Common surgical drugs Flashcards
Lidocaine - state the following:
- Purpose
- Mechanism of action
Purpose:
- Local anaesthetic (local or regional anaesthesia)
Mechanism of action:
- Use-dependent block of voltage gated Na channels
- Preferentially binds to small, myelinated (afferent) nerves
- Therefore, results in block of nociceptive and sympathetic signals
Bupivacaine - state the following:
- Purpose
- Mechanism of action
Purpose:
- Local anaesthetic (longer acting, used for spinal blocks)
Mechanism of action:
- Use-dependent block of voltage gated Na channels
- Preferentially binds to small, myelinated (afferent) nerves
- Therefore, results in block of nociceptive and sympathetic signals
Codeine - state the following:
- Use
- Mechanism of action
- Adverse effects
- Warnings / contraindications
Use:
- Mild-moderate analgesia
- Cough depressant
Mechanism of action:
Moderate agonist
- Approx. 1/10th potency compared to morphine
Adverse effects:
- Respiratory Depression (worse in children)
- Constipation
- Nausea / vomiting
Warnings / contraindications:
- Manual labourers/drivers
- Elderly
- Bed-bound
- Asthmatics
- Biliary tract obstruction
- Respiratory Diseases
- Renal impairment
- Pregnancy
Morphine - state the following:
- Use
- Mechanism of action
- Adverse effects
- Warnings / contraindications
Use:
- Analgesia (and euphoria)
Mechanism of action:
Strong agonist
- Strong affinity to Mu receptor (complete activation)
Adverse effects:
- Respiratory Depression
- Emesis
- GI tract – constipation and nausea
- Cardiovascular
- Miosis
- Histamine release (asthmatics)
Warnings / contraindications:
- Manual labourers/Drivers
- Elderly
- Bed-bound
- Asthmatics
- Biliary tract obstruction
- Respiratory Diseases
- Renal impairment
- Pregnancy
Ibuprofen and Naproxen - state the following:
- Use
- Mechanism of action
- Adverse effects
- Warnings / contraindications
- Important drug reactions
Use:
- Ibuprofen is short acting, Naproxen is long acting
- Analgesic
- Anti-inflammatory
- Anti-pyrexic
Mechanism of action:
- Inhibition of COX enzyme (competes with arachidonic acid at hydrophobic site)
- COX-1 and COX-2 selective (in between)
Adverse effects:
GI effects:
- Dyspepsia, nausea, peptic ulceration, bleeding and perforation (decrease mucus and bicarbonate secretion and increase acid secretion)
- Exacerbation of existing inflammatory bowel disease
Renal effects:
- Reversible reduced GFR and renal blood flow
- Increased: Na, H2O and BP
Warnings / contraindications:
- Elderly
- Chronic use
- Alcohol
- History of peptic ulceration
- Presence of H pylori
- CKD
- HF
Important drug reactions:
- Aspirin
- Glucocorticoid steroids
- Anticoagulants
Senna - state the following:
- Use
- How does it work
Use:
- Laxative (stimulant) for constipation
- Generally used in the elderly where their GI motility may be poor and the cause of their constipation
How does it work:
- Increases intestinal motility
Fybogel - state the following:
- Use
- How does it work
Use:
- Laxative (bulk-forming) for constipation
- Aka medicinal fibre
How does it work:
- Increases the bulk of the faeces, which pushes on the walls of the gut, resulting in increased gut peristalsis
- Should consider checking the fibre intake of the individual first
Lactulose - state the following:
- Use
- How does it work
Use:
- Laxative (osmotic) for constipation
- Generally used for mild constipation (Movicol for more significant constipation)
How does it work:
- Increases the amount of water in the stool
- Lactulose specifically works by increasing the osmolarity of the gut contents and draws water in
Co-Amoxiclav (Augmentin) - state the following:
- What is it made up of
- Drug class
- Mechanism of action
- Uses
What is it made up of:
- Clavulanic acid and Amoxicillin
- Inhibit cell wall synthesis
- The clavulanic acid part inactivates the beta-lactamase enzymes, to increase efficacy of the amoxicillin (less is broken down)
Drug class:
- Penicillin
Mechanism of action:
- Bactericidal
- Inhibits cell wall synthesis
Uses:
- Pneumonia Meningitis
- UTI
- STI
- Skin / soft tissue infection
- Otitis media
Teicoplanin - state the following:
- Drug class
- Mechanism of action
- Uses
Drug class:
- Glycopeptide (similar to Vancomycin)
Mechanism of action:
- Inhibit cell wall synthesis
- Blocks addition of NAG-MAN-PEP repeats
Uses:
- C. diff (oral)
- Gram +ve organisms
Gentamicin - state the following:
- Drug class
- Mechanism of action
- Uses
- 2 main adverse effects
Drug class:
- Aminoglycoside
Mechanism of action:
- Binds to ribosomes (misreading of mRNA)
Uses:
- Gram -ve sepsis
2 main adverse effects:
- Ototoxicity
- Nephrotoxicity
Flucloxacillin - state the following:
- Drug class
- Mechanism of action
- Uses
Drug class:
- Penicillin
Mechanism of action:
- Bactericidal
- Inhibits cell wall synthesis
Uses:
- Pneumonia Meningitis
- UTI
- STI
- Skin / soft tissue infection
- Otitis media
Metronidazole - state the following:
- Uses
- What to avoid whilst having this antibiotic?
Uses:
- Anaerobic bacteria
- Protozoa
What to avoid whilst having this antibiotic:
- Alcohol!
Metoclopramide - state the following:
- Drug class
- Mechanism of action
- Uses
- Adverse effects
Drug class:
- D2 receptor antagonist
Mechanism of action:
- Antagonises D2 receptor
- Increases ACh muscarinic receptors in the gut
- Promotes gastric emptying and peristalsis
Uses:
- GORD
- Ileus
- Lactation in breastfeeding mothers
Adverse effects:
- Galactorrhoea
- Extrapyramidal effects
Cyclizine - state the following:
- Drug class
- Mechanism of action
- Uses
- Adverse effects
Drug class:
- H1 receptor antagonist
Mechanism of action:
- Antagonises H1 receptor
- Reduces the effects of histamine
- Overall, reduces stimulation of the CTZ and vomiting centres
Uses:
- Motion sickness
- Morning sickness
Adverse effects:
- Sedation
- Anti-muscarinic effects
- Long QT syndrome
Not good for small children and little old ladies
