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Flashcards in Pharmacology Deck (52)
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1

What do you need to remember about naloxone?

1/2 life only minutes (may need infusion/repeat doses)
Pt will go crazy (security?)
Pt will be in pain
Lowers pt seizure threshold

2

What is amiodarone?

Class II anti-arrhythmic
K+ channel blocker
Used in chemical cardioversion
Prolong QT interval
Inhibits hepatic enzymes (be careful if used with digoxin)

3

What is flecainide?

Na+ channel blocker
Class I C anti-arrhythmic

4

What is sotalol?

Non cardio-selective ß-blocker
Class III anti-arrhythmic (rhythm control)
Prolongs QT interval
Renally excreted

5

What is verapamil?

Non-dihydropyridine Ca2+ channel blocker
Class IV anti-arrhythmic
Hepatic metabolism
Can cause AV block
Rate limiting

6

What receptors does noradrenaline work on?

+++ alpha-1
+++ alpha-2
+ ß1

7

What receptors does adrenaline work on?

+++ alpha-1
++ alpha-2
+++ ß1
++ ß2

8

What receptors does dopamine work on?

++ alpha-1
+ alpha-2
++ ß1
+++ ß2
+++ DA

9

What receptors does dobutamine work on?

+ alpha-1
+++ ß1
+ ß2

10

What receptors does isoproterenol work on?

++ ß1
++ ß2

11

Why is verapamil and bisoprolol a bad combination?

Verapamil causes AV block
Combined with ß-blocker-> bradycardia

12

What is ciprofloxacin?

A quinolone Abx
Broad spectrum (gram+ and -)
Gram -ve sepsis, skin, UTI, resp
Can be used in penicillin allergy (instead of tazocin)
SE: thrush, D&V, MRSA promotion

13

Issues with metformin in an acute patient?

Can potentiate hypoglycaemia
Raises lactate (confuses clinical picture)

14

Warfarin and diclofenac co-prescription is bad because:

Both highly protein bound, compete with eachother, more free drug
Diclofenac also causes gastritis, warfarin can cause bleeding-> GI bleeds

15

What drugs should not be combined in someone with renal issues?

NSAIDs, ACEi and betablockers

16

Causes of poor pain relief

• Inadequate assessment
• Poor choice of analgesic
• Incorrect dose
• Wrong frequency (24hr clock)
• Wrong mode of delivery (eg orally in a pt with an ileus)

17

What is the 1st step in the WHO analgesia ladder?

Paracetamol
NSAID

18

What is the 2nd step in the WHO analgesia ladder?

Weak opioid (codeine)
Paracetamol
NSAID

19

What is the 3rd step in the WHO analgesia ladder?

Strong opioid
Paracetamol
NSAID

20

What is the 4th step in the WHO analgesia ladder?

Nerve block
Epidurals
PCA pump
Spinal stimulators

21

What is the proper name for paracetamol?

Acetaminophen

22

Dose of paracetamol

1g/6hrly in adults >50kg
60mg/kg/day max if <50kg
90mg/kg/day max in children

23

SE of NSAIDs

COX-2 SE-> platelet function (increases risk of bleeding), gut mucosal damage (peptic ulceration), renal impairment, bronchospasm.

24

Contraindications of NSAIDs

Allergy, asthma, GI upset, coagulopathy, renal impairment, CVS disease

25

Why is effect of codeine variable?

Metabolism varies between individuals with codeine via CYP2D6. Oral only. Synergism with paracetamol.

26

What opioid is best in renal failure

Fentanyl (doesn't accumulate)

27

Which opioid is best in obstetrics

Pethidine

28

Which opioid is better tolerated that codeine?

Oxycodone

29

SE of opioids

n&v, bradycardia, pruritis, constipation, dizziness, sedation, hallucinations, respiratory depression, tolerance/dependence/addiction.

30

What is a PCA?

Patient controlled anaesthesia
Syringe driver with button (locks off for 5 mins)
Fentanyl/oxycodone/morphine