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Pharmacology Flashcards

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1
Q

Name some P450 inhibitors

A

Sodium valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Alcohol (binge)
Chloramphenicol
Erythromycin
Sulphonamides
Ciprofloxacin
Omeprazole
Metronidazole
Grapefruit juice

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2
Q

Name some P450 inducers

A

Carbamazepine
Rifampicin
Alcohol (chronic)
Phenytoin
Griseofulvin
Phenobarbitone
Sulphonylureas

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3
Q

Name some side effects of amiodarone

A

Pulmonary fibrosis
Hepatotoxicity
Corneal deposits
Thyroid dysfunction
Blue-grey skin discolouration

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4
Q

Name some drugs which may worsen glycaemic control

A

Thiazide diuretics
Antipsychotics
Beta blockers
Corticosteroids

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5
Q

In which conditions should griseofulvin be avoided?

A

Pregnancy
Porphyria
Liver disease

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6
Q

How do you treat C. diff?

A

First line: vancomycin
Second line: Oral fidaxomicin for 10 days

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7
Q

Name some key statin side effects

A

Myositis
GI upset
Altered liver function
Rarely, pancreatitis and interstitial lung disease

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8
Q

Which antidepressants are considered safest in pregnancy?

A

Sertraline - can be used during breast feeding too
Fluoxetine

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9
Q

Name some SEs of ethambutol

A

Red-green colour blindness
Peripheral neuropathy
Optic neuritis

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10
Q

Name some suitable antihypertensives to use in pregnancy

A

Labetalol
Nifedipine
Methyldopa

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11
Q

Name some osmotic laxatives

A

Lactulose
Movicol
Phosphate
Sodium citrate

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12
Q

Name some bulk forming laxatives

A

Ispaghula husk
Methylcellulose

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13
Q

Which AED carries the highest risk of congenital malformations?

A

Sodium valproate

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14
Q

Metaclopromide is most suitable for which causes of N&V?

A

Gastritis
Gastric stasis
Functional bowel obstruction

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15
Q

Cyclizine is most suitable for which causes of N&V?

A

Mechanical bowel obstruction
Raised ICP
Motion sickness

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16
Q

Haloperidol is most suitable for which causes of N&V?

A

Metabolic - i.e. hypercalcaemia and renal failure

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17
Q

What topical agent can be used for fungal nail infection?

A

5% amorolfine nail laquer

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18
Q

Which drugs can increase saliva production?

A

Clozapine
Neostigmine

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19
Q

Name some SEs of viagra

A

Visual disturbances
Headaches
Nasal congestion
Flushing
GI upset

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20
Q

Define tardive dyskinesia

A

Repetitive, purposeless, involuntary movements

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21
Q

How long should antibiotics be prescribed for in men?

A

7 days

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22
Q

Which antidiabetic drug is associated with bladder cancer?

A

Pioglitazone

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23
Q

Which antidiabetic drug is associated with B12 deficiency?

A

Metformin

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24
Q

Which drugs can induce hyperuricaemia?

A

Alcohol
Diuretics - loop and thiazide
Salicylates
Pyrazinamide
Ethambutol
Nicotinic acid
Cytotoxic agents

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25
Which drugs can cause lichenoid eruptions?
ACE-i NSAIDs Methyldopa Chloroquine Oral antidiabetics Thiazide diuretics Gold
26
What is the treatment for head lice?
Dimeticone 4% lotion Wet combing
27
Which drug may be used in anorexia associated with cancer?
Prednisolone or dexamethasone
28
Which laxative may be helpful in the treatment of constipation in terminally ill patients?
Co-danthramer (combination laxative)
29
How does co-cyprindiol work?
A combination of: Cytoproterone acetate (synthetic progestogen) - androgen receptor blocker Ethinylestradiol
30
What is tibolone?
Oestrogen receptor agonist
31
Which drug limits the maximum dose of simvastatin to 20mg?
Amlodipine - weak inhibitor of CYP450
32
Name some SEs of SSRIs
Increased risk of GI bleeding Increased anxiety and agitation
33
Describe the MOA of tramadol
A synthetic, centrally acting, opiate like analgesic Seizures are a rare effect of tramadol
34
Which drug is useful for the treatment of nausea and vomiting in mechanical bowel obstruction?
Cyclizine
35
Name some important drug interactions to be aware of when prescribing azathioprine
Allopurinol: reduce dose Febuxostat: not recommended Co-trimoxazole/trimethoprim: increased risk of haem toxicity Warfarin: anticoagulant effect reduced Clozapine: increased risk of agranulocytosis ACE-i: may cause anaemia Aminosalicylates: bone marrow toxicity Methotrexate: may require adjustment
36
What types of nausea and vomiting can be treated with metoclopramide?
Gastritis Gastric stasis Functional bowel obstruction
37
Name an important complication of metformin use
B12 deficiency
38
At what dose does aspirin toxicity occur?
>250mg/kg
39
Name some side effects of adenosine
Flushing, chest pain and bronchospasm
40
Which drugs are useful in the treatment of primary open angle glaucoma?
Beta blockers Sympathomimetics Carbonic anhydrase inhibitors These will reduce the production of aqueous humour Prostaglandin analogues, sympathomimetics and miotics will increase the drainage of aqueous humour
41
Name some ECG changes seen in digoxin toxicity
ST changes Inverted T waves in V4-6
42
Name some drugs that can cause urinary retention
Tricyclic antidepressants e.g. amitriptyline Anticholinergics e.g. antipsychotics, Antihistamines Opioids NSAIDs Disopyramide
43
Name some adverse effects associated with tamoxifen
Menstrual disturbance: vaginal bleeding, Amenorrhoea Hot flushes - 3% of patients stop taking tamoxifen due to climacteric side-effects Venous thromboembolism Endometrial cancer
44
What monitoring is required for statins?
LFTs at baseline, 3 months and 12 months
45
What monitoring is required for amiodarone?
TFT, LFT, U&E, CXR prior to treatment TFT, LFT every 6 months
46
What monitoring is required for methotrexate?
FBC, LFT, U&E
47
What is the MOA of cocaine?
Cocaine blocks the uptake of dopamine, noradrenaline and serotonin
48
What is used for the management of chest pain associated with cocaine?
Benzodiazepines + glyceryl trinitrate PCI if MI
49
Name some SEs of trimethoprim
Rashes, including photosensitivity Pruritus Suppression of haematopoiesis
50
What is the MOA of pyrazinamide?
Converted by pyrazinamidase into pyrazinoic acid which in turn inhibits fatty acid synthase (FAS) I
51
What are some SEs of pyrazinamide?
Hyperuricaemia causing gout Arthralgia, myalgia Hepatitis
52
Name some SEs of sildeanfil
Visual disturbances blue discolouration non-arteritic anterior ischaemic neuropathy Nasal congestion Flushing Gastrointestinal side-effects Headache Priapism
53
What drugs are contraindicated in pregnancy?
ACE inhibitors, angiotensin II receptor antagonists Statins Warfarin Sulfonylureas Retinoids (including topical) Cytotoxic agents
54
How do you treat ethylene glycol toxicity?
Ethanol has been used for many years Works by competing with ethylene glycol for the enzyme alcohol dehydrogenase this limits the formation of toxic metabolites (e.g. Glycoaldehyde and glycolic acid) which are responsible for the haemodynamic/metabolic features of poisoning Fomepizole, an inhibitor of alcohol dehydrogenase, is now used first-line in preference to ethanol Haemodialysis also has a role in refractory cases
55
Name some precipitating factors for digoxin toxicity
classically: hypokalaemia digoxin normally binds to the ATPase pump on the same site as potassium. Hypokalaemia → digoxin more easily bind to the ATPase pump → increased inhibitory effects increasing age renal failure myocardial ischaemia hypomagnesaemia, hypercalcaemia, hypernatraemia, acidosis hypoalbuminaemia hypothermia hypothyroidism drugs: amiodarone, quinidine, verapamil, diltiazem, spironolactone (competes for secretion in distal convoluted tubule therefore reduce excretion), ciclosporin. Also drugs which cause hypokalaemia e.g. thiazides and loop diuretics
56
What is the MOA of quinolones?
Inhibit topoisomerase II (DNA gyrase) and topoisomerase IV
57
Name some adverse effects of quinolones
Lower seizure threshold in patients with epilepsy tendon damage (including rupture) - the risk is increased in patients also taking steroids cartilage damage has been demonstrated in animal models and for this reason quinolones are generally avoided (but not necessarily contraindicated) in children lengthens QT interval
58
Describe the management of lithium toxicity
mild-moderate toxicity may respond to volume resuscitation with normal saline haemodialysis may be needed in severe toxicity sodium bicarbonate is sometimes used but there is limited evidence to support this. By increasing the alkalinity of the urine it promotes lithium excretion
59
Name some causes of drug induced thrombocytopaenia
quinine abciximab NSAIDs diuretics: furosemide antibiotics: penicillins, sulphonamides, rifampicin anticonvulsants: carbamazepine, valproate heparin
60
Explain the MOA of metformin
acts by activation of the AMP-activated protein kinase (AMPK) increases insulin sensitivity decreases hepatic gluconeogenesis may also reduce gastrointestinal absorption of carbohydrates
61
Name some drugs to avoid in renal failure
antibiotics: tetracycline, nitrofurantoin NSAIDs lithium metformin

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