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Autacoids > Basics > Flashcards

Basics Flashcards

1
Q

Amine autacoids

A

Histamine
Serotonin

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2
Q

Lipid autacoids

A

Eicosanoids - Prostanglandins, Leukotrienes, Lipoxins

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3
Q

Peptide autacoids

A

Angiotensin
urotensin
endothelin
natriuretic peptide
bradykinin

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4
Q

gas autacoid

A

nitrous oxide

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5
Q

which 2nd gen antihistaminic crosses BBB

A

Cetirizine
has sedative action

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6
Q

least sedative 1st gen antihistaminic which can be given during daytime

A

Chlorpheniramine

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7
Q

H1 partial agonist

A

Betahistine
brand name: Vertin
used in treatment of vertigo in benign positional vertigo and meniere’s disease

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8
Q

highly sedative 1st gen antihistaminics

A
  1. Promethazine (max sedation, LA, anticholinergic)
  2. Diphenhydramine (transdermal patch for motion sickness)
  3. Doxepin (also TCA)
  4. Doxylamine along with vitamin B6 (safest in pregnancy, DOC for morning sickness)
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9
Q

moderately sedative 1st gen antihistaminics

A
  1. Cyclizine, Meclizine (most effective for sea sickness)
  2. Cinnarizine (also blocks calcium channel on vestibular nerves)
  3. Cyproheptadine (antihistaminic plus antiserotonin - treatment of serotonin syndrome)
  4. Pheniramine (avil): cough syrup
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10
Q

least sedative 1st gen antihistaminics

A
  1. Chlorpheniramine
  2. Clemastine
  3. Tirolidine
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11
Q

least sedative 1st gen antihistaminics

A
  1. Chlorpheniramine
  2. Clemastine
  3. Tirolidine
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12
Q

2nd gen antihistaminic

A
  1. Terfinadine, Astemizole (banned) _ CYP3A4 inhibitor, when combined with Erythromycin or Ketoconazole, Torsades de pointes
  2. Fexofenadine - active Terfinadine
  3. Cetirizine (new- Levocetirizine)
  4. Loratidine - most potent
  5. Rupatidine - PAF inhibitor
  6. Ebastine, Acrivastine, Bilastine
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13
Q

Mast cell stabilizer

A

Ketotifen
Olopatidine

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14
Q

Topical antihistaminic

A

Azelastine
Levocarbastine
Olopatidine
Ketotifen
Alcaftadine

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15
Q

H2 blockers

A
  1. Cimetidine
  2. Ranitidine
  3. Famotidine - only non competitive blocker
  4. Roxatidine
  5. Nizatidine
  6. Lafutidine
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16
Q

H3 inverse agonist

A

Tiprolisant/ Pitolisant for narcolepsy or daytime sleepiness (DOC- Modafinil)

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17
Q

Tryptophan hydroxylase inhibitor

A

Telotristat for treatment of diarrhoea in carcinoid syndrome

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18
Q

5HT1

A

5HT 1A - Buspirone, Gepirone - anti anxiety drug

5HT 1B/1D- Triptans, Erogotamine - DOC - acute migraine

5HT 1F- Lasmitidan - acute migraine

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19
Q

Triptans

A

Sumatriptan - DOC for acute attack of migraine
Eletriptan- most effective
Rizatriptan- rapid or fastest
Frovatriptan- longest
Almotriptan
Naratriptan - max oral
Zolmitriptan

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20
Q

Triptans as nasal spray

A

Sumatriptan
Zolmitriptan

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21
Q

dopamine agonist ergots

A

Bromocriptine
Pergolide
Cabergoline

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22
Q

Serotonin agonist ergots

A

Erogotamine
Dihydroxyergotamine
Methysergide

23
Q

Oxytocin agonist ergots

A

Ergometrine/Ergonovine
Dihydrergometrine
Methyl ergometrine/Methergin

24
Q

Miscellaneous ergots

A

Ergotoxine
LSD/ Ly Sergic Diethylamide

25
Q

Drugs causing pulmonary fibrosis

A

Bleomycin
Amiodarone
Doxycycline
Nitrofurantoin
Ergots
Sulfonamides
Talc

26
Q

acute migraine attack

A

unilateral pulsatile headache

mild headache- NSAIDs (Paracetamol, Aspirin, Indomethacin, Nefopam) + caffeine

moderate to severe headache - Triptans > erogotamine
if triptans are contraindicated, opioids (iv morphine or pethidine, nasal spray of butarphanol)

aura
antiemetics (domperidone, methoclopramide)

Antipsychotics( Chlorpromazine, Prochlorperazine)

27
Q

Prophylaxis in chronic migraine

A
  1. beta blockers - Propranolol
  2. antiepileptics - valproate, topiramate, gabapentin
  3. calcium channel blockers- flunarizine, verapamil
  4. TCA- antitryptilene, nortriptyline
  5. antiserotonin - cyproheptadine, ketanserin, methysergide
  6. mao inhibitor - phenelzine

off label use- petasite plant, Clonidine, botulinum toxin

new drug- cgrp 2 inhibitor

28
Q

cgrp 2 inhibitor

A

oral
1. rimegepant
2. atogepant
3. olcegepant
4. zavegepant

mab against gcrp2(inj)
1. erenumab
2. eptinezumab
3. galcanezumab
4. fremanezumab

29
Q

5HT2

A

5HT 2C agonist - Lorcaserin

5HT 2A/B/C antagonist - Olanzapine, Clozapine

5HT2 to 4 antagonist - Cyproheptadine, Ketanserin, Methysergide

30
Q

5HT3 antagonists

A

antimotility in GIT - alosetron for treatment of diarrhoea in IBS

antiemetics in CTZ -doc for chemotherapy induced nausea and vomiting, radiotherapy induced nausea vomiting, gastroenteritis
- Ondesetron (emset), Granisetron, Tropisetron, Ramosetron, Palonosetron (longest, most potent)

31
Q

antiemetics

A
  1. motion sickness - antimuscarinic (hyoscine), antihistaminic (diphenhydramine, promethazine) - not effective in CINV RINV gastroenteritis
  2. CINV, RINV, gastroenteritis - 5HT3 antagonist, D2 antagonist, NK1 antagonist , CB1 agonist - not effective in motion sickness
32
Q

CINV

A
  1. doc - setrons - Ondesetron, Granisetron, Palonosetron - only effective upto 24 hrs
  2. Pitants - block NK1 - Aprepitant, Fosaprepitant, Netupitant, Rolapitant
  3. D2 antagonist - Domperidone, Methoclopramide
  4. CB1 agonist - Nabilone, Dronabinol
  5. Dexamethasone (glucocorticoid)
33
Q

setron effective in delayed phase also

A

Palonosetron

34
Q

setron effective in delayed phase also

A

Palonosetron

35
Q

antiemetic which stimulates appetite

A

Nabilone
Dronabinol

36
Q

CB1 inverse agonist

A

Rimonabant (supresses appetite - antiobesity drug)

banned- suicidal thought

37
Q

THT4 antagonist

A

Cisapride - banned
Mosapride
Tegaserod - banned
Renzapride
Itopride
Prucalopride

38
Q

Prokinetics

A
  1. contract LES - treatment of GERD and to prevent aspiration into lung
  2. increase gastric motility - used in gastroparesis
  3. increase intestinal motility - used in constipation
39
Q

Prokinetics list

A
  1. 5HT4 agonist - Mosapride, Itopride, Prucalopride
  2. D2 antagonist - Domperidone
  3. Anticholinesterase - Neostigmine
  4. All above action - Methoclopramide
40
Q

which antiemetic can cause Parkinson and hyperprolactinemia

A

Methoclopramide

41
Q

which antibiotic has prokinetic action

A

Erythromycin (stimulates motilin receptor)

42
Q

inhibit Phospholipase A2

A

corticosteroid

43
Q

inhibit COX enzyme

A

NSAID

44
Q

inhibit LOX enzyme

A

Zileuton

45
Q

dual COX and LOX inhibitor

A

Licofelone - treatment of osteoarthritis

46
Q

inhibitor of PAF

A

Apafant
Lexipafant
Modipafant

treatment of acute pancreatitis

47
Q

PGE1 (synthetic form)

A
  1. Gemeprost (vaginal) - MTP
  2. Lubiprostone (oral) - chloride secretor used in constipation in IBS
  3. Alprostadil(iv) - vasodilator - erectile dysfunction (cavernosal inj), open ductus arteriosus, critical limb ischemia
  4. Misoprostol - MTP upto 63 days/1st trimester (sublingual/vaginal) , treatment of NSAID induced peptic ulcer (oral)
    SE- diarrhoea, teratogenic (mobius syndrome)
48
Q

MTP/ Medical abortion

A

PGE1 - Misoprostol, Gemeprost (1st trimester)

PGE2 - Dinoprostone (2nd)

PGF2alpha - Dinoprost, Carboprost (2nd)

antiprogestin - Mifepristone

antifolate - Methotrexate (no longer used for MTP as it causes incomplete abortion)

49
Q

MTP guidelines in India

A

day 1- Mifepristone 200 mg oral (kills fetus)
day 3- Misoprostol (expels fetus)
upto 49 days of gestation (400 microgram orally or vaginally)
upto 63 days of gestation (800 microgram sublingual or vaginally)

50
Q

PGE2

A

Dinoprostone
DOC for cervical ripening (dilated) - vaginally
MTP (2nd trimester)

SE- osteoporosis

51
Q

PGF 2 alpha

A

Dinoprost - MTP 2nd trimester - iv or intraamniotic

Carboprost - MTP 2nd trimester (im inj) and controls post partum haemorrhage (im)
SE-asthma

Latanoprost, Bimatoprost, Travoprost, Tafluprost - topical eye drops used as DOC for glaucoma

52
Q

PGI2/prostacyclin

A

Treprostinil
Iloprost
Epoprostinol

iv

Doc for pulmonary artery hypertension
antiplatelet during hemodialysis

53
Q

TXA2

A

physiological antagonist of PGI2

Autacoids (4 decks)

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