Browse topics
Clinical pharmacology
39 notes, 119 questions and 336 flashcards.
Tier 1 is core knowledge expected of every trainee. Tier 2 is deeper or less common.
Presentations
- Drug-induced delirium and agitationFree sampleFinding the medicine, poison or withdrawal behind agitated or hypoactive delirium, telling the toxidromes apart at the bedside, and treating the cause without making it worse.Tier 1, approach to a presentation, 3 questions, 8 flashcards
- Presentations associated with adverse drug interactionsWorking back from the presentation (hyperkalaemia, bleeding, rhabdomyolysis, arrhythmia, confusion, AKI) to the drug combination behind it, and the high-yield pairs the exam keeps returning to.Tier 1, approach to a presentation, 4 questions, 9 flashcards
- Toxic and drug-induced seizuresWhich poisons, medicines and withdrawal states cause seizures, why benzodiazepines come first and phenytoin doesn't belong, the antidotes that stop specific toxic seizures, and what follow-up a provoked seizure needs.Tier 1, approach to a presentation, 3 questions, 9 flashcards
Key conditions
Acute and chronic effects of substance use
- Alcohol: acute and chronic effectsHow ethanol is handled by the body, acute intoxication and its complications including alcoholic ketoacidosis and the head-injured drunk patient, and the organ damage of long-term heavy drinking.Tier 1, condition, 3 questions, 9 flashcards
- Benzodiazepine and Z-drug harms and dependenceHow benzodiazepines and Z-drugs work, the harms of long-term use (falls, crashes, cognition, overdose with opioids), Australian scheduling, recognising dependence and withdrawal, diazepam conversion and tapering, and deprescribing in older people.Tier 1, condition, 3 questions, 9 flashcards
- Cannabis and hallucinogensCannabinoid pharmacology, acute and chronic effects of cannabis including psychosis and hyperemesis, medicinal cannabis in Australia, and the hallucinogenic toxidrome from LSD, psilocybin, NBOMes, ketamine and deliriants.Tier 1, condition, 3 questions, 10 flashcards
- Opioid intoxication and overdoseOpioid receptor pharmacology, the opioid toxidrome and its mimics, naloxone dosing and observation, the quirks of methadone, buprenorphine, tramadol, fentanyl and nitazenes, and the chronic effects of long-term opioid use.Tier 1, condition, 3 questions, 10 flashcards
- Stimulant toxicity: amphetamines, cocaine and ecstasyHow methamphetamine, cocaine and MDMA act, telling the sympathomimetic toxidrome from its mimics, treating agitation, hyperthermia, chest pain, sodium channel blockade and hyponatraemia, and the chronic harms and treatment of stimulant use disorder.Tier 1, condition, 3 questions, 9 flashcards
Poisoning
- Antidepressant poisoningRisk by class (tricyclics, venlafaxine, bupropion, citalopram, MAOIs, SSRIs and mirtazapine), the QRS and aVR rules for sodium channel blockade, bicarbonate and airway management, QT monitoring, seizures and serotonin toxicity.Tier 1, condition, 3 questions, 9 flashcards
- Antidiabetic medicine poisoningInsulin and sulfonylurea overdose (delayed and recurrent hypoglycaemia, octreotide, observation periods), metformin-associated lactic acidosis and the EXTRIP dialysis criteria, and overdose of SGLT2 inhibitors, GLP-1 receptor agonists and other newer agents.Tier 1, condition, 3 questions, 8 flashcards
- Antihypertensive poisoningCalcium channel blocker and beta-blocker poisoning (verapamil and diltiazem vs dihydropyridines, propranolol and sotalol), echo-guided choice between vasopressors and high-dose insulin, calcium, glucagon, pacing, ECMO, the EXTRIP dialysis advice, and clonidine, prazosin and RAS blocker overdose.Tier 1, condition, 3 questions, 10 flashcards
- Antipsychotic poisoningReceptor-based prediction of toxicity, agent-by-agent risk (quetiapine, olanzapine, amisulpride, clozapine, chlorpromazine, haloperidol), the 2025 CTRC recommendations on QT monitoring, airway and hypotension management, dystonia, and how to tell NMS from serotonin and anticholinergic toxicity.Tier 1, condition, 3 questions, 8 flashcards
- Digoxin poisoningAcute versus chronic digoxin toxicity, precipitants in older people, the ECG and potassium clues, when to measure and how to read a level, and the small titrated digoxin Fab doses Australian practice moved to in 2020.Tier 1, condition, 3 questions, 9 flashcards
- Paracetamol poisoningRisk assessment by dose and the single-line Australian nomogram, the two-bag acetylcysteine regimen, modified-release, massive and repeated supratherapeutic ingestions, liver failure criteria, and the 2025 pack-size changes.Tier 1, condition, 3 questions, 9 flashcards
- Sedative poisoning and the sedative-hypnotic toxidromeRecognising the sedative-hypnotic toxidrome and its mimics, risk assessment by agent (benzodiazepines, Z-drugs, alprazolam, baclofen, gabapentinoids, barbiturates, GHB, chloral hydrate), supportive care and airway decisions, when flumazenil is and isn't safe, and enhanced elimination.Tier 1, condition, 3 questions, 9 flashcards
Substance use disorder and withdrawal
- Alcohol use disorder and withdrawalFree sampleThe neurobiology of alcohol withdrawal, predicting and treating it in hospital (benzodiazepines, phenobarbital, thiamine), how the withdrawal toxidromes of other drugs compare, and the evidence behind relapse-prevention drugs.Tier 1, condition, 3 questions, 9 flashcards
- Nicotine dependence and cessationNicotine pharmacology and withdrawal, assessing dependence, combination NRT, varenicline, cytisine (now available in Australian pharmacies) and bupropion, the 2024 vaping laws, smoking and drug interactions in hospital, special populations, and nicotine poisoning.Tier 1, condition, 3 questions, 9 flashcards
- Opioid use disorder and opioid agonist treatmentDiagnosing opioid use disorder, choosing between methadone, sublingual and depot buprenorphine, safe induction including low-dose starts with fentanyl, interactions and QTc, the PBS opioid dependence program, pregnancy, and leaving treatment.Tier 1, condition, 3 questions, 9 flashcards
Toxidromes
- Anticholinergic toxidromeCentral and peripheral antimuscarinic features, the common Australian culprits (sedating antihistamines, antipsychotics, tricyclics, Datura and Brugmansia), the ECG check before physostigmine, and the evidence for physostigmine and rivastigmine over sedation.Tier 1, condition, 3 questions, 8 flashcards
- Cholinergic toxidromeMuscarinic, nicotinic and central features of acetylcholine excess, organophosphate and carbamate insecticide poisoning, atropine titrated to a dry chest, the weak evidence for oximes, and the intermediate syndrome that follows apparent recovery.Tier 1, condition, 3 questions, 9 flashcards
- Serotonin syndromeSerotonin toxicity as a dose-related spectrum, the drug combinations that cause severe cases, the Hunter criteria, how to tell it from NMS and anticholinergic toxicity, and management from benzodiazepines and cyproheptadine to paralysis and cooling.Tier 1, condition, 3 questions, 9 flashcards
Less common or complex conditions
Poisonings
- Carbon monoxide poisoningSources and clusters, why pulse oximetry misleads, co-oximetry and what the COHb level does and doesn't tell you, high-flow oxygen, the contested place of hyperbaric oxygen in Australia, cyanide in smoke inhalation, pregnancy and delayed neurological sequelae.Tier 2, condition, 3 questions, 7 flashcards
- Pesticide poisoningThe pesticides that matter in Australian practice beyond organophosphates, with paraquat, glyphosate, chlorophenoxy herbicides, long-acting anticoagulant rodenticides and metal phosphides, and what to do first for each.Tier 2, condition, 3 questions, 8 flashcards
- Salicylate poisoningDose-based risk, the mixed respiratory alkalosis and high anion gap acidosis, serial levels for delayed absorption, chronic toxicity mistaken for sepsis in older people, urinary alkalinisation with potassium, EXTRIP criteria for haemodialysis, and the danger of intubation.Tier 2, condition, 3 questions, 8 flashcards
- Snake bite envenomingAustralian snakebite from first aid to discharge, with the envenoming syndromes by snake, serial bloods over 12 hours, one vial of antivenom, why the venom detection kit doesn't decide treatment, and early collapse after brown snake bites.Tier 2, condition, 3 questions, 9 flashcards
- Spider bites and insect stingsFunnel-web, redback and the harmless rest, why white-tail spiders don't cause necrotic ulcers, bee, wasp and jack jumper ant stings from local reaction to anaphylaxis, venom immunotherapy, and tick bites.Tier 2, condition, 3 questions, 9 flashcards
Investigations and procedures
- Drug clearance and dosing in liver and renal impairmentFree sampleHow to read creatinine, eGFR, Cockcroft-Gault clearance, LFTs and the Child-Pugh score when choosing a dose, with worked examples for DOACs, AKI and cirrhosis and the traps that make each test misleading.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- ECG changes in drug toxicityA toxicology read of the ECG, covering sodium channel blockade (QRS and aVR), potassium channel blockade (QT and the QT nomogram), AV nodal blockers, digoxin and drug-induced hyperkalaemia, with worked examples and the findings that change treatment.Tier 1, medical sciences concept, 3 questions, 9 flashcards
- Screening for substance misuse and brief interventionsHow to screen for alcohol and other drug use with standard drinks, AUDIT, AUDIT-C and the WHO ASSIST, how to read urine drug screens and alcohol biomarkers, and how to deliver a brief intervention (FRAMES) and know when to refer instead.Tier 1, medical sciences concept, 3 questions, 10 flashcards
- Therapeutic drug monitoringHow to request and read a drug level step by step (timing, steady state, sample tube, total versus free, renal and hepatic function), worked examples for lithium, vancomycin and carbamazepine, laboratory monitoring for adverse reactions, and when a result should change the dose.Tier 1, medical sciences concept, 3 questions, 8 flashcards
- Withdrawal scales for alcohol and opioidsWhat the Alcohol Withdrawal Scale, CIWA-Ar, COWS and SOWS measure, how to score and act on them with worked examples, and when a score misleads (delirium, sepsis, beta-blockers, non-English speakers).Tier 1, medical sciences concept, 3 questions, 7 flashcards
- Pain scoring toolsSelf-report intensity scales (NRS, verbal, faces), function and sedation scores used with opioids, the PEG and DN4 for chronic and neuropathic pain, what change is clinically meaningful, and how to choose a tool for the patient in front of you.Tier 2, medical sciences concept, 3 questions, 8 flashcards
Specific issues
- Controlled drug legislation, medicines regulation and fundingHow a medicine reaches an Australian patient, from TGA registration and the Poisons Standard schedules to PBAC cost-effectiveness and PBS restrictions, plus state Schedule 8 rules, real-time prescription monitoring, unapproved-medicine access and the 2026 co-payments.Tier 2, topic overview, 3 questions, 9 flashcards
- Ethics and consent in off-label prescribingWhat off-label means in Australia and how it differs from unapproved medicines, the CATAG framework (revised 2026), PBS and legal consequences, what consent should cover, and examples from adult medicine where regulators have stepped in.Tier 2, topic overview, 3 questions, 7 flashcards
Medication safety
- Medication error risk and obtaining an accurate medication historyWhere medication errors happen (selection, dose, transcription, dispensing, administration), the patient, drug and system factors that raise risk, the APINCHS high-risk medicines, and how to take a best possible medication history and reconcile it at admission, transfer and discharge under the NSQHS Medication Safety Standard.Tier 1, topic overview, 3 questions, 8 flashcards
- Prescribing in special populationsA practical framework for adjusting drugs in older people, kidney and liver impairment, pregnancy and lactation, obesity, critical illness and known pharmacogenetic risk, with worked dose calculations and the prescribing issues that matter for Aboriginal and Torres Strait Islander and Māori patients.Tier 1, topic overview, 4 questions, 8 flashcards
- Assessing likelihood of an adverse drug reactionHow to judge whether a drug caused an adverse event, using the Naranjo scale (10 questions, score bands) with a worked example, the WHO-UMC categories, drug-specific tools (RUCAM, ALDEN), their limitations, and when to report to the TGA.Tier 2, topic overview, 3 questions, 7 flashcards