50 Drugs Flashcards
Name some cardioselective beta-blockers and their side effects
- Bisoprolol and Atenolol. They are selective for beta 1 receptors in cardiac and renal tissue.
- Side effects are bradycardia, hypotension, BRONCHOSPASM, fatigue, cold extremities, sleep disturbance
Name some non-cardioselective beta blockers and their side effects
- Propanolol and carvediol. Used in migraine prophylaxis + others.
- Side effects are bradycardia, hypotension, fatigue, cold extremities, sleep disturbances and loss of hypoglycaemia awareness
What are the side effects of Aspirin?
Bleeding, peptic ulceration, angioedema, bronchospasm
What are the side effects of clopidogrel?
Bleeding, abdominal pain and diarrhoea
What are the side effects of tissue plasminogen activators?
Bleeding and allergic reaction/angioedema
What are the side effects of unfractionated heparin and LMWH?
Unfractionated and LMWH - Bleeding, heparin induced thrombocytopenia and osteoporosis
What are the side effects of Warfarin?
Bleeding, warfarin necrosis and osteoporosis
What are the side effects of dabigatran and factor Xa inhibitors?
Dabigitran - Bleeding or dyspepsia.
Factor Xa - bleeding and nausea
What are the side effects of ACE inhibitors?
Dry cough,
Hypotension,
Hyperkalaemia,
Renal impairment
What features of nitrates and the side effects?
Features - Converted to NO which is cardioselectivity and acts predominantly on coronary blood vessels.
Side effects - Headaches, postural hypotension and tachycardia
What is the mechanism of action of rate limiting calcium channel blockers?
Prevent entry of calcium by blocking L type calcium channels. Therefore myocardial and smooth muscle contractility is reduced, It dilates coronary blood vessels and reduced afterload and prolongs AV node conduction which slows the HR.
Examples = verapamil and diltiazem
Indications = SVT, angina and hypertension
What are the side effects of rate limiting calcium channel blockers?
Verapamil = constipation, flushing, headaches, hypotension.
Diltiazem = GI upset, bradycardia, peripheral oedema, dizziness, headaches and hypotension
Explain the mechanism of action of non-rate limiting calcium channel blockers and some examples
- Prevent cellular entry of calcium by blocking L type calcium channels, depress contractility, dilate coronary arteries and reduce afterload but these do not lower heart rate so used in hypertension and angina.
Eg, amlodipine or nifedipine
What are the side effects of non rate limiting calcium channel blockers?
- Ankle oedema, abdo pain, palpitations, flushing, headaches
What is the mechanism of action of statins and the side effects?
Inhibits HMG CoA reductase which is the rate limiting stem in the synthesis of cholesterol. This increased LDL receptor expression and increases hepatic uptake of cholesterol, lowering plasma cholesterol levels.
Side effects = Myalgia, myopathy, GI disturbances, liver abnormalities
Explain the mechanism of action of amiodarone
It blocks cardiac potassium channels, prolonging repolarization of the cardiac action potential. Resorting sinus rhythm and slowing AV conduction. Used in SVT or VT
What are the side effects of amiodarone?
Photosensitivity skin reactions,
Hypersensitivity reactions
Hypo/hyperthyroidism
Pulmonary fibrosis
Neurological disturbances
GI disturbances
Explain the mechanism of action of beta lactams
Attaches to penicillin binding proteins on bacterial cell wall, inhibiting transpeptidase enzyme which does cross linking of bacterial cell wall.
Failure to cross link induces bacterial cell autolysis
What is the mechanism of action of vancomycin?
Inhibits cell wall synthesis in gram positive bacterial causing cell death
What is the mechanism of action of macrolides?
Binds to 50s ribosome subunit and inhibits bacterial protein synthesis
Name an example of an ICS and normal corticosteroids
Beclomethasone - Decreases formation of pro-inflammatory cytokines
Prednisolone - up regulation of anti-inflammatory mediators and down regulation of pro-inflammatory mediators and immunosuppression. Can induce signs and symptoms of Cushings
