Drugs Flashcards
1
Q
What class of drug is Alendronate/ Alendronic acid?
A
Biphosphonate
2
Q
What diseases are treated with Alendronate/ Alendronic acid?
A
- Osteoporosis (1st line)
- Breast cancer (Reduces risk of fracture due to osteoporosis).
3
Q
What is the mechanism of action for alendronate/ alendronic acid?
A
- Attachment to hydroxyapatite binding sites on bony surfaces, leading to inhibition of osteoclastic bone resorption.
4
Q
What are the side effects of alendronate/ alendronic acid?
A
- Atypical femoral fractures
- Osteonecrosis of the jaw
- Oesophageal issues (ulcers oesophagitis etc.)
- Other generic side effects (GI symptoms, headaches, dysphagia).
5
Q
What are the contraindications of alendronate/ alendronic acid?
A
- Oesophageal abnormalities
- Hypocalcaemia
- Reduced GI motility
- Pregnancy
- Kidney disease/failure
6
Q
What are the interactions of alendronate/ alendronic acid?
A
- Interacts with a huge amount of drugs. Prescribe with care.
7
Q
What class of drug is Amlodipine?
A
Calcium channel blocker
8
Q
What disease(s) is amlodipine used to treat?
A
- STABLE angina
- Hypertension (1st line)
- NOT unstable angina or HF, as could further suppress cardiac function and exacerbate symptoms.
9
Q
What is the mechanism of action for amlodipine?
A
CCB.
Inhibits the movement of calcium ions into cells. This causes:
- Vascular smooth muscle relaxation (vascular dilation)
- Decreased myocardial force.
- Decreased heart rate.
- Decreased conduction velocity in the heart.
10
Q
What are the potential side effects of amlodipine?
A
- Abdominal pain
- Palpations/tachycardia
- Vomiting/headache
- Hypotension and associated oedema.
11
Q
What are the contraindications of amlodipine?
A
- Cardiogenic shock
- UNSTABLE angina
- Significant aortic stenosis
- Persistent postural hypotension.
12
Q
What notable drug(s) will potentially interact with amlodipine?
A
- Magnesium. Amlodipine and magnesium should not be prescribed together.
13
Q
What class of drug is atenolol?
A
- Beta-blocker
14
Q
What disease(s) are treated with atenolol?
A
- Hypertension
- Angina
- Arrhythmia
- Migraine prophylaxis
- Myocardial infarction (MI)
15
Q
What is the mechanism of action of atenolol?
A
- Blocks effect if hormone epinephrine (adrenaline).
- This decreases sympathetic activity, and lowers blood pressure, force of heart contractions, and helps to rectify abnormal heart rhythms.
16
Q
What are the side effects of atenolol?
A
- Tummy ache
- Brachycardia and associated peripheral vascular disease.
- Syncope
- Heart failure
- Erectile dysfunction
- Generic side effects (diarrhoea, dizziness, dyspnoea etc.)
17
Q
What are the contraindications of atenolol?
A
- Asthma
- Hypotension
- Brachycardia
- Metabolic acidosis
- AV Block (2nd and 3rd degree).
- Uncontrolled HF.
18
Q
What does atenolol interact with?
A
- Adrenaline/norepinephrine. This would increase the risk of hypertension (unopposed vasoconstriction) and brachycardia.
19
Q
What class of drug is atracurium?
A
- Non-depolarising neuromuscular blocking drug.
20
Q
What is atracurium used for?
A
- Used alongside general anaesthesia during surgery.
- Used to facilitate mechanical ventilation in ICU.
21
Q
What is the mechanism of action of antracurium?
A
- Antracurium antagonises the neurotransmitter action of ACh by binding to the ACh receptors at the NMJ.
22
Q
What are the side effects of atracurium?
A
- Flushing/hypotension
- Bronchospasm
- Tachycardia and cardiac arrest (rare).
23
Q
What are the contraindications of atracurium?
A
- No direct contraindications.
- Be careful prescribing to patients with neuromuscular disorders.
24
Q
What does atracurium interact with?
A
- Steroids. These decrease the effect of non-depolarising neuromuscular blocking drugs.
- Clindamycin. Increases the effect of NDNMB drugs.
25
What class of drug is bendroflumethiazide?
Thiazide diuretic.
26
What diseases are treated with bendroflumethiazide?
- Oedema
| - Hypertension
27
What is the mechanism of action for bendroflumethiazide?
- Thiazide diuretic.
- Inhibits NaCl Co-transporters in the distal convoluted tubules of the nephron.
- This inhibits Na+ and Cl- reabsorption.
- Salt and water excretion is promoted.
28
What are the side effects of bendroflumethiazide?
- Metabolic alkalosis (due to disruption to electrolyte levels)
- Constipation or diarrhoea
- Dry mouth
- Electrolyte imbalances
- Erectile dysfunction
- Electrolyte imbalance
- Hyperglycaemia/uricaemia/calcaemia.
- Hypokalaemia.
29
What are the contraindications of bendroflumethiazides?
- Addison's disease (primary hypoadrenalism) as they would risk dropping BP too low.
- Hypercalcaemia
- Hyponatraemia
- Metabolic alkalosis
- Hyperuricaemia (TD's raise serum uric acid levels).
30
What does bendroflumethiazide interact with?
- Lots of things. Highly interactive - prescribe with caution.
31
What class of drug is cefuroxime?
A cephalosporin (broad spectrum antibiotic)
32
What diseases is cefuroxime used to treat?
- Infections of: soft tissues, respiratory tract, urinary tract, genital tract and the CNS.
- Can also be used anaphylactically.
- Second line for pneumonia.
33
What is the mechanism of action of cefuroxime?
- Broad spectrum antimicrobial.
- Inhibits cell wall synthesis.
- Antimicrobial activity against many types of bacteria.
34
What are the side effects of cefuroxime?
- No serious ones.
| - Typical ones some people may have to any medication (abdominal pain, diarrhoea, headache etc.).
35
What are the contraindications of cefuroxime?
- None. Very safe drug.
36
What does cefuroxime interact with?
- No interactions severe enough to be noted.
37
What class of drug is celecoxib?
- COX-2 inhibitor.
38
What is celecoxib used to treat?
- Ankylosing spondylitis
| - Sometimes osteo/rheumatoid arthritis (less common).
39
What is the mechanism of action of celecoxib?
- Selective inhibition of COX-2 (meaning not acting on COX-1), reducing prostaglandin synthesis.
- Prostaglandins are a key part of the pain and inflammatory pathway.
- Therefore, celecoxib has analgesic and anti-inflammatory effects.
40
How is celecoxib NOT as likely to cause peptic ulcers as aspirin or ibuprofen are?
- These older NSAIDS inhibit COX enzymes much like celecoxib does. However, they do not SELECTIVELY inhibit only COX-2.
- Older NSAIDs inhibit both COX-1 and COX-2.
- COX-1 is the enzyme primarily responsible for prostaglandin secretion in the GI tract, so suppression of this means less prostaglandins are secreted into the mucosa of the GI.
- As a result, the stomach/duodenum is less protected from the stomach acid, and peptic ulcers are more likely to form.
- Celecoxib ONLY INHIBITS COX-2 ENZYMES, leaving prostaglandin secretion in the gastric mucosa largely unaltered.
41
What are the side effects of celecoxib?
- Angina/ MI
- BPH
- GI disorders (less common than with non-selective NSAIDS.)
- Increased risk of infection (due to inflammatory suppression).
- Oedema
- Weight increase
- Potentially impaired renal function
42
What are the contraindications of celecoxib?
- Previous evidence of NSAID hypersensitivity (aspirin, ibuprofen etc.)
- Sulfonamide sensitivity (because celecoxib contains a sulfonamide group).
- Renal impairment (creatinine clearance of less than 30mL per min).
43
What does celecoxib interact with?
When prescribed with other NSAIDS, may increase risk of peptic ulceration and subsequent perforation/bleeding.
44
What class of drug is chloramphenicol?
Broad-spectrum antibiotic.
45
What diseases can chloramphenicol be used to treat?
- Otitis externa (ear infection).
- Superficial eye infection
- Life-threatening infections (esp. if caused by Haemophilus influenza).
46
What is the mechanism of action of chloramphenicol?
- Inhibits proteins from forming within bacteria.
| - This kills bacteria (antibiotic).
47
What are the side effects of chloramphenicol?
- Allergy (this is very rare)
48
What are the contraindications for chloramphenicol?
- Acute porphyrias (this is a rare genetic disorder).
49
What does chloramphenicol interact with?
- Some diabetic medications.
| - Not much else.
50
What class of drug is ciclosporin?
Immunosuppressant
51
What is ciclosporin used for?
- Severe ulcerative colitis (2nd line after corticosteroids)
- Severe psoriasis/atopic dermatitis
- Organ transplantation.
52
What is the mechanism of action for ciclosporin?
- Inhibits the production and release of lymphokines.
| - Results in the suppression of cell-mediated immune response.
53
What are the potential side effects of ciclosporin?
- Appetite decrease/ diarrhoea/ GI discomfort.
- Electrolyte imbalances
- Peptic ulcer
- Fatigue/fever/vomiting
54
What are the contraindications for ciclosporin?
- Malignancy
- Uncontrolled hypertension
- Uncontrolled infections
- Active ocular/peri-ocular infection (when administered by eye).
55
What does ciclosporin interact with?
- Many other drugs due to immunosuppressive nature.
| - PRESCRIBE WITH CAUTION.
56
What class of drug is ciprofloxacin?
Broad-spectrum antibiotic.
57
What diseases can be treated with ciprofloxacin?
Wide range of infections. For example:
- Crohn's disease
- Diverticulitis
- Eye infection
- Gonorrhoea (if bacteria causing it are sensitive)
58
What is the mechanism of action for ciprofloxacin?
- Inhibits DNA replication of bacteria.
| - Prevents bacterial growth/replication.
59
What are the potential side effects of ciprofloxacin?
- Various allergic responses
- QT prolongation (a longer interval between heart beats).
- GI symptoms (sickness, pain etc.)
60
What are the contraindications for ciprofloxacin?
- History of tendon disorders related to use of quinolone antibiotics.
(ciprofloxacin is a type of quinolone antibiotic).
61
What does ciprofloxacin interact with?
- NSAIDS. These will increase the risk of seizure.
62
What class of drug is co-amoxiclav?
- A combination antibiotic (Amoxicillin + clavulanic acid)
63
What is co-amoxiclav used to treat?
- Acute diverticulitis.
| - Infections due to beta-lactamase-producing bacterial strains.
64
What is the mechanism of action for co-amoxiclav?
- The penicillin component interferes with bacterial wall synthesis.
- The clavulanic acid component acts as a B-lactamase inhibitor, allowing amoxicillin to work on bacterial strains that would otherwise be resistant.
65
What are the side affects of co-amoxiclav?
- Diarrhoea (Especially likely as amoxicillin is a broad-spectrum penicillin)
- Increased risk of infection in future (Co-amoxiclav-resistant E. Coli UTIs for example)
66
What are the contraindications to co-amoxiclav?
- Previous evidence of hypersensitivity to ANY penicillin (risk of anaphylaxis).
- In this case, a different B-lactam antibiotic such as a cephalosporin should be provided instead.
67
What does co-amoxiclav interact with?
- Warfarin. Increases the risk of bleeding.
| - Methotrexate (an immunosuppressant). Co-amoxiclav will make methotrexate even more toxic.
68
What class of drug is diamorphine?
An opioid (analgesics)
69
What is diamorphine used to treat?
- Acute pain
- Chronic uncontrolled pain
- MI
70
What is the mechanism of action of diamorphine?
- A narcotic analgesic that acts on the CNS and smooth muscles. It depresses the CNS, which is what results in the analgesic effect.
71
What are the side effects of diamorphine?
- Arrhythmia and palpitations
- Confusion and hallucinations
- Dizziness/nausea
- Potential development of opioid dependancy/addiction.
72
What are the contraindications for diamorphine?
- Acute respiratory depression.
- Patients in a coma
- Head injury or raised ICP (this is because opioids will interfere with the vital neurological pupillary assessments).
- Phaeochromocytoma (tumour of the adrenal gland, resulting in increased adrenaline secretion). Increase risk of hypertensive crisis.
73
What drugs interact with diamorphine?
- Not many
| - Be cautious when prescribing alongside other neurological drugs.
74
What class of drug is dalteparin?
- It is a type of heparin (anticoagulant).
75
What is dalteparin used for?
- Unstable coronary artery disease
- Prophylactically for DVT prior to surgery.
- DVT
- Pulmonary embolism
- Thromboembolism
76
What is the mechanism of action for dalteparin?
- Increases action of antithrombin III.
- This is a protein responsible for inhibiting factor IIa (thrombin), factor Xa (protein responsible for cleaving prothrombin into thrombin) and several other clotting factors too.
77
What are the potential side effects of taking dalteparin?
- Haemorrhage
- Thrombin-induced thrombocytopaenia (platelet deficiency).
- Hyperkalaemia (due to aldosterone secretion being inhibited).
78
What are the contraindications for heparin?
- Patient is hypersensitive to unfractionated or low molecular weight heparin.
- Patient is at high risk of problematic bleeding, prescribe with extreme caution .
- Potassium (hyperkalaemia) and platelet count (thrombocytopenia) need measuring both before and regularly during a course of heparin.
79
Which drugs interact with dalteparin?
- Clopidogrel. It is an anticoagulant, and when combined with heparin (an anti-platelet) will increase risk of bleeding.
- NSAIDs such as ibuprofen, aspirin or celecoxib. All will increase the risk of bleeding - should be taken with caution after speaking to the doctor.
80
What class of drug is dobutamine?
B1 adrenergic receptor stimulant ("cardiac stimulant")
81
What is dobutamine used for?
- MI
- Perioperatively to cardiac surgery (often CABG). It will provide temporary support to the myocardium.
- Cardiomyopathy
- Septic/cardiogenic shock.
82
What is the mechanism of action of dobutamine?
- Binds selectively to B1 adrenergic receptors.
- Causes sympathetic stimulation of the heart, causing things like increased heart rate, contractility, heart conduction velocity and ultimately increasing cardiac output.
83
What are the side effects of dobutamine?
- Arrhythmia, palpations and chest pain
- Vasoconstriction
- Bronchospasm/dyspnoea
84
What are the contraindications for dobutamine?
- Very few direct contraindications.
| - Manufacturer says breastfeeding.
85
What other drugs interact with dobutamine?
- B-blockers increase the risk of hypertension and brachycardia - AVOID.
- Some of the drugs used to treat Parkinson's. B1 agonists should be avoided as together they will increase the risk of a hypertensive crisis.
86
What class of drug is Doxazosin?
Alpha blocker (antihypertensive)
87
What is doxazosin used to treat?
- Hypertension
- BPH
(a-blocker)
88
What is the mechanism of action for doxazosin?
- Competitive alpha-1 antagonist post-synaptically.
- Results in inhibition of the alpha-1 receptors, leading to vasodilation of the arterioles and veins.
- For BPH, antagonism of the alpha-1 receptors results in relaxation of the muscles in both the prostate and the bladder. This leads to easier urination.
89
What are the potential side effects of doxazosin?
- Arrhythmia, chest pain
- Confusion, vertigo, nausea
- Hypotension, headache, nausea and stroke.
- GI discomfort
90
What are the contraindications for doxazosin?
- Micturition syncope
| - Postural hypotension
91
What other drugs does doxazosin interact with?
- Viagra and other erectile dysfunction medications
| - CAN BE prescribed alongside other anti-hypertensives, but must be careful patient doesn't end up being hypotensive.
92
What class of drug is ephedrine?
An alpha/beta receptor agonist.
93
What is ephedrine used to treat?
- Reversal of hypotension caused by spinal or epidural anaesthesia.
- Airway obstruction
- Neuropathic oedema
- Nasal congestion
94
What is the mechanism of action of ephedrine?
- Acts on the SNS, and indirectly stimulates the alpha and beta receptors.
- Results in increased post-synaptic activity of norepinephrine, leading to increased sympathetic activity.
95
What are the potential side effects of ephedrine?
- Anxiety, headache, insomnia, nausea, hyperhidrosis.
- Arrhythmia, palpations
- Confusion, irritability, asthenia.
- Vomiting
96
What are the contraindications for ephedrine?
- No direct contraindications
| - Be careful if the patient has other hyper-sympathetic conditions (DM, hypertension, hyperthyroidism etc.)
97
What drugs interact with ephedrine?
- Antidepressants/ anxiety drugs.
| - Some Parkinson's drugs (such as safinamide, a monoxide-oxidase-B inhibitor).
98
What class of drug is erythromycin?
- Macrolide antibiotic (an alternative to penicillin).
99
What is erythromycin used to treat?
- Many infections, especially if the patient is allergic to penicillin.
- Gastroenteritis (Effective against campylobacter, which is the most common cause of gastroenteritis).
100
What is the mechanism of action for erythromycin?
- Inhibits protein synthesis within the bacteria by binding to the rRNA polynucleotides.
101
What are the side effects of erythromycin?
- Diarrhoea, decreased appetite, GI discomfort.
| - Headache, nausea, vomiting.
102
What are the contraindications for erythromycin?
- No direct contraindications except for acute porphyrias.
103
What does erythromycin interact with?
- Lots of drugs, including chemotherapy ones. Prescribe with caution.
104
What class of drug is ethinylestradiol?
- Synthetic oestrogen (HRT)
105
What is ethinylestradiol used to treat?
- Oestrogen deficiency
- Female hypogonadism
- Osteoporosis anaphylaxis
- Palliative treatment of prostate cancer.
106
What is the mechanism of action for ethinylestradiol?
- Has the effects that would be expected by increasing oestrogen levels in the body.
- For example, reducing bone resorption (osteoporosis treatment).
107
What are the potential side effects of ethinylestradiol?
- Breast abnormalities, feminisation
- Electrolyte imbalances
- Cholelithiasis
- Fluid retention
- Mood changes, depression.
108
What are the contraindications for ethinylestradiol?
- Thromboembolic disease.
- History of breast cancer
- Liver disease
- Vaginal bleeding
109
What does ethinylestradiol interact with?
- Some drugs, but no specific drug classes.
| - One example is raloxifene (used to treat osteoporosis if biphosphonates are not feasible.)
110
What class of drug is furosemide?
Loop diuretic
111
What diseases is furosemide used to treat?
- Oedema
- Resistant hypertension
- Heart failure (hypervolaemic).
112
What is the mechanism of action of furosemide?
- Inhibits the luminal Na-K-Cl co-transporters in the ascending loop of Henle.
- This reduces Na, K and Cl reabsorption from the urine.
- As a result, there is increased excretion of water and salts.
113
What are the potential side effects of furosemide?
- Dizziness, fatigue, headache, nausea.
- Electrolyte imbalances, muscle spasms
- Metabolic alkalosis (due to loss of fluids, leading to increased concentration of HCO3-).
114
What are the contraindications to furosemide?
- Anuria (failure of kidneys to produce urine).
- Coma (Associated with liver cirrhosis).
- Renal failure due to nephrotoxic/hepatotoxic drugs.
- Hypokalaemia
- Severe hyponatraemia
115
What other drugs does furosemide interact with?
- A huge number of drugs are completely contraindicated.
| - Prescribe with caution.
116
What class of drug mesalazine? What is it used to treat?
- 5-Aminosalicyclic acid
| - 1st line treatment for ulcerative collitis
117
What is a potential side effect of rifampicin?
- Haematuria.
| - "Red urine = Rifampicin"
118
What is rifampicin commonly used to treat?
- TB. Used for 3 months together with pyridoxine.
