BB DRUG LISTS Flashcards
1
Q
What is L-Dopa?
A
This is a synthetic precursor of dopamine that is often used in the treatment of Parkinson’s disease
2
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
3
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
4
Q
What are the potential motor complications of L-Dopa use?
A
On-off effects, dyskinesia, wearing off effects and dystonia
5
Q
Name 4 different types of dopamine agonist
A
Rotigotine, bromocriptine, perogolide and ropnirole
6
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
7
Q
What are selegiline and rasagiline?
A
These are monoamine oxidase b inhibitors (MAOb); they prevent residual dopamine from being oxidised
8
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
9
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
10
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
11
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
12
Q
Name some anticholinergic drugs that may be used in the treatment of Parkinson’s disease
A
Benzatropine, benzhexol, orphenadrine, procyclidine and trihexyphenidyl
13
Q
What is benzatropine?
A
Anticholinergic drug (muscarinic receptor antagonist) used in the treatment of PD
14
Q
What is benzhexol?
A
Anticholinergic drug (muscarinic receptor antagonist) used in the treatment of PD
15
Q
What is orphenadrine?
A
Anticholinergic drug (muscarinic receptor antagonist) used in the treatment of PD
16
Q
What is procyclidine?
A
Anticholinergic drug (muscarinic receptor antagonist) used in the treatment of PD
17
Q
What is trihexyphenidyl?
A
Anticholinergic drug (muscarinic receptor antagonist) used in the treatment of PD
18
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
19
Q
What is tetrabenazine?
A
This is a drug used in the treatment of Huntington’s disease which inhibits synaptic vesicle monoamine transporter
20
Q
What are the monoamine neurotransmitters?
A
Dopamine, serotonin, norepinephrine, and histamine
21
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
22
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
23
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
24
Q
What are olanzapine and haloperidol?
A
They are antipsychotic drugs
25
How may olanzapine and haloperidol be used in the treatment of Huntington's disease?
They are antipsychotic drugs which are dopamine receptor antagonists and therefore prevent the action of this excitatory neurotransmitter
26
What are imipramine and amitriptyline?
Antidepressants
27
Which antidepressants may be used in the treatment of Huntington's disease?
Imipramine and amitriptyline
28
What is the function of paracetamol?
It's an analgesic, antipyretic with a small anti-inflammatory effect
29
What's the official name for paracetamol?
Acetaminophen
30
What is the mechanism of action of paracetamol?
COX-2 inhibition (prevents prostaglandin production) and modulates the endocannibinoid system
31
Name three examples of NSAIDs
Aspirin, ibuprofen and diclofenac
32
What is aspirin?
A form of NSAID
33
What is the function of aspirin?
It's a analgesic, antipyretic and anti-inflammatory drug with slight anti-platelet activity (hence why it is given in suspected MI)
34
What is the mechanism of action of aspirin?
COX-1 and COX-2 inhibitor
35
What is ibuprofen?
A form of NSAID
36
What is the function of ibuprofen?
Has analgesic and anti-inflammatory functions
37
What is the mechanism of action of ibuprofen?
COX-1 and COX-2 inhibitor
38
What is diclofenac?
An NSAID
39
What is the function of diclofenac?
It's an analgesic and anti-inflammatory drug
40
What is the mechanism of action of diclofenac?
It's a COX-1 and COX-2 inhibitor
41
What is the mechanism of action of amitriptyline?
It inhibits amine reuptake and also blocks sodium and calcium channels
42
What is morphine?
Morphine is an opioid drug used to treat pain, it's a TYPICAL opioid drug
43
What is the function of morphine?
It decreases the excitability of neurones and reduces the release of neurotransmitters
44
What is the mechanism of action of morphine?
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
45
What is the active metabolite of morphine?
M6G (morphine-6-glucuronide)
46
What is tramadol?
An ATYPICAL opioid drug that is an agonist at Mu receptors in the CNS but also prevents the reuptake or serotonin and noradrenaline
47
What are carbamazepine and sodium valproate often used to treat?
Epilepsy as they are anticonvulsants, but they can also be used in the treatment of certain types of pain e.g. neuropathic pain
48
What types of drug may be used to treat neuropathic pain?
Anticonvulsants (e.g. carbamazepine/sodium valproate/pregabalin) or antidepressants (e.g. amitriptyline)
49
What is the mechanism of action of carbamazepine and sodium valproate?
Bind to sodium channels to prevent them from opening (reducing depolarisation)
50
What is pregabalin and gabapentin?
These are anticonvulsant drugs that act on alpha-2-delta subunit of calcium channels to prevent opening of the channel
51
Name three local anaesthetics
Lignocaine, bupivacaine, prilocaine
52
What is the suffix associated with local anaesthetics?
-caine
53
What is the mechanism of action of local anaesthetics (e.g. Lignocaine, bupivacaine, prilocaine)
Blocks sodium ion channels
54
What are the potential side effects of local anaesthetic?
There is always a risk of systemic toxicity such as hypotension, respiratory depression and bradycardia
55
Give some examples of inhaled general anaesthetics
halothane, enflurane, isoflurane, NO, xenon
56
Give some examples of intravenous general anaesthetics
propofol, thiopental, etomidate, ketamine
57
What is the mechanism of action of general anaesthetics?
They either activate inhibitory receptors (e.g. GABA receptors) or inactivate excitatory receptors (e.g. glutamate receptors)
58
What is a potential side effect of general anaesthesia?
Cardiovascular depression may be induced which is a fatal complication
59
What are the two main drugs used in the treatment of headache and migraine?
Sumatriptan and methysergide
60
What is the main drug(s) used in the treatment of absence seizures?
Sodium valproate OR ethosuximide (T-type calcium channel blocker)
61
What is sumatriptan?
This is a 5HT1bd agonist that is used in the treatment of migraine and cluster headaches
62
What is sumatriptan used for?
Migraine pain and cluster headaches
63
What is the mechanism of action of sumatriptan?
Is a 5HT1bd agonist which leads to vasoconstriction of the smooth muscle --> prevents release of neuropeptides from the nerve endings which cause headache
64
What is methysergide?
This is a 5HT1bd agonist that is used in the treatment cluster headaches
65
What is methysergide used for?
Cluster headache treatment
66
What is the mechanism of action of methysergide?
Is a 5HT1bd agonist which leads to vasoconstriction of the smooth muscle --> prevents release of neuropeptides from the nerve endings which cause headache
67
What are the various drug targets in the treatment of epilepsy?
Sodium channels, GABA channels, calcium channels, neurotransmitter release and presence
68
Which drugs have zero order kinetics?
```
Phenytoin, Phenylbutazone
Warfarin
Heparin
Ethanol
Aspirin & other salicylates
Theophylline, Tolbutamide
Salicylates
```
69
What is phenytoin?
This is an anticonvulsant drug that acts on sodium channels to prevent depolarisation (antagonist); this drug illustrates zero order kinetics
70
What is carbamazepine
This is an anticonvulsant drug that acts on sodium channels to prevent depolarisation (antagonist)
71
What is sodium valproate
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
72
What is lamotrigine?
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
73
What is topiramate?
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
74
What drug is used in the treatment of status epilepticus?
Intravenous diazepam
75
How may clonazepam be used in the treatment of epilepsy?
This is a benzodiazepine that works to positively modulate the GABAa receptor in order to create an inhibitory effect and cause sedation
76
How may phenobarbitone be used in the treatment of epilepsy?
This is a barbiturate that works to positively modulate the GABAa receptor in order to create an inhibitory effect and cause sedation
77
How may ethosuximide be used in the treatment of epilepsy?
This is a T-type calcium channel blocker than is used in the treatment of absence seizures
78
Outline how levetiracetam may be used in the treatment of epilepsy
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
79
Outline how tiagabine may be used in the treatment of epilepsy
This drug acts on the GAT1 (GABA transporter) to prevent the reuptake of GABA so that it continue to elicit it's inhibitory effects
80
Outline how viagabrin may be used in the treatment of epilepsy
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
81
What are beta interferons?
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
82
What is the function of beta-interferons?
To reduce immune cell proliferation in multiple sclerosis
83
What are the potential side-effects of beta-interferons?
Flu like symptoms and injection site reactions
84
What are glatiramer acetate and copaxone?
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
85
What is dimethyl fumarate?
It's a drug used in the treatment of MS that works by inhibiting proliferation of immune cells
86
What is the function of dimethyl fumarate?
It is an immune cell proliferation inhibitor that prevents further demyelination in multiple sclerosis
87
What are the potential side-effects of dimethyl fumarate?
Hot flushes, GI problems and infections
88
What is alemtuzumab?
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
89
What is the function of alemtuzumab?
To reduce inflammation by binding to mature lymphocytes (via CD52) and therefore treating the inflammation of MS
90
What are the potential side effects of alemtuzumab use?
Infection, idiopathic thrombocytopenia purport, secondary autoimmunity (thyroid disease)
91
What is fingolimod?
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
92
What are the potential side-effects of using fingolimod?
Arrhythmias and infection
93
What is natalizumab?
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.
94
What drug, used in the treatment of multiple sclerosis, may lead to progressive multifocal leukoencephalopathy (PML)?
Natalizumab
95
What are the two main types of drugs used in the treatment of Alzheimer's disease?
Cholinesterase inhibitors (to increase ACh levels in the brain) and NMDA receptor antagonists (to reduce excitotoxicity)
96
Name three cholinesterase inhibitors that are used in the treatment of Alzheimer's disease
Donepezil, rivastigmine, galantamine
97
What is the function of donepezil?
Cholinesterase inhibitor used in the treatment of Alzheimer's disease to increase ACh levels in the brain
98
What is the function of rivastigmine?
Cholinesterase inhibitor used in the treatment of Alzheimer's disease to increase ACh levels in the brain
99
What is the function of galantamine?
Cholinesterase inhibitor used in the treatment of Alzheimer's disease to increase ACh levels in the brain
100
What is memantine?
It's an NMDA (glutamate) receptor antagonist which works to reduce the excitotoxicity seen in those with Alzheimer's disease
101
Name four typical antipsychotic drugs
Chlorprozamine, haloperidol, flupenthixol, fluphenazine
102
What is the key difference between typical and atypical antipsychotics/neuroleptics?
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.
103
What is haloperidol?
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
104
What are the potential side effects of typical antipsychotics?
Extra-pyramidal effects, tarditive dyskinesia, hyperprolactinaemia (galactorrhoea, amenorrhoea)
105
Name 4 atypical antipsychotics
Risperidone, olanzapine, clozapine, palperidone
106
What condition are antipsychotics usually prescribed for?
Schizophrenia
107
What is clozapine?
It's an atypical antipsychotic used in the treatment of schizophrenia that has additional specificity to D4 receptors
108
What is the mechanism of action of clozapine?
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
109
When may clozapine be prescribed in the treatment of schizophrenia?
It's the preferable treatment for drug-resistant schizophrenia
110
What is a characteristic side-effect of clozapine drug use?
Agranulocytosis
111
What are the potential side effects of atypical antipsychotics?
Weight gain, dyslipidaemia, type 2 diabetes
112
What are the potential side effects of atypical antipsychotics?
Weight gain, dyslipidaemia, type 2 diabetes
113
Which two drugs, used in the treatment of schizophrenia, may be administered via depo injection?
Haloperidol and fluphenazine (typical antipsychotics); this is done if there is lack of compliance to prescribed medications
114
Name three treatments for bipolar disorder
Lithium, sodium valproate and carbamazepine
115
Give some of the potential side-effects of lithium treatment for bipolar disorder
Thirst, nausea, fine tremor, polyuria, weight gain, oedema, acne
116
What kinds of drugs may be given to treat depression?
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)
117
Name 3 tricyclic antidepressants
Imipramine, amitriptyline, clomipramine
118
What is amitriptyline?
A form of tricyclic antidepressant
119
Outline the mechanism of action of tricyclic antidepressants
Inhibit amine reuptake and has an affinity for H1, M3, a1 and a2 receptors
120
What are the potential side effects of TCA use?
Dry mouth, blurred vision, constipation, weight gain, postural hypotension
121
Name three monoamine oxidase inhibitors?
Phenelzine, iproniazid, tranylcypromine
122
Outline the mechanism of action of the monoamine oxidase inhibitors used in the treatment of depression.
These are irreversible non-selective inhibitors which are useful in the treatment of atypical depression
123
Which kind of drugs are most likely to be used in the treatment of atypical depression?
Irreversible monoamine oxidase inhibitors
124
What is meant by the 'cheese reaction' in the context of irreversible monoamine oxidase inhibitors?
The body will react with tyramine containing foods such as cheese
125
What is moclobemide?
An example of a reversible monoamine oxidase inhibitor, commonly used in the treatment of depression
126
How do reversible MAOIs such as moclobemide differ from irreversible MAOIs such as phenelzine?
Reversible MAOIs have an increased selectivity for MAOa and are safer
127
What are the potential side effects of moclobemide use?
Nausea, agitation and confusion
128
Name three SSRIs
Fluoxetine, paroxetine and citalopram
129
What is fluoxetine?
An SSRI, often used in the treatment of depression
130
What is citalopram?
An SSRI, often used in the treatment of depression
131
What are some of the advantages of using SSRIs in the treatment of depression?
There is no anticholinergic activity, there are no cardiotoxic effects and it's safe in overdose
132
What are the potential side effects of SSRI use?
Nausea, headaches, GI irritation, anxiety and loss of limbido
133
What is venfaxine?
A form of serotonin noradrenaline reuptake inhibitor that may be used in the treatment of depression
134
Give an example of an SNRI
Venfaxine
135
How do SNRIs compare to SSRIs?
SNRIs have more cardiovascular side effects than SSRIs
136
What is reboxetine?
This is a noradrenaline reuptake inhibitor that is involved in the treatment of depression
137
Name a noradrenaline reuptake inhibitor that is used in the treatment of depression
Reboxetine
138
What is mirtazepine?
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
139
Give an example of a NaSSA, used in the treatment of depression
Mirtazepine
140
What is trazodone?
A serotonin antagonist and reuptake inhibitor (SARI) that mainly acts on 5-HT2 receptors
141
Name one SARI (serotonin antagonist reuptake inhibitor) used in the treatment of depression
Trazodone
142
Which types of drugs may be used in the treatment of anxiety?
Buspirone/ipsapirone, benzodiazepines, SSRIs, barbiturates and beta blockers
143
What is buspirone?
A partial 5-HT1a agonist used in the treatment of anxiety
144
What is ipsapirone?
A partial 5-HT1a agonist used in the treatment of anxiety
145
Name three benzodiazepines
Diazepam, clonazepam and alprazolam
146
Explain the mechanism of action of benzodiazepines
Drugs such as diazepam, clonazepam and alprazolam potentiate GABA-induced hyper polarisation by increasing the opening frequency of channels
147
What conditions are benzodiazepines commonly prescribed for?
Epilepsy (status epilepticus), anxiety and insomnia
148
Name a barbiturate drug
Phenobarbitone
149
Outline the mechanism of barbiturates e.g. phenobarbitone
Potentiates GABA induced hyperpolarisation by increasing opening duration of channels
150
Why are barbiturates such as phenobarbitone rarely used in treatment nowadays?
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
151
Name a beta blocker that may be prescribed to combat anxiety
Propanolol
152
Name two benzodiazepines that may be used in the treatment of insomnia
Lorazepam and temazepam
153
Name two Z drugs
Zolpidem and eszopiclone
154
What drugs may be used in the treatment of insomnia?
Benzodiazepines, Z drugs and pregabalin (anticonvulsant)
155
Outline the mechanism of action of Z drugs in the treatment of insomnia
Bind to the alpha subunit of GABAa and induce hyperpolarisation
156
What drug is likely to be given in short-term insomnia?
Benzodiazepine
157
What drug is likely to be given in a long-term/chronic insomnia?
Z drugs such as zoo-idem or eszopiclone
158
Name two drugs which can be used as anti-emetics
Domperidone and ondanetron
159
What is domperidone?
This is a peripherally active D2 receptor antagonist that is used in the treatment of emesis
160
What is ondanetron?
This is a 5-HT3 receptor antagonist that is used in the treatment of emesis
161
Which drug may be given to aid alcohol withdrawal in addiction?
Disulfaram; this is an aldehyde dehydrogenase inhibitor which aids in the maintenance of alcohol abstinence as it cannot be cleared
162
Which drug may be given to aid in smoking cessation in addiction?
Bupropion; this is a monoamine reuptake inhibitor
163
Name four drugs involved in relieving and aiding opioid addiction
Naltrexone, naloxone, methadone and clonidine
164
What is naltrexone?
An opioid antagonist that helps prevent relapse in individuals that are giving up opiates such as heroine
165
What is naloxone?
This drug blocks Mu opioid receptors and therefore combats the effects of an opioid overdose if this event occurs
166
What is methadone
A form of opioid that may be given to heroine addicts in order to wean them off of the drug progressively
167
What is clonidine?
It is an alpha-2-agonist in the body which helps to reduce the withdrawal symptoms from opiate use cessation
