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Pharmacology/ Therapeutics Flashcards

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1
Q

Donepazil
S/E (1)
CI (1)

A

SE
1. insomnia
CI
1. bradycardia

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2
Q

Name as many dopamine agonists as you can (7)

A
  1. Bromocriptine (SE cardiac fibrosis)
  2. Ropinirole
  3. Capergoline (SE cardiac fibrosis)
  4. Apomorphine
  5. Pramipexole
  6. Transdermal rotogitine
  7. Pergolide (SE cardiac fibrosis)

BRATCPP

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3
Q

Name 2 MAO B inhibitors

A
  1. Rasagaline

2. Selegiline

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4
Q

Name 2 COMT inhibitors

A
  1. Entacapone

2. Tolcapone

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5
Q

3 SE of DA

A
  1. Excessive sleepiness
  2. Hallucinations
  3. Impulse control
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6
Q

Triptans
SE (2)
CI (2)

A

SE

  1. Tingling
  2. Tightness/ heaviness throat and chest

CI

  1. IHD
  2. CVD
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7
Q

Long QT causes

A 
SSRIs
TCAs/ terfenadine
Ondansetron
Methadone/ MI/ myocarditis/ macrolides
Amiodarone
Chloroquine, ciprofloxacin
Hypothermia/ haloperidol 
Low K, Mg, Ca
Erythromycin
SAH
Sotalol

STOMACHLESS

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8
Q

Phenytoin

SE

A 
SE (PRANG HATDD)
Peripheral neuropathy 
Rash - toxic epidermal necrolysis
Ataxia
Nystagmus
Gingival hyperplasia 
Hirsutism 
Anaemia (megaloblastic)
Teratogenic 
Dizziness
Diplopia
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9
Q

Sodium valproate

SE

A 
WHAT PLANT 
Weight gain
Hepatotoxicity
Ataxia
Tremor
Thrombocytopaenia
Pancreatitis
Low Na
Alopecia
Nausea
Teratogenic
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10
Q

PPI S/E (4)

A
  1. Low sodium
  2. Low magnesium
  3. Clostridium difficile
  4. Osteoporosis
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11
Q

Sulphasalazine SE (2)

A
  1. Oligospermia

2. Pulmonary fibrosis

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12
Q

Name x3 5-ASA

A
  1. Sulphasalazine
  2. Mesalazine
  3. Olsalazine
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13
Q

AZT

SE (3)

A
  1. bone marrow depression
  2. pancreatitis
  3. increased risk of non-melanoma skin cancer
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14
Q

MTX

SE (5)

A
  1. Myelosuppression
  2. Mucositis
  3. Pneumonitis
  4. Pulmonary fibrosis
  5. Liver fibrosis
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15
Q

Hydroxychloroquine
S/E (1)
What investigations need to be done before and during taking this medication? How often?

A

Bulls eye retinopathy - can results in permanent visual loss

Baseline ophthalmological examination and annual screening

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16
Q

BishOsphOnates

SE (3)

A

OOO

  1. Osteonecrosis of jaw
  2. Oesophagitis
  3. Oeosophageal ulcers
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17
Q 
Prednisolone SE (5)
Hint: CHOICE
A
  1. Cushing’s
  2. Hirsutism+HTN+ hyperlipidaemia
  3. Osteoporosis, avascular necrosis femoral head,
  4. Impaired glucose tolerance, insomnia
  5. Cataracts
  6. Eating - weight gain

CHOICE

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18
Q

Mesalazine SE (2)

A
  1. Pancreatitis

2. Agranulocytosis

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19
Q

Leflunomide SE

What group of medication is it?

A

DMARD

  1. Liver impairment
  2. Interstitial lung disease
  3. Hypertension
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20
Q

Gold SE (1)

A

Proteinuria

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21
Q

Penicillamine SE (2)

A

Proteinuria

Exacerbation of myasthenia gravis

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22
Q

Etanercept SE (2)

A
  1. Demyelination

2. Reactivation of TB

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23
Q 
Thiazolidinediones 
MOA
Example
CI 
SE (4)
A 
Pioglitazone, reduces insulin resistance peripherally
CI: HF
1. Weight gain
2. Liver impairment 
3. Fluid retention 
4. Bladder cancer

PIogLItaZONE
Pio = pie = weight gain
LIver impairment
ZONE= transitional cell carcinoma = bladder ca

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24
Q

Lithium SE

A
  1. Diabetes insipidus
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25
Finasteride SE (4)
1. erectile dysfunction 2. reduced libido 3. ejaculation problems 4. gynaecomastia
26
Anastrozole SE (3)
1. Menopausal symptoms 2. Osteoporosis 3. Insomnia
27
Loop diuretics SE (4)
1. Ototoxicity 2. Gout 3. Low calcium/ magnesium/ chloride/ sodium/ BP/ potassium 4. Renal impairment
28
Carbimazole SE
1. Agranulocytosis | 2. Crosses the placenta - can only be used in small doses in pregnancy
29
Name six drugs that can cause gynaecomastia
1. Spiro 2. digoxin 3. cannabis 4. finasteride 5. GnRH agonists e.g. goserelin, buserelin 6. oestrogens
30
Name three medications that can cause raised prolactin
1. metoclopramide 2. domperidone 3. haloperidol
31
Levothyroxine SE (4)
1. hyperthyroidism: due to over treatment 2. reduced bone mineral density 3. worsening of angina 4. atrial fibrillation
32
Tetracyclines | S/E:
1. discolouration of teeth: therefore should not be used in children < 12 years of age 2. photosensitivity 3. angioedema 4. black hairy tongue
33
P450 enzyme inhibitors and inducers | What is the difference?
Inducers = breaks down other drugs more quickly Inhibitors = leads to toxicity of other drugs, as prevents the breakdown
34
Rifampicin Inducer/ inhibitor SE (2)
potent liver enzyme inducer hepatitis orange secretions
35
isoniazid inducer/ inhibitor SE (3)
peripheral neuropathy - prevent with pyridoxine (Vitamin B6) hepatitis agranulocytosis liver enzyme inhibitor
36
pyrazinamide | SE (3)
hyperuricaemia causing gout arthralgia, myalgia hepatitis
37
ethambutol | SE (1)
optic neuritis: check visual acuity before and during treatment
38
Two antimalarials CI if has epilepsy
Chloroquine | Mefloquine
39
``` Isotretinoins SE (7) Cannot be used which which medication and why? ```
1. Teratogenic (use two forms of contraception) 2. Dry skin/ eyes/ lips/ mouth 3. Low mood 4. Raised triglycerides 5. Hair thinning 6. Epistaxis 7. Photosensitivity Cannot be combined with tetracycline as risk of intracranial HTN
40
CCB | SE
1. Flushing 2. Ankle oedema 3. Headache 4. Constipation
41
``` Monitoring What drugs (3) will you need to monitor the LFTs? ```
Statins LFTs at baseline, 3 months and 12 months Sodium valproate Glitazones
42
Monitoring | What drug will you need to monitor the U&E?
ACE U&E prior to treatment U&E after increasing dose U&E at least annually
43
Monitoring | TFT, LFT
Amiodarone TFT, LFT, U&E, CXR prior to treatment TFT, LFT every 6 months
44
Monitoring | FBC, LFT, U&E
MTX FBC, U&Es and LFTs before starting treatment and repeated weekly until therapy stabilised, thereafter patients should be monitored every 2-3 months'
45
Monitoring | FBC, LFT
AZT FBC, LFT before treatment FBC weekly for the first 4 weeks FBC, LFT every 3 months
46
Monitoring | Level, TFT, U&E
Lithium TFT, U&E prior to treatment Lithium levels weekly until stabilised then every 3 months TFT, U&E every 6 months
47
1. Headaches 2. N&V 3. Vertigo 4. Confusion 5. Weakness 6. Pink skin and mucosae
CO poisoning
48
CO poisoning Ix (2) Mx
Venous or arterial blood gas ECG Mx 1. 100% O2 non rebreather for 6 hours, target sats 100% 2. Hyperbaric oxygen if severe (>30%)
49
Overdose and poisoning: management | Paracetamol
activated charcoal if ingested < 1 hour ago N-acetylcysteine (NAC) liver transplantation
50
Overdose and poisoning: management | Salicyclate
urinary alkalinization with IV bicarbonate | haemodialysis
51
Overdose and poisoning: management Opioid/opiates Benzodiazepines
Naloxone | Flumezanil (supportive care only if not severe or iatrogenic)
52
Overdose and poisoning: management | Tricyclic antidepressants
IV bicarbonate
53
Overdose and poisoning: management | Lithium
mild-moderate toxicity: volume resuscitation with normal saline haemodialysis may be needed in severe toxicity
54
Overdose and poisoning: management Warfarin Heparin
Vitamin K, prothrombin complex | Protamine sulphate
55
Overdose and poisoning: management BB Organophosphate insecticides
If bradycardic then atropine in resistant cases glucagon may be used atropine
56
Overdose and poisoning: management Ethylene glycol Methanol poisoning
1. fomepizole, an inhibitor of alcohol dehydrogenase 2. Ethanol 3. Haemodialysis
57
Overdose and poisoning: management | Lead
Dimercaprol, calcium edetate
58
Overdose and poisoning: management | Cyanide
Hydroxocobalamin; also combination of amyl nitrite, sodium nitrite, and sodium thiosulfate
59
Quinolones MOA (1) CI (3) SE (3)
inhibit topoisomerase II (DNA gyrase) and topoisomerase IV CI pregnant, breasfeeding, G6PD 1. Long QT 2. Lowers seizure threshold 3. Tendon damage/ rupture, increased risk if also taking steroids
60
``` Macrolides Cannot be used with? Why? SE (2) Inhibitor/ inducer? Azithro SE (2) ```
CI not to use with statins as macrolides are inzyme inhibitors therefore reduce breakdown of statins and increase risk of myopathy and rhabdomylysis. 1. Long QT 2. cholestatic jaundice Azithromycin - hearing loss and tinnitus
61
P450 inducers (therefore reduce efficacy of other drugs due to increased breakdown) BullShit CRAP GPS
``` Barbiturates St John Warts Carbamezapine Rifampacin Alcohol (chronic) Phenytoin Griseofluvin Phenobarbitol Sulfonylureas + smoking ```
62
P4550 inhibitors (therefore increase toxicity risk) SICKFACES.COM
``` Sodium valproate Isoniazid Cipro Ketoconazole Fluconazole Acute alcohol Chloramphenicol Erythro Sulfonamides Cimetidine Omeprazole Metronidazole ```
63
Adrenaline doses in anaphylaxis and cardiac arrest
anaphylaxis: 0.5ml 1:1,000 IM | cardiac arrest: 1ml of 1:1000 IV or 10ml 1:10,000 IV
64
``` Mx alcohol Acute withdrawal (2) To encourage abstinence (1) CI (2) Reduces craving, known to be a weak antagonist of NMDA receptors (1) ```
``` Thiamine Benzo Disulfram - can cause severe reaction if also drinks ETOH CI IHD, psychosis acamprosate ```
65
Amiodorone SE (10) - name as many as you can Drug interactions (2)
1. Slate grey appearance 2. Hypo/ hyperthyroidism 3. Pulmonary fibrosis 4. Liver fibrosis 5. Corneal deposits 6. Peripheral neuropathy 7. Photosensitivity 8. Long QT 9. Thrombophlebitis 10. Bradycardia Warfarin - increases INR Digoxin - increases digoxin levels
66
Aspirin potentiates? (3)
1. PO hypoglycaemics 2. warfarin 3. steroids
67
``` Diclofenac contraindications (4) Should be switched to? ```
1. ischaemic heart disease 2. peripheral arterial disease 3. cerebrovascular disease 4. congestive heart failure Naproxen or ibuprofen or topical diclofenac
68
Name an inhibitor of 5 alpha-reductase Indications (2) SE (5)
Finasteride benign prostatic hyperplasia male-pattern baldness 1. impotence 2. decrease libido 3. ejaculation disorders 4. gynaecomastia 5. breast tenderness
69
Gentamicin is what type of abx? Adverse effects (2) CI (1) Monitoring
Aminoglycoside 1. Ototoxicity 2. Nephrotoxicity Myasthenia gravis Peak and trough Peak 1 hour post dose Trough to be checked just before next dose due If trough raised, interval should be increased If peak raised, dose should be decreased
70
Heparin SE Heparin-induced thrombocytopaenia (HIT) will occur after how long of use of heparin?
1. bleeding 2. thrombocytopenia 3. osteoporosis/ risk of fractures 4. hyperkalaemia 5-10 days
71
Tamoxifen MOA SE (4) How long is it used for?
oestrogen receptor antagonist and partial agonist menopausal symptoms VTE endometrial cancer 5 years post tumour removal
72
St John's Wort is used in? | Inhibitor/ inducer
Mild-moderate depression | Inducer, therefore reduces effectiveness of warfarin/ ciclosporin/ COCP
73
SE Metformin (2)
lactic acidosis | GI effects
74
SE sulfonylureas (4)
Hypoglycaemic episodes Increased appetite and weight gain SIADH Liver dysfunction (cholestatic)
75
SE glitazones (4)
Weight gain Fluid retention Liver dysfunction Fractures
76
SE gliptins
Pancreatitis
77
SE trimethoprim (3)
Rashes, including photosensitivity Pruritus Suppression of haematopoiesis
78
SE metro
reaction after drinking ETOH
79
SE Erythromycin
prolongs QT

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