Flashcards in Pharmacology Deck (52)
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
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)
What is flecainide?
Na+ channel blocker
Class I C anti-arrhythmic
What is sotalol?
Non cardio-selective ß-blocker
Class III anti-arrhythmic (rhythm control)
Prolongs QT interval
What is verapamil?
Non-dihydropyridine Ca2+ channel blocker
Class IV anti-arrhythmic
Can cause AV block
What receptors does noradrenaline work on?
What receptors does adrenaline work on?
What receptors does dopamine work on?
What receptors does dobutamine work on?
What receptors does isoproterenol work on?
Why is verapamil and bisoprolol a bad combination?
Verapamil causes AV block
Combined with ß-blocker-> bradycardia
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
Issues with metformin in an acute patient?
Can potentiate hypoglycaemia
Raises lactate (confuses clinical picture)
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
What drugs should not be combined in someone with renal issues?
NSAIDs, ACEi and betablockers
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)
What is the 1st step in the WHO analgesia ladder?
What is the 2nd step in the WHO analgesia ladder?
Weak opioid (codeine)
What is the 3rd step in the WHO analgesia ladder?
What is the 4th step in the WHO analgesia ladder?
What is the proper name for paracetamol?
Dose of paracetamol
1g/6hrly in adults >50kg
60mg/kg/day max if <50kg
90mg/kg/day max in children
SE of NSAIDs
COX-2 SE-> platelet function (increases risk of bleeding), gut mucosal damage (peptic ulceration), renal impairment, bronchospasm.
Contraindications of NSAIDs
Allergy, asthma, GI upset, coagulopathy, renal impairment, CVS disease
Why is effect of codeine variable?
Metabolism varies between individuals with codeine via CYP2D6. Oral only. Synergism with paracetamol.
What opioid is best in renal failure
Fentanyl (doesn't accumulate)
Which opioid is best in obstetrics
Which opioid is better tolerated that codeine?
SE of opioids
n&v, bradycardia, pruritis, constipation, dizziness, sedation, hallucinations, respiratory depression, tolerance/dependence/addiction.