneous Flashcards

1
Q

What kind of environment do acidic drugs require for absorption?

A

Acidic

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2
Q

Examples of acidic drugs?

A

Aspirin
Phenytoin
Penicillins

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3
Q

What kind of environment do basic drugs require for absorption?

A

Basic environment

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4
Q

Give examples of basic drugs

A

Diazepam
Morphine
Pethidine

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5
Q

Why are aspirin and penicillin not well absorbed in older people?

A

Albumin binds to acidic drugs, and albumin is often decreased in older people

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6
Q

Why is the volume of distribution of lipophilic drugs increased in the elderly?

A

Increased fat in proportion to muscle mass in the elderly

sarcopenic obesity

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7
Q

What effect does a large volume of distribution have on half life?

A

Big VD = long half life

in general, but exceptions do exist

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8
Q

What type of drug does albumin bind to?

Is albumin acidic or basic?

A

Albumin is basic

It binds to acidic drugs

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9
Q

What type of drug does alpha1 glycoprotein bind to?

A

Binds to basic drugs

alpha1 glycoprotein is acidic

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10
Q

In the elderly, are levels of albumin increased or decrease?

A

Decreased

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11
Q

In the elderly, are levels of alpha1 glycoprotein increased or decreased?

A

Increased

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12
Q

Define volume of distribution

A

The theoretical volume that would be necessary to contain the total amount of an administered drug at the same concentration that it is observed in the blood plasma.

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13
Q

Define half life

A

The amount of time needed for the quantity of the drug to be halved

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14
Q

How will renal / liver impairment affect the clearance of a drug?

Does this impact the half life?

A

Lower clearance

Longer half life

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15
Q

Do older people have an increased or a decreased volume of distribution?

A

VD for lipophilic drugs increases (more fat : muscle)

VD for hydrophilic drugs decreases (less body water)

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16
Q

How is hepatic metabolism affected in the elderly?

A

Reduced liver function due to decreased liver size, reduced blood flow and disease etc.

First pass metabolism is decreased so often doses need to be reduced to avoid toxicity e.g. with propanolol

17
Q

How does renal metabolism change in the elderly?

A

Decreased GFR

Note: serum creatinine isn’t a reliable measure in the elderly (it’s muscle mass dependent)

–> use creatinine clearance and eGFR instead

18
Q

Why does warfarin take a few days to work?

A

Long half life

19
Q

Name some drugs with a narrow therapeutic index (<2)

A 
Theophylline 
Warfarin 
Lithium 
Digoxin 
Gentamicin 
Vancomycin 
Phenytoin 
Carbamazepine 
Levothyroxine
20
Q

Drugs commonly associated with adverse reactions in the elderly?

A 
Warfarin 
Digoxin 
Insulin 
Benzodiazepines
Diuretics 
NSAIDs
Steroids 
Opioids
21
Q

What other drug should you start when giving an old person opioids?

A

Lactulose / senna

22
Q

Side effects of metoclopramide

A

Restless
Fatigue
Parkinsonism
Insomnia

23
Q

Mechanism of action of metoclopramide?

A

Dopamine antagonist

24
Q

Give examples of dopamine antagonists used as antiemetics?

Which of these could be used in Parkinsons and why?

A

Domperidone
(can be used in parkinsons because it doesn’t cross the blood brain barrier)

Metoclopramide
Prochlorperazine

25
Q

How does cyclazine work? What is it?

A

Antiemetic

H1 antagonist

26
Q

Give an example of a 5HT3 antagonist

A

Ondanestron

27
Q

Methotrexate side effects?

A

Pulmonary fibrosis
Teratogenic
Hepatotoxicity
Myelosuppression

28
Q

Prednisolone side effects?

A 
Impaired glucose tolerance (steroid induced diabetes) 
Osteoporosis 
Hypertension 
Cushing's
AVN femoral head
29
Q

Important side effect of anti TNF drugs?

A

Reactivation of TB

30
Q

Side effect of sulphasalazine that’s particularly important to men wanting to start a family?

A

Reduced sperm count

31
Q

Side effect of hydroxychloroquine?

A

Eye problems

32
Q

Side effects of IM gold?

A

Proteinuria

Peripheral neuropathy

33
Q

Side effects of Penicillinamine?

A

Rash
Myasthenia syndrome
Good pasture’s
Anaemia

34
Q

What haematological side effect does azathiporine cause?

A

Myelosuppression

35
Q

Endocrine side effect of lithium?

A

Hypothyroidism

drugs (3 decks)

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