Classify

Question 1

Local anaesthetics

Answer 1

Amides and esters

Amide:
Lignocaine
Bupivacaine
Prilocaine
Ropivicaine

Ester:
Amethocaine (tetracaine)
Procaine
Cocaine

Question 2

Opiods vs opiate

Answer 2

Opiate is all naturally occuring substances with morphine like properties
Opioid is a generic term that includes synthetic substances with an affinity for opiod receptors

Question 3

NSAIDs

Answer 3

Classified according to action on COX isoenzymes (1/2)

Non specific *aspirin, ibuprofen)

Prefernetial COX 2 (meloxicam)

COX 2 specific (parecoxib/celecoxib)

Question 4

Anti-arrhythmics

Answer 4

Vaughn Williams:

Class 1- sodium channel blockade
1a prolongs refractory period (procainamide)
1b shortens - lidocaine, phenytoin
1c has no effect (flecainide)

Class 2- B blockers (esmolol, bisoprolol)

Class 3- Potassium channel blockade (sotalol, amiodarone)

Class 4 - calcium channel blockers (diltiazem(

Question 5

Functional classification of antiarythmics

Answer 5

SVT- B blocker, verapamil, adenosine, digoxine
VT- lidocaine
SVT + VT- amiodarone, flecanide
Digoxin toxicity- phenytoin

Question 6

Anti-hypertensives

Answer 6

Mechanism

Vasodilator agents
ACE inhibition/ARBs
Calcium antagonists
Nitrates
K channel blockers

B blockers

Diuretics

Centrally acting drugs (clonidine, methyldopa)

Ganglion blockers (trimetaphan)

Question 7

ACEi

Answer 7

Prodrugs and active drugs

Prodrugs-enalopril, ramipril
Active- captopril, lisinopril

Question 8

Alpha Blockers

Answer 8

Non selective
A1 blockers
A2 blockers

Non selective (completely) labetolol
Non selective alpha- phentolamine, phenoxybenzamine
A1 blockers prazosin, doxazosin
A2- atipemazole (dexmed antidote)

Question 9

Beta Blockers

Answer 9

Cardioselective and non

Cardioselective (relatively B1)
BEAM
Bisoprolol
Esmolol
Atenolol
Metoprolol

Question 10

Inotropes

Answer 10

Agents that increase cardiac myocardial contractility

Catecholamines/sympathomimetcs- adr, NA, isoprenaline, dobutamine

PDE inhibitors
Selective (PDE3) -milrinone , enoximone
Non selective- aminophylline

Calcium channel sensitisers
Levosimendan

Question 11

Vasopressors

Answer 11

Sympathomimetics
- Catecholamines
- Non catecholamines

Directly acting vasopressors (vasopressin and analogues)

Question 12

CNS stimulants?

Answer 12

?Analeptic drugs (mainly used for action as respiratory stimulants)- Doxapram

Psychoanaleptics-
Amphetamines,
Methylxanthines- caffient

Sympathomimetics

Question 13

ANtiepileptics

Answer 13

Drugs enhancing GABA mediated inhibition
- Drugs that facilitate GABA (benzos, Barbituates)
- GABA agonists (acamprosate)
- Inhibit GABA tranaminase (normally breaks down GABA- valproate, vigabatrin)

Drugs that Inhibit/stabilise Na channels

Phenytoin, Lamotrigine, carbamazepine

Keppra- unknown, possibly prevents release of vesicles of NT

Question 14

Insulins

Answer 14

Long/short acting

Rapid- Lispro (humalog), novorapid (aspart)
Short- human soluble insulin, actrapid
Intermediate -isophane insulin (humlin I, insulatard)
Long- insulin detemir (levemir), Glargine (lantus)

Question 15

Oral hypoglycaemic

Answer 15

?NICE

Biguanides- metformin
Sulphonylureas (gliclazide)
SGLT2 inhibitors- canagliflozin, dapagliflozin
Gliptins (alogliptin)
DPP4 inhibitors (alogliptin)
Incretin mimetics/GLP1 analogues

Question 16

DIuretics

Answer 16

Site of action

PCT- CA inhibitiors acetazolomide
Loop diuretics- furosemide, bumetanide
DCT- thiazide diuretics, K+ sparing
CD- aldosterone antagonists

Question 17

Antiemetics

Answer 17

Receptor

5HT3 antagonists- Ondansetron, granisetron
D2 antagonist- metoclopramide, domperidone
Anti muscarinic- hyoscine
Antihistamine- cyclizine
NK1-aripeptritant

Mixed receptor-
Phenothiazines (prochlorperazine) -D2/h1, muscarininc
Dexamethasone (unknown)
Cannabinoids- CTZ

Question 18

Antimuscarinics

Answer 18

Competitively inhibit post synaptice mACH receptors

Natural-
atropine
Hyoscine (scopolamine)

Semisynthetic-
Ipratropium
Tiotropium

SYnthetic-
Vesicoselective- oxybutinin
Mydriatics- cyclopentate
Antisecretory- glycopyrollate
antiparkinsonian- procyclidine

Question 19

Antibiotics

Answer 19

Mechanism

Cell wall-
B lactams- penicillins, cephalosporins , carbapenems
Glycopeptides- vanc/teic

Protein synthesis
30s- gent, tetracyclines
50s - Macrolides, loncosamides

DNA synthesis
Ciprofloxacin, metronidazole, trimethoprim (antifolate)

Question 20

Uterus

Answer 20

Contraction triggered by- alpha 1 stimulation
Prostaglandin activation
Oxytocin

Inhibited by B2 stimulation

Drugs-
Oxytocin- synt
Ergot alkaloid (ergometrine)
Prostaglandin analgues (carboprost, misoprostol)
Adreno agonists- NA

Question 21

Tocolytics

Answer 21

B agonists (terbutaline, salbutamol)
CAlcium antahonists (nifedipine, mag)
GTN
VOlatiles
Atosiban (antagonise oxytocin)

Question 22

Anticoagulants?

Answer 22

Antiplatelets
Heparins (unfractionated + LMWH)
DOACs
Fibrinolytic system

Question 23

Oral anticoagulants

Answer 23

Warfarin
DOACS

Question 24

Antiplatelets

Answer 24

COX inhibitors (aspirin)
ADP antagonists (clopi, prasrugrel, ticagrelor)
Dipyrimadole (PDE inhibitor)
G2b3a inhibitors (tirofiban)