50 More High-Yield Clinical Pharmacy One-Liners for Exam Revision — Part 2
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These 50 additional clinical pharmacy one-liners continue your revision series with new facts covering pharmacotherapy, drug interactions, adverse effects, clinical monitoring, emergency management, and medication safety. They are organized into five sections of 10 statements each for quick memorization.
1. Cardiology & Renal Pharmacotherapy (10)
1. Amlodipine blocks L-type calcium channels in vascular smooth muscle and commonly causes peripheral edema.
2. Verapamil and diltiazem slow AV nodal conduction and can cause bradycardia; avoid combining them with beta-blockers without careful assessment because of the risk of heart block.
3. Hydralazine is a direct arterial vasodilator that may cause reflex tachycardia and drug-induced lupus-like syndrome.
4. Clonidine is a central alpha-2 adrenergic agonist; abrupt discontinuation can cause rebound hypertension.
5. Dapagliflozin and other SGLT2 inhibitors may cause an initial, usually reversible eGFR decline; assess the overall clinical context rather than automatically discontinuing treatment.
6. Eplerenone blocks mineralocorticoid receptors and may cause hyperkalemia; it has fewer androgen-related adverse effects than spironolactone.
7. Amiodarone prolongs cardiac repolarization and may cause pulmonary toxicity, thyroid dysfunction, liver injury, and corneal deposits.
8. Statins inhibit HMG-CoA reductase; unexplained muscle pain or weakness warrants assessment for statin-associated muscle injury.
9. Fenofibrate lowers triglycerides by activating PPAR-alpha; combining it with a statin may increase muscle toxicity risk, particularly in susceptible patients.
10. Ivabradine inhibits the sinoatrial node's funny current (If), reducing heart rate with relatively little direct effect on myocardial contractility.
2. Infectious Diseases & Antimicrobial Stewardship (10)
11. Linezolid inhibits bacterial protein synthesis at the 50S ribosomal subunit and can cause thrombocytopenia and other myelosuppression.
12. Daptomycin disrupts bacterial cell-membrane function and can cause myopathy; monitor creatine kinase as clinically indicated.
13. Macrolides such as clarithromycin can prolong the QT interval and inhibit CYP3A4, creating clinically significant drug interactions.
14. Ceftriaxone is a third-generation cephalosporin that inhibits cell-wall synthesis; it can cause biliary sludge and is associated with important neonatal precautions.
15. Carbapenems have broad-spectrum activity, but imipenem can increase seizure risk, especially in susceptible patients or with excessive exposure.
16. Acyclovir can cause crystal-associated acute kidney injury, particularly with IV administration; adequate hydration and appropriate dosing reduce risk.
17. Fluconazole inhibits fungal ergosterol synthesis and can inhibit drug-metabolizing enzymes, increasing concentrations of certain medications.
18. Doxycycline can cause photosensitivity; counsel patients to use sun protection and follow product-specific administration instructions.
19. Nitrofurantoin is used for selected cases of uncomplicated lower urinary tract infection, but it is not appropriate for suspected pyelonephritis because of inadequate renal tissue concentrations.
20. Antimicrobial stewardship promotes the right antibiotic, dose, route, and duration, using culture results and clinical response to support de-escalation when appropriate.
3. Endocrine, Gastrointestinal & Metabolic Pharmacotherapy (10)
21. DPP-4 inhibitors (e.g., sitagliptin) increase incretin activity and generally have a low risk of hypoglycemia when used alone; several require renal dose adjustment.
22. Pioglitazone activates PPAR-gamma to improve insulin sensitivity but can cause edema, weight gain, and worsening heart failure.
23. Acarbose inhibits intestinal alpha-glucosidases, delaying carbohydrate absorption; common adverse effects include flatulence and diarrhea.
24. Glucagon raises blood glucose by stimulating hepatic glucose release and can be used for severe hypoglycemia when a patient cannot safely take oral carbohydrate.
25. Bisphosphonate-associated hypocalcemia is more likely in patients with vitamin D deficiency or pre-existing calcium abnormalities; correct relevant deficiencies before treatment.
26. Proton pump inhibitors (PPIs) irreversibly inhibit gastric parietal-cell H⁺/K⁺-ATPase and suppress gastric acid secretion.
27. Ondansetron blocks 5-HT3 receptors to prevent nausea and vomiting but may prolong the QT interval, especially in predisposed patients.
28. Metoclopramide blocks dopamine D2 receptors and can cause extrapyramidal symptoms and tardive dyskinesia; treatment duration should be limited according to prescribing guidance.
29. Lactulose treats hepatic encephalopathy by promoting ammonia excretion through its effects in the colon; dosing is commonly adjusted to achieve about two to three soft stools daily.
30. Orlistat inhibits gastric and pancreatic lipases, reducing dietary fat absorption; it can cause oily stools and reduce absorption of fat-soluble vitamins.
4. CNS, Psychiatry & Neurology (10)
31. Duloxetine inhibits serotonin and norepinephrine reuptake and is used for depression, anxiety, and selected chronic pain conditions.
32. Bupropion inhibits norepinephrine and dopamine reuptake and can aid smoking cessation, but it is contraindicated in seizure disorders and current or prior bulimia or anorexia nervosa.
33. Venlafaxine inhibits serotonin and norepinephrine reuptake; abrupt discontinuation can cause a significant discontinuation syndrome.
34. Buspirone acts primarily as a partial agonist at serotonin 5-HT1A receptors and has a delayed onset for anxiety treatment.
35. Sumatriptan activates 5-HT1B/1D receptors to treat acute migraine but is contraindicated in patients with certain vascular diseases, including ischemic coronary artery disease.
36. Topiramate can cause cognitive slowing, paresthesia, kidney stones, and metabolic acidosis; it also carries important pregnancy-related risks.
37. Pramipexole stimulates dopamine receptors to treat Parkinson disease and restless legs syndrome but may cause sleep attacks, hallucinations, and impulse-control disorders.
38. Donepezil inhibits acetylcholinesterase and may cause nausea, diarrhea, bradycardia, and syncope.
39. Memantine blocks NMDA receptor activity and is used for moderate-to-severe Alzheimer disease; dizziness and confusion can occur.
40. Fluoxetine has a long half-life, so interactions and adverse effects may persist after discontinuation; allow appropriate washout before starting an interacting medicine such as an MAO inhibitor.
5. Toxicology, Anticoagulation & Medication Safety (10)
41. Apixaban and rivaroxaban directly inhibit factor Xa; andexanet alfa is a specific reversal option for certain life-threatening or uncontrolled bleeds where available and appropriate.
42. Dabigatran directly inhibits thrombin (factor IIa); idarucizumab specifically reverses its anticoagulant effect.
43. Methotrexate inhibits dihydrofolate reductase at lower doses and affects folate metabolism; high-dose therapy may require leucovorin rescue and drug-level monitoring.
44. Methotrexate dosing errors can be fatal: for many inflammatory diseases it is prescribed once weekly, not daily.
45. Salicylate poisoning can cause tinnitus, respiratory alkalosis, and metabolic acidosis; severe toxicity may require urinary alkalinization and hemodialysis.
46. Beta-blocker overdose may cause bradycardia, hypotension, and hypoglycemia; severe cases may require specialist-directed treatments such as high-dose insulin euglycemia therapy.
47. Calcium channel blocker overdose can cause profound hypotension and bradycardia; treatment may include IV calcium, vasopressors, and high-dose insulin under expert toxicology guidance.
48. Iron poisoning can cause gastrointestinal injury, metabolic acidosis, and shock; deferoxamine is a chelating agent used in significant toxicity.
49. Lithium toxicity is more likely with dehydration, impaired renal function, and interacting drugs such as NSAIDs, ACE inhibitors, and thiazide diuretics.
50. High-alert medications, including insulin, anticoagulants, and opioids, warrant safeguards such as standardized concentrations, independent checks where appropriate, and careful patient monitoring.
Quick Revision Table: High-Yield Drug Interactions
Drug combination | Key concern |
|---|---|
Verapamil + beta-blocker | Bradycardia / AV block |
Clarithromycin + selected statins | Increased statin exposure and myopathy risk |
Lithium + thiazide diuretic | Increased lithium concentration and toxicity |
Methotrexate + trimethoprim-sulfamethoxazole | Increased marrow toxicity risk |
Opioid + benzodiazepine | Sedation and respiratory depression |
ACE inhibitor + spironolactone | Hyperkalemia |
Multiple QT-prolonging drugs | Increased risk of serious arrhythmia |
NSAID + anticoagulant | Increased bleeding risk |
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