Browse topics
Pharmacology
86 notes, 264 questions and 756 flashcards.
Tier 1 is core knowledge expected of every trainee. Tier 2 is deeper or less common.
Cardiology
- Heparins and direct oral anticoagulants: pharmacology and reversalFree sampleHow unfractionated heparin, low molecular weight heparin, fondaparinux and the DOACs work, how their kinetics drive renal dosing, monitoring and interactions, the mechanism of HIT, and how each is reversed.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- Warfarin pharmacology, monitoring and reversalHow warfarin blocks vitamin K recycling, why the INR rises before the patient is protected, how the INR is calculated, the CYP2C9 and VKORC1 sources of variability, and Australian reversal with four-factor PCC (Beriplex) and vitamin K.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- ACE inhibitors, angiotensin receptor blockers and sacubitril-valsartanHow ACE inhibitors, ARBs and neprilysin inhibition change angiotensin II, bradykinin and natriuretic peptides, why creatinine rises and potassium climbs, the bradykinin basis of cough and angioedema, the 36-hour washout, fetotoxicity, and the trial numbers that are examined.Tier 2, medical sciences concept, 4 questions, 9 flashcards
- Amiodarone, digoxin and adenosineThe pharmacology behind three drugs that don't fit neatly into Vaughan Williams. Amiodarone's huge volume of distribution, iodine load and thyroid effects; digoxin's Na/K-ATPase mechanism, renal clearance and P-glycoprotein interactions; adenosine's 10-second half-life and its A1 receptor effects on the AV node.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Antiarrhythmic drug mechanisms and the Vaughan Williams classificationHow each Vaughan Williams class changes the cardiac action potential, use dependence and reverse use dependence, why flecainide needs an AV nodal blocker and a normal heart, the CAST lesson, and the 2018 modernised classification.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Antiplatelet drugs: aspirin, P2Y12 inhibitors and GP IIb/IIIa antagonistsHow aspirin, clopidogrel, prasugrel, ticagrelor, dipyridamole and the GP IIb/IIIa antagonists act on platelet activation, and how irreversibility, prodrug activation, CYP2C19 and adenosine explain their timing, interactions and side effects.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Beta blockersBeta-adrenoceptor signalling and how selectivity, lipophilicity, intrinsic sympathomimetic activity and extra actions (alpha blockade, sodium and potassium channel block) explain the uses, adverse effects and overdose features of beta blockers.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Calcium channel blockersHow dihydropyridine and non-dihydropyridine calcium channel blockers act on L-type channels in vascular smooth muscle, myocardium and nodal tissue, and how that tissue selectivity explains their uses, oedema, interactions and overdose.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Loop and thiazide diureticsWhere loop and thiazide diuretics act in the nephron, how tubular secretion and the dose-response curve explain dosing and resistance, and how the transport physiology explains hypokalaemia, alkalosis, hyponatraemia and the opposite effects on calcium.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Nitrates and other antianginals (nicorandil, ivabradine, perhexiline)How nitrates relieve angina through nitric oxide, cGMP and preload reduction (with a worked wall stress example), why tolerance develops and nitrate-free intervals work, the PDE5 inhibitor interaction, and the distinct mechanisms and toxicities of nicorandil, ivabradine and perhexiline.Tier 2, medical sciences concept, 4 questions, 9 flashcards
- Non-statin lipid-lowering agents: ezetimibe, PCSK9 inhibitors, fibrates and omega-3Mechanisms and numbers for ezetimibe (NPC1L1), PCSK9 antibodies and inclisiran, bempedoic acid, fibrates, omega-3 fatty acids and bile acid sequestrants, with worked LDL calculations, outcome trials and Australian PBS status.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Potassium-sparing diuretics and mineralocorticoid receptor antagonistsHow aldosterone drives sodium reabsorption and potassium and hydrogen secretion in the collecting duct, how spironolactone, eplerenone, finerenone and amiloride interrupt it, why hyperkalaemia follows, and the trials and PBS rules the exam uses.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Statins: mechanism, pharmacokinetics and muscle toxicityHow HMG-CoA reductase inhibition upregulates LDL receptors, the CTT rule of 22% fewer events per 1 mmol/L with a worked NNT, how lipophilicity and CYP3A4, OATP1B1 and SLCO1B1 shape interactions and myopathy, anti-HMGCR necrotising myopathy, and the nocebo trials.Tier 2, medical sciences concept, 3 questions, 9 flashcards
Clinical pharmacology
- Absorption, bioavailability, routes of delivery and volume of distributionFree sampleHow drugs cross membranes, what sets oral bioavailability (including first-pass metabolism and P-glycoprotein), how route and formulation change exposure, and how volume of distribution and protein binding explain loading doses, dialysability and drug levels.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- Antimicrobial PK/PD: time-dependent and concentration-dependent killingMIC, free drug and the three PK/PD indices (fT>MIC, Cmax/MIC, AUC/MIC), which antibiotic classes follow each, and how they explain extended beta-lactam infusions, once-daily aminoglycosides, AUC-guided vancomycin and underdosing in sepsis, augmented renal clearance and hypoalbuminaemia.Tier 1, medical sciences concept, 3 questions, 8 flashcards
- Antipsychotic adverse effects: extrapyramidal, metabolic, cardiac and clozapine-specificThe mechanism and timing of each extrapyramidal syndrome and NMS, why some antipsychotics cause weight gain, diabetes and QT prolongation, and clozapine's neutropenia, myocarditis, gut hypomotility and CYP1A2 interaction with smoking, with Australian monitoring thresholds.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- Antipsychotics: dopamine pathways and receptor profiles of typical and atypical agentsThe four dopamine pathways, the D2 occupancy window, why atypical agents differ (5-HT2A blockade, fast dissociation, partial agonism), and how each drug's off-target receptor profile predicts its side effects and its use in Parkinson disease, delirium and hyperprolactinaemia.Tier 1, medical sciences concept, 3 questions, 8 flashcards
- Bronchodilators: beta-2 agonists, muscarinic antagonists and theophyllineHow beta-2 agonists, muscarinic antagonists and methylxanthines relax airway smooth muscle, how onset and duration explain their roles in asthma and COPD, why SABA-only asthma treatment is unsafe, and the adverse effects and theophylline kinetics that Paper 1 examines.Tier 1, medical sciences concept, 3 questions, 8 flashcards
- Clearance, half-life, steady state and loading and maintenance dosesClearance and volume of distribution as the two primary parameters, half-life as their consequence, first-order and zero-order elimination, time to steady state, hepatic extraction ratio, renal excretion, and how to calculate loading and maintenance doses.Tier 1, medical sciences concept, 3 questions, 10 flashcards
- Drug metabolism and the cytochrome P450 systemPhase I and phase II metabolism, the main CYP isoenzymes with their substrates, inhibitors and inducers, the time course of inhibition and induction, prodrugs and toxic metabolites, and the interactions Paper 1 builds questions around.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- Mechanisms of drug interactions: CYP and P-glycoprotein induction and inhibition, herbal medicines and pharmacodynamic synergyHow drugs alter each other's absorption, metabolism and excretion (CYP and P-glycoprotein inhibition and induction, chelation, tubular secretion), why time course and fraction metabolised predict severity, complementary medicine interactions, and additive pharmacodynamic harms.Tier 1, medical sciences concept, 3 questions, 10 flashcards
- Neurobiology of addiction: reward, tolerance, dependence and withdrawalMesolimbic dopamine and the three-stage addiction cycle, the receptor mechanisms by which each drug class raises dopamine, cellular tolerance and sensitisation, allostasis and the anti-reward systems that drive withdrawal, and how these explain agonist treatment and relapse.Tier 1, medical sciences concept, 2 questions, 10 flashcards
- Opioid receptor pharmacology and individual opioidsOpioid receptor signalling and where each effect comes from, full and partial agonists and antagonists, tolerance, and the kinetics, metabolites and interactions that set morphine, oxycodone, hydromorphone, fentanyl, codeine, tramadol, tapentadol, methadone and buprenorphine apart.Tier 1, medical sciences concept, 4 questions, 10 flashcards
- Paracetamol and NSAID pharmacologyHow paracetamol and NSAIDs work, why COX-1 and COX-2 inhibition explain their gastric, renal, platelet, cardiovascular and respiratory effects, paracetamol metabolism and NAPQI, and the NNTs for acute pain.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- Pharmacodynamics: receptors, dose-response, agonists and antagonistsReceptor types, affinity, efficacy and potency, the dose-response curve, full, partial and inverse agonists, competitive, non-competitive and irreversible antagonism, spare receptors, therapeutic index, and tolerance, with the clinical cases Paper 1 uses.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- Pharmacokinetics and drug dosing in kidney impairment and dialysisHow reduced kidney function changes absorption, distribution, clearance and response, estimating clearance with Cockcroft-Gault versus eGFR, the dose-adjustment calculation, and which drugs dialysis removes.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- Safe opioid prescribing and opioid stewardshipThe pharmacology behind opioid harm, oral morphine equivalent daily dose and the risk thresholds, the evidence on opioids in chronic non-cancer pain, Australian regulation (TGA 2020 changes, codeine rescheduling, take-home naloxone, real-time monitoring) and the ACSQHC acute pain stewardship standard.Tier 1, medical sciences concept, 3 questions, 8 flashcards
- SSRIs and SNRIs: mechanism, pharmacokinetics and adverse effectsHow serotonin and noradrenaline reuptake inhibitors act and why their benefit is delayed, the half-life and CYP450 differences that drive washout times and interactions, and the mechanisms behind hyponatraemia, bleeding, QT prolongation, serotonin toxicity and discontinuation symptoms.Tier 1, medical sciences concept, 3 questions, 8 flashcards
- Substance use epidemiology, alcohol risk guidelines and harm reductionWhat the NHMRC alcohol guidelines say and the evidence behind the numbers, how to count standard drinks, Australian prevalence data for alcohol, tobacco and illicit drugs, and the harm reduction framework with its evidence, including needle and syringe programmes, take-home naloxone and opioid agonist treatment.Tier 1, medical sciences concept, 2 questions, 10 flashcards
- Adjuvant analgesics: gabapentinoids, antidepressants, ketamine and lidocaineMechanisms of neuropathic pain and the drugs that target them, gabapentinoid kinetics and renal dosing, antidepressant analgesia, sodium channel blockers, ketamine and lidocaine, with NeuPSIG NNTs and the harms that matter.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- GABA-A receptor pharmacology of benzodiazepines and Z-drugsHow benzodiazepines and Z-drugs modulate the GABA-A receptor, why they have a ceiling that barbiturates and alcohol lack, how subunits map to effects, and the pharmacokinetic differences (oxidation versus glucuronidation, lipid solubility, active metabolites) that decide drug choice in liver disease, older people and overdose.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Inhaled corticosteroids, leukotriene antagonists and biologics for asthma and allergic diseaseHow inhaled corticosteroids suppress type 2 airway inflammation and why their pharmacokinetics set the balance of local and systemic effect, how leukotriene receptor antagonists work, and the targets, biomarkers and adverse effects of anti-IgE, anti-IL-5, anti-IL-4R and anti-TSLP biologics, with current Australian PBS status.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Pharmacokinetics in liver disease and critical illnessHepatic extraction ratio and why cirrhosis raises oral bioavailability of high-extraction drugs, choosing drugs in liver disease, and how capillary leak, hypoalbuminaemia and augmented renal clearance change antibiotic dosing in sepsis.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Therapeutic drug monitoring: principles and key drugsWhen a drug level helps, how sample timing and steady state affect interpretation, and the targets and traps for vancomycin, aminoglycosides, digoxin, lithium, phenytoin and other monitored drugs, including changes in renal function, albumin and critical illness.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Tricyclic, MAOI and atypical antidepressantsThe receptor profile of tricyclics and how it predicts their adverse effects and lethal toxicity, irreversible and reversible MAO inhibition and the tyramine reaction, and the mechanisms of mirtazapine, agomelatine, vortioxetine, reboxetine, bupropion and esketamine.Tier 2, medical sciences concept, 3 questions, 8 flashcards
Endocrinology
- Antiresorptive drugs: bisphosphonates and denosumabFree sampleHow nitrogen-containing bisphosphonates poison the osteoclast mevalonate pathway, why their tiny oral absorption and long skeletal retention shape dosing and drug holidays, how denosumab blocks RANKL and why stopping it causes rebound vertebral fractures, and the mechanisms of the acute phase reaction, hypocalcaemia, osteonecrosis of the jaw and atypical femoral fracture.Tier 1, medical sciences concept, 3 questions, 8 flashcards
- Glucocorticoid pharmacology: receptor mechanism, relative potency, indications and contraindicationsHow glucocorticoids act through the cytosolic receptor, why 11-beta-HSD enzymes decide mineralocorticoid effect and prodrug activation, how to convert between steroids, when HPA suppression and adrenal insufficiency follow, and the rheumatology and palliative indications and contraindications Paper 1 examines.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- Incretin-based therapies: GLP-1 receptor agonists, dual agonists and DPP-4 inhibitorsThe incretin effect, why GLP-1 receptor agonists and tirzepatide lower glucose without much hypoglycaemia, how half-life engineering sets weekly dosing and slow titration, the outcome trials, and the adverse effects (nausea, gallstones, retinopathy, aspiration) that follow from the mechanism. DPP-4 inhibitors for comparison.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- Insulin pharmacology and regimensHow insulin signals through its receptor, how amino acid changes and formulation make rapid, basal and weekly analogues, how the kidney clears insulin, and the basal-bolus arithmetic, potassium shift and C-peptide questions Paper 1 asks.Tier 1, medical sciences concept, 3 questions, 8 flashcards
- Metformin and sulfonylureasHow metformin lowers hepatic glucose output and why its renal clearance drives lactic acidosis and interaction risk, how sulfonylureas close the beta-cell K-ATP channel independent of glucose, and the hypoglycaemia, overdose, monogenic diabetes and kidney questions Paper 1 builds on them.Tier 1, medical sciences concept, 3 questions, 8 flashcards
- SGLT2 inhibitors: renal mechanism, cardiorenal benefit and euglycaemic ketoacidosisHow blocking proximal tubular glucose reabsorption lowers glucose in proportion to filtered load, why tubuloglomerular feedback causes the expected eGFR dip and slows CKD, the heart failure and kidney trials with worked NNTs, and the physiology of euglycaemic ketoacidosis and perioperative withholding.Tier 1, medical sciences concept, 3 questions, 8 flashcards
- Anabolic bone agents (teriparatide, romosozumab), SERMs and menopausal hormone therapy for boneWhy intermittent PTH builds bone while continuous PTH destroys it, how teriparatide, abaloparatide and romosozumab differ, why an anabolic must be followed by an antiresorptive and why the order matters, and how raloxifene and menopausal hormone therapy protect bone through oestrogen receptor signalling.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Drugs for pituitary, adrenal and gonadal hormone excess and deficiencyMechanisms of dopamine agonists, somatostatin analogues, pegvisomant, steroidogenesis inhibitors and receptor blockers for hormone excess, and of glucocorticoid, mineralocorticoid, desmopressin and sex steroid replacement, with the lab patterns each drug produces.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Thyroid drugs: thionamides, levothyroxine and radioactive iodineWhere each thyroid drug acts on hormone synthesis, release and peripheral conversion, why thionamides take weeks to work, how carbimazole and propylthiouracil differ in pregnancy and toxicity, the iodine effects (Wolff-Chaikoff, Jod-Basedow, amiodarone), levothyroxine kinetics and interactions, and how radioactive iodine works.Tier 2, medical sciences concept, 3 questions, 9 flashcards
Gastroenterology and hepatology
- Acid suppression: proton pump inhibitors and H2 antagonistsHow the parietal cell secretes acid, why PPIs are acid-activated irreversible prodrugs taken before breakfast, CYP2C19 effects and the clopidogrel question, H2 antagonist tachyphylaxis, and the mechanisms behind PPI hypomagnesaemia, B12 and iron deficiency, rebound acid and false test results.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- Alcohol metabolismZero-order ethanol elimination and how to calculate a falling blood alcohol level, the alcohol and aldehyde dehydrogenase pathway with its NADH and acetaldehyde consequences, CYP2E1 induction, the biochemistry behind alcoholic ketoacidosis and hypoglycaemia, ALDH2 and ADH1B variants, and the osmolar gap.Tier 1, medical sciences concept, 3 questions, 10 flashcards
- Aminosalicylates, budesonide and gut-selective biologics in IBDHow sulfasalazine and mesalazine formulations deliver 5-ASA to the right segment of bowel, why first-pass metabolism makes budesonide gut-selective, how vedolizumab's alpha-4-beta-7 target avoids PML, and the IL-12/23 and IL-23 biologics, with the toxicity and interaction questions Paper 1 asks.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Laxatives and antidiarrhoeal agentsHow osmotic, stimulant, prokinetic, secretagogue and opioid-antagonist laxatives move water and stool, how loperamide, octreotide and bile acid sequestrants slow the gut, and the stool osmotic gap, lactulose and loperamide toxicity questions Paper 1 builds on them.Tier 2, medical sciences concept, 3 questions, 8 flashcards
Genetic and metabolic medicine
Geriatric medicine
Immunology and allergy
- Antihistamines, mast cell stabilisers, adrenaline and immunoglobulin replacementReceptor pharmacology of H1 antihistamines (and why second-generation drugs don't sedate), mast cell stabilisers and anti-IgE, how adrenaline's alpha and beta effects reverse anaphylaxis and why the IM thigh route is used, and the kinetics, dosing and adverse effects of immunoglobulin replacement.Tier 2, medical sciences concept, 4 questions, 10 flashcards
- Antiproliferative immunosuppressants: azathioprine, mycophenolate and cyclophosphamideHow azathioprine, mycophenolate and cyclophosphamide stop lymphocytes dividing, why TPMT and NUDT15 genotype and allopurinol decide azathioprine dosing, why mycophenolate is lymphocyte selective and teratogenic, and why cyclophosphamide needs mesna, fertility planning and a cumulative dose count.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Calcineurin inhibitors and mTOR inhibitorsHow tacrolimus and ciclosporin block IL-2 transcription and sirolimus and everolimus block the IL-2 signal, why CYP3A4 and P-glycoprotein interactions dominate their dosing, and how afferent arteriolar vasoconstriction explains CNI nephrotoxicity, hyperkalaemia and hypertension.Tier 2, medical sciences concept, 3 questions, 9 flashcards
Infectious diseases
- Aminoglycosides and glycopeptides: mechanism, dosing and toxicityHow gentamicin and vancomycin kill bacteria, why aminoglycosides are given once daily and vancomycin is dosed to an AUC, and the mechanisms behind nephrotoxicity, ototoxicity, neuromuscular blockade and vancomycin infusion reactions.Tier 1, medical sciences concept, 3 questions, 8 flashcards
- Beta-lactam antibiotics: penicillins, cephalosporins and carbapenemsHow beta-lactams inhibit penicillin-binding proteins, the spectrum logic of each penicillin, cephalosporin and carbapenem group and their gaps (MRSA, enterococci, Listeria, atypicals), beta-lactamase inhibitors including avibactam, pharmacokinetics, class and drug-specific adverse effects (neurotoxicity, flucloxacillin cholestasis, carbapenem-valproate interaction), and penicillin allergy cross-reactivity and de-labelling with PEN-FAST.Tier 1, medical sciences concept, 3 questions, 10 flashcards
- HIV lifecycle and antiretroviral drug classes: mechanisms, toxicity and interactionsEach step of the HIV replication cycle and the drug class that blocks it, from CCR5 antagonists and NRTIs to integrase and capsid inhibitors, with the class and drug-specific toxicities (HLA-B*57:01, tenofovir tubulopathy, OCT2 creatinine rise), barrier to resistance, hepatitis B overlap and the CYP3A4 interactions of pharmacokinetic boosters.Tier 1, medical sciences concept, 3 questions, 10 flashcards
- Antifungal drugsTargets, spectrum and mechanism-based toxicity of polyenes, azoles, echinocandins, flucytosine and terbinafine, with azole CYP3A4 interactions, voriconazole pharmacogenetics and therapeutic drug monitoring.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Antiviral drugs for herpesviruses, CMV and influenzaHow aciclovir, valaciclovir, ganciclovir, foscarnet, cidofovir, letermovir, maribavir and the influenza antivirals work, why activation by viral kinases explains their selectivity and resistance, and the mechanisms of their kidney, marrow and electrolyte toxicity.Tier 2, medical sciences concept, 3 questions, 10 flashcards
- Fluoroquinolones, trimethoprim-sulfamethoxazole, nitroimidazoles and nitrofurantoinHow fluoroquinolones, trimethoprim-sulfamethoxazole, metronidazole and nitrofurantoin damage bacterial DNA or folate synthesis, and the mechanisms behind their key toxicities, interactions and laboratory effects, including the TGA boxed warning for fluoroquinolones.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Macrolides, tetracyclines, lincosamides and oxazolidinonesRibosomal targets, spectrum, resistance and the mechanism-based adverse effects and interactions of macrolides, tetracyclines, clindamycin and linezolid, including QT prolongation, CYP3A4 inhibition, toxin suppression and serotonin toxicity.Tier 2, medical sciences concept, 3 questions, 9 flashcards
Medical oncology
- Cancer immunotherapy: checkpoint inhibitors, CAR T cells and immune-related toxicityHow CTLA-4, PD-1 and PD-L1 blockade releases T cells, why that produces immune-related adverse events with a predictable timing and organ pattern, how irAEs are graded and treated, and how CAR T cells cause cytokine release syndrome and ICANS.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- Alkylating agents and platinum compoundsHow alkylating agents and platinum compounds cross-link DNA, why cyclophosphamide needs mesna and cisplatin needs saline, how carboplatin is dosed with the Calvert formula, and the toxicities Paper 1 links to each mechanism.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Antimetabolites: methotrexate, fluoropyrimidines, gemcitabine and purine analoguesHow antimetabolites block nucleotide synthesis in S phase, why folinic acid rescues methotrexate but potentiates 5-FU, DPYD testing before fluoropyrimidines (MBS-funded since November 2025), TPMT and the allopurinol interaction, and the toxicities each mechanism explains.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Endocrine therapy in breast and prostate cancer: SERMs, aromatase inhibitors and androgen deprivationHow tamoxifen, aromatase inhibitors, fulvestrant, GnRH agonists and antagonists, abiraterone and androgen receptor inhibitors work, why their mechanisms explain flare, mineralocorticoid excess, bone loss and drug interactions, and how resistance develops.Tier 2, medical sciences concept, 4 questions, 9 flashcards
- Microtubule inhibitors, anthracyclines and topoisomerase inhibitorsHow vinca alkaloids and taxanes disrupt the mitotic spindle, how topoisomerase poisons turn transient DNA breaks into lethal ones, why irinotecan toxicity depends on UGT1A1, and how anthracycline cardiotoxicity relates to cumulative dose and is monitored under the ESC cardio-oncology guideline.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Monoclonal antibodies against HER2, EGFR, VEGF and CD20How therapeutic monoclonal antibodies are built, named and cleared, how trastuzumab, cetuximab, bevacizumab and rituximab kill or starve tumour cells, why RAS status decides cetuximab use, and the mechanism-based toxicities examiners ask about.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Principles of cytotoxic chemotherapy: cell kinetics, dosing, combination and resistanceGompertzian tumour growth, the log-kill hypothesis, cell-cycle specificity, the rules for combining drugs, dosing by body surface area and by carboplatin AUC (Calvert formula), pharmacogenomic dose adjustment (DPYD, UGT1A1, TPMT), and the mechanisms of drug resistance, including P-glycoprotein.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Radiotherapy: radiobiology, delivery and acute and late toxicityHow ionising radiation kills cells, the linear-quadratic model and BED calculations behind fractionation and hypofractionation, the 4 Rs, oxygen and the cell cycle, and how acute and late radiation toxicity differ in timing and mechanism.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Small-molecule tyrosine kinase inhibitorsHow tyrosine kinase inhibitors bind their targets, why resistance mutations such as T315I and T790M arise, the class toxicities that follow from each target, and the absorption and CYP3A4 interactions that change exposure.Tier 2, medical sciences concept, 3 questions, 8 flashcards
Nephrology
- Erythropoiesis-stimulating agents, intravenous iron and potassium binders in kidney diseaseWhy CKD causes anaemia (erythropoietin deficiency, hepcidin-driven iron restriction), how ESAs, IV iron preparations and HIF-PH inhibitors work and harm, the Hb ceiling from CHOIR, CREATE and TREAT, and the exchange mechanisms, onset and adverse effects of polystyrene sulfonate, patiromer and sodium zirconium cyclosilicate.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Phosphate binders, vitamin D analogues and calcimimetics in CKDThe FGF23, calcitriol and PTH sequence behind CKD mineral and bone disorder, and how calcium-based and non-calcium phosphate binders, active vitamin D, cinacalcet and etelcalcetide act on it, with their adverse effects, interactions and the trials the exam quotes.Tier 2, medical sciences concept, 3 questions, 8 flashcards
Neurology
- Antiseizure medications: mechanisms, pharmacokinetics and adverse effectsHow antiseizure medications act on sodium channels, GABA, SV2A, calcium channels and glutamate, why phenytoin and carbamazepine behave unpredictably, the inducer and inhibitor interactions examiners test, HLA-linked hypersensitivity, and teratogenic risk including current valproate advice.Tier 1, medical sciences concept, 4 questions, 10 flashcards
- Cholinesterase inhibitors, memantine and anticholinergic burdenHow donepezil, rivastigmine and galantamine differ, why cholinergic effects cause bradycardia, syncope and incontinence, memantine's uncompetitive NMDA block and renal clearance, and how anticholinergic burden scales and the Drug Burden Index are calculated.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Dopaminergic drugs for Parkinson diseaseLevodopa kinetics and why wearing-off appears, decarboxylase, COMT and MAO-B inhibitors, dopamine agonists and impulse control disorders, amantadine, infusion therapies, and which antiemetics and antipsychotics block dopamine.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Fibrinolytic agents and the pharmacology of stroke thrombolysisThe plasminogen-plasmin system, why tenecteplase is a single bolus and alteplase an infusion, fibrin specificity and PAI-1 resistance, dosing pitfalls, bleeding and angioedema mechanisms and reversal, and time-dependent NNTs from the trial data.Tier 2, medical sciences concept, 3 questions, 8 flashcards
- Multiple sclerosis disease-modifying therapies: mechanisms of actionHow MS disease-modifying drugs work, from interferon and glatiramer to teriflunomide, fumarates, S1P modulators, cladribine, natalizumab, anti-CD20 and alemtuzumab, and how each mechanism predicts its adverse effects, monitoring and washout.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Triptans, CGRP-targeted drugs and migraine preventivesThe trigeminovascular basis of migraine drugs, 5-HT1B/1D and 5-HT1F agonists, gepants and CGRP monoclonal antibodies, how preventives such as topiramate, propranolol and botulinum toxin work, key interactions and worked NNTs.Tier 2, medical sciences concept, 3 questions, 9 flashcards
Obstetric medicine
Palliative medicine
- Antiemetics and prokinetics: receptor-based pharmacologyThe inputs to the vomiting reflex and their receptors, how D2, 5-HT3, NK1, H1 and muscarinic antagonists, corticosteroids and olanzapine map onto them, the prokinetics (metoclopramide, domperidone, erythromycin, prucalopride), and the interactions and adverse effects that follow from each mechanism.Tier 1, medical sciences concept, 3 questions, 8 flashcards
- Opioid dose conversion and route switchingA stepwise method for converting between opioids and routes using ANZCA oral morphine equivalents, why oral to parenteral ratios differ between drugs, incomplete cross-tolerance, breakthrough dosing, and the timing of fentanyl patch and subcutaneous infusion switches, with worked examples.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- Opioid toxicity and opioid-induced hyperalgesia in palliative careWhy opioid toxicity develops in palliative patients (renal accumulation of active metabolites, dose escalation, interactions), how to tell opioid-induced neurotoxicity and hyperalgesia from tolerance and disease progression, and the pharmacology behind dose reduction, rotation, naloxone titration and NMDA antagonists.Tier 2, medical sciences concept, 3 questions, 8 flashcards
Rheumatology
- Leflunomide, hydroxychloroquine and sulfasalazineMechanisms, kinetics and toxicities of the other conventional synthetic DMARDs, including DHODH inhibition and cholestyramine washout for leflunomide, lysosomal and TLR effects and retinal screening for hydroxychloroquine, and azo-bond cleavage and acetylator status for sulfasalazine.Tier 1, medical sciences concept, 3 questions, 10 flashcards
- Methotrexate pharmacology and toxicityHow low-dose weekly methotrexate works (polyglutamates and adenosine), its saturable absorption and renal clearance, why trimethoprim and daily dosing errors cause pancytopenia, folate supplementation and folinic acid rescue, and the monitoring and pregnancy rules examiners test.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- TNF inhibitors: mechanism, screening and adverse effectsHow the five TNF inhibitors differ in structure and why that matters for IBD, granulomatous disease and pregnancy, why TNF blockade reactivates TB and hepatitis B, how to read drug levels and anti-drug antibodies after loss of response, and the class contraindications.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- JAK inhibitors: mechanism and safetyHow JAK inhibitors block cytokine signalling through JAK-STAT, why receptor pairings predict their benefits and adverse effects, how their kinetics and clearance shape dosing, and what ORAL Surveillance changed about MACE, cancer and VTE risk.Tier 2, medical sciences concept, 3 questions, 9 flashcards
- Non-TNF biologics: IL-6, IL-17, IL-12/23, B-cell and T-cell costimulation blockadeHow each non-TNF biologic class works, why the cytokine targeted predicts which diseases respond and which adverse effects appear (masked CRP with IL-6 blockade, candidiasis and IBD with IL-17 blockade, hypogammaglobulinaemia and hepatitis B reactivation with rituximab), and how to choose by mechanism.Tier 2, medical sciences concept, 4 questions, 9 flashcards