Drug MoA

Question 1

Clopidogrel

Answer 1

P2Y12 inhibitor - prevents ADP binding and activating GPIIb and IIIa complex

Question 2

Aspirin

Answer 2

COX-1 inhibitor - inhibits TXA2 preventing thrombosis

Question 3

Apixaban, rivaroxaban

Answer 3

Direct Xa inhibitor. Prevents prothrombin conversion to thrombin. Thrombin catalyses fibrinogen to fibrin clot

Question 4

Dabigatran

Answer 4

Direct thrombin inhibitor. Thrombin catalyses fibrinogen to fibrin clot

Question 5

Fondaparinux, LMWH

Answer 5

Indirect Xa inhibitor

Question 6

Abciximab

Answer 6

GPIIb/IIIa inhibitor. Prevents platelet aggregation - binding of fibrinogen, vWf

Question 7

Trimethoprim

Answer 7

Dihydrofolate reductase inhibitor (prevents production of tetrahydrofolic acid). Essential in thymidine pathway inhibiting DNA synthesis

Question 8

Methotrexate

Answer 8

Competitively inhibits dihydrofolate reductase - DNA, RNA synthesis inhibited

Question 9

Sulfasalazine

Answer 9

Unclear - immunosuppressive, antibacterial, anti-inflammatory. Appears to inhibit the cystine-glutamate antiporter

Question 10

Lithium

Answer 10

Decrease NE release
Inhibit dopamine and /NMDA (glutamate)
Increase serotonin synthesis
Increase GABA (inhibitory neurotransmitter)

Question 11

Trazodone

Answer 11

blockade 5-HT2A receptor. Increasing dose antagonises H1 and Alpha-1-receptors

Question 12

Olanzapine

Answer 12

Combination of dopamine and 5-HT2 antagonism

Question 13

Donepezil, galantamine, rivastigmine

Answer 13

Cholinesterase Inhibitors - enhance cholinergic transmission

Question 14

Memantine

Answer 14

NMDA antagonist (reduce glutamate reducing destruction of brain cells)

Question 15

Cetirizine

Answer 15

metabolite of hydroxyzine

H1 inhibitor

Question 16

Cinacalcet

Answer 16

reduce PTH decreasing serum calcium

Question 17

Cinnarizine

Answer 17

inhibits contraction of vascular smooth muscle through blockade of L-type and T-type Ca channels.
D2, H1 and mACH receptors

Question 18

Ropinirole

Answer 18

non-ergot-derived dopamine receptor antagonist

parkinsons

Question 19

allopurinol

Answer 19

purine analogue. Xanthine oxidase inhibitor.
Reducing uric acid formation in gout
(also possibly purine synthesis)

Question 20

colchicine

Answer 20

binds to tubulins preventing microtubule formation.
Anti-mitotic.
In gout, binds to neutrophils preventing migration to uric acid crystals

Question 21

Sodium Valproate, lamotrigine, carrbamazepine

Answer 21

blocking voltage-dependent sodium-channel conductance. It has been found to inhibit depolarization of the glutaminergic presynaptic membrane, thus inhibiting release of glutamate

Question 22

ethosuximide

Answer 22

Bock LVA Ca channels

Question 23

phenobarbital

Answer 23

GABA increases flow of chloride ions into neuron decreasing excitability of post-synaptic neuron

Question 24

BZD

Answer 24

enhance GABA action

Question 25

mechanism of epileptic seizures

Answer 25

Excitatory effect inward Na and Ca currents | Inhibition effect inward Cl outward K and GABA

Question 26

Flecanide and class

Answer 26

Class IC Blocks sodium channel, slowing the upstroke of the cardiac action potential. The greatest effect is on the His-Purkinje system and ventricular myocardium.

Question 27

Amiodarone and class

Answer 27

``` class III Blocks potassium channel Prolongs phase 3 of the cardiac action potential, the repolarization phase where there is normally decreased calcium permeability and increased potassium permeability. ```

Question 28

lidocaine

Answer 28

``` class IB Slowing activation of action potential through Na channel ```

Question 29

Disopyramide

Answer 29

Increase sodium permeability of cardiac myocyte

Question 30

Where are pacemaker cells found

Answer 30

Sino-atrial node within wall of right atrium. | SA nodal pacemaker activity normally governs the rhythm of the atria and ventricles

Question 31

B-Blockers

Answer 31

1, cardiac B1 blockade - decrease HR, CF and CO 2. Suppress reflex tachycardia caused by vasodilators 3. B1 JGA blockade - decrease renin release - decrease RAAS mediated vasoconstriction 4. long term - decreased peripheral vascular resistance

Question 32

ACE

Answer 32

1. Block ACE preventing Angiotensin II which reduces afterload on heart 2. Reduces intra-glomerular pressure 3. Reduces aldosterone promoting Na and H20 excretion. Reduce preload - beneficial in HF.

Question 33

ARB

Answer 33

Block AT1 receptor (Ang II) 1. Inhibit ANS and kidney 2. Reduces CO and TPvR 3. Kidney TPvR and fluid volume

Question 34

Methylphenidate

Answer 34

Binds the DA transporter preventing the reuptake of DA

Question 35

Theophylline

Answer 35

Methylxanthine - PDE4 inhibitor Adenosine blocker histone deacetylase inhibitor

Question 36

LAMA SAMA

Answer 36

block muscarinic effects of acetylcholine action