Pharmacology

Question 1

What are two side effects of ACE Inhibitors?

Answer 1

Dry cough, angioedema

Question 2

What is the effect of ACE Inhibitors on the kidneys?

Answer 2

Efferent tubule dilatation, decreasing the GFR

Question 3

Why are ACE Inhibitors first-time treatment for diabetic patients with hypertension?

Answer 3

Renal protective

Question 4

What is the electrolyte abnormality associated with ACEIs?

Answer 4

Hyperakalaemia

Question 5

What is the electrolyte abnormality associated with ARBs?

Answer 5

Hyperkalaemia

Question 6

What is the mechanism of action of ARBs?

Answer 6

Inhibits binding of Angiotensin II to the AT1 receptor

Question 7

What class of drugs do Verapamil and Diltiazem belong to?

Answer 7

Calcium channel blockers

Question 8

What drugs are contra-indicated to Verapamil and Diltiazem? Why?

Answer 8

Beta-blockers, because when prescribed with Verapamil and Diltiazem can cause heart block. They are all negative ionotropes

Question 9

Give three examples of Dihydropyridine drugs. Why are these not contraindicated to Beta-blockers like other CCBs?

Answer 9

Amlodipine
Felodipine
Nifedipine

Because they act on the peripheral vascular system, not directly on the heart

Question 10

Where does Bendroflumethiazide work on the kidneys? Mechanism of action?

Answer 10

Proximal aspect of the Distal Convoluted Tubule. Na/Cl symporter inhibitor

Question 11

What are the electrolyte abnormalities seen with Bendroflumethiazine?

Answer 11

Hyponatraemia
Hypokalaemia
Hypercalcaemia

Question 12

What is Nicorandil used to treat? Mechanism of action?

Answer 12

Angina, potassium channel blocker

Question 13

What is the mechanism of action of Warfarin? What clotting factors are affected?

Answer 13

Vitamin K antagonist

Clotting factors 2, 7, 9, 10 and Protein C

Question 14

What is the target INR for patients with:

VTE, VTE recurrence, and AF

Answer 14

VTE: 2.5
VTE recurrence: 3.5
AF: 2.5

Question 15

Are ACEI safe in pregnant women?

Answer 15

No

Question 16

Is Warfarin safe in pregnant women?

Answer 16

No, but can be used when breast feeding

Question 17

What conditions / drugs may potentiate affects of Warfarin? 7 examples

Answer 17

Liver disease

Amiodarone, Ciprofloxacin, NSAIDs, Aspirin, Statins
Cranberry Juice

Question 18

What is the mechanism of action of Fondaparinux?

Answer 18

Anticoagulant, factor Xa inhibitor

Activates anti-thrombin III

Question 19

What is the mechanism of action of Apixaban and Rivaroxaban?

Answer 19

Anticoagulant, factor Xa inhibitor

Question 20

Bendroflumethiazide can hypokalaemia to cause which ECG abnormalities?

Answer 20

U waves

Question 21

Give examples of two medications which increase risk the likelihood of a DVT

Answer 21

COCP

HRT

Question 22

How is Fondaparinux Sodium administered for VTE Prophylaxis?

Answer 22

Subcutaneous injection

Question 23

How are Inhaled Corticosteroid medications stepped down in asthmatic patients?

Answer 23

25-50% dose reduction at a time

Question 24

What is considered a low, moderate and high dose of inhaled corticosteroid in asthma treatment?

Answer 24

<400 mcg = low dose
400 - 800 mcg = moderate dose
>800 mcg = high dose

Question 25

What is the mechanism of action for Salbutamol / Levosalbutamol?

Answer 25

Short acting bronchodilator, B2 receptor agonist`

Question 26

Give three examples of Inhaled Corticosteroids used in asthma management

Answer 26

Budesonide Beclomethasone Fluticasone

Question 27

What is the MoA for Budesonide / Beclomethasone / Fluticasone?

Answer 27

Inhaled corticosteroids, gluticocortoid receptor agonist

Question 28

Give two examples LABAs. What is the mechanism of action?

Answer 28

Salmeterol, Formoterol | B2 receptor agonist

Question 29

What is the mechanism of action of Montelukast?

Answer 29

Leukotriene receptor antagonist

Question 30

Give examples of three Leukotriene receptor antagonists

Answer 30

Montelukast, Zafirlukast, Pranlukast

Question 31

What is the mechanism of action of Theophylline?

Answer 31

- Non selective phosphodiesterase inhibitor | - Non selective adenosine receptor antagonist

Question 32

What is the mechanism of action of Tiotropium / Ipratropium?

Answer 32

Anti-cholinergic drug, muscarinic receptor antagonist

Question 33

What is the mechanism of action of Atropine?

Answer 33

Muscarinic acetylcholine receptor antagonist

Question 34

How is Atropine administered in patients with Bradycardia with haemodynamic compromise?

Answer 34

500 mcg Atropine, IV, every 3-5 mins for a maximum of 6 doses / 3 mg

Question 35

What is the mechanism of action of Rifampicin?

Answer 35

DNA-dependent RNA Polymerase Inhibitor

Question 36

What is the mechanism of action of Isoniazid?

Answer 36

Mycolic acid synthesis inhibitor

Question 37

What is the mechanism of action of Pyrazinamide?

Answer 37

Fatty acid synthase (FAS) inhibitor

Question 38

What is the mechanism of action of Ethambutol?

Answer 38

Arabinosyl transferase inhibitor

Question 39

What is the mechanism of action of Ticagrelor?

Answer 39

Antiplatelet medication, P2Y12 inhibitor

Question 40

What is the mechanism of action of Prasugrel?

Answer 40

Antiplatelet medication, P2Y12 inhibitor

Question 41

In patients developing tolerance to modified release Isosorbide mononitrate, what change to their drug regime should occur?

Answer 41

Patients should take their second daily dose after 8 hours instead of 12 hours, allowing nitrate levels to fall for a further 4 hours

Question 42

What is the mechanism of action of Aspirin?

Answer 42

Antiplatelet, inhibits the production of thromboxane A2

Question 43

What is the mechanism of action of Clopidogrel

Answer 43

Antiplatelet, inhibits ADP binding to its platelet receptor

Question 44

What is the mechanism of action of Dipyridamole?

Answer 44

Phosphodiesterase inhibitor

Question 45

What four antibiotics could predispose you to C. Diff infection?

Answer 45

4 C's Clindamycin Cephalosporins Co-amoxiclav Ciprofloxacin + Quinolones

Question 46

When commencing statin treatment, it typically can cause a rise in ALT / AST. But when should it be stopped?

Answer 46

Treatment with statins should be discontinued if serum transaminase concentrations rise to and persist at 3 times the upper limit of the reference range