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BioMed S2 > 19. Pharmacology - Drug Types > Flashcards

19. Pharmacology - Drug Types Flashcards

1
Q

Antacids: brand names

A

Gaviscon

Mucogel

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2
Q

Antacids: indications

A

Dyspepsia

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3
Q

Antacids: mechanism

A

Neutralise stomach acid (alkaline)

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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

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5
Q

Antacids: alternatives

A

Diet and lifestyle changes, water, potato
juice, aloe vera, liquorice, slippery elm,
bicarbonate soda and water (short-term), avoid caffeine, manage stress, herbs, non-acidic forms of supplements; e.g. vitamin C.

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6
Q

H2-Receptor Antagonists: brand name

H for histamine

A

Ranitidine (Zantac)

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7
Q

H2-Receptor Antagonists: indications

A

Ulcer healing
GORD

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8
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

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9
Q

H2-Receptor Antagonists: adverse effects

A 
Liver and/or kidney-impaired patients - drugs can compromise detoxification pathways
Headaches
Diarrhoea
Rashes
Fatigue
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10
Q

Proton Pump Inhibitors (PPIs): brand names

Proton = hydrogen

A

Omeprazole
Lansoprazole
(-zole)

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11
Q

Proton Pump Inhibitors (PPIs): indications

A

GORD
Peptic ulcers
Preventing NSAID-associated ulceration
Eradicate helicobacter with antibiotics

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12
Q

Proton Pump Inhibitors (PPIs): mechanism

A

Blocks the proton pumps (hydrogen pumps) in the gastric lining thus reducing stomach acidity

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13
Q

Proton Pump Inhibitors (PPIs): contraindications

A

Liver disease
Pregnancy

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14
Q

Proton Pump Inhibitors (PPIs): adverse effects

A 
Gastric cancer (masking symptoms)
Constipation
Abdominal pain
Headaches
Dizziness
Anaemia (HCI converts iron to soluble form)
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15
Q

Proton Pump Inhibitors (PPIs): alternatives

A

Water, slippery elm, aloe vera, less stress, diet changes (i.e. less caffeine), herbs.
Cabbage juice (Substance U, glutamine)

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16
Q

Antispasmodics: brand name

A

Buscopan (Hyoscine)

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17
Q

Antispasmodics: mechanism

A

Inhibit intestinal smooth muscle depolarisation by blocking acetylcholine receptors (anti-cholinergic)
Reduces peristalsis

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18
Q

Antispasmodics: adverse effects

A

Constipation
Palpitations
Reduced bronchial secretions
Urinary retention

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19
Q

Antispasmodics: alternatives

A

Magnesium, herbs — antispasmodics, homeopathy, acupuncture, tissue salts, ginger root, peppermint oil; e.g. BioCare’s Peppermint Complex.

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20
Q

Anti-Motility Drugs: brand names

A

Codeine phosphate
Loperamide (Imodium)

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21
Q

Anti-Motility Drugs: indications

A

Uncomplicated, acute diarrhoea in adults

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22
Q

Anti-Motility Drugs: mechanism

A

Loperamide acts on opioid receptors in the intestinal muscles, which reduces peristalsis

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23
Q

Anti-Motility Drugs: contraindications

A

Do not use if diarrhoea cause is infectious e.g. dysentery

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24
Q

Anti-Motility Drugs: adverse effects

A

Nausea
Constipation
Drowsiness

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25
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

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26
Q

Anti-Motility Drugs: alternatives

A

Probiotics, tannin, charcoal, clay, apple pectin to bind the stool.
Pysllium husk, flaxseed

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27
Q

Corticosteroids: brand names

A

Prednisolone
Hydrocortisone

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28
Q

Corticosteroids: indications

A

Inflammatory condition e.g. inflammatory bowel disease, autoimmune diseases (RA, lupus, MS)
Topically for eczema

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29
Q

Corticosteroids: mechanism

A

Switches off multiple inflammatory genes - cytokines, inflammatory mediators etc

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30
Q

Corticosteroids: adverse effects

A 
Suppress immunity
Oral thrush
Indigestion
Insomnia
Mood changes (aggressive, irritable)
Thinning of skin
Osteoporosis*
Cataracts
Glaucoma
Diabetes mellitus

*suppression of osteoblasts

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31
Q

Corticosteroids: cautions

A

If stopped suddenly = adrenal cortical insufficiency
In excess = Cushing’s

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32
Q

Laxative - Bulk-Forming: brand names

A

Fybogel
Normacol

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33
Q

Laxative - Bulk-Forming: mechanism

A

Increase faecal mass to stimulate peristalsis

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34
Q

Laxative - Bulk-Forming: administration

A

Must be taken with water

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35
Q

Laxative - Stimulant: brand names

A

Senna
Senokot

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36
Q

Laxative - Stimulant: mechanism

A

Irritate intestinal lining and promote histamine release, increasing intestinal motility

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37
Q

Laxative - Stimulant: adverse effects

A

May cause diarrhoea
Flatulence
Hypokalaemia

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38
Q

Laxative - Stimulant: cautions

A

Short term use only
Address cause
Senna can irritate the colon and long-term use has been linked to colon cancer

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39
Q

Laxative - Osmotic: brand names

A

Lactulose
Magnesium salts

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40
Q

Laxative - Osmotic: mechanism

A

Contains sodium ions which attract water into colon by drawing fluid from the body or retaining fluid

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41
Q

Laxative - Osmotic: adverse effects

A

Colic
Lazy bowel

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42
Q

Laxative - Osmotic: cautions

A

Magnesium salts are often abused and may cause dehydration

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43
Q

Cardiac Glycosides: brand names

A

Digoxin
Lanoxin

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44
Q

Cardiac Glycosides: indications

A

Atrial fibrillation
Heart failure
Also increases GFR

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45
Q

Cardiac Glycosides: mechanism

A

Increase myocardium force of contraction by increasing Ca influx into the heart muscle (reduces heart rate, increases force)

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46
Q

Cardiac Glycosides: interactions

A

Ca - agonistic - increases effect

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47
Q

Cardiac Glycosides: adverse effects

A

NVD
Anorexia
Abdominal pain
Visual disturbances

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48
Q

Cardiac Glycosides: cautions

A

Low Mg, Ca, K increases toxicity

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49
Q

Cardiac Glycosides: alternatives

A

Hawthorne
EFAs
Mg, K, Ca (heart foods)

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50
Q

Calcium Channel Blockers: brand name

A

Amlodipine

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51
Q

Calcium Channel Blockers: indications

A

Angina
Hypertension

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52
Q

Calcium Channel Blockers: mechanism

A

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)

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53
Q

Calcium Channel Blockers: adverse effects

A 
NVD
Dizziness
Headaches
Fatigue
Oedema
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54
Q

Diuretics: brand names

A

Furosemide
Bendroflumethiazide

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55
Q

Diuretics: indications

A 
Hypertension
Pulmonary oedema
Chronic heart failure
General oedema
Kidney/liver diseases
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56
Q

Diuretics: mechanism

A

Reduces reuptake of primary filtrate from different regions of the nephron = decreases blood volume and pressure

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57
Q

Diuretics: adverse effects

A

Mineral loss - hypokalaemia (weakness, fatigue, muscle cramps, palpitations, hallucinations)

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58
Q

Diuretics: alternatives

A

Celery, asparagus, dandelion

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59
Q

Beta Blockers: brand name

A

Atenolol

-ol

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60
Q

Beta Blockers: indications

A

Hypertension
Angina
Arrhythmia
Atrial fibrillation

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61
Q

Beta Blockers: mechanism

A

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

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62
Q

Beta Blockers: adverse effects

A 
Fatigue
Sexual dysfunction
Cold extremities
Hypotension
Sleep disturbance
Psoriasis exacerbation
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63
Q

Beta Blockers: caution

A

May weaken heart in long term

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64
Q

ACE Inhibitors: brand name

A

Ramipril

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65
Q

Angiotensin II Antagonists: brand names

A

Losartan
Irbesartan

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66
Q

ACE Inhibitors: mechanism

A

Stops the conversion of angiotensin I to angiotensin II - a vasoconstrictor

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67
Q

Angiotensin II Antagonists: mechanism

A

Blocks receptors stopping the action of angiotensin II

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68
Q

ACE Inhibitors/Angiotensin II Antagonists: adverse effects

A

Hypotension
Persistent dry cough (due to rise in bradykinin)
NVD
Reduces glomerular filtration (esp in renal impairment
Hyperkalaemia (due to aldosterone inhibition)

69
Q

ACE Inhibitors/Angiotensin II Antagonists: caution

A

Often need to use diuretic at same time

70
Q

Nitrates: brand name

A

Glyceryl trinitrate (GTN)

71
Q

Nitrates: indications

A

Angina pectoris

72
Q

Nitrates: mechanism

A

Dissolves in the blood as nitrous oxide (NO) which is a rapid, potent vasodilator

73
Q

Nitrates: caution

A

Tolerance develops rapidly in continual use

74
Q

Nitrates: administration

A

Sublingual (spray)

75
Q

Nitrates: alternatives

A

Argenine*

* amino acid precursor of NO

76
Q

Anti-Coagulants: brand names

A

Heparin
Warfarin
Aspirin

77
Q

Anti-Coagulants: indications

A

DVT
Pulmonary embolism
TIAs

78
Q

Anti-Coagulants: mechanism

A

Inhibits synthesis of four clotting factors

79
Q

Anti-Coagulants: interactions

A

Gingko
Ginger
Fish oils
Vit E

80
Q

Anti-Coagulants: cautions - warfarin/aspirin

A

Must be closely monitored (used as rat poison)

81
Q

Anti-Coagulants: cautions - heparin

A

Quick action
Short duration

82
Q

Anti-Coagulants: administration - warfarin/aspirin

83
Q

Anti-Coagulants: administration - heparin

A

Parenteral (injected)

84
Q

Anti-Coagulants: alternatives

A

Support liver function, cayenne pepper, ginger, rutin and vitamin C to help strengthen capillaries, herbs (ginkgo), vitamin E, diet, detox

85
Q

Statins: brand name

A

Simvastatin

86
Q

Statins: indications

A

Hypercholesterolaemia

87
Q

Statins: when prescribed/mechanism

A

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*)

*High presence of insulin increases activity of HMG-CoA reductase

88
Q

Statins: adverse effects

A 
Insomnia
Dizziness
Fatigue - due to depletion of CoQ10
Headaches - due to depletion of CoQ10
Liver damage
Gastro-intestinal effects
Muscle aches
89
Q

Statins: cautions

A

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

90
Q

Statins: CoQ10 requirements

A

100mg CoQ10 per day
Enzyme required to support mitochondrial function, reduce muscle pain

91
Q

Statins: alternatives

A

Red rice yeast (natural statin), artichoke, fish oil, soluble fibre, diet and lifestyle intervention essential, liver function, herbs that promote bile (and hence cholesterol)
excretion; e.g. dandelion.

92
Q

Bronchodilators: brand names

A

Salbutamol (Ventolin) - immediate action/short duration
Salmeterol - delayed action, longer duration (not to be used in acute attack)

93
Q

Bronchodilators: indications

A

Symptomatic relief of bronchoconstriction

94
Q

Bronchodilators: mechanism

A

Acts on beta-2 receptors in the lungs (beta-2 agonists)
Stimulation of these receptors causes bronchodilation

95
Q

Bronchodilators: adverse effects

A 
Tremor
Anxiety
Headache
Palpitations
Muscle cramping
96
Q

Bronchodilators: administration

97
Q

Steroid Inhalers: brand names

A

Becotide (brown inhaler)
Symbicort inhaler

98
Q

Steroid Inhalers: indications

A 
Asthma prophylaxis (preventative)
COPD
99
Q

Steroid Inhalers: mechanism

A

Reduces airway inflammation, oedema and mucus secretion

100
Q

Steroid Inhalers: adverse effects

A

Adrenal suppression (Addison’s)
Oral candidiasis
Respiratory tract infections

101
Q

Steroid Inhalers: alternatives

A

Buteyko breathing, anti-inflammatory foods and herbs, bronchodilators (i.e. magnesium), mucous membrane support, acupuncture, manual therapy.

102
Q

Leukotriene Receptor Antagonists: indications

A

Non-steroidal asthma prophylaxis

103
Q

Leukotriene Receptor Antagonists: mechanism

A

Blocks a chemical reaction that can lead to inflammation

104
Q

Leukotriene Receptor Antagonists: adverse effects

A

NVD (fewer than steroids)

105
Q

Leukotriene Receptor Antagonists: alternatives

A

Bronchodilator and anti-asthmatic herbs, identify and treat cause (allergy), avoid triggers,
LOX inhibitors — Boswellia / quercetin.

106
Q

Antihistamines: brand name (non-sedating)

A

Clarityn (Loratadine)

107
Q

Antihistamines: brand name (sedating)

A

Piriton, Benadryl

cross the BBB

108
Q

Antihistamines: indications

A

Hayfever, allergies, pruritus

109
Q

Antihistamines: adverse effects (non-sedating)

A

Myalgia (muscle pain)

110
Q

Antihistamines: adverse effects (sedating)

A

Drowsiness
Anti-muscarinic (urinary retention, dry mouth, constipation, blurred vision)

111
Q

Antihistamines: alternatives

A

Identify and treat cause (allergy), avoid triggers, anti-allergy / immune herbs and supplements,
quercetin, vitamin C, homeopathy, acupuncture.

112
Q

Anxiolytics: brand names

A

Diazepam (Valium)
Lorazepam

113
Q

Anxiolytics: indications

A

Muscle relaxant
Minimising drug withdrawal
Severe/disabling insomnia/anxiety (short term only)

114
Q

Anxiolytics: mechanism

A

Acts on GABA receptors - inhibitory CNS neurotransmitter

115
Q

Anxiolytics: adverse effects

A 
Highly addictive
Drowsiness/confusion
Muscle weakness
Paradoxical effects
Dependence
Tolerance/dependence
Withdrawal causes anxiety
Insomnia
Anorexia
Tremor
Perspiration
Tinnitus
Perceptual disturbance
Hallucinations
Paranoia
116
Q

Anxiolytics: alternatives

A

Herbs, Mg, theanine, vitamin B6*

*required to converted glutamate to GABA

117
Q

Anti-Depressants: brand names/classes

A

Citalopram
Amitriptyline

Classes include:
Selective serotonin re-uptake inhibitors (SSRIs)
Tricyclic anti-depressants

118
Q

Anti-Depressants: indications

A

Chronic and major depression (not acute depression)

119
Q

Anti-Depressants: adverse effects

A 
Suppression
Nausea
Vomiting
Low sex drive
Blurred vision
GIT upset
Feeling agitated or shaky
Sleep disturbance
Loss of appetite
120
Q

Anti-Depressants: alternatives

A

Herbs such as St. John’s
Wort, rhodiola, Bach flowers, homeopathy,
acupuncture.

121
Q

Analgesics: brand names

A

Non-opioid (act peripherally) - aspirin, paracetamol, ibuprofen
Opioid (act on pathway in CNS) - codeine, morphine

122
Q

Analgesics: mechanism

A

Painkillers - they modulate pain perception

123
Q

Analgesics: adverse effects

A

GIT bleeding
Low stomach acidity
Liver disease
Constipation

124
Q

Analgesics: alternatives

A

For headaches — feverfew, peppermint, herbs, homeopathy,
acupuncture.
For inflammation — Devil’s Claw, ginger, turmeric, EFAs, etc.

125
Q

Anti-Microbials: indications

A

Bacterial infections
Fungal infections
Viral infections

126
Q

Anti-Microbials: brand names (anti-bacterial)

A

Broad/narrow spectrum antibiotics - penicillin

127
Q

Anti-Microbials: brand names (anti-fungal)

A

Systemic - fluconazole, clotrimazole, ketoconazole

Non-systemic

128
Q

Anti-Microbials: brand names (anti-viral)

A

Acyclovir - inhibits viral replication

Only effective early on

129
Q

Anti-Microbials: cautions

A

Antibiotic resistance - eg MRSA
Anti-virals - quite toxic

130
Q

Anti-Microbials: alternatives

A

Garlic, ginger, colloidal / nano silver, grapefruit seed extract, elderberry, Nat mur (cold sores esp. sunlight related), essential oils (e.g. tea tree), herbs.

131
Q

Anti-Malarials: brand names

A

Quinine
Prophylaxis: Larium

132
Q

Anti-Malarials: cautions

A

Resistance is common
No drug 100% effective

133
Q

Anti-Malarials: side effects

A

Renal impairment, epilepsy

134
Q

Anti-Malarials: alternatives

A

Prevent mosquito bites! — cover up, wear dull colours, use unscented toiletries, natural
mosquito repellents, nets, citronella, vitamin B1
.

135
Q

Diabetic Drugs: brand names

A

Insulin (injections)
Metformin

136
Q

Diabetic Drugs: indications

A

Insulin - mostly T1
Metformin - mostly T2
Insulin resistance

137
Q

Diabetic Drugs: mechanism

A

Metformin - increases cell sensitivity to insulin and lowers glycaemic levels

138
Q

Diabetic Drugs: adverse effects

A

Elevates homocysteine - linked to breast cancer
Nausea
Loss of appetite

139
Q

Diabetic Drugs: cautions

A

Increased homocysteine can be damaging to blood vessels
Leads to atherosclerosis
Viatamin Bs needed to methalyate homocysteine

140
Q

Diabetic Drugs: administration

A

Injection - insulin
Oral - metformin

141
Q

Diabetic Drugs: alternatives

A

Whole organic diet, chromium*, zinc, magnesium, gymnema, cinnamon, alpha lipoic acid, vit. D, exercise. Avoid stress.

*improves insulin sensitivity

142
Q

Thyroid Drugs: brand names

A

Hypothyroidism - Thyroxine
Hyperthyroidism - Carbimazole

143
Q

Thyroid Drugs: mechanism (Thyroxine)

A

Replaces lack of thyroid hormone

144
Q

Thyroid Drugs: mechanism (Carbimazole)

A

Prevents the conversion of iodine to its useable form
Blocks the combination of converted iodine with other components to form thyroid hormones

145
Q

Thyroid drugs: alternatives

A

(Depending on whether hypo or hyper) herbs, iodine, selenium, acupuncture. Glandular thyroid, homeopathy.

146
Q

Hormones: brand name (masculination reduction)

147
Q

Hormones: indications (Androcur)

A

Used to treat masculinisation in women e.g. PCOS

148
Q

Hormones: mechanism (Androcur)

A

Contains active ingredient cyproterone which reduces testosterone production

149
Q

Chemotherapy: drug type

A

Cytotoxic drugs

150
Q

Chemotherapy: mechanism

A

Interferes with cell cycle, triggering cell death (apoptosis) in rapidly dividing cells

151
Q

Chemotherapy: adverse effects

A 
Very toxic
Cancer
Bone marrow suppression (anaemia, leukopenia, thrombocytopenia)
GIT ulceration
Skin ulceration/burns
Hair loss
152
Q

Chemotherapy: cautions

A

All kills healthy cells

153
Q

Tamoxifen: indications

A

Breast cancer - only hormonally driven (oestrogen positive)

154
Q

Tamoxifen: mechanism

A

Blocks oestrogen receptors

155
Q

Tamoxifen: adverse effects

A 
Mimics menopause
Uterine fibroids
Visual disturbance
Liver enzyme elevation
Osteoporosis
156
Q

NSAIDs: brand name

A

Ibuprofen (half life 2-3hrs)
Diclofenac
Aspirin

157
Q

NSAIDs: indication

A

Pain relief - mild to moderate

158
Q

NSAIDs: mechanism

A

Inhibits the activity of cyclooxygenase (COX), therefore inhibiting prostaglandin synthesis

159
Q

NSAIDs: contraindication

160
Q

NSAIDs: adverse effects

A 
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
161
Q

NSAIDs: cautions

A

Diclofenac - increases risk of CVD

162
Q

NSAIDs: administration

A

Tablet

Gel onto skin

163
Q

NSAIDS: alternatives

A

Anti-inflammatory diet, devil’s claw, boswellia (frankincense oil), omega-3, turmeric, homeopathy, acupuncture.

164
Q

Gout Drugs: brand name (preventative)

A

Allopurinol

165
Q

Gout Drugs: brand name (acute attacks)

A

Colchicine

166
Q

Gout Drugs: mechanism (Allopurinol)

A

Inhibits enzyme ‘xanthine oxidase’ that turns purines into uric acid
Also decreases endogenous purine synthesis

167
Q

Gout Drugs: mechanism (Colchicine)

A

Inhibits urate crystal deposition

168
Q

Gout Drugs: caution

A

Colchicine - very toxic

169
Q

Gout Drugs: alternatives

A

Dissolve uric acid crystals,
hydration, diet and lifestyle changes, cherries, nettles, homeopathy, acupuncture, folate.

BioMed S2 (34 decks)

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