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Rhi’s MSRA > Pharmacology > Flashcards

Pharmacology Flashcards

(95 cards)

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1
Q

Resistant HTN despite optimal doses ACEi/ARB + CCB + thiazide-like diuretic. What to start?

A

K </= 4.5 spironolactone
(caution for reduced egfr, risk of hyperkalaemia)
K >4.5 alpha-blocker or B-blocker

(If still uncontrolled on 4 drugs, specialist advice to be sought)

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2
Q

Treatment for tinea capitis?

A

Oral griseofulvin
Or
Ketoconazole shampoo

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3
Q

Which antihypertensive drug means you can only take 20mg simvastatin with it?

A

Amlodipine

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4
Q

For ischaemic stroke and TIA, which anti-platelet to take for life?

A

Clopidogrel

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5
Q

Which antihypertensives can worsen glycemic control?

A

Thiazides ie bendroflumethiazide
Beta-blockers

Others: glucocorticoids, anti-psychotics

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6
Q

Side effects of peripheral acting CCB ie ‘pines’

A

P- Peripheral oedema
I - DIzziness
N -Nausea
E - Ebdominal pain!?
S - Sleepy - fatigue

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7
Q

Digoxin OD antidote?

A

Digoxin-specific antibody fragments

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8
Q

Cyanide antidote?

A

Hydroxacobalamin

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9
Q

Carbon monoxide antidote

A

100% OXYGEN

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10
Q

Lead antidote?

A

Dicamperol

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11
Q

Organophosphate insecticide antidote?

A

Atropine

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12
Q

Methanol poisoning tx?

A

ETHANOL
Or haemodialysis

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13
Q

Beta-blocker toxicity treatment?

A

If bradycardia —> atropine
In resistant cases —> glucagon

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14
Q

Warfarin antidote

A

Vitamin K!
Prothrombin complex

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15
Q

Heparin antidote?

A

Protamine sulphate

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16
Q

TCA OD antidote?

A

IV bicarbonate reduces seizures
Lignocaine for arrhythmias
Dialysis

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17
Q

Benzodiazepines OD tx?

A

FLUMAZENIL

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18
Q

Main side effects of amiodarone?

A

Amiodarone is a BITCH
-Blue skin discolouratio/bradycardia
-Interstitial lung disease/pulmonary fibrosis
-Thyroid (hypo and hyper)
-Corneal deposits - blindness
-Hepatotoxicity /hypotension when IV

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19
Q

Side effects of Digoxin?

A

BAD DIG!
-Blurred/yellow vision
-Arrhythmias (ectopics and bradycardias and ECG changes (ST depression, TWI)
-Diarrhoea/nausea

-Dizziness
-Insomnia
-Gynaecomastia

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20
Q

Adenosine side effects

A

FLUSHING
BRONCHOSPASM
CHEST PAIN

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21
Q

Which antidiabetic drug should not be used in heart failure?

A

Pioglitazone
-heart failure increased when combined with insulin!
-also small increased risk of bladder cancer

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22
Q

What family of medication is Dapaglifozin in and how does it work?

A

SGLT2 inhibitor (reduce the sodium-glucose co-transporter 2 in kidneys to:)
-reduce glucose reabsorption &
-increase urinary glucose exertion

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23
Q

Side effect of SGLT2 inhibitors?

A

Increased risk of UTIs
(Due to increased urinary glucose excretion - more sugar in wee!)

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24
Q

Examples of short acting insulins?
Onset of action?
Peak of action?
How long do they last?

A

Insulin aSpart, liSpro & gluliSine (all have an ‘S’!)
Onset 15 mins
Peak at 1 hour
Last 3-4 hours

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25
One example of intermediate acting insulin? Onset and peak of action? How long do they last?
Isophane insulin (begins with I!) Onset 2-4 hours Peak 6-7 hours Last 20 hours
26
Long acting insulin samples? Onset of action? How long do they last?
Insulin detemir and insulin gLargine Onset 1-3 hours Last 20-24 hours
27
What type of antidiabetic is metformin and how does it work?
BIGUANIDE Decreases glucogenesis and increases peripheral utilisation of glucose (Only acts in presents of exogenous insulin so only effective is there are functioning pancreatic islet cells!)
28
Examples of sulfonylureas? How do they work?
IDEs ie gliclazide Increase insulin secretion
29
Example of thiazolidinedione? How do they work?
Pioglitazone Reduce peripheral insulin resistance
30
Example of DPP-4 inhibitor? How does it work?
Sitagliptin Increase insulin secretion and lower glucagon secretion
31
Patient with diabetes, diagnosed with HTN - what to start?
ACE inhibitor or ARB (Regardless of age or race!!)
32
How often to measure BP in patients with diabetes and HTN and what BP to aim for? What BP to aim for if known nephropathy/retinopathy/cerebrovascular damage?
Every 1-2 months BP <140/90 Or <130/80 if known damage as above
33
Which medication to avoid in open-angle glaucoma?
Anti-muscarinics ie cyclopentolate (as will dilate pupil and worsen blockage!)
34
Antidote for benzodiazepine poisoning?
FlumaZenil (Both have Zs!)
35
Antidote for arsenic?
Dicamperol
36
Drugs used for Alzheimer’s?
Donepezil Galantamine Rivastigmine Memantine
37
First line drug for both focal and tonic-clonic seizures?
Lamotrigine
38
First line treatment for absence seizures?
Ethosuximide
39
drugs for focal seizures?
1st line - lamotrigine Levetiracetam (also for tonic-clonic) Gabapentin / Pregabalin!
40
Step management for diabetes
1) TRIAL OF LIFESTYLE CHANGES 2) Metformin 3) Any additionals of either DPP-4i, gliclazide, sulfonylurea, Pioglitazone or SGLT-2i
41
First choice Tx for suspected meningococcal disease?
Benzylpenicillin
42
First line Tx for lower UTI? In pregnancy?
Nitrofurantoin (if eGFR >40) Trimethoprim (if low risk of resistance) Pregnancy: nitrofurantoin still (avoid at term)
43
Acute sore throat first line abx?
Phenoxymethylpenicillin
44
Drug interactions with SSRIs?
Antiepileptics (reduce seizure threshold) Antidiabetics (affect diabetic control) Aspirin/NSAIDs/anticoagulation/antiplatelets (increased bleeding risk) HIV protease inhibitors Lithium (SS/NMS) MAOIs (SS/NMS) SNRIs (increased SS/ NMS) Tamoxifen Other sedative drugs
45
Side effects of first - generation anti psychotics?
Extrapyramidal symptoms! DAPT -dystonic reactions (abnormal movements of face/body) -Akathisia (motor restlessness) -Pseudoparkinsonism - tremor, bradykinesia, rigidity -Tardive dyskinesia (rhythmic involuntary movements)
46
Antipschotic side effects (not extrapyramidal):
Weight gain Hyperprolactinaemia Sedation Sleep apnoea Anticholinergic effects Reduced seizure threshold Impaired glucose tolerance Neuroepileptic malignant syndrome Pneumonia Neutropenia Abnormal LFTs Photosensitivity- chlorpromazine Rash - olanzapine/quetiapine Diplopia - aripiprazole Restless legs
47
ECG changes in anticholinergic toxicity?
Prolongation of QRS
48
Aspirin toxicity symptoms Acid base disturbance?
Hyperventilating Sweating Nausea & vomiting Epigastric discomfort Tinnitus and deafness RESPIRATORY ALKALOSIS which then is followed by METABOLIC ACIDOSIS
49
Centaur criteria
‘Decide FATE of abx’ Fever Absent cough Tender cervical lymphadenopathy Exudate
50
Uncomplicated diverticulitis first line abx?
Co-amoxiclav
51
First line for BV?
METRONIDAZOLE (Fishy smell on the metro!)
52
Common drugs that cause mouth ulcers?
Cytotoxic drugs Nicorandil NSAIDs
53
Why is tetracycline contra-indicated in pregnancy, breast-feeding and children under 12 years?
Permanent tooth staining!
54
What is an allele?
Different DNA sequence at the same physical locus
55
What is sodium valproate a risk for in pregnancy for the baby?
NEURAL TUBE DEFECTS
56
Drugs that increase saliva production?
Clozapine Neostigmine
57
Which vaccines may contain egg protein?
Influenza MMR Yellow fever
58
What does the spleen protect against (what kind of bacteria)?
ENCAPSULATED bacteria !
59
Which are encapsulated bacteria?
‘SHiN SKiS’ without the ‘i’s… Strep pneumoniae Hib Neisseria meningitidis Group B Strep Klebsiella pneumoniae Salmonella typhi
60
Vaccines given to patients following splenectomy?
Pneumonoccal vaccine Hib vaccine Meningococcal vaccine Influenza vaccine
61
Side effects of statins?
Myositis - can lead to rhabdomyolysis GI disturbance - rarely pancreatitis Hepatic disturbance/jaundice Interstitial lung disease
62
Examples of steroid creams that are: Mild Moderate Potent Very potent
‘HELP EVERY BAD DERMATOLOGIST! Mild- hydrocortisone Moderate- Eumovate Potent - Betnovate (and Cutivate) Very potent - Dermovate
63
Max dose of lidocaine that can be used as local anaesthetic?
3mg/kg Or 7mg/kg (with epenephrine) (because it causes vasoconstriction, so slower to get to the heart)
64
What is 1% lidocaine equivalent to? (Mg/ml)
1 gram (1000g) in 100ml 10mg/ml ie for 70kg man, you can give 70x3mg = 210mg =21ml
65
Where are these antibodies found and what do they do? IgA IgG IgM IgE IgD
IgA - found in breathing passages, digestive tract, eyes, ears, vagina -protect body surfaces exposed to outside foreign substances IgG - all body fluids -fighting bacterial and viral infections (‘let’s Go get ‘em!) IgM- blood and lymph -first antibody MADE in response to infection IgE - lungs/skin/mucous membranes -react to foreign substances ie pollen (Etopy!?) IgD - blood Antibody production
66
Diabetic Drugs associated with: 1) lower/extremity amputation ? 2) bladder cancer? 3) decreased vitamin B12 levels ?
1) canagliflozin (SGLT2 inhibitor) 2) pioglitazone 3) metformin
67
Nephrotoxic drugs?
NSAIDs ACE-inhibitors Phenytoin Penicillin, rifampicin Furosemide, thiazide diuretics Methotrexate Anticholinergics TCAs Lithium
68
Woman who’s symptoms have recovered wants to stop SSRI. How to stop?
Continue for further 6 months (from remission of symptoms!)
69
Drugs associated with lichenoid eruptions?
ACEi NSAIDs Methyldopa Chloroquine Oral antidiabetics Thiazide diuretics Gold
70
How to reverse warfarin for patient having heavy bleeding, INR >10?
Omit warfarin Give vitK AND Prothrombin Complex Concentrate (PCC) ie Octaplex
71
Treatment for head lice?
DIMETICONE
72
Medication used for severe acne and mod severe hirsutism?
Co-cyprindiol
73
Uses for goserelin?
Endometriosis Precocious puberty Infertility Uterine fibroids Breast cancer Prostate cancer
74
Drugs that can be started to help patient stop smoking?
Bupropion (norepinephrine and dopamine reuptake inhibitor, and nicotine antagonist) Varenicline - nicotinic receptor partial agonist
75
Drug class of tamoxifen? Side effects of tamoxifen? When can’t you use it?
selective estrogen receptor modulator (SERM) Hot flushes Nausea Fluid retention Vaginal bleeding/discharge Fatigue Skin rash Thrombotic disease Don’t use in pregnancy & breastfeeding!
76
TCA overdose symptoms
Dilated pupils Dry mouth Drowsiness Sinus tachycardia / BROAD COMPLEX TACHYCARDIA - NEED ECG Urinary retention Increased reflexes
77
What drug turns urine red?
RIFAMPICIN (R = red!)
78
Drugs for Tb and common side effects?
2 months RIPE 4 months of RI RIFAMPICIN - Red secretions! Isoniazid - perIpheral neuropathy Pyrazinamide - Hepatitis (pray 4 liver) Ethambutol - Eyes (optic neuritis, red-green colour blindness)
79
Statin side effects
‘MILD’ side effects Myositis Interstitial lung disease LFT derangement Disturbance of GI/ rarely pancreatitis
80
Drugs that cause gingival hyperplasia?
PLEASE CUT NOW: Phenytoin Ciclosporin Nifedipine (& some other CCBs)
81
Which drugs are used for tuberculous meningitis?
RIPE for 2 months RI for 10 months
82
Live attenuated vaccines?
MY ROME TRIP Measles Yellow fever Rotavirus Oral typhoid Mumps Endemic Typhus TB (BCG) Rubella Influenza (nasal) Plague
83
What symptoms does SCID involve? Severe combined immunodeficiency
SCID Small - failure to thrive Cutaneous - dermatitis Infections (recurrent) Diarrhoea
84
What type of conditions is metoclopramide used for ?
Gastritis Gastric stasis FUNCTIONAL bowel obstruction Due to prokinetic action
85
Cyclizine is good for which conditions?
Mechanical bowel obstruction Raised ICP Motion sickness
86
What is Haloperidol good for?
Metabolic causes of vomiting ie hypercalcaemia, renal failure
87
Risk of Azathioprine plus ACEi?
Anaemia and myelosuppression (A plus A = A)!
88
Classic side effects of metformin?
GI side effects LACTIC ACIDOSIS
89
Serious Side effect of gliptins/DPP-4 inhibitors ie sitagliptin?
Pancreatitis! (Ps!)
90
Side effects of sulfonylureas ie gliclazide?
Hypoglycaemia Increased appetite/weight gain Inappropriate ADH secretion Liver dysfunction
91
Side effects of glitazones ie pioglitazone?
Weight gain Fluid retention (avoid in heart failure!) Liver dysfunction Fractures
92
Most significant side effect of hydroxychloroquine?
Retinopathy
93
What to prescribe to prevent peripheral neuropathy from isoniazid?
PYRIDOXINE (vitamin B6)
94
Side effects of SGLT-2 inhibitors ie empaGLIFLOZIN?
UTI and genital infections Keroacidosis Increased risk of lower limb amputation sGLt2 = GLiflozins
95
Treatment for Wilson’s disease?
Penicillamine

Rhi’s MSRA (13 decks)

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