Block 5 drug Flashcards
What are bisphosphonates ?
Bisphosponates are prescribed to help your bones stay as strong as possible.
Alendronic acid
Drug class: Bisphosphonate
Indication: if you are at risk of developing osteoporosis. or if you have osteoporosis
Mechanism: Aledronic acid is a potent inhibitor of bone resorption. It inhibits osteoclast proliferation and induces osteoclast apoptotic cell death
Contraindications: need to be over 18
Side effects:
- fever
- chills
- pain in the muscle or joints
- headache
How to take Aledronic acid ?
How often: take 1 tablet (everyday) or liquid once a week. First thing in the morning before you eat or drink. Stay sitting or standing for 30 minutes after taking medication so the medicine does not irritate the oesophagus.
The usual dose of alendronic acid for adults is 70mg taken once a week. There is also a 10mg tablet you take once a day.
Alendronic acid can be taken by most adults aged 18 and over. It’s sometimes prescribed for children with osteoporosis.
Do not give it to children under the age of 18 unless it’s prescribed by a doctor.
What is osteoporosis
Osteoporosis is a condition in which your bones get weaker and are more likely to break.
Osteoporosis can happen for many reasons, but you are more likely to get it if:
you’re a woman who has been through the menopause
you take steroids, such as prednisolone, every day for a long time (which means 3 months, or longer)
you’ve had a certain type of cancer treatment – some treatments can increase your risk of developing osteoporosis. Your oncology doctor or nurse will discuss this with you
Calciferol (vitamin D)
Drug class: Vitamin D
Indications: rickets , osteoporosis , hypoparathyroidism
Mechanism: binds to vitamin D receptors in the intestine to increase calcium and phosphate absorption
Contraindications:
sarcoidosis, decreased kidney function, high amount of calcium or phosphate in the blood.
Side effects:
HRT (hormone replacement therapy)
Drug class:
Indication: is used to relieve symptoms of menopause. It replaces hormones that are at a lower level as you reach menopause.
Example of HRT: Estradiol
Drug class: HRT , steroid ( synthetic estrogen)
Indication: used by women to help reduce the symptoms of menopause such as hot flashes and vaginal dryness.
Mechanism: binds to estrogen receptors
Contraindications:
- If you are at risk of any of the (side effects)
Side effects:
- Increase your risk of DVT
- Increase your risk of CVD
- Increase your risk of stroke
Raloxifene
Drug class: SERM (selective estrogen receptor modulator )
Indication:
- used for the prevention and treatment of osteoporosis in post menopausal women.
- used to reduce teh risk of breast cancer in post menopausal women
Mechanism:
- Is a selective estrogen receptor modulator that acts as both an estrogen agonist and antagonist via differential effects on the tissue-specific estrogen receptors.
Side effects:
- hot flashes ( more common in the first 6 months)
-leg cramps
- swelling of the hands, feet, ankles and lower legs
- flue like syndrome
- joint pain
- sweating
- difficulty falling asleep or staying asleep
Contraindications:
- any type of thrombosis
- PMH of DVT, pulmonary embolism, renal vein thrombosis …..
Codeine
Drug class: opiate
Indication: used to treat moderate to severe pain (less potent than morphine)
Mechanism: selective agonist of the mu opioid receptor
Contraindications:
- children less than 12 yrs old
- respiratory depression
- cannot use with Monoamine oxidase inhibitor
Side effects:
- constipation
- feeling sleepy
- confusion
- dry mouth
Oxycodone
Drug class: opioid
Indication: used in the management of moderate to severe pain
Mechanism: opioid agonist
Contraindications:
- respiratory depression
- GI obstruction
Side effects:
- constipation
- feeling or being sick
- sleepy
Lidocaine
Drug class: anesthetic
Indication: anesthetic of the amide group. Used for local anesthesia or regional anesthesia (injection )
Mechanism: amide type anesthetic. Acts on sodium channels on nerve cell membranes. Lidocaine cations keep sodium channels locked from the inside which prevents nerve depolarization. As a result, with sufficient blockage, the membrane of the postsynaptic neuron will ultimately not depolarize and will thus fail to transmit an action potential.
Contraindication:
- heart block
- liver problems
- glucose-6-phosphate dehydrogenase (G6PD) deficiency.
-methemoglobinemia, a type of blood disorder
Side effects :
- bruising, burning, swelling at application site
- blueish coloured lips, fingernails or palms
Tramadol
Drug class: centrally acting opiate agonist SNRI (serotonin/norepinephrine reuptake inhibitor)
Indication: used for the management of moderate to severe pain in adults.
Mechanism: Tramadol binds weakly to κ- and δ-opioid receptors and to the μ-opioid receptor with 6000-fold less affinity than morphine
Contraindications:
Side effects: feeling sleepy
dry mouth
Zopiclone
Drug class: nonbenzodiazepine
Indications: used to treat difficulty sleeping
Dopamine
Drug class: catecholamine neurotransmitter
Levodopa ( L- dopa) ( l-3,4-dihydroxyphenylalanine)
- Humans, as well as a portion of the other animals that utilize l-DOPA, make it via biosynthesis from the amino acid l-tyrosine
- Levodopa is a medication used most commonly in the treatment of Parkinson’s disease and other movement disorders (e.g. dopa-responsive dystonia).
- Its administered to patients with parkisons disease due to its ability to cross the blood brain barrier.
- Often used in combination with carbidopa. Levodopa can be metabolised to dopamine on either side of the blood-brain barrier and so it is generally administered with a dopa decarboxylase inhibitor like carbidopa to prevent metabolism until after it has crossed the blood-brain barrier
- Once past the blood-brain barrier, levodopa is metabolized to dopamine and supplements the low endogenous levels of dopamine to treat symptoms of Parkinson’s
What is Parkinsons disease ?
Parkinson’s disease is a condition that affects the brain. It causes problems like shaking and stiffness that get worse over time.
The main symptoms of Parkinson’s disease are shaking (tremors), slow movements and stiffness.
Treatments for Parkinson’s disease include therapies to help with movement problems, medicines and sometimes brain surgery.
Parkinson’s disease is caused by a loss of nerve cells in part of the brain. It’s not clear exactly why this happens.
- Peripheral side effects are reduced by the co-administration of a peripheral dopa decarboxylase inhibitor, such as carbidopa.
With time, and as the underlying disease progresses, levodopa may become a less effective and patients may report end-of-dose effects, where motor activity progressively declines as the previous dose wears off, and on-off phenomena, which manifest as seemingly random fluctuations in drug effect.
One of the most disabling side effects are the drug-induced dyskinesias, writhing and uncoordinated movements of the limbs associated with poorly organised dopaminergic control of motor activity.
It typically takes 2-5 years to develop complete loss of response.
Levodopa
Drug class: dopamine precursor
Indication: management of Parkinson’s disease. Tablet.
Mechanism: Levodopa by various routes crosses the blood brain barrier, is decarboxylated to form dopamine
Contraindications: should not be used if you are taking monoamine oxidase inhibitors (MAOIs) because it can lead to a hypertensive crisis. There should be a 14-day washout period when switching from levodopa to an MAOI or vice versa
Side effects: Hypotension
Restlessness
Gastrointestinal upset
In rare cases, dopamine excess can result in psychiatric reactions including acute psychosis.
