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MSRA > Pharmacology > Flashcards

Pharmacology Flashcards

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
Q

Which drugs can cause lichenoid eruptions?

A

ACE-i
NSAIDs
Methyldopa
Chloroquine
Oral antidiabetics
Thiazide diuretics
Gold

26
Q

What is the treatment for head lice?

A

Dimeticone 4% lotion
Wet combing

27
Q

Which drug may be used in anorexia associated with cancer?

A

Prednisolone or dexamethasone

28
Q

Which laxative may be helpful in the treatment of constipation in terminally ill patients?

A

Co-danthramer (combination laxative)

29
Q

How does co-cyprindiol work?

A

A combination of:
Cytoproterone acetate (synthetic progestogen) - androgen receptor blocker
Ethinylestradiol

30
Q

What is tibolone?

A

Oestrogen receptor agonist

31
Q

Which drug limits the maximum dose of simvastatin to 20mg?

A

Amlodipine - weak inhibitor of CYP450

32
Q

Name some SEs of SSRIs

A

Increased risk of GI bleeding
Increased anxiety and agitation

33
Q

Describe the MOA of tramadol

A

A synthetic, centrally acting, opiate like analgesic
Seizures are a rare effect of tramadol

34
Q

Which drug is useful for the treatment of nausea and vomiting in mechanical bowel obstruction?

A

Cyclizine

35
Q

Name some important drug interactions to be aware of when prescribing azathioprine

A

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
Q

What types of nausea and vomiting can be treated with metoclopramide?

A

Gastritis
Gastric stasis
Functional bowel obstruction

37
Q

Name an important complication of metformin use

A

B12 deficiency

38
Q

At what dose does aspirin toxicity occur?

A

> 250mg/kg

39
Q

Name some side effects of adenosine

A

Flushing, chest pain and bronchospasm

40
Q

Which drugs are useful in the treatment of primary open angle glaucoma?

A

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
Q

Name some ECG changes seen in digoxin toxicity

A

ST changes
Inverted T waves in V4-6

42
Q

Name some drugs that can cause urinary retention

A

Tricyclic antidepressants e.g. amitriptyline
Anticholinergics e.g. antipsychotics, Antihistamines
Opioids
NSAIDs
Disopyramide

43
Q

Name some adverse effects associated with tamoxifen

A

Menstrual disturbance: vaginal bleeding, Amenorrhoea
Hot flushes - 3% of patients stop taking tamoxifen due to climacteric side-effects
Venous thromboembolism
Endometrial cancer

44
Q

What monitoring is required for statins?

A

LFTs at baseline, 3 months and 12 months

45
Q

What monitoring is required for amiodarone?

A

TFT, LFT, U&E, CXR prior to treatment
TFT, LFT every 6 months

46
Q

What monitoring is required for methotrexate?

A

FBC, LFT, U&E

47
Q

What is the MOA of cocaine?

A

Cocaine blocks the uptake of dopamine, noradrenaline and serotonin

48
Q

What is used for the management of chest pain associated with cocaine?

A

Benzodiazepines + glyceryl trinitrate
PCI if MI

49
Q

Name some SEs of trimethoprim

A

Rashes, including photosensitivity
Pruritus
Suppression of haematopoiesis

50
Q

What is the MOA of pyrazinamide?

A

Converted by pyrazinamidase into pyrazinoic acid which in turn inhibits fatty acid synthase (FAS) I

51
Q

What are some SEs of pyrazinamide?

A

Hyperuricaemia causing gout
Arthralgia, myalgia
Hepatitis

52
Q

Name some SEs of sildeanfil

A

Visual disturbances
blue discolouration
non-arteritic anterior ischaemic neuropathy
Nasal congestion
Flushing
Gastrointestinal side-effects
Headache
Priapism

53
Q

What drugs are contraindicated in pregnancy?

A

ACE inhibitors, angiotensin II receptor antagonists
Statins
Warfarin
Sulfonylureas
Retinoids (including topical)
Cytotoxic agents

54
Q

How do you treat ethylene glycol toxicity?

A

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
Q

Name some precipitating factors for digoxin toxicity

A

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
Q

What is the MOA of quinolones?

A

Inhibit topoisomerase II (DNA gyrase) and topoisomerase IV

57
Q

Name some adverse effects of quinolones

A

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
Q

Describe the management of lithium toxicity

A

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
Q

Name some causes of drug induced thrombocytopaenia

A

quinine
abciximab
NSAIDs
diuretics: furosemide
antibiotics: penicillins, sulphonamides, rifampicin
anticonvulsants: carbamazepine, valproate
heparin

60
Q

Explain the MOA of metformin

A

acts by activation of the AMP-activated protein kinase (AMPK)
increases insulin sensitivity
decreases hepatic gluconeogenesis
may also reduce gastrointestinal absorption of carbohydrates

61
Q

Name some drugs to avoid in renal failure

A

antibiotics: tetracycline, nitrofurantoin
NSAIDs
lithium
metformin

MSRA (13 decks)

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