Pharmacology Facts

Question 1

Which factor in the clotting cascade do Enoxaparin and Rivaroxaban act on ?

Answer 1

Enoxaparin inhibts Factor Xa (activated factor 10)

Question 2

Which factor in the clotting cascade does Apixaban act on?

Answer 2

Apixaban inhibits factor Xa (activated factor 10)

Question 3

How does Dabigatran work?

Answer 3

Direct thrombin inhibition preventing fibrin formation and hence clot development

Question 4

What is the standard treatment for TB and what are their major side effects?

Answer 4

Rifampicin - Hepatitis, rashes, febrile reaction, orange/red secretions (N.B. contact lenses), many drug interactions including warfarin and OCP
Isoniazid - Hepatitis, rashes, peripheral neuropathy, psychosis
Pyrazinamide - Hepatitis, rashes, vomiting, arthralgia
Ethambutol - Retrobulbar neuritis

Therefore, MUST do a baseline visual acuity test and LFT’s which must be monitored closely

Question 5

Give 3 examples of loop diuretics

Answer 5

Furosemide, bumetanide, torsemide

Question 6

What is the main indication use of loop diuretics

Answer 6

Fluid overload

Question 7

What is the mechanism of action of loop diuretics

Answer 7

Inhibit the NA K Cl- transporter in the loop of Henle

Question 8

Name 2 thiazide or thiazide like diuretics

Answer 8

bendroflumethiazide, indapamide

Question 9

main indications for use of thiazide diuretics

Answer 9

Hypertension, fluid overload

Question 10

What is the mechanism of action of thiazide diuretics

Answer 10

Inhibits NaCl channel in distal convoluted tubule

Question 11

The common side effects of thiazide diuretics

Answer 11

Hyponatraemia, hypokalaemia, dehydration, hypercalcaemia, hyperuricaemia, hypomagnesaemia, alkalosis

Question 12

Where are loop diuretics metabolised

Answer 12

Liver and kidney

Question 13

Where are thiazide diuretics metabolised

Answer 13

Kidney

Question 14

Name 2 types of potassium sparing diuretics and name one drug in each category

Answer 14

Aldosterone antagonists (spironolactone)
epithelial Na channel blockers (amiloride)

Question 15

1 of the main indications for use of potassium sparing diuretics

Answer 15

Potassium losing tubulopathies, hypertension, heart failure

Question 16

Common side effects of potassium sparing diuretics

Answer 16

Hypokalaemia, gynaecomastia

Question 17

To avoid risk of hyperkalaemia which medications would you not prescribe along with potassium sparing diuretics

Answer 17

ACE inhibitors, angiotensin receptor blockers

Question 18

Name 2 carbonic anhydrase inhibitors

Answer 18

Acetazolamide, brinzolamide

Question 19

Which ions do carbonic anhydrase inhibitors increase the renal excretion of

Answer 19

Sodium, potassium, bicarbonate

Question 20

4 common side-effects of carbonic anhydrase inhibitors

Answer 20

Flushing, metabolic acidosis, liver failure and agranulocytosis

Question 21

What effect do carbonic anhydrase inhibitors have in the eye

Answer 21

Decrease production of aqueous humour (thus used for glaucoma)

Question 22

Name 4 examples of corticosteroids

Answer 22

Prednisolone, hydrocortisone, dexamethasone, triamcinolone

Question 23

6 of the common side effects of corticosteroids

Answer 23

Adrenal suppression, hyperglycaemia, psychosis, insomnia, indigestion, mood swings

Question 24

Lists some important but uncommon side effects of corticosteroids

Answer 24

Diabetes, cataracts, glaucoma, peptic ulceration, susceptibility to infections, osteoporosis, muscle wasting, skin thinning, Cushingoid appearance

Question 25

What should you consider prescribing with corticosteroids

Answer 25

PPI, bisphosphonates, (and issue them with a steroid card if long-term)

Question 26

How does tolvaptan work?

Answer 26

Vasopressin receptor 2 antagonist

Question 27

5 side effects of beta blockers

Answer 27

``` bronchospasm, cold peripheries, fatigue, sleep disturbances, including nightmares. erectile dysfunction ```

Question 28

Which types of oral hypoglyceamiac agents (anti-diabetic drugs) typically cause weight loss?

Answer 28

GLP-1 agonists (-tides) | SGLT-2 inhibitors (-gliflozins)

Question 29

How does digoxin work?

Answer 29

Decreases conduction through the AV node (thus slowing ventricular rate in AF and A.flutter) Increases force of cardiac muscle contraction due to inhibition of the Na+/K+ ATPase pump. Also stimulates vagus nerve.

Question 30

Why should verapamil not be given with beta blockers?

Answer 30

May cause heart block

Question 31

5 commonly used drugs that can cause peripheral neuropathy

Answer 31

Phenytoin Amiodarone. Isoniazid. Nitrofurantoin Metronidazole. (also Ciprofloxacin) . (PAIN MC)

Question 32

Mechanism of action for salbutamol

Answer 32

ß2-selective adrenergic agonists Increase cAMP in SMC’s resulting in relaxation and thus bronchodilation

Question 33

Name 2 long acting beta agonists

Answer 33

Formeterol, Salmeterol

Question 34

What type of drug is Ipratropium?

Answer 34

Anti-muscarinic

Question 35

Common side effects of ipratropium

Answer 35

Effects | Dry mouth, constipation, cough, headache

Question 36

What category of drugs are Aminophylline and Theophylline?

Answer 36

Xanthines

Question 37

Mechanism of action of Aminophylline

Answer 37

Block phosphodiesterases resulting in decreased cAMP breakdown causing bronchodilation (also positive chronotropic and inotropic effects, diuretic action)

Question 38

What are the toxic effects of aminophylline if overdosed?

Answer 38

Toxic effects are serious arrhythmias, seizures, N&V, hypotension (theraputic window is 10-20mg/L)

Question 39

Common side effects of aminophylline

Answer 39

Headache, GI upset, reflux, palpitations, dizziness

Question 40

Name 3 glucocorticoid steroids for inhalation

Answer 40

Beclomethasone, Budesonide, Fluticasone