Feb 252019

Toxicology and Drugs is the study of the nature, effects, and detection of poisons. Medicos Library has provided high standard Toxicology and Drugs Notes by Dr. Yousif Abdallah Hamad.

Summary of Notes:

Pharmacokinetics: metabolism

  • phase I reactions: oxidation, reduction, hydrolysis. Mainly performed by the P450 enzymes but some drugs are metabolised by specific enzymes, for example alcohol dehydrogenase and xanthine oxidase. Products of phase I reactions are typically more active and potentially toxic
  • phase II reactions: conjugation. Products are typically inactive and excreted in urine or bile. Glucuronyl, acetyl, methyl, sulphate and other groups are typically involved

Drug metabolism in patients with advanced liver disease

  • Drug processing via mixed function oxidases is affected early in liver disease
  • Conjugation reactions are affected to a lesser extent by advanced liver disease and only occur in very late stage disease
  • Plasma proteins fall in liver disease and may negatively affect drug distribution
  • Both intrahepatic and extrahepatic cholestasis may affect the metabolism of drugs that are actively secreted into bile, eg ciprofloxacin

Effects of age on drug metabolism

  • For these reasons, ‘box-ticking’ healthy elderly studies are rarely able to detect problems associated with the use of new drugs in the elderly age group
  • Many problems associated with the use of new drugs in the elderly may only be discovered through adverse event reporting during the post-launch period

Advice form Dr. Yousif Abdallah Hamad

How to use the notes to study for MRCP:

  • Initially, you need to skim through the notes at least twice to build up an idea about the syllabus of MRCP. Highlight any portion that is difficult so that you can concentrate on that during your revision.
  • Next proceed to the question banks. You can choose to do Passmedicine, onexamination or Pastest. I usually recommend students to do Passmedicine and the Pastest.
  • As you go through the questions make a super-revised notes of your own. Write down in one sentence what you learned from the question you just attempted.
  • If you get any question wrong or you get confused then return to the notes and re-read one more time before attempting the question again. And write down the point in red in you revision notes so that you can skim through it easily during your revision.
  • I have highlighted some points in yellow and green to help you concentrate on those points. As you go through passmedicine and pastest, you can highlight the points further to help in your revision.
  • During your revision before the main exam, only read the highlighted portions including those that you highlighted when practicing the question bank. And also read your super-revised notes that you made from the question banks.

I believe these method has worked for many students and will help you in your journey to be successful in MRCP part 1 and as well as build your basics for Part 2.

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