Exam (elaborations)
MRCP 1 – Pharamacology Exam 2024
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MRCP 1 – Pharamacology Exam 2024
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MRCP 1 – Pharamacology Exam 2024Oculogyric crisis (Dystonia) -
reaction to drugs, in particular neuroleptics and dopaminergic medications
(classically metoclopramide and haloperidol) - agitated, has a clenched jaw and
her eyes are deviated upwards.(Oculogyric crisis)
℞: IV antimuscarinic: benztropine or procyclidine
Calcium channel blockers adverse effects - ⛑Headache
⛑ Flushing
⛑ Ankle oedema
⛑Verapamil also commonly causes constipation⛑
beta blockers adverse effects - ⛑Bronchospasm (especially in asthmatics)
⛑ Fatigue
⛑ Cold peripheries
⛑ Sleep disturbances
Methanol poisoning
,MRCP 1 – Pharamacology Exam 2024
causes both the effects associated with alcohol (intoxication, nausea etc) and also
specific visual problems, including blindness. These effects are thought to be
secondary to the accumulation of formic acid.
℞: fomepizole (competitive inhibitor of alcohol dehydrogenase) or ethanol -
Methanol poisoning
causes both the effects associated with alcohol (intoxication, nausea etc) and also
specific visual problems, including blindness. These effects are thought to be
secondary to the accumulation of formic acid.
℞: fomepizole (competitive inhibitor of alcohol dehydrogenase) or ethanol
Ethylene glycol toxicity
Ethylene glycol is a type of alcohol used as a coolant or antifreeze.
Features of toxicity are divided into 3 stages:
Stage 1: symptoms similar to alcohol intoxication: confusion, slurred speech,
dizziness
Stage 2: metabolic acidosis with high anion gap and high osmolar gap. Also
tachycardia, hypertension
,MRCP 1 – Pharamacology Exam 2024
Stage 3: acute kidney injury
℞: fomepizole, an inhibitor of alcohol dehydrogenase, is now used first-line in
preference to ethanol - Ethylene glycol toxicity
Ethylene glycol is a type of alcohol used as a coolant or antifreeze.
Features of toxicity are divided into 3 stages:
Stage 1: symptoms similar to alcohol intoxication: confusion, slurred speech,
dizziness
Stage 2: metabolic acidosis with high anion gap and high osmolar gap. Also
tachycardia, hypertension
Stage 3: acute kidney injury
℞: fomepizole, an inhibitor of alcohol dehydrogenase, is now used first-line in
preference to ethanol
Acute intermittent porphyria
, MRCP 1 – Pharamacology Exam 2024
autosomal dominant - caused by a defect in porphobilinogen deaminase, an
enzyme involved in the biosynthesis of haem. - What disease causes port-wine
colored urine, polyneuropathy and painful abdomen?
Drugs which may precipitate attack
barbiturates
halothane
benzodiazepines
alcohol
oral contraceptive pill
sulphonamides
acute intermittent porphyria is brought to the Emergency Department by the
police due to an acute psychosis.
What is the most suitable drug for sedation? - Chlorpromazine is considered safe
to use in patients with acute intermittent porphyria.
Adrenaline induces
⬆ High sugar
⬆ High Lactate
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