Drug classes Flashcards
Gaviscon
Antacid - buffers stomach acid
H2 antagonist
Ranitidine - reduces gastric acid secretion
Proton pump inhibitors
Omeprazole, Lansoprazole, Pantoprazole - reduce gastric acid secretion
Loperamide
Anti-diahorreal - slows transit of the bowel contents & increases anal sphincter tone
Senna
Laxative - stimulates peristalsis
Mesalazine, Sulfasalazine
Aminosalicylates - anti-inflammatory & immunosuppressive effects on the bowel
Anti-emetics
Metoclopramide, Domperidone - D2 receptor antagonists in the chemoreceptor trigger zone - promote gastric emptying
Loop diuretics
Furosemide, Bumetanide, Torasemide - 1) Inhibit reabsorption from the ascending loop of Henle + 2) Dilate capacitance veins
Thiazide diuretics
Bendroflumethiazide - prevent sodium & water reabsorption at the early distal convoluted tubule
Potassium-sparing diuretics
Spironalactone - potentiates thiazide or loop diuretics by antagonising sodium & water absorption in the late distal tube
Beta blockers (B1 selective)
Atenolol, Bisoprolol, Metoprolol - 1) Reduce the force of contraction & speed of conduction of the heart to reduce cardiac work & oxygen demand + 2) Reduce renin secretion from the kidney
Beta blockers (non-selective)
Propanolol - B2 antagonism lowers peripheral resistance via vasodilation
Calcium channel blockers (vascular selective)
Amlodipine, Nifedipine - relax & vasodilate arterial smooth muscles to reduce arterial pressure by decreasing calcium entry & therefore reducing intracellular calcium concentration
Calcium channel blocker (cardiac selective)
Verapamil - reduces myocardial contractility & ventricular rate by suppressing cardiac conduction across the AV node - this reduces afterload & therefore reduces myocardial oxygen demand
Calcium channel blocker (mixed)
Diltiazem - reduces areterial pressure + reduces myocardial contractility & ventricular rate
ACE inhibitors
Ramipril, Lisinopril, Perindopril - 1) Reduce peripheral vascular resistance (afterload) + 2) Reduce aldosterone levels to promote sodium & water excretion
Angiotensin-1 receptor blockers
Losartan, Candesartan, Irbesartan - 1) Reduce peripheral vascular resistance (afterload) + 2) Reduce aldosterone levels to promote sodium & water excretion
Nitrate (short-acting)
GTN (glycerol trinitrate) - reduces cardiac work & myocardial oxygen demand by relaxing venous capacitance vessels to reduce preload & LV filling
Nitrate (long-acting)
ISMN (isosorbide mononitrate) - reduces cardiac work & myocardial oxygen demand by relaxing venous capacitance vessels to reduce preload & LV filling
Digoxin
Cardiac glycoside - 1) Negatively chronotropic (reduces heart rate) + 2) Positively ionotropic (increases force of contraction)
Amiodarone
Anti-dysrhythmics - 1) Suppress spontaneous depolarisation + 2) Slow conduction velocity + 3) Increase resistance to depolarisation in the AV node
Anti-platelet agent
Aspirin - reduces platelet aggregation and risk of arterial occlusion by irreversibly inhibiting COX
Clopidogrel
Anti-platelets - prevent platelet aggregation and reduce risk of arterial occlusion by binding irreversibly to ADP receptors on the surface of platelets
Heparins
Enoxaparin, Dalteparin, Fondaparinux, Unfractionated heparin - prevent the formation & propagation of blood clots by inhibiting thrombin & factor Xa
Oral anticoagulant
Warfarin - inhibits hepatic production of vitamin K-dependent coagulation factors & cofactors by inhibiting vitamin K epoxide reductase
Novel anticoagulant
Rivaroxaban - direct inhibition of activated factor X (factor Xa)
Statins
Simvastatin, Atorvastatin, Pravastatin, Rosuvastatin - reduce serum cholesterol levels by inhibiting HMG CoA reductase
B2 agonists (short-acting)
Salbutamol, Terbutaline - relax smooth muscle of the bronchi to improve airflow
B2 agonists (long-acting)
Salmeterol, Formoterol - relax smooth muscle of the bronchi to improve airflow
What electrolyte imbalance can B2-agonists be used as an adjuvant for?
Hyperkalaemia - stimulate Na+/K+-ATPase pumps on cell surface membranes, causing a shift of extracellular K+ to the intracellular component
Ipratropium
Short-acting anticholinergic - reduces smooth muscle tone & secretions from the respiratory tract
Tiotropium
Long-acting anticholinergic - reduces smooth muscle tone & secretions from the respiratory tract
Corticosteroids
Prednisolone, Hydrocortisone, Dexamethasone, Beclometasone - modify the immune response by binding to cystolic glucocorticoid receptors that translocate to the nucleus & bind GC elements that regulate gene expresion
Carbocysteine
Mucolytics
Tricyclic antidepressant
Amitryptiline - inhibits neuronal reuptake or 5-HT & NA from the synapse (as well as many other receptors)
SSRIs
Citalopram, Sertraline, Fluoxetine - preferentially inhibit 5-HT uptake from the synapse
Benzodiazepines
Diazepam, Lorazepam, Midazolam, Temazepam, Chlordiazepoxide - facilitate & enhance binding of GABA to the GABA-A receptor
NSAIDs
Diclofenac, Ibuprofen, Naproxen, Etoricoxib - inhibit synthesis of prostaglandins from arachidonic acid by inhibiting cyclooxygenase - therapeutic benefits are principally mediated though COX-2
Strong opioids (immediate-release)
Morphine (Oramorph) - activate opioid receptors in the CNS to reduce neuronal excitability & pain transmission - 1) Blunt response to hypoxia & hypercapnoea to reduce breathlessness + 2) Relieve pain 3) Reduce cardiac work & oxygen demand
Strong opioids (slow-release)
Morphine (MST Continus) - activate opioid receptors in the CNS to reduce neuronal excitability & pain transmission - 1) Blunt response to hypoxia & hypercapnoea to reduce breathlessness + 2) Relieve pain 3) Reduce cardiac work & oxygen demand
Weak opioids
Codeine, Tramadol, Dihydrocodeine - metabolised in the liver to produce relatively small amounts of morphine & dihydromorphine that act on opioid receptors & reduce pain transmission
Tramadol (moderate strength) is a synthetic analogue of…
Codeine
How do penicillins work?
B-lactam ring causes bacterial cell swelling, lysis & death by inhibiting enzymes responsible for cross-linking peptidoglycans in bacterial cell walls
Broad spectrum penicillins (2 examples) - what makes them more broad than standard penicillins?
Amoxicillin - addition of an amino group to the side chain increases efficacy against aerobic Gram-negative bacteria
Co-amoxiclav - addition of clavulanic acid (B-lactamase inhibitor) further increases the spectrum to include B-lactamase producing bacteria)
What is Tazocin a combination of?
Piperacillin (penicillin side chain converted to a form of urea to increase spectrum to include Pseudomonas aeruginosa) + Tazobactam (B-lactamase inhibitor, meaning it is active against B-lactamase producing bacteria)
Penicillinase-resistant penicillin
Flucloxacillin
Cephalosporins
Cephradine, Cefotaxime - B-lactam ring inhibits enzymes responsible for cross-linking peptidoglycans in bacterial cell walls, causing bacterial cell swelling, lysis & death
Carbapenems
Meropenem, Ertapenem - B-lactam ring inhibits enzymes responsible for cross-linking peptidoglycans in bacterial cell walls, causing bacterial cell swelling, lysis & death
How does trimethoprim work?
Slows bacteria growth by inhibiting bacterial folate synthesis (bacteriostatic)
What is co-trimoxazole a combination of?
Trimethoprim + Sulfamethoxazole - sulfamethoxazole also inhibits bacterial folate synthesis but at a different step to trimethoprim, meaning that the combination makes a more complete inhibition of folate synthesis - therefore bactericidal
How does nitrofurantoin work?
Metabolised in bacterial cells by nitrofurantoin reductase, and its active metabolite damages bacterial DNA causing cell death (bactericidal)
Tetracycline
Doxycycline - inhibits bacterial cell growth - binds to the 30S subunit, which prevents binding of tRNA to mRNA, meaning the protein synthesis is inhibited
Aminoglycoside
Gentamicin - enters bacterial cells via an oxygen-dependent transport system, and binds irreversibly to the 30S subunit to inhibit protein synthesis - it is bactericidal but mechanism is not understood
Macrolides
Clarithromycin, Erythromycin, Azithromycin - inhibit protein synthesis by binding to the 50S subunit to block translocation, which inhibits elongation of the polypeptide chain
Quinolone
Ciprofloxacin - kills bacteria by inhibiting DNA synthesis
Metronidazole - active against aerobic or anaerobic bacteria?
Anaerobic + Protozoa - aerobic bacteria are unable to reduce metronidazole to its damaging free radical
How does metronidazole work?
Enters bacterial cell walls by passive diffusion where it is reduced to a nitroso free radical that binds to bacterial DNA & causes widespread damage, DNA degradation & cell death
Glycopeptide
Vancomycin - inhibits synthesis of the cell walls of Gram-positive bacteria by inhibiting growth & cross-linking of peptidoglycan chains - Gram-negative bacteria have a different cell wall (lipopolysaccharide)
Antithrombolytics/Antithrombotics can be divided into 2 classes
Anticoagulants - slow down clotting, thereby reducing fibrin formation and preventing clots from forming and growing
Antiplatelets - prevent platelets from clumping and also prevent clots from forming and growing
Sinemet is a combination of
Levodopa (precursor of DA that can cross the BBB) + Carbidopa (peripheral dopa-decarboxylase inhibitor)
Madopar is a combination of
Levodopa (precursor of DA that can cross the BBB) + Benserizide (peripheral dopa-decarboxylase inhibitor)
Why is dopamine itself not given to treat PD?
It cannot cross the BBB, so levodopa is given instead (which is a DA precursor)
Ropinrole and Pramipexol
DA agonists - relatively selective for the D2 receptor in the striatum
Phenytoin
Anti-convulsant that inhibits spread of seizure activity by binding to inactive sodium channels and therefore preventing sodium influx into the neuron. This prevents action potential from being fired.
Sodium valproate
Anti-convulsant that inhibits spread of seizure activity by binding to inactive sodium channels and therefore preventing sodium influx into the neuron. This prevents action potential from being fired.
It also increases the brain content of GABA (principal inhibitory neurotransmitter)
Carbamazepine
Anti-convulsant that inhibits spread of seizure activity by binding to inactive sodium channels and therefore preventing sodium influx into the neuron. This prevents action potential from being fired.
Paracetamol
Non-opioid pain killer - reduces the pain threshold in the CNS by weakly inhibiting COX-2
Allopurinol
Xanthine oxidase inhibitor to lower plasma uric acid concentrations and reduce precipitation of uric acid in the joints & kidneys
(Xanthine oxidase metabolises xanthine, which is produced from purines, to uric acid)
Cetirizine
Antihistamine for allergy
