19. Pharmacology - Drug Types Flashcards
1
Q
Antacids: brand names
A
Gaviscon
Mucogel
2
Q
Antacids: indications
A
Dyspepsia
3
Q
Antacids: mechanism
A
Neutralise stomach acid (alkaline)
4
Q
Antacids: adverse effects
A
Overuse of antacids - acid rebound indigestion
Reduced absorption of nutrients from food
Bloating - carbonate produces CO2
Reduced GIT immune defence
5
Q
H2-Receptor Antagonists: brand name
A
Ranitidine (Zantac)
6
Q
H2-Receptor Antagonists: indications
A
Ulcer healing
GORD
7
Q
H2-Receptor Antagonists: mechanism
A
Used to block the action of histamine on parietal cells in the stomach, decreasing the production of acid by these cells
8
Q
H2-Receptor Antagonists: adverse effects
A
Liver and/or kidney-impaired patients - drugs can compromise detoxification pathways Headaches Diarrhoea Rashes Fatigue
9
Q
Proton Pump Inhibitors (PPIs): brand names
A
Omeprazole
Lansoprazole
(-zole)
10
Q
Proton Pump Inhibitors (PPIs): indications
A
GORD
Peptic ulcers
Preventing NSAID-associated ulceration
Eradicate helicobacter with antibiotics
11
Q
Proton Pump Inhibitors (PPIs): mechanism
A
Blocks the proton pumps (hydrogen pumps) in the gastric lining thus reducing stomach acidity
12
Q
Proton Pump Inhibitors (PPIs): contraindications
A
Liver disease
Pregnancy
13
Q
Proton Pump Inhibitors (PPIs): adverse effects
A
Gastric cancer (masking symptoms) Constipation Abdominal pain Headaches Dizziness Anaemia (HCI converts iron to soluble form)
14
Q
Antispasmodics: brand name
A
Buscopan (Hyoscine)
15
Q
Antispasmodics: mechanism
A
Inhibit intestinal smooth muscle depolarisation by blocking acetylcholine receptors (anti-cholinergic)
16
Q
Antispasmodics: adverse effects
A
Constipation
Palpitations
Reduced bronchial secretions
Urinary retention
17
Q
Anti-Motility Drugs: brand names
A
Codeine phosphate
Loperamide (Imodium)
18
Q
Anti-Motility Drugs: indications
A
Uncomplicated, acute diarrhoea in adults
19
Q
Anti-Motility Drugs: mechanism
A
Loperamide acts on opioid receptors in the intestinal muscles, which reduces peristalsis
20
Q
Anti-Motility Drugs: contraindications
A
Do not use if diarrhoea cause is infectious e.g. dysentery
21
Q
Anti-Motility Drugs: adverse effects
A
Nausea
Constipation
Drowsiness
22
Q
Anti-Motility Drugs: cautions
A
In dehydration, fluid/electrolyte replacement is the primary concern
Reduced peristalsis = more time for electrolytes and fluid to be re-absorbed
23
Q
Corticosteroids: brand names
A
Prednisolone
Hydrocortisone
24
Q
Corticosteroids: indications
A
Inflammatory condition e.g. inflammatory bowel disease, autoimmune diseases (RA, lupus, MS)
25
Corticosteroids: mechanism
Switches off multiple inflammatory genes - cytokines, inflammatory mediators etc
26
Corticosteroids: adverse effects
```
Suppress immunity
Oral thrush
Indigestion
Insomnia
Mood changes (aggressive, irritable)
Thinning of skin
Osteoporosis
Cataracts
Glaucoma
Diabetes mellitus
```
27
Corticosteroids: cautions
If stop suddenly = adrenal cortical insufficiency
| In excess = Cushing's
28
Laxative - Bulk-Forming: brand names
Fybogel
| Normacol
29
Laxative - Bulk-Forming: mechanism
Increase faecal mass to stimulate peristalsis
30
Laxative - Bulk-Forming: administration
Must be taken with water
31
Laxative - Stimulant: brand names
Senna
| Senokot
32
Laxative - Stimulant: mechanism
Irritate intestinal lining and promote histamine release, increasing intestinal motility
33
Laxative - Stimulant: adverse effects
May cause diarrhoea
Flatulence
Hypokalaemia
34
Laxative - Stimulant: cautions
Short term use only
Address cause
Senna can irritate the colon and long-term use has been linked to colon cancer
35
Laxative - Osmotic: brand names
Lactulose
| Magnesium salts
36
Laxative - Osmotic: mechanism
Contains sodium ions which attract water into colon by drawing fluid from the body or retaining fluid
37
Laxative - Osmotic: adverse effects
Colic
| Lazy bowel
38
Laxative - Osmotic: cautions
Magnesium salts are often abused and may cause dehydration
39
Cardiac Glycosides: brand names
Digoxin
| Lanoxin
40
Cardiac Glycosides: indications
Atrial fibrillation
Heart failure
Also increases GFR
41
Cardiac Glycosides: mechanism
Increase myocardium force of contraction by increasing Ca influx into the heart muscle (reduces HR, increases force)
42
Cardiac Glycosides: interactions
Ca - agonistic - increases effect
43
Cardiac Glycosides: adverse effects
NVD
Anorexia
Abdominal pain
Visual disturbances
44
Cardiac Glycosides: cautions
Low Mg, Ca, K increases toxicity
45
Calcium Channel Blockers: brand name
Amlodipine
46
Calcium Channel Blockers: indications
Angina
| Hypertension
47
Calcium Channel Blockers: mechanism
Blocks influx of calcium to heart and vascular smooth muscle
| Dual effect - heart contraction force is reduced and coronary artery/peripheral arterioles dilate (lowers BP)
48
Calcium Channel Blockers: adverse effects
```
NVD
Dizziness
Headaches
Fatigue
Oedema
```
49
Diuretics: brand names
Furosemide
| Bendroflumethiazide
50
Diuretics: indications
```
Hypertension
Pulmonary oedema
Chronic heart failure
General oedema
Kidney/liver diseases
```
51
Diuretics: mechanism
Reduces reuptake of primary filtrate from different regions of the nephron = decreases blood volume and pressure
52
Diuretics: adverse effects
Mineral loss - hypokalaemia (weakness, fatigue, muscle cramps, palpitations, hallucinations)
53
Beta Blockers: brand name
Atenolol
| -ol
54
Beta Blockers: indications
Hypertension
Angina
Arrhythmia
Atrial fibrillation
55
Beta Blockers: mechanism
Cardio-selective - targets beta-1 receptors only
Blocks the action of beta receptors mostly in the myocardium - antagonise sympathetic nervous system
Lowers HR/BP
Causes vasodilation
56
Beta Blockers: adverse effects
```
Fatigue
Sexual dysfunction
Cold extremities
Hypotension
Sleep disturbance
Psoriasis exacerbation
```
57
Beta Blockers: caution
May weaken heart in long term
58
ACE Inhibitors: brand name
Ramipril
59
Angiotensin II Antagonists: brand names
Losartan
| Irbesartan
60
ACE Inhibitors: mechanism
Stops the conversion of angiotensin I to angiotensin II - a vasoconstrictor
61
Angiotensin II Antagonists: mechanism
Blocks receptors stopping the action of angiotensin II
62
ACE Inhibitors/Angiotensin II Antagonists: adverse effects
Hypotension
Persistent dry cough (due to rise in bradykinin)
NVD
Reduces glomerular filtration (esp in renal impairment
Hyperkalaemia (due to aldosterone inhibition)
63
ACE Inhibitors/Angiotensin II Antagonists: caution
Often need to use diuretic at same time
64
Nitrates: brand name
Glyceryl trinitrate (GTN)
65
Nitrates: indications
Angina pectoris
66
Nitrates: mechanism
Dissolves in the blood as nitrous oxide (NO) which is a rapid, potent vasodilator
67
Nitrates: caution
Tolerance develops rapidly in continual use
68
Nitrates: administration
Sublingual (spray)
69
Anti-Coagulants: brand names
Heparin
Warfarin
Aspirin
70
Anti-Coagulants: indications
DVT
Pulmonary embolism
TIAs
71
Anti-Coagulants: mechanism
Inhibits synthesis of four clotting factors
72
Anti-Coagulants: interactions
Gingko
Ginger
Fish oils
Vit E
73
Anti-Coagulants: cautions - warfarin/aspirin
Must be closely monitored (used as rat poison)
74
Anti-Coagulants: cautions - heparin
Quick action
| Short duration
75
Anti-Coagulants: administration - warfarin/aspirin
Oral
76
Anti-Coagulants: administration - heparin
Parenteral (injected)
77
Statins: brand name
Simvastatin
78
Statins: indications
Hypercholesterolaemia
79
Statins: when prescribed/mechanism
Prescribed when there's a 20% risk of a CV event - includes all diabetics >40
Inhibits an enzyme involved in cholesterol synthesis (HMG-CoA reductase)
80
Statins: adverse effects
```
Insomnia
Dizziness
Fatigue - due to depletion of CoQ10
Headaches - due to depletion of CoQ10
Liver damage
Gastro-intestinal effects
Muscle aches
```
81
Statins: cautions
Often combined with anti-hypertensives, aspirin, diabetes management and/or diet/lifestyle
High insulin stimulates the action of enzyme HMG-CoA reductase so diabetics often have high cholesterol
Links to dementia due to the loss of cholesterol in brain
The same enzyme that makes cholesterol is the same enzyme that makes CoQ10
Statins can deplete CoQ10 levels leading to muscle pain
82
Statins: administration
100mg CoQ10 per day
83
Bronchodilators: brand names
Salbutamol (Ventolin) - immediate action/short duration
Salmeterol - delayed action, longer duration
Not to be used in acute attack
84
Bronchodilators: indications
Symptomatic relief of bronchoconstriction
85
Bronchodilators: mechanism
Acts on beta-2 receptors in the lungs (beta-2 agonists)
| Stimulation of these receptors causes bronchodilation
86
Bronchodilators: adverse effects
```
Tremor
Anxiety
Headache
Palpitations
Muscle cramping
```
87
Bronchodilators: administration
Inhaler
88
Steroid Inhalers: brand names
Becotide (brown inhaler)
| Symbicort inhaler
89
Steroid Inhalers: indications
```
Asthma prophylaxis (preventative)
COPD
```
90
Steroid Inhalers: mechanism
Reduces airway inflammation, oedema and mucus secretion
91
Steroid Inhalers: adverse effects
Adrenal suppression (Addison's)
Oral candidiasis
Respiratory tract infections
92
Leukotriene Receptor Antagonists: indications
Non-steroidal asthma prophylaxis
93
Leukotriene Receptor Antagonists: mechanism
Blocks a chemical reaction that can lead to inflammation
94
Leukotriene Receptor Antagonists: adverse effects
NVD (fewer than steroids)
95
Antihistamines: brand name (non-sedating)
Clarityn (Loratadine)
96
Antihistamines: brand name (sedating)
Piriton, Benadryl
| cross the BBB
97
Antihistamines: adverse effects (non-sedating)
Myalgia (muscle pain)
98
Antihistamines: adverse effects (sedating)
Drowsiness
| Anti-muscarinic (urinary retention, dry mouth, constipation, blurred vision)
99
Anxiolytics: brand names
Diazepam (Valium)
| Lorazepam
100
Anxiolytics: indications
Muscle relaxant
Minimising drug withdrawal
Severe/disabling insomnia/anxiety (short term only)
101
Anxiolytics: mechanism
Acts on GABA receptors - inhibitory CNS neurotransmitter
102
Anxiolytics: adverse effects
```
Highly addictive
Drowsiness/confusion
Muscle weakness
Paradoxical effects
Dependence
Tolerance/dependence
Withdrawal causes anxiety
Insomnia
Anorexia
Tremor
Perspiration
Tinnitus
Perceptual disturbance
Hallucinations
Paranoia
```
103
Anti-Depressants: brand names/classes
Citalopram
Amitriptyline
Classes include:
Selective serotonin re-uptake inhibitors (SSRIs)
Tricyclic anti-depressants
104
Anti-Depressants: indications
Chronic and major depression (not acute depression)
105
Anti-Depressants: adverse effects
```
Suppression
Nausea
Vomiting
Low sex drive
Blurred vision
GIT upset
Feeling agitated or shaky
Sleep disturbance
Loss of appetite
```
106
Analgesics: brand names
Non-opioid (act peripherally) - aspirin, paracetamol, ibuprofen
Opioid (act on pathway in CNS) - codeine, morphine
107
Analgesics: mechanism
Painkillers - they modulate pain perception
108
Analgesics: adverse effects
GIT bleeding
Low stomach acidity
Liver disease
109
Anti-Microbials: indications
Bacterial infections
Fungal infections
Viral infections
110
Anti-Microbials: brand names (anti-bacterial)
Broad/narrow spectrum antibiotics - penicillin
111
Anti-Microbials: brand names (anti-fungal)
Systemic - fluconazole, clotrimazole, ketoconazole
| Non-systemic
112
Anti-Microbials: brand names (anti-viral)
Acyclovir - inhibits viral replication
113
Anti-Microbials: cautions
Anti-virals - quite toxic
114
Diabetic Drugs: brand names
Insulin
| Metformin
115
Diabetic Drugs: indications
Insulin - mostly T1
Metformin - mostly T2
Insulin resistance
116
Diabetic Drugs: mechanism
Metformin - increases cell sensitivity to insulin and lowers glycaemic levels
117
Diabetic Drugs: adverse effects
Elevates homocysteine - linked to breast cancer
Nausea
Loss of appetite
118
Diabetic Drugs: cautions
Increased homocysteine can be damaging to blood vessels
| Leads to atherosclerosis
119
Diabetic Drugs: administration
Injection - insulin
| Oral - metformin
120
Thyroid Drugs: brand names
Hypothyroidism - Thyroxine
| Hyperthyroidism - Carbimazole
121
Thyroid Drugs
Hypothyroidism
| Hyperthyroidism
122
Thyroid Drugs: mechanism (Thyroxine)
Replaces lack of thyroid hormone
123
Thyroid Drugs: mechanism (Carbimazole)
Prevents the conversion of iodine to its useable form
| Blocks the combination of converted iodine with other components to form thyroid hormones
124
Hormones: brand name (masculination reduction)
Androcur
125
Hormones: indications (Androcur)
Used to treat masculinisation in women e.g. PCOS
126
Hormones: mechanism (Androcur)
Contains active ingredient cyproterone which reduces testosterone production
127
Chemotherapy: drug type
Cytotoxic drugs
128
Chemotherapy: mechanism
Interferes with cell cycle, triggering cell death (apoptosis) in rapidly dividing cells
129
Chemotherapy: adverse effects
```
Very toxic
Cancer
Bone marrow suppression (anaemia, leukopenia, thrombocytopenia)
GIT ulceration
Skin ulceration/burns
Hair loss
```
130
Chemotherapy: cautions
All kills healthy cells
131
Tamoxifen: indications
Breast cancer - only hormonally driven (oestrogen positive)
132
Tamoxifen: mechanism
Blocks oestrogen receptors
133
Tamoxifen: adverse effects
```
Mimics menopause
Uterine fibroids
Visual disturbance
Liver enzyme elevation
Osteoporosis
```
134
NSAIDs: brand name
Ibuprofen (half life 2-3hrs)
Diclofenac
Aspirin
135
NSAIDs: indication
Pain relief - mild to moderate
136
NSAIDs: mechanism
Inhibits the activity of cyclooxygenase (COX), therefore inhibiting prostaglandin synthesis
137
NSAIDs: contraindication
IBD
138
NSAIDs: adverse effects
```
Damage to gut lining - prostaglandins play crucial role in synthesis of gastric mucus
Provides barrier against acidity
No mucus = ulcer = bleeding = anaemia
Liver damage
Immune suppression
```
139
NSAIDs: cautions
Diclofenac - increases risk of CVD
140
NSAIDs: administration
Tablet
| Gel onto skin
141
Gout Drugs: brand name (preventative)
Allopurinol
142
Gout Drugs: brand name (acute attacks)
Colchicine
143
Gout Drugs: mechanism (Allopurinol)
Inhibits enzyme 'xanthine oxidase' that turns purines into uric acid
Also decreases endogenous purine synthesis
144
Gout Drugs: mechanism (Colchicine)
Inhibits urate crystal deposition
145
Gout Drugs: caution
Colchicine - very toxic
