FRACP Paediatrics > Medications > Flashcards

Medications Flashcards

(40 cards)

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1
Q

Which chemotherapy drugs cause secondary malignancy?

A
  • Cyclophosphamide.

- Etoposide (AML).

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2
Q

What is the most common long term side effect of cyclosporin?

A
  • Hirsuitism.
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3
Q

Side effects of asparginase?

A
  • Pancreatitis, hyperglycaema, allergies, coagulopathy, encephalopathy.
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4
Q

Side effects of cyclophosphamide?

A
  • Myelosuppression, haemorrhagic cystitis, secondary malignancy, sterility, lung fibrosis, SIADH.
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5
Q

Side effects of doxorubicin?

A
  • Myelosuppression, necrosis on extravasation, cardiotoxicity, radiation recall.
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6
Q

Side effects of vincristine?

A
  • Peripheral neuropathy, ptosis, constipation, jaw and bone pain, extravasation injury.
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7
Q

Side effects of 6-mercaptopurine?

A
  • Myelosuppression, hepatic necrosis.
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8
Q

Which hepatic enzyme is induced by St Johns Wort?

A
  • CYP3A4
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9
Q

Which hepatic enzyme does cyclosporin inhibit?

A
  • CYP3A4
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10
Q

What medication is used as first line treatment for threadworm/pinworm (Enterobius vermiculars)?

A
  • Pyrantel or mebendazole.

- Shower on the night medication and again in the morning to remove eggs laid overnight.

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11
Q

How many half lives does it take for a drug to reach steady state?

A

5

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12
Q

Which antiepileptic should not be used in JME?

A
  • Carbemazapine.

- Known to cause deterioration in 68% of patients with JME.

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13
Q

Side effects of Vigabatrin?

A
  • Visual field constriction from peripheral retinal atrophy.
  • Optic neuritis.
  • Vision loss (rods > cones so predominantly night vision).
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14
Q

Side effects of Carbamazepine?

A
  • Nausea and vomiting.
  • Dizziness.
  • Drowsiness.
  • Liver dysfunction.
  • Hyponatraemia (SIADH).
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15
Q

Side effects of Gabapentin?

A
  • Somnolence.
  • Dizziness.
  • Tremor/ataxia.
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16
Q

Side effects of Lamotrigine?

A
  • Rash.
  • Nausea.
  • Dizziness.
  • Tremor.
  • Diplopia.
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17
Q

Side effects of Sodium Valproate?

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A
  • Weight gain.
  • Hair loss.
  • Tremor.
  • Dizziness.
  • Nausea and vomiting.
  • Easy bruising.
  • Birth defects.
18
Q

What medications increase cyclosporin levels?

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A
  • Ketoconazole, erythromycin, warfarin, itraconazole and fluconazole.
19
Q

What medications decrease cyclosporin levels?

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A
  • Phenytoin, phenobarbitol, carbamazepine, rifampicin, alcohol abuse, sulphynyureas, St Johns Wort.
20
Q

What are side effects of hydroxycholoquine?

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A
  • Nausea - most common side effect and may stop children from eating. Wean the dose and advise to give at night.
  • Corneal toxicity - reversible.
  • Retinal toxicity - rare, loss of colour vision and blindness. Irreversible.
21
Q

How does Tocilizumab work?

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A
  • Tocilizumab is a recombinant humanized anti-human monoclonal antibody directed against IL-6 receptor.
22
Q

How does Infliximab work?

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A
  • Chimeric monoclonal antibody that binds TNFa.

- Etnercept also binds TNFa but is a recombinant protein.

23
Q

How does Anakinra work?

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A
  • IL1 inhibitor.

- Canakinumab and Rilanocept are also IL1 inhibitors.

24
Q

Why does topiramate cause nephrolithiasis?

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A
  • Inhibits carbonic anhydrase leading to metabolic acidosis.
  • Defect in renal tubular acidification as a result of loss of carbonic anhydrase impairs compensatory drop in urine pH.
  • This leads to development of calcium phosphate nephrolithiasis.
25
What is the mechanism of action of penicillins?
- Inhibit cell wall synthesis. | - Irreversibly bind to DD transpeptidase (penicillin binding protein) and prevent transpeptidation.
26
What antibiotics are used for MRSA?
- Glycopeptides (vancomycin and teicoplanin).
27
What are the relative potencies of glucocorticoids compared to cortisol?
- Prednisilone 4:1 - Betamethasone 25:1 - Dexamethasone 25:1
28
Omeprazole affects gastric parietal cell function by inhibition of which pathway?
- Inhibits H+K+ ATPase (proton pump) by irreversibly binding on the luminal surface. - Blocks the final step in gastric acid secretion by parietal cells.
29
What features are associated with in utero alcohol exposure?
-short palpebral fissures, blepharoptosis. epicanthal folds, telcanthus, smooth philtrum, small upper lip.
30
What features are associated with in utero phenytoin exposure?
- Craniofacial abnormalities, hypoplastic phalanges/nails.
31
What features are associated with in utero sodium valproate exposure?
- Spina bifida, preaxial defects, low IQ.
32
What features are associated with in utero warfarin exposure?
- Nasal hypoplasia, stippled epiphyses, CNS defects secondary to cerebral haemorrhage.
33
What antibiotic does not have action against Pseudomonas?
- Cefotaxime
34
Which antiepileptics are inducers?
- Phenytoin, phenobarbital and carbemazepine.
35
Which chemotherapy agent is most likely to cause renal Fanconi syndrome
- Ifosfamide. - Particularly doses >54g/m2. - Hypophosphataemia, hypokalaemia, glycosuria, proximal RTA, hypouricaemia. - Decreased tubular reabsorption on PO4 and increased fractional excretion of Na, K and Ca. - Increased urinary amino acids and HCO3. - Can cause glomerular and tubular toxicity. - Proximal tubular dysfunction is prominent and characterised by Fanconi syndrome and hypophosphataeimic ricketts. - IFO dose >100g/m2, age <5y and combination therapy with platins increase risk.
36
What is a bacteriostatic antibiotic?
- Antibiotic that limits the growth of bacteria by interfering with the bacterial protein production. - Examples: Macrolides, sulfonamides, trimethoprim, chloramphenicol, licosamides (clindamycin).
37
What is a bacteriocidal antibiotic?
- Kill bacteria. | - Examples: aminoglycosides, b-lactams, fluoroquinolones, nitrofurantoin, vancomycin, daptomycin.
38
What medications and drugs are serotinergic?
- SSRI and SNRI antidepressants. - TCA's. - Amphetamines, MDMA and cocaine. - Tramadol. - St Johns Wort. - Triptans. - Metocloparmide and ondansetron.
39
What are features of serotonin syndrome?
- Fever, tachycardia, sweating. - Dilated pupils. - Agitation, confusion, hypomania. - Tremor, myoclonus and increased reflexes. - Also develop nausea and diarrhoea.
40
Side effects of cytarabine?
- Fever is a common side effect. | - Oral mucocytis.
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