Pharmacology Flashcards
(255 cards)
1
Q
Orlistat class
A
pancreatic lipase inhibitor
2
Q
Asprin in breast feeding risk of?
A
Reyes syndrome
bleeding problems
3
Q
Quinolones (-floxacin) mechanism ?
A
Inhibit DNA Gyrase
4
Q
aminoglycosides, and tetracyclines mechanism (gent / cyclines)
A
inhibit bacterial ribosomal protein synthesis
5
Q
Penicillins action
A
binds to proteins -> impairs osmotic balance -> cell lysis
Cell wall synthesis
6
Q
Cephalosporins action
A
bactericidal
Inhibit cell wall synthesis
7
Q
How does metronidazole work
A
free radical production within anaerobic organisms
8
Q
Aspirin overdose -> what blood gas initially? then? Pathophysiology of each
A
Respiratory alkalosis
[salicylates stimulate the respiratory drive ]
Followed by metabolic acidosis if severe
[due to disruption of ATP production -> anaerobic respiration and build-up of lactic acid ]
9
Q
Why sub lingual drugs needed in lower doses
A
Avoid first pass metabolism
10
Q
Carbamazepine’s key side effects
A
Cerebellar toxitiy
C for C in the brain
Hyponatraemia
11
Q
Need co amox but amox allergy? What if preg?
A
Doxy + metro
Preg = Azithro + metro
12
Q
Normal metabolism of paracetamol ? In OD?
A
conjugation to glucuronic acid
[NOT GLUTATHIONE]
in OD - pathway saturated so non specific P450 oxidation which produces toxic metabolite (NAPQI)
->NAPQI is conjugated by gluathione
If excess of NAPQI (glutathione saturated) then it binds to hepatocytes and causes cell death
13
Q
Cardiac history - pt comes in complaining things have a weird colour or halo’s around. + nausea + anorexia + brady =?
A
Digoxin toxicity
14
Q
Seen on ECG of therapeutic digoxin
A
Prolonged PR + scooped ST
15
Q
Rx of digoxin toxicity? Key marker of mortality?
A
Fab fragments [digoxin specific antibody]
Potassium level >5
16
Q
CP450 pneumonic
A
Bare minimum - remeber both mnemonics and the C in CRAPGPS is carbamazepine and s is sulphonylureas
Inducers - Reduces concentration of drugs) CRAP GPs
Carbemazepines
Rifampicin
Alcohol
Phenytoin
Griseofulvin
Phenobarbitone
Sulphonylureas
Inhibitors (Increases concentration of drugs) SICKFACES.COM
Sodium valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Alcohol & Grapefruit juice
Chloramphenicol
Erythromycin
Sulfonamides
Ciprofloxacin
Omeprazole
Metronidazole
17
Q
On multiple agents which increase QT why do die?
A
Torsade du pointes
18
Q
Epilepsy with side effects:
Hair loss, liver damage, pancreatitis, weight gain?
A
Sodium valproate
19
Q
Discoloured teeth in infants - what drug in preg?
A
Tetracyclines
TEETHracycline
20
Q
Where do thiazide diruetics work on
A
The proximal segment of the distal convoluted tubule
21
Q
Where do loop diuretics work?
A
Ascending loop of henle
22
Q
Where do aldosterone antagonists work eg spironolactone
A
collecting duct
23
Q
Where does amiloride work?
A
distal segment of distal convoluted tubule eNAC channels
24
Q
Epilepsy and vision problems =
A
vigabatrin
V for vision
(loss of peripheral vision and retinal atrophy)
May also get alopecia and aggression
25
What happens in mdma toxiticy?
SIADH -> hypoNa
26
Key types of drug contra indicated with sildenafil?
Nitrates + nicroandil
27
Statins are HMG-CoA-reductase inhibitors? What does this mean? How does ezetimibe work?
Statins reduce cholesterol synthesis
Ezetimibe - reduces intestinal cholesterol absorption
28
How is lithium cleared
95% renal clearance
[none in liver]
29
How do PPIs work
inhibit H+/K+ATPase
30
Which antieileptic key for hypoNa
carbamazepine
31
Need to check before starting azathioprine therapy
TPMT
32
Drug of choice in hyperthyroid pregnancy
Propylthiouracil in first 2 trimesters
Often switched to Carbimazole before delivery
33
Vit D replacement levels in OP
400-800 units daily
[+1500mg Ca]
34
Who gets drug-induced lupus
White people
35
How does enox work?
potentiates action of anti-thrombin III
36
Diuretics class and where they act
MALT K
Mannitol (Osmotic Diuretics): water reabsorption in the proximal tubule
Acetazolamide (Carbonic Anhydrase Inhibitors): proximal tubule
Loop Diuretics: thick ascending loop of Henle, =/=> Na+/K+/2Cl- transporter (furosemide, ethacrynic acid)
Thiazides: distal tubule, =/=> Na+/Cl- symporter (hydrochlorothiazide, indapamide)
K+ sparing agents: distal nephron (late distal tubule + collecting ducts). Aldosterone receptor antagonist (spironolactone) Na+/K+ e
xchange by of Na+ channels (amiloride, triamterene)
37
Tricyclic OD key thing to give? 3 things worried about
IV Sodium Bicarbonate
Acidosis
Seizures
Arrhythmias
[50% chance of ventricular arrythmias with QRS >160ms)
38
Tricyclic OD key thing to give? 3 things worried about
IV Sodium Bicarbonate
Acidosis
Seizures
Arrhythmias
[50% chance of ventricular arrhythmias with QRS >160ms)
39
Oliguric crisis Rx
Procyclidine
40
Methanol poisoning rx mainstay if gubbed?drug? Mechanism?
RRT
Fomepizole - inhibitor of alcohol dehydrogenase
if mild and conscious -> try soda bic first
41
Where is methanol metabolised? Which is the metabolite which causes acidosis, blindness and end-organ damage?
Why could you give ethanol if no fomepizole?
Liver -> toxic metabolites
Formic acid [similar name to FORMepizole]
Ethanol competes with methanol (prevents toxic metabolite formation)
42
Drugs which cause lung fibrosis
Blah NeverMind
Bleomycin Nitrofurantoin MTX
43
Rifampicin action
RNA polymerase disruption
44
Diabetes and HGV licence
Need to discuss with DVLA if insulin dependent.
Need regular blood sugar checks when driving and before driving
45
When dialysis for methanol level?
Serum methanol >50mg/dl
46
Red urine and tears which drug
Rifampicin
Red Rif
47
HBA1C target? If on gliclazide or other drug which causes Hypos?
48mmol/mol
53
48
1st line for dual therapy T2DM if patient is obese?
DPP4 inhibitor
-gliptin
Or GLP-1
-Glutide
49
Which classes diabetic meds cause hypos (excluding insulin smart arse)
Sulphonyureas
-gliflozin (SGLT2 inhibitos)
50
Which antiepileptic - gum hypertrophy
Phenytoin
51
How does theophylline work?
Adenosine receptor blocker ->relaxation of smooth muscle
52
Key SE of bosentan (used for pulm HTN)
liver toxicity
53
What does finasteride do?
Prevents conversion of testosterone to dihydrotestosterone by inhibiting 5a-reductase
54
Drug for reducing prolactin in pituitary adenomas
Bromocriptine (dopamine agonist)
55
How does clomifene work
Stimulates pituitary release of GnRH
56
Green / blue urine from which infection? Which most common drug also causes it?
Pseudomonas
Amitriptyline
57
Long-term key risk of TNFa inhibitors
Lymphoma
58
How does amiodarone affect sight?
Corneal deposits
59
eg of aromatase inhibitor? Mechanism?
Letrozole, Anastrozole
Aromatase inhibitor
Blocks conversion of androgens -> oestrogens
60
Which antihypertensives bad with ciclosporin? Antibiotic?
Verapamil, diltiazem
Macrolides
[also imidazole based antifungals - good luck]
61
Who gets phenytoin toxicity even when drug in the normal range on bloods?
Uraemia
HypoAlbumin
Hyperbilirubin
[Get decreased phenytoin protein binding - drug appears to be in normal range but actually has more free non bound active bits in blood]
62
Who gets phenytoin toxicity even when drug in the normal range on bloods?
Uraemia
HypoAlbumin
Hyperbilirubin
[Get decreased phenytoin protein binding - drug appears to be in the normal range but actually has more free non bound active bits in blood]
63
Key side effect of donepezil
Cholinesterase inhibitor
->Brady most important
[Urine incontinence, hepatitis, GI upset]
64
Which NSAID most likely to cause convulsions in OD? What are symptoms of NSAID OD due to?
Mefanamic acid
Inhibition of cyclo-oxygenase
65
Why do you often get a little bit of hyperthyroid with reduced TSH pregnancy
B-HCG stimulates thyroid hormone production
66
how does carbimazole work
Converted to active metabolite - methimazole
-Inhibits iodination of tyrosine
66
how does carbimazole work
Converted to active metabolite - methimazole
-Inhibits iodination of tyrosine
67
First line antihypertensive if on lithium
Amlodipine
(ACEi can increase lithium levels)
68
How is propythiouracil different from carbimazole
Blocks peripheral conversion of thyroxine -> t3
69
Parkinsons drug which can be given S/C if no oral route
Apomorphine
70
Multiple fungal nails Rx
Oral Terbinafine
(topical only if 1 nail affected)
71
anti-emetics -setron's are which class? Where do they work?
5HT-3 receptor antagonists
Medulla oblongata
72
Which parkinsons drug makes urine dark
L-dopa
73
Ciprofloxacin and a sore ankle whats happened
Ciprofloxacin induced achilles tendonitis
more likely if >60, on steroids, renal impairment or prev transplant/tendon rupture
74
How does NAC work in Paracetamol OD
Conjugates NAPQI as an exogenous glutathione source
75
3 main choices of Antihypertensive in pregnancy
Labetalol
Nifedipine
Methydopa
-Should also be prescribed aspirin
76
B Blocker OD Rx hypotension/brady? Hypoglycaemic?
Widened QRS?
IV glucagon - for symptomatic brady
-+/- Atropine, +/-isoprenaline
IV dextrose - if hypoglycaemic
Sodium bicarb for wide QRS or hypotension not fluid responsive
77
OD -> Hypo. Not diabetic drug
B blockers
78
Half life of adenosine? What drug increases this? When is it CI'd?
5s
Dipyridamole
May cause complete heart block in...
2/3rd degree heart block
Sick sinus syndrome
Verapamil
79
Which anti-epileptic is associated with osteomalacia? What on bloods would make you suspicious
Phenytoin
HypoCa, HypoVitD, HypoPO4
Raised ALP
80
Sulfonylureas mechanism and key side effects
stimulate insulin secretion by acting on the K+ ATP channel on the surface of the pancreatic β-cell
weight gain and risk of hypoglycemia
81
PPAR-γ agonists (thiazolidinediones)
Eg?
Mechanism?
Key side effects?
Pioglitazone
Act on adipose tissue to increase adipogenesis and lipogenesis in peripheral adipose depots.
Fluid retention -> Oedema / heart failure
risk of fractures
82
2 types of incretin class? EG?
Effect?
Side effects?
Oral (DPP-4) inhibitors (gliptins)
Injectable glucagon-like peptide-1 receptor agonists (GLP-1) -glutide
Stimulate glucose-induced insulin secretion
suppress glucagon production
Weight loss - mostly GLP-1 (good)
Risk of pancreatitis
83
SGLT2 inhibitors eg?
Mechanism?
Good for?
Key risks
-Gliflozin
Glycosuric suppress reabsorption of glucose from the proximal tubule
beneficial effects on major adverse cardiac even
UTIs / genital infections
84
Which diabetic drug may caused reduced gastric emptying
Gliptins
85
How do SLG2- inhibitors improve bp?
Osmotic diuresis
86
Which antidiabetic cause eDKA
SLG-2 inhibitors
87
Which class antidiabtics worst for fluid retention
-glitazones
(thiazolidinediones)
88
Medications causing erythema nodosum
Omeprazole
HepB vaccine
Isotrenatoin
89
drugs metabolised by CYP-2D6
Antidepressants - Tricyclic / SSRI
B blockers
c
Dihydrocodeine (converted to morphine)
Ecstasy
90
Dihydrocodeine but no analgesic effect?
Reduced CYP-2D6 action
[usually concerted to morphine]
91
Why take statins at night
HMG-CoA-reductase most active when fasting (and liver blood flow increased lying flat)
92
Which pain killer has actions on serotonin and may contribute to serotonin syndrome
Tramadol
93
What class is Phenelzine? what do you need to avoid
MAOi
SSRIs as risk of serotonin syndrome
94
Sumatriptan mechanis
5HT-1 agonist
95
hypertensive crisis and collapse Rx
IV Sodium nitroprusside
96
Hypokalaemic on furosemide - long term plan?
Add a potassium-sparing diruetic eg amiloride / spironolactone
97
What is aminophylline - how is it different in potency to theophylline
Theophylline + [ethylenediamine]
makes it 20x more potent
98
Key side effects of theophylline? in excess
Insomnia + agitation
[metabolic acidosis + hypoK]
OD -> profound hypoK and supraventricular arrythmias
99
Option for Rx of Kallman's other than testosterone
Human Chorionic Gonadotrophin
100
How does trimethoprim work
Inhibits dihydrofolate reductase
101
What happens if you use allopurinol during an acute gout attack?
Prolongs and exacerbates episode
102
very low fibrinogen + bleed-> give what
Cryo
[Fibrinogen, VWF, VIII, XIII]
103
What is the renal extraction ratio of a drug
The decline in plasma concentration from arterial -> venous section of kidney
104
What is disodium cromoglycate used for? mechanism?
Asthma
Inhibits mast cell degranulation
105
In a question - how might you work out which drug is the most water-soluble?
The ones which are lipid soluble will cross blood-brain barrier...
Eg Antidepressants, Acyclovir, benzos all need to be lipid soluble to get to brain
106
Which antiepileptic for weight gain
Sodium valproate
107
What will the question have if they want you to recognise severe CO poisoning?
Evidence of tissue ischemia
Eg -ST depression on ECG
-Raised lactate
108
TB drug causing Visual issues / colourblind
Ethambutol
-E for Eyes
109
Ciclosporin inhibts which IL
IL-2
110
What does warfarin inhibit
Factors 2,7, 9, 10
Protein C
111
How does the POP work
Thickens cervical mucus
-> Sperm cannot enter
112
What does ondansetron do to the 5-HAII receptors
Inhibits them
113
Phenytoin OD sx
Agitation, Ataxia, nystagmus, drowsiness
114
Abdo cramps, shivering, rhino/diarrhoea, tachy/hypertensive - features of withdrawal from?
Opiates
115
Malignant hyperthermia drug?
Dantrolene
[ryanodine receptor 1, and decreasing intracellular calcium concentration]
-> reduced muscle contraction
116
Metformin mechanism
adenosine monophosphate-activated protein kinase agonist
[LOL WTF - mebe just ignore this]
117
>55 HTN didn't tolerate amlodipine due to ankle swelling. Whats the next line?
Thiazide-like diuretic Eg indapamide / metolazone
118
Mild allergy to penicillins (GI upset) and nitro-resistant bug in urine = what ABx in preg?
Cefalexin
119
Which cardio drugs do you need to avoid BBlockers in? Class ?
Verapamil / diltiazem
non-dihydropyridine calcium antagonist
120
In whom might isoniazid cause more liver toxicity?
Rapid acetylator -> more toxic metabolites to liver
Slow acetylator would lead to higher drug concentrations and lead to systemic effects eg peripheral neuropathy
121
Which antimalarial worst in G6PD
Primaquine
122
Penicillamine adverse effects
Acute interstitial nephritis + pancytopenia
123
Type A/B/C/D/E adverse drug reactions
A - Anticipated Eg Brady cardia from B blockers
B - Unexpected and unpredictable
C - Occur after prolonged use Eg peripheral neuropathy
D - Occur long after treatment finished Eg Cancer 20 years later
E - Due to withdrawal of drug
124
Cisplatin key side effect bar nephro/ototoxicity
Peripheral neuropathy
125
Why diarrhoea in metformin
Bile salt malabsorption
126
Benzo remachanism
GABA Agonist
127
3 ways which CKD alters drug pharmacokinetics
Gastric absorption
Protein binding
Volume of distribution
128
Which Abx class risk of neuro Sx and chillies tendon rupture
Fluroquinolones - Eg Levofloxacin
129
Bar nitrates what is the other ci to PDE-5 inhibitors
Coronary artery disease
130
Key drugs affected by acetylator status
PISH'D
procainamide - Slow = drug induced lupus
isoniazid - slow = peripheral neurpathy, fast = liver toxicity
sulphonamides (especially salicylazosulphapyridine)
hydralazine - slow = drug induced lupus
Dapsone
[Nitrezepam]
131
Want to start a mab in someone who has previously been treated for TB. What test do you do?
Interferon-gamma release assay
Positive test = current or latent infection which means need anti-TB drugs while getting -mab.
132
In who is a mantoux test positive
Prev TB / BCG
133
Ataxia and peripheral neuropathy which antiepileptic
Phenytoin
134
Gum hyperplasia and dupurytrens contracture which antiepileptic
Phenytoin
135
COX inhibitor (non-selective) Egs?
Selective COX-2 inhibitors?
Aspirin, NSAIDS eg diclofenac / nefopam
Celecoxib / rofecoxib
136
What is hypertrichosis?
excessive hair growth
Eg cyclosporin
137
Bosentan mechanism
Endothelin A+B receptor antagonist
138
Endothelin A vs B fucntion
A - vasoconstriction of smooth muscle
B - Production of nitric oxide and prostaglandin
139
Haemodialysis in lithium?
Level >6
Level > 5 and creatinine >150
Any level and decreased consciousness/life-threatening eg seizures
[If lithium naive and level >4]
140
What is cisapride? Key risk
Prokinetic
QT prolongation
[Fatal arrhythmias if given with P450 inhibitors]
141
Present with a stroke - hypertensive at the time (but not crisis). When should antihypertensive meds be started?
After 2 weeks
Or on hospital discharge
Risk of worsening cerebral ischemia if started immediately.
142
Memantine mechanism
NMDA antagonist
[Not agonist]
143
Amiodarone mechanism
Potassium channel blocker
144
Sotalol mechanism
Selective B1 blocker
Potassium channel blocker
145
Lidocaine mechanism
Sodium channel blocker
146
How do CCBs work as an anti-arrhythmic
Delay AVN conduction
147
Issue of graves and radioactive iodine
Worsens exophthalmos in first 3 months
148
Strong predictor of bleeding when anticoagulated in alcoholics
AST/ALT ratio
149
Withdrawal symptoms with hallucinations. Alcohol or benzo?
Alcohol
150
2 examples of a thiazide-like diuretic when to use?
Indapamide, Chlotalidone, metolazone
CCB unsuitable in black / >55
151
Posioning smells [wtf]
Eggs
Garlic
almonds
Mothballs
Eggs - hydrogen sulphide
Garlic - Arsenic / selenium
almonds - cyanide
Mothballs - Napthalene
152
B1 vs B2 receptors
B1 - heart (one heart)
B2 - Lungs (2 lungs), vessels, GI....
153
Buprinon used for?
Mechanism? 2 Key contraindications
Smoking cessation
inhibition of norepinephrine and dopamine reuptake
Cirrhosis
Seizures (reduces threshold)
154
Trastuzumab other name? Mechanism it causes cardiomyopathy?
Herceptin
erb-B2 inhibitor
155
Tiotropium class?
Long-acting anticholinergic (anti-muscarinic)
156
Why are penicillins and glycopeptides (eg vanc) ineffective against chlamydia ?
Chlamydia lacks a cell wall
157
2 protiens expressed by Ca cells which make them resistant to chemo
P-glycoprotein
Multidrug restiant protein
[accelerates eflux of toxic agents out the cells]
158
What causes the dry cough with ACEi
Decreased Bradykinin breakdown
159
Phaeo + HTN what drug for BP
A-blocker - Eg Phenylbenzamine [doxazosin]
160
Dipyridamole class
Phosphodiesterase inhibitor
[-> upregulates cAMP -> blocks platelet response from ADP]
161
Clopidogrel class? What does this do?
ADP inhibitor
Adenosine diphosphate receptor inhibitors
They prevent platelet aggregation by selectively and irreversibly binding the platelet surface receptor P2Y12
[These drugs antagonize the P2Y12 platelet receptors and therefore prevent the binding of ADP to the P2Y12 receptor.]
162
Skin infection while breastfeeding
Still fluclox
163
Glococorticoid induced osteoperosis Rx
Bisphosphonates
164
Aspirin OD when would activated charcoal help
<2hrs
165
Cardiac drug causing oral ulceration
Nicrorandil
166
nicorandil mechanism? How many people get headaches
ATP dependent Potassium channel activator
35% get headaches
167
Drugs that decrease digoxin secretion -> toxicity
verapamil, quinine, nifedipine and quinidine
168
Entamoeba 1st line Rx?
Metronidazole
169
Which antipsychotic 1st line for schitz and best re making them fat
Risperidone
170
CN VI palsy caused by what class of Abx? why?
Tetracyclines -> intracranial hypertension
171
Drugs causing intracranial HTN ? Withdrawal of what class does it as well?
Tetracyclines
Amiodarone
Oral contraceptive
Withdrawl of steroids
172
Eculizumab is used for? Targets?
Paroxysmal nocturnal haematuria
Complement (C5)
173
What links chlorpromazine, ciprofloxacin, ofloxacin, cimetidine, phenytoin, naproxen, captopril, erythromycin, azithromycin, and dicloxacillin.
Can cause obstructive jaundice
174
If a question asks about which drug works through direct drug action rather than achieving effects through a metabolite how could you work it out?
The one that can go IV will work though direct action (probably)
175
Imatinib is what
Tyrosine kinase inhibitor
176
Hypersalivation and rhinorrheoa in what withdrawal
opiate
177
TB - now significant interstitial nephritis - which drug?
Rifamipicin
178
Which metal poisoning could you use penicillamine for?
Copper - Duh
179
Thallium posioning Rx
Prussian blie
180
Isolated thrombocytopenia cause
Rx?
ITP
Steroids if bleeding / platelets <20
181
What is bioequivalance
Drugs have the same effect
181
What is bioequivalance
Drugs have the same effect
182
Trimethoprim severe side effect
Pancytopenia or agranulocytosis
183
Bblockers and potassium
May cause hyperk RARELY
184
Most common Abx causing obstructive jaundice
Co-amoxiclav (cholestasis)
185
Enzymes insulin inhibits?
Activates?
Those in glucogenesis
Eg - Pyruvate carboxylase
Activates
Acetyl-CoA Carboxylase
ATP citrate lipase
G6PD
186
Which Rheum DMARD would cause nephrotic syndrome (membranous glomerulonephritis)? Which HLA is assoc with this?
Penicillamine
[Or gold - rarely used]
Strong assoc with HLA DR3
187
Why might you need to increase the dose of carbamazepine about 2 weeks after starting?
Ie initially therapeutic level then became sub-therapeutic
Autoinduction of CP450 -> increased metabolism
188
Why do you not use alkaline solutions on acid burns
May cause heating / exacerbate injury
189
Acid burns - what is the mechanism? What electrolyte disturbance is common after?
Skin coagulative and liquefactive necrosis through hydrolyzing of proteins
HypoCa
190
Which cardiac med causes methaemoglobinaemia? What else might be seen on blood / film?
Nitrates
Cause Fe2+ (ferrous) -> Fe3+ (ferric)
Heinz bodies and haemolytic anaemia
191
Heinz bodies mean what has happened?
indicative of oxidative injury to the erythrocyte
192
Trimethoprim when breast feeding?
Cipro?
Doxy?
All good - the neural tube has developed now
Cipro BAD - tendon rupture in kids
Doxy bad - uptake into developing bones and tooth discolouration
193
Paraquat (pesticide) OD kills you how?
Oxygen free radical toxicity
Acute alveolitis -> respiratory failure
If survives likle yo get pulm fibrosis
194
Renal issue with amphotectin B
T1 RTA
-> HypoK
May also cause renal DI
195
Meningitis contacts given
Cipro (oral )
196
Methotrexate therapy - which common drug can affect clearance
Omeprazole
197
Mpost importat part of vit A for sight
retinaldehyde
198
UTI - given abx and now peripheral neuropathy?
Nitrofurantoin
[Nitro-Neuro]
may cause other neuro issues too eg optic neuritis / nystagmus / vertigo
199
Cyanide antidote
Amyl nitrite
200
Young woman vomiting post chemo 1st line rx
IV ondansetron
201
Gitelmans - what long term diuretic for rx
K sparing Eg amiloride
202
Rosuvastatin Key hepatic transporters
OATP1B1
BCRP
203
Rosuvastatin Key hepatic transporters
OATP1B1
BCRP
204
Why phenytoin levels fall slowly
Protein bunding 90% protein bound
205
Tinnitus, dizziness, increased resp rate and sweating
Salcicilate OD
206
Most common side effect of cyclophosphamide
Anaemia, neutropenia and thrombocytopenia
Hemorrhagic cystitis is quite rare - unless in high dose Eg Chemo
207
new AF Rx. Now hepatotoxicity drug?
Amiodarone
208
Antiepileptic causing PCOS
Sodium Valproate
[teratogenic and ovary smashing]
209
3 main SEs of ciclosporin
Chronic interstitial nephritis
Hyperkalaemia
Hair grows (hypertrichosis)
210
3 common drugs with a high first-pass metabolism - so used in caution in liver disease
Verapamil
Morphine
Propanolol
211
Cranberry juice classically messes with which drug via which transporter?
Grapefruit?
Grapefruit - warfarin, ciclosporin and statin
-CYP3A4
Cranberry - Warfarin
-CYP2C9
212
When lithium conc taken for routine testing? Therapeutic range
12 hours after dose
0.4-1mmol/L
213
Big cause of postural hypotension in old people
Doxasisin most
[more than diuretics]
214
Before Tb RIPE rx what needs to be assessed
Visual assessment
215
Docetaxel mechanism
Bind to microtubules -> apoptosis
216
Buserelin does what? mechanism
decreases androgen production
GnRH agonist
->increased levels then after few weeks of therapy testosterone levels fall
217
Drug causes of gynaecomastia
DISCO
Digoxin
Isoniazid
Spironolactone
Cimetidine
Oestrogens.
218
What are the COMMON side effects of olanzapine
Weight gain
Rise in LDL, Triglycerides, glucose
219
Which antidiabetic - Short term insulin release when taken directly before meals ?
[For shift workers with periods of fasting]
Meglitinides
[Nateglinide, repaglinide]
220
Why is domperidone better than metoclopramide
Does NOT cross the blood-brain barrier
-> doesn't cause extrapyramidal side effects eg parkinsonism
221
Amphotericin has lots of side effects including when administered - how is can these be reduced
Lipid bound preperation
222
Where does haloperidol act for its antiemetic properties
Chemoreceptor trigger zone
223
Which Abx most strongly assoc with steven johnsons
Co-trimoxazole (sulfonamides the bit causing the reaction]
224
Azithromycin works how
Inhibits bacterial ribosomal protein synthesis
[MACROLIDES]
225
Drug leading to blue vision
Sildenafil
[Blue pill in toilets]
226
C diff no oral option best Rx ? Why
IV Metronidazole
-excreted into bile better than vanc
227
Lead toxicity leads to vague Sx of anaemia, GI upset and...?
Rx?
Isolated nerve lesions Eg common peroneal
Oral DSMA or IV EDTA for chelation
228
2 options for drug induced dystonia
Procyclidine
Benzatropine
229
Indometacin mechanism
Inhibits prostaglandin synthase and COX
230
which type of calcium channel do CCBs affect
L type
231
Tolterodine used for bladder instability is used why? Mechanism
Antimuscarinic
Specific to bladder - get less anticholinergic side effects
232
Rosacea - given rx and develops blue-gray skin
Minocycline
233
OD - unconcious with dilated pupils and tachycardia with ectopics
Tricyclic
234
Which diuretics decrease lithium concentration
Osmotic and
Acetazolamide
-> increase excretion
235
Aspirin sensitivity syndrome Sx
Flushing, bronchospasm, urticaria
236
Which Abx may cause drug induced autoimmune haemolysis? Parkinsons drug causing this?
Penicillin
Mdopa
237
Abciximab is a
Glycoprotein2b3a inhibitor
238
PPAR-a Example
PPAR-y example
a - fibrates (lower triglycerides and increase HDL)
y - glitazones
239
Why GI bleed with NSAIDs
Depletes mucosal prostaglandin E levels
240
On metformin, prescribed Abx -> goes to party gets MALA why
Alcohol
[metformin is renally excreted not affected by hepatic enzymes]
241
Azathioprine inhibits ...? Which means?
AzathioPRINE inhibits PuRINE synthesis
-> supresses lymphocytes
242
Posoning with nerve agent eg sarin key effects?
Cholinergic [not anti]
Brady, sweating / salivation
Muscle fasicultions / tremor / neuro
243
Why does verapamil need such a lower dose when given IV
Bioavailability
[high first pass metabolism]
244
Nabilone is used in chemo - mechanism
Cannabinoid receptor agonist
[antiemetic]
Nabi - caNabinoid
245
Previous pre-eclampsia. Preg again - rx?
Aspirin 75
246
Which diuretic most leads to HypoNa and Hypok
Thiazides > furosemide
247
CO poisoning in preg
Reduces oxygen dissociation from maternal to fetal Hb -> profound fetal hypoxia
248
Drug causing parotid swelling
Propylthiouracil
Pp
249
Why terlipressin in hepatorenal syndrome
Increases arterial vascular resistance -> reduces splanchnic hypovolemia
Decreases renin
250
Antiemetic for motion sickness
Cinnarizine
251
What is classed as very common side effect
Occurrs in >10%
252
4-methylpyrazole mechanism
Its fomepizole
Competitive inhibitor of alcohol dehydrogenase
253
methotrexate inhibits dihydrofolate reductase. But what does this mean for rheum A
leads to reduced purine synthesis
