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Pharmacology Flashcards

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1
Q

Celecoxib MOA

Indications

A

Cox-2 inhibitor

less UGI SE compared to Naproxen (inhibits Cox-1 and 2)

OA, RA, AS

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2
Q

How does Celecoxib differ from other NSAIDs?

A

Celecoxib = Cox-2 inhibitor

NSAIDs e.g. Naproxen inhibit Cox-1 and 2

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3
Q

Cox -1 inhibition affects

A

COX-1 affects platelet aggregation -> beneficial cardiovascular effects.

However platelet aggregation not affected by COX-2

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4
Q

Ivabradine

MOA?

Use?

A

Blocks If channel in SAN -> reduced HR

Novel anti-anginal
second line to CCBs e.g. diltiazem and verapamil

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5
Q

Flecainide MOA

Indication

A

Sodium channel blocker

Anti-arrhythmic used for tachyarrhythmias e.g. AF

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6
Q

Doxazocin

MOA

Uses

A

Alpha blocker

Tx HTN, also used for LUTs Sx

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7
Q

Spironolactone SE

A

Gynaecomastia

Inhibits enzymes in testosterone synthesis pathway, and blocks receptor binding of testosterone. Also displaces oestradiol from SHBG so increases free oestrogen levels

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8
Q

SE bisphosphonates

pamidronate /zolendronic acid

A

Jaw osteonecrosis.

Due to anti-resorptive action of the nitrogen containing bisphosphonates.

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9
Q

SE Lithium

A

Diabetes insipidus

Hypercalcaemia

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10
Q

Clarithromycin increases concentration/ AUC and risk of toxicity of which COPD drug

A

theophylline

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11
Q

Clarithromycin + statin risk of

A

rhabdomyolysis

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12
Q

AntiHTN CI in pregnancy

A

ACEi

ARB

BB

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13
Q

AntiHTN used in pregnancy

A

labetolol

methyldopa

2nd line = nifedipine

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14
Q

Selegine

MOA

Indication?

A

MAO -inhibitor

Selegine used with levodopa in PD

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15
Q

Analgesic that increases lithium concentration (by decreasing renal clearance)

A

Diclofenac

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16
Q 
St John's wort
Carbamazepine
Phenobarbitone
Rifampicin
Phenytoin

effect on warfarin

A

decreases warfarin conc

as both are CYP450 inducer

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17
Q

ABx causing achilles tendon rupture

A

Fluoroquinolones

  • floxacins
    e. g ciprofloxacins
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18
Q

Adalimumab MOA

A

TNF-a inhibitor

Binds human TNFa and stops it binding to receptors -> reduces inflammation
in e.g. psoriasis

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19
Q

Why use metformin in PCOS

A

Increases insulin sensitivity / PERIPHERAL GLUCOSE UPTAKE
(insulin resistance in PCOS)

this -> ovulation in increased chances of CONCEPTION

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20
Q

Drug that can improve outcomes in severe sepsis

A

LOW DOSE steroids (hydrocortisone)

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21
Q

Ertolinib for e.g. pancreatic Ca

MOA

mechanism of resistance

A

MOA - targets epidermal growth factor (EGFR) tyrosine kinase + ATP binding -> cell signalling

Resistance after 1 year as mutation in ATP binding site

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22
Q

Causes QT shortening

Electrolytes
Endocrine
Drugs

A

High Ca, High Mg

Thyrotoxicosis

DIGOXIN

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23
Q

Dopamine effect on prolactin

A

inhibits prolactin from anterior pituitary

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24
Q

Drugs that increase prolactin levels

A

Antipsychotics e.g. Risperidone

APs = DA receptor antagonists therefore less DA therefore higher prolactin

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25
Hyperprolactinaemia Sx
``` amenorrhoea galactorrhoea infertility loss libido erectile dysfunction ```
26
Exanatide MOA more associated with
GLP-1 analague GLP-1 increases insulin secretion more associated with
27
Rare complication of Exanatide
pancreatitis
28
Drug increasing risk of mortality after acute MI
Nifedipine (Ca antagonist)
29
Criteria transferring to liver unit after paracetamol poisoning
``` pH <7.3 systolic BP <80 creatinine >200 INR >2 at 48h or ?3.5 at 72h encephalopathy ```
30
Macrolides e.g. Clarithromycin Fluoxetine / other SSRIs Cimetidine Omeprazole effects on CYP450 Effect on warfarin
CYP450 INHIBITOR So INCREASES conc of warfarin
31
Drug that induces G6PD
NSAIDs
32
Woman on azathioprine wants to start a family | What do you do?
Continue azathioprine
33
Drugs safe for use in acute intermittent porphyria
Ibuprofen Amoxocillin Opiates
34
Antiepileptic associated with constricted visual fields
Vigabatrin should be stopped when vision deterioration
35
Analgesic effect of adding partial opioid agonist e.g. Buprenorphine to morphine
Reduces analgesic effect As blocks mu receptors from binding morphine
36
Recreational drugs causing CK in 1000's
Ecstasy (MDMA) Phencyclidine (PVP)
37
Drugs used in opioid addiction MOA
Buprenorphine + naloxone Buprenorphine partia mu agonist - so binds receptor but don't get full effects Naloxone blocks mu receptors -> stops heroin binding and stops the high
38
RX alcohol withdrawal 1st line = then give...
1st line = Benzo e.g. chlordiazepoxide (or PO lorazepam if hepatic impairment) to reduce seizure risk Also give thiamine to prevent risk of irreversible Korsakoff's psychosis
39
When to give ABx for otitis media in children
if fever or systemic Sx otherwise if just pain then give analgesia
40
Pioglitazone MOA Indication SEs CI in ...
MOA - PPAR gamma agonist, lowers blood glucose, improve insulin sensitivity Indication - DM SEs - fluid retention, decreased bone mineral density CI in pts with Hx of HF
41
Clopidogrel MOA
ADP receptor antagonist Prevents platelet aggregation
42
Equivalent glucocorticoid, Hydrocortisone : Prednisolone How much Pred would you give if taking 20mg Hydrocortisone?
Pred : Hydrocort 4: 1 20mg Hydrocortisone -> 5mg Pred
43
Cisplatin chemotherapy MOA
causes cross linking of DNA | inhibits DNA replication
44
BB overdose (get low HR and BP) 1st line 2nd line
1st = IV atropine 2nd = IV glucagon
45
Rx methanol poisoning
ethanol
46
Common SE of cisplatin
Ototoxicity BM toxicity Peripheral neuropathy Nephrotoxicity
47
Quinine OD effects
blindness (spasm retinal artery) tinnitus/deafness arrhythmias
48
AED associated with weight gain PCOS tremor hair loss
Sodium valproate
49
AED associated with gingival hypertrophy hypocalcaemia
Phenytoin
50
AED associated with skin rash Steven -Johnson syndrome
Lamotrigine
51
Tamoxifen and Raloxifene MOA
Selective oestrogen receptor modulator
52
SE of Tamoxifen
``` endometrial hyperplasia (as SERM acts on endometrial receptors) ```
53
Cyclosporin MOA Indication
T cell suppression Atopic dermatitis, psoriasis
54
Myasthenia Gravis MOA
ACh - R ABs Reduced ACh receptors available, but same amount of ACh
55
Myasthenia Gravis Ix
EMG (abnormal jitter response)
56
Drug that interacts with cranberry juice
Warfarin
57
Drug that interacts with grapefruit
Simvastatin
58
Recurrent PEs despite being on warfarin Next steps?
Switch warfarin to DOAC, or IVC filter
59
Exanatide MOA
GLP-1 analogue suppresses appetite, stops liver glucose secretion, slows gastric emptying, stimulates insulin release
60
Epileptic Tremor, seizure, confusion nystagmus, hyperreflexia Which drug OD
Lithium toxicity
61
Rigidity, fever, autonomic instability, delirium, high creatinine phosphokinase Which OD?
Neuroleptic malignant syndrome
62
Metformin MOA
Biguanide improves insulin sensitivity and increases hepatic gluconeogenesis
63
Diabetic drugs CI immediately after MI
Metformin increased risk of lactic acidosis due to tissue hypoxia
64
Pt with depression muscle cramps / lethargy Hyponatraeia Low serum osmolality High Urine osmolality Causative drug? Why?
SSRI e.g. Fluoxetine SSRIs can cause SIADH
65
Disulfiram MOA Indication
Inhibits acetaldehyde breakdown (which is EtOH metabolite). High acetaldehyde -> N+V when drink EtOH Indication - EtOH withdrawal NB can get serious reaction when use alcohol-based perfumes
66
CYP450 Inducers effect on warfarin
``` St John's wort Carbamazepine Phenobarbitone Rifampicin Phenytoin ``` decreases warfarin
67
CYP450 inhibitors effects on warfarin
Macrolides e.g. Clarithromycin Fluoxetine/ SSRIs Fluconazoles Increases warfarin
68
Antiemetics Ondansetron MOA
5HT3 antagonist
69
Antiemetic Hyoscine MOA
Hyoscine - anticholinerginc/histaminergic
70
Antiemetic Domperidone MOA
Domperidone - antiDopaminergic
71
Antiemetic Aprepitant MOA indication
neurokinin receptor blocker used for chemotherapy nausea
72
Drug causing angioedema, bronchospasm, urticaria | in hypersensitive patients
Aspirin
73
Pioglitazone increases risk of which cancer?
Bladder cancer
74
Rx acromegaly and carcinoid tumours MOA
Octreotide Somatostatin analogue (stops GH secretion)
75
OD in farmer Miosis and hypersalivation
ACh overactivity e.g. insecticide
76
Rx delirium tremens hallucinations, confusion, agitation 2-3 days after stopping
Oral lorazepam
77
Rx restless leg syndrome
Ropinirole and rotigotine
78
AED that can cause severe hepatotoxicity
Sodium valproate
79
Sildenafil (for erectile dysfunction) SE
Blue rings
80
Furosemide MOA
Loop diuretic Blocks Na reabsorption in loop of Henle
81
Thiazide MOA
Block Na and Cl reabsorption in DCT
82
Imatinib MOA used in which Ca
tyrosine kinase inhibitor stops cell proliferation as signal transduction inhibition Used in CML
83
Rx cyanide poisoning
dicobalt EDTA (Kelocyanor)
84
Change in antiHTN has anaphylaxis Likely causative drugs?
ACEi | ARB
85
Pioglitazone CI in
Heart failure
86
Sodiuim valproate risk in pregnancy
neural tube defect so give folate supplements
87
Rx for remission of membranous glomerulonephritis
Cyclophosphamide + Methylprednisolone
88
Rx eclampsia / eclamptic fit
MgSO4
89
SE of erythropoeitin in ESRF
HTN and seizures
90
Metformin can reduce absorption of what?
B12
91
Sildenafil CI with which drugs
nitrates | including nitrate derivatives e.g. nicroandil
92
Erythema nodosum drug causes
OCP Aspirin (salicylates) Sulphonamides Sarcoid TB
93
Delirium drug Mx Avoid which drugs
Haloperidol or Olanzapine Avoid BDZs (over-sedation + inc delirium risk)
94
Ezetimibe MOA Indication
prevents gut cholesterol absorption used to lower LDL cholesterol
95
Levetiracetam (Keppra) PO or IV what to do in renal failure
Good oral absorption Does not affect hepatic enzymes Reduce dose in renal failure
96
LMWH MOA
inhibits antithrombin
97
Progesterone missed pill must be taken within
3 hours
98
COCP missed pill must be taken within
12 hours
99
Inhibitor of gastric acid secretion
prostaglandin
100
51M 4m pale stools and diarrhoea and wt loss Ca 1.8 ALP 300 Cause?
pancreatic carcinoma lack pancreatic enzymes -> increase SI fat absorption -> Ca not absorbed
101
Rash + coeliac disease
dermatitis herpetiformis
102
Dermatitis herpetiformis Which Ig seen at dermo-epidermal junction
IgA
103
Somatostatin Released from? Role?
pancreas inhibits insulin and glucagon secretion
104
dysphagia and regurgitation/ gurgling in throat hallitosis +/- palpable lump in the neck on examination
Pharygeal pouch herniation between the thyropharyngeus and cricopharyngeus muscles (Killian's dehiscence, in the inferior constrictor of the pharynx), resulting in a diverticulum where food and other debris can collect
105
Pharyngeal pouch Ix
barium swallow
106
GORD Sx Endoscopy - Barrett's + low grade dysplasia Rx?
PPI
107
loss of the APC gene on the long arm of chromosome 5 condition?
Familial adenomatous polyposis (FAP)
108
intestinal hamartomatous polyps, | peri-oral pigmentation
Peutz-Jeghers syndrome (PJS) is an autosomal dominant
109
How to differentiate Peutz-Jeghers syndrome familial adenomatous polyposis Hereditary nonpolyposis colon cancer
Peutz-Jeghers syndrome - lots polyps + perioral pigmentation FAP - polyps + no pignmentation HNPCC - no pigmentation
110
Ascites on diuretic Na drops to 118 Mx?
If Na <120 Stop diuretic Give fluids
111
25M diabetes mellitus recurrent chest infections referred to the gastro w/ chronic diarrhoea 3m abnormal liver function tests + Abdo USS - fatty liver and gallstones
Cystic fibrosis
112
Stop smoking effect on UC
increases risk UC
113
Smoking effect on women w/ CD
earlier disease onset
114
drug causing pancreatitis
azathioprine
115
Ix pharyngeal pouch achalasia
PP - barium swallow | achalasia - oesophageal manometry
116
40F 3m dysphagia + wt loss + vomiting predominantly solid food + reports she has had trouble with liquids too CXR - fluid level behind the right heart border
Achalasia Barium swallow may show a classical bird beak appearance
117
Achalasia Rx
oesophageal dilatation or surgical myotomy
118
perifollicular haemorrhages and bleeding gums which deficiency?
Vitamin C
119
B1 deficiency - B12/cyanocobalamin deficiency -
B1 - Wernicke's B12 - subacute combined degeneration of SC

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