BB DRUG LISTS Flashcards by Danielle Hilton | Brainscape

Q

What is L-Dopa?

A

This is a synthetic precursor of dopamine that is often used in the treatment of Parkinson’s disease

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Q

What drugs are usually given in combination with L-Dopa and why?

A

With a DOPA-carboxylase inhibitor such as carbodipa or bensarazide to prevent peripheral carboxylation which can have emetic effects

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Q

What are the potential side-effects of L-Dopa?

A

Nausea and vomiting (due to peripheral activation of postrema), postural hypotension, psychosis (due to over-activation of the mesolimbic pathway) and sleep disturbances

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Q

What are the potential motor complications of L-Dopa use?

A

On-off effects, dyskinesia, wearing off effects and dystonia

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Q

Name 4 different types of dopamine agonist

A

Rotigotine, bromocriptine, perogolide and ropnirole

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Q

What is rotigotine, it’s use and it’s administration method?

A

It’s a dopamine receptor agonist used in the treatment of Parkinson’s disease and it’s given via a transdermal patch

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Q

What are selegiline and rasagiline?

A

These are monoamine oxidase b inhibitors (MAOb); they prevent residual dopamine from being oxidised

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Q

What is the use of selegiline and rasagiline?

A

They may be used in the treatment of Parkinson’s disease as they are MAOb inhibitors and therefore increase the dopamine availability in the synaptic cleft and may reduce on-off symptoms

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Q

What are entacapone and tolcapone?

A

These are COMT inhibitors that are used in the treatment of Parkinson’s disease in combination with L-DOPA

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Q

What is amantadine?

A

It’s an anti-viral drug that works to block dopamine reuptake by the presynaptic neurone and increases dopamine release and therefore can be used in the treatment of Parkinson’s disease

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Q

How may anticholinergic drugs be used in the treatment of Parkinson’s disease?

A

Dopamine loss leads to the hyperactivity of cholinergic cells and therefore cholinergic muscarinic antagonists will reduce the effects of this and reduce tremor

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Q

Name some anticholinergic drugs that may be used in the treatment of Parkinson’s disease

A

Benzatropine, benzhexol, orphenadrine, procyclidine and trihexyphenidyl

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Q

What is benzatropine?

A

Anticholinergic drug (muscarinic receptor antagonist) used in the treatment of PD

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Q

What is benzhexol?

A

Anticholinergic drug (muscarinic receptor antagonist) used in the treatment of PD

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Q

What is orphenadrine?

A

Anticholinergic drug (muscarinic receptor antagonist) used in the treatment of PD

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Q

What is procyclidine?

A

Anticholinergic drug (muscarinic receptor antagonist) used in the treatment of PD

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Q

What is trihexyphenidyl?

A

Anticholinergic drug (muscarinic receptor antagonist) used in the treatment of PD

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Q

What are some of the potential side-effects of anticholinergic drugs used in the treatment of Parkinson’s?

A

Dry mouth, constipation and urinary retention

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Q

What is tetrabenazine?

A

This is a drug used in the treatment of Huntington’s disease which inhibits synaptic vesicle monoamine transporter

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Q

What are the monoamine neurotransmitters?

A

Dopamine, serotonin, norepinephrine, and histamine

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Q

What is baclofen?

A

This is a GABAb receptor agonist that is used in the treatment of Huntington’s disease to reduce the involuntary movements by inducing more inhibitory neurotransmitter release

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Q

What drug types are used to treat Parkinson’s disease?

A

L-Dopa (synthetic dopamine precursor), dopamine agonists, MAOb inhibitors, COMT inhibitors, anti-vitals and anticholinergic (muscarinic antagonist) drugs

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Q

What drug types are used to treat Huntington’s disease?

A

Amine transporter inhibitors (tetrabenazine), GABAb agonist (baclofen), antipsychotics (dopamine receptor antagonists) and antidepressants

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Q

What are olanzapine and haloperidol?

A

They are antipsychotic drugs

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Q

How may olanzapine and haloperidol be used in the treatment of Huntington’s disease?

A

They are antipsychotic drugs which are dopamine receptor antagonists and therefore prevent the action of this excitatory neurotransmitter

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Q

What are imipramine and amitriptyline?

A

Antidepressants

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Q

Which antidepressants may be used in the treatment of Huntington’s disease?

A

Imipramine and amitriptyline

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Q

What is the function of paracetamol?

A

It’s an analgesic, antipyretic with a small anti-inflammatory effect

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Q

What’s the official name for paracetamol?

A

Acetaminophen

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Q

What is the mechanism of action of paracetamol?

A

COX-2 inhibition (prevents prostaglandin production) and modulates the endocannibinoid system

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Q

Name three examples of NSAIDs

A

Aspirin, ibuprofen and diclofenac

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Q

What is aspirin?

A

A form of NSAID

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Q

What is the function of aspirin?

A

It’s a analgesic, antipyretic and anti-inflammatory drug with slight anti-platelet activity (hence why it is given in suspected MI)

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Q

What is the mechanism of action of aspirin?

A

COX-1 and COX-2 inhibitor

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Q

What is ibuprofen?

A

A form of NSAID

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Q

What is the function of ibuprofen?

A

Has analgesic and anti-inflammatory functions

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Q

What is the mechanism of action of ibuprofen?

A

COX-1 and COX-2 inhibitor

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Q

What is diclofenac?

A

An NSAID

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Q

What is the function of diclofenac?

A

It’s an analgesic and anti-inflammatory drug

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Q

What is the mechanism of action of diclofenac?

A

It’s a COX-1 and COX-2 inhibitor

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Q

What is the mechanism of action of amitriptyline?

A

It inhibits amine reuptake and also blocks sodium and calcium channels

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Q

What is morphine?

A

Morphine is an opioid drug used to treat pain, it’s a TYPICAL opioid drug

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Q

What is the function of morphine?

A

It decreases the excitability of neurones and reduces the release of neurotransmitters

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Q

What is the mechanism of action of morphine?

A

Binds to Mu receptors in the central nervous system which increases potassium conductance and decreases calcium conductance (prevents depolarisation) which leads to decreased excitability and reduced neurotransmitter release

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Q

What is the active metabolite of morphine?

A

M6G (morphine-6-glucuronide)

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Q

What is tramadol?

A

An ATYPICAL opioid drug that is an agonist at Mu receptors in the CNS but also prevents the reuptake or serotonin and noradrenaline

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Q

What are carbamazepine and sodium valproate often used to treat?

A

Epilepsy as they are anticonvulsants, but they can also be used in the treatment of certain types of pain e.g. neuropathic pain

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Q

What types of drug may be used to treat neuropathic pain?

A

Anticonvulsants (e.g. carbamazepine/sodium valproate/pregabalin) or antidepressants (e.g. amitriptyline)

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Q

What is the mechanism of action of carbamazepine and sodium valproate?

A

Bind to sodium channels to prevent them from opening (reducing depolarisation)

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Q

What is pregabalin and gabapentin?

A

These are anticonvulsant drugs that act on alpha-2-delta subunit of calcium channels to prevent opening of the channel

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Q

Name three local anaesthetics

A

Lignocaine, bupivacaine, prilocaine

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Q

What is the suffix associated with local anaesthetics?

A

-caine

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Q

What is the mechanism of action of local anaesthetics (e.g. Lignocaine, bupivacaine, prilocaine)

A

Blocks sodium ion channels

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Q

What are the potential side effects of local anaesthetic?

A

There is always a risk of systemic toxicity such as hypotension, respiratory depression and bradycardia

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Q

Give some examples of inhaled general anaesthetics

A

halothane, enflurane, isoflurane, NO, xenon

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Q

Give some examples of intravenous general anaesthetics

A

propofol, thiopental, etomidate, ketamine

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Q

What is the mechanism of action of general anaesthetics?

A

They either activate inhibitory receptors (e.g. GABA receptors) or inactivate excitatory receptors (e.g. glutamate receptors)

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Q

What is a potential side effect of general anaesthesia?

A

Cardiovascular depression may be induced which is a fatal complication

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Q

What are the two main drugs used in the treatment of headache and migraine?

A

Sumatriptan and methysergide

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Q

What is the main drug(s) used in the treatment of absence seizures?

A

Sodium valproate OR ethosuximide (T-type calcium channel blocker)

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Q

What is sumatriptan?

A

This is a 5HT1bd agonist that is used in the treatment of migraine and cluster headaches

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Q

What is sumatriptan used for?

A

Migraine pain and cluster headaches

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Q

What is the mechanism of action of sumatriptan?

A

Is a 5HT1bd agonist which leads to vasoconstriction of the smooth muscle –> prevents release of neuropeptides from the nerve endings which cause headache

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Q

What is methysergide?

A

This is a 5HT1bd agonist that is used in the treatment cluster headaches

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Q

What is methysergide used for?

A

Cluster headache treatment

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Q

What is the mechanism of action of methysergide?

A

Is a 5HT1bd agonist which leads to vasoconstriction of the smooth muscle –> prevents release of neuropeptides from the nerve endings which cause headache

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Q

What are the various drug targets in the treatment of epilepsy?

A

Sodium channels, GABA channels, calcium channels, neurotransmitter release and presence

Q

Which drugs have zero order kinetics?

A

Phenytoin, Phenylbutazone
Warfarin
Heparin
Ethanol
Aspirin &amp; other salicylates
Theophylline, Tolbutamide
Salicylates

Q

What is phenytoin?

A

This is an anticonvulsant drug that acts on sodium channels to prevent depolarisation (antagonist); this drug illustrates zero order kinetics

Q

What is carbamazepine

A

This is an anticonvulsant drug that acts on sodium channels to prevent depolarisation (antagonist)

Q

What is sodium valproate

A

This is an anticonvulsant drug that acts on sodium channels to prevent depolarisation (antagonist) that can be used to treat all types of seizures, including absence seizures

Q

What is lamotrigine?

A

This is an anticonvulsant drug that acts on sodium channels to prevent depolarisation (antagonist) AS WELL AS inhibiting presynaptic calcium channels to prevent glutamate release

Q

What is topiramate?

A

This is an anticonvulsant drug that acts on sodium channels to prevent depolarisation (antagonist) AS WELL AS acting as an agonist at GABAa channels and inhibits presynaptic glutamate release –> inhibitory effects

Q

What drug is used in the treatment of status epilepticus?

A

Intravenous diazepam

Q

How may clonazepam be used in the treatment of epilepsy?

A

This is a benzodiazepine that works to positively modulate the GABAa receptor in order to create an inhibitory effect and cause sedation

Q

How may phenobarbitone be used in the treatment of epilepsy?

A

This is a barbiturate that works to positively modulate the GABAa receptor in order to create an inhibitory effect and cause sedation

Q

How may ethosuximide be used in the treatment of epilepsy?

A

This is a T-type calcium channel blocker than is used in the treatment of absence seizures

Q

Outline how levetiracetam may be used in the treatment of epilepsy

A

This drug binds to SV2A to modulate the release of neurotransmitter from the presynaptic neurone, and also inhibits the N-type calcium channel which prevents the stimulation of NT release in the first place –> can prevent myoclonic seizures

Q

Outline how tiagabine may be used in the treatment of epilepsy

A

This drug acts on the GAT1 (GABA transporter) to prevent the reuptake of GABA so that it continue to elicit it’s inhibitory effects

Q

Outline how viagabrin may be used in the treatment of epilepsy

A

This drug inhibits GABA transaminase in the presynaptic neurone which inhibits the metabolism of GABA and therefore more is available so can continue to exert it’s inhibitory function on the postsynaptic neurones

Q

What are beta interferons?

A

These are drugs which are used in the treatment of multiple sclerosis; they reduce immune cell proliferation to prevent the demyelination.

They are given via SQ or IM injection

Q

What is the function of beta-interferons?

A

To reduce immune cell proliferation in multiple sclerosis

Q

What are the potential side-effects of beta-interferons?

A

Flu like symptoms and injection site reactions

Q

What are glatiramer acetate and copaxone?

A

These are SQ injected drugs used in the treatment of MS which reduce relapse but not the progression of the disease; they block T cells from attacking the myelin

Q

What is dimethyl fumarate?

A

It’s a drug used in the treatment of MS that works by inhibiting proliferation of immune cells

Q

What is the function of dimethyl fumarate?

A

It is an immune cell proliferation inhibitor that prevents further demyelination in multiple sclerosis

Q

What are the potential side-effects of dimethyl fumarate?

A

Hot flushes, GI problems and infections

Q

What is alemtuzumab?

A

This is a form of monoclonal antibody that binds to CD52 proteins present on mature lymphocytes which causes their death which reduces the inflammatory response associated with multiple sclerosis

Q

What is the function of alemtuzumab?

A

To reduce inflammation by binding to mature lymphocytes (via CD52) and therefore treating the inflammation of MS

Q

What are the potential side effects of alemtuzumab use?

A

Infection, idiopathic thrombocytopenia purport, secondary autoimmunity (thyroid disease)

Q

What is fingolimod?

A

This is a drug used to treat MS which is a sphingosine-1-phosphate receptor modulator; this sequesters lymphocytes in lymph nodes, preventing them from contributing to an autoimmune reaction

Q

What are the potential side-effects of using fingolimod?

A

Arrhythmias and infection

Q

What is natalizumab?

A

It’s a monoclonal antibody against the alpha-4 integrin; this prevents leukocytes by being able to adhere to the epithelium and enter the CNS.

Q

What drug, used in the treatment of multiple sclerosis, may lead to progressive multifocal leukoencephalopathy (PML)?

A

Natalizumab

Q

What are the two main types of drugs used in the treatment of Alzheimer’s disease?

A

Cholinesterase inhibitors (to increase ACh levels in the brain) and NMDA receptor antagonists (to reduce excitotoxicity)

Q

Name three cholinesterase inhibitors that are used in the treatment of Alzheimer’s disease

A

Donepezil, rivastigmine, galantamine

Q

What is the function of donepezil?

A

Cholinesterase inhibitor used in the treatment of Alzheimer’s disease to increase ACh levels in the brain

Q

What is the function of rivastigmine?

A

Cholinesterase inhibitor used in the treatment of Alzheimer’s disease to increase ACh levels in the brain

Q

What is the function of galantamine?

A

Cholinesterase inhibitor used in the treatment of Alzheimer’s disease to increase ACh levels in the brain

Q

What is memantine?

A

It’s an NMDA (glutamate) receptor antagonist which works to reduce the excitotoxicity seen in those with Alzheimer’s disease

Q

Name four typical antipsychotic drugs

A

Chlorprozamine, haloperidol, flupenthixol, fluphenazine

Q

What is the key difference between typical and atypical antipsychotics/neuroleptics?

A

Typical antipsychotics came first and the main ones are chlorpromazine and haloperidol but these have extrapyramidal effects with increased dosage e.g. tremor. Atypical antipsychotics are also known as ‘second generation’ and these have less extrapyramidal side effects and the main one is clozapine; atypical also have effects on other receptors such as 5HT2, alpha1, H1 and M receptors too.

Q

What is haloperidol?

A

It’s a typical neuroleptic (antipsychotic) that acts as an antagonist at D2 receptors and also has anticholinergic effects, used in the treatment of schizophrenia

Q

What are the potential side effects of typical antipsychotics?

A

Extra-pyramidal effects, tarditive dyskinesia, hyperprolactinaemia (galactorrhoea, amenorrhoea)

Q

Name 4 atypical antipsychotics

A

Risperidone, olanzapine, clozapine, palperidone

Q

What condition are antipsychotics usually prescribed for?

A

Schizophrenia

Q

What is clozapine?

A

It’s an atypical antipsychotic used in the treatment of schizophrenia that has additional specificity to D4 receptors

Q

What is the mechanism of action of clozapine?

A

It’s an atypical antipsychotic which works by antagonising D2 and D4 receptors as well as binding to 5HT2, alpha 1, H1 and M receptors

Q

When may clozapine be prescribed in the treatment of schizophrenia?

A

It’s the preferable treatment for drug-resistant schizophrenia

Q

What is a characteristic side-effect of clozapine drug use?

A

Agranulocytosis

Q

What are the potential side effects of atypical antipsychotics?

A

Weight gain, dyslipidaemia, type 2 diabetes

Q

What are the potential side effects of atypical antipsychotics?

A

Weight gain, dyslipidaemia, type 2 diabetes

Q

Which two drugs, used in the treatment of schizophrenia, may be administered via depo injection?

A

Haloperidol and fluphenazine (typical antipsychotics); this is done if there is lack of compliance to prescribed medications

Q

Name three treatments for bipolar disorder

A

Lithium, sodium valproate and carbamazepine

Q

Give some of the potential side-effects of lithium treatment for bipolar disorder

A

Thirst, nausea, fine tremor, polyuria, weight gain, oedema, acne

Q

What kinds of drugs may be given to treat depression?

A

TCAs, MAO inhibitors, reversible MAO inhibitors, SSRIs, SNRIs (serotonin, noradrenaline receptor inhibitors), noradrenaline reuptake inhibitors, NaSSA (noradrenergic and specific seratonergic antidepressants) and SARI (serotonin antagonist and reuptake inhibitor)

Q

Name 3 tricyclic antidepressants

A

Imipramine, amitriptyline, clomipramine

Q

What is amitriptyline?

A

A form of tricyclic antidepressant

Q

Outline the mechanism of action of tricyclic antidepressants

A

Inhibit amine reuptake and has an affinity for H1, M3, a1 and a2 receptors

Q

What are the potential side effects of TCA use?

A

Dry mouth, blurred vision, constipation, weight gain, postural hypotension

Q

Name three monoamine oxidase inhibitors?

A

Phenelzine, iproniazid, tranylcypromine

Q

Outline the mechanism of action of the monoamine oxidase inhibitors used in the treatment of depression.

A

These are irreversible non-selective inhibitors which are useful in the treatment of atypical depression

Q

Which kind of drugs are most likely to be used in the treatment of atypical depression?

A

Irreversible monoamine oxidase inhibitors

Q

What is meant by the ‘cheese reaction’ in the context of irreversible monoamine oxidase inhibitors?

A

The body will react with tyramine containing foods such as cheese

Q

What is moclobemide?

A

An example of a reversible monoamine oxidase inhibitor, commonly used in the treatment of depression

Q

How do reversible MAOIs such as moclobemide differ from irreversible MAOIs such as phenelzine?

A

Reversible MAOIs have an increased selectivity for MAOa and are safer

Q

What are the potential side effects of moclobemide use?

A

Nausea, agitation and confusion

Q

Name three SSRIs

A

Fluoxetine, paroxetine and citalopram

Q

What is fluoxetine?

A

An SSRI, often used in the treatment of depression

Q

What is citalopram?

A

An SSRI, often used in the treatment of depression

Q

What are some of the advantages of using SSRIs in the treatment of depression?

A

There is no anticholinergic activity, there are no cardiotoxic effects and it’s safe in overdose

Q

What are the potential side effects of SSRI use?

A

Nausea, headaches, GI irritation, anxiety and loss of limbido

Q

What is venfaxine?

A

A form of serotonin noradrenaline reuptake inhibitor that may be used in the treatment of depression

Q

Give an example of an SNRI

A

Venfaxine

Q

How do SNRIs compare to SSRIs?

A

SNRIs have more cardiovascular side effects than SSRIs

Q

What is reboxetine?

A

This is a noradrenaline reuptake inhibitor that is involved in the treatment of depression

Q

Name a noradrenaline reuptake inhibitor that is used in the treatment of depression

A

Reboxetine

Q

What is mirtazepine?

A

This is a form of noradrenergic and serotonergic antidepressant used in the treatment of depression (NaSSA); it works by antagonising 5-HT2 and a2 receptors

Q

Give an example of a NaSSA, used in the treatment of depression

A

Mirtazepine

Q

What is trazodone?

A

A serotonin antagonist and reuptake inhibitor (SARI) that mainly acts on 5-HT2 receptors

Q

Name one SARI (serotonin antagonist reuptake inhibitor) used in the treatment of depression

A

Trazodone

Q

Which types of drugs may be used in the treatment of anxiety?

A

Buspirone/ipsapirone, benzodiazepines, SSRIs, barbiturates and beta blockers

Q

What is buspirone?

A

A partial 5-HT1a agonist used in the treatment of anxiety

Q

What is ipsapirone?

A

A partial 5-HT1a agonist used in the treatment of anxiety

Q

Name three benzodiazepines

A

Diazepam, clonazepam and alprazolam

Q

Explain the mechanism of action of benzodiazepines

A

Drugs such as diazepam, clonazepam and alprazolam potentiate GABA-induced hyper polarisation by increasing the opening frequency of channels

Q

What conditions are benzodiazepines commonly prescribed for?

A

Epilepsy (status epilepticus), anxiety and insomnia

Q

Name a barbiturate drug

A

Phenobarbitone

Q

Outline the mechanism of barbiturates e.g. phenobarbitone

A

Potentiates GABA induced hyperpolarisation by increasing opening duration of channels

Q

Why are barbiturates such as phenobarbitone rarely used in treatment nowadays?

A

There is a major risk of drug dependence, there is the potential for fatal toxicity in overdose leading to respiratory depression and there are severe withdrawal symptoms

Q

Name a beta blocker that may be prescribed to combat anxiety

A

Propanolol

Q

Name two benzodiazepines that may be used in the treatment of insomnia

A

Lorazepam and temazepam

Q

Name two Z drugs

A

Zolpidem and eszopiclone

Q

What drugs may be used in the treatment of insomnia?

A

Benzodiazepines, Z drugs and pregabalin (anticonvulsant)

Q

Outline the mechanism of action of Z drugs in the treatment of insomnia

A

Bind to the alpha subunit of GABAa and induce hyperpolarisation

Q

What drug is likely to be given in short-term insomnia?

A

Benzodiazepine

Q

What drug is likely to be given in a long-term/chronic insomnia?

A

Z drugs such as zoo-idem or eszopiclone

Q

Name two drugs which can be used as anti-emetics

A

Domperidone and ondanetron

Q

What is domperidone?

A

This is a peripherally active D2 receptor antagonist that is used in the treatment of emesis

Q

What is ondanetron?

A

This is a 5-HT3 receptor antagonist that is used in the treatment of emesis

Q

Which drug may be given to aid alcohol withdrawal in addiction?

A

Disulfaram; this is an aldehyde dehydrogenase inhibitor which aids in the maintenance of alcohol abstinence as it cannot be cleared

Q

Which drug may be given to aid in smoking cessation in addiction?

A

Bupropion; this is a monoamine reuptake inhibitor

Q

Name four drugs involved in relieving and aiding opioid addiction

A

Naltrexone, naloxone, methadone and clonidine

Q

What is naltrexone?

A

An opioid antagonist that helps prevent relapse in individuals that are giving up opiates such as heroine

Q

What is naloxone?

A

This drug blocks Mu opioid receptors and therefore combats the effects of an opioid overdose if this event occurs

Q

What is methadone

A

A form of opioid that may be given to heroine addicts in order to wean them off of the drug progressively

Q

What is clonidine?

A

It is an alpha-2-agonist in the body which helps to reduce the withdrawal symptoms from opiate use cessation