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Phase 2a diseases > Drugs > Flashcards

Drugs Flashcards

1
Q

What class of drug is Alendronate/ Alendronic acid?

A

Biphosphonate

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2
Q

What diseases are treated with Alendronate/ Alendronic acid?

A
  • Osteoporosis (1st line)

- Breast cancer (Reduces risk of fracture due to osteoporosis).

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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.
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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).
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5
Q

What are the contraindications of alendronate/ alendronic acid?

A
  • Oesophageal abnormalities
  • Hypocalcaemia
  • Reduced GI motility
  • Pregnancy
  • Kidney disease/failure
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6
Q

What are the interactions of alendronate/ alendronic acid?

A
  • Interacts with a huge amount of drugs. Prescribe with care.
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7
Q

What class of drug is Amlodipine?

A

Calcium channel blocker

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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.
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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.

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10
Q

What are the potential side effects of amlodipine?

A
  • Abdominal pain
  • Palpations/tachycardia
  • Vomiting/headache
  • Hypotension and associated oedema.
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11
Q

What are the contraindications of amlodipine?

A
  • Cardiogenic shock
  • UNSTABLE angina
  • Significant aortic stenosis
  • Persistent postural hypotension.
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12
Q

What notable drug(s) will potentially interact with amlodipine?

A
  • Magnesium. Amlodipine and magnesium should not be prescribed together.
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13
Q

What class of drug is atenolol?

A
  • Beta-blocker
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14
Q

What disease(s) are treated with atenolol?

A
  • Hypertension
  • Angina
  • Arrhythmia
  • Migraine prophylaxis
  • Myocardial infarction (MI)
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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.
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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.)
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17
Q

What are the contraindications of atenolol?

A
  • Asthma
  • Hypotension
  • Brachycardia
  • Metabolic acidosis
  • AV Block (2nd and 3rd degree).
  • Uncontrolled HF.
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18
Q

What does atenolol interact with?

A
  • Adrenaline/norepinephrine. This would increase the risk of hypertension (unopposed vasoconstriction) and brachycardia.
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19
Q

What class of drug is atracurium?

A
  • Non-depolarising neuromuscular blocking drug.
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20
Q

What is atracurium used for?

A
  • Used alongside general anaesthesia during surgery.

- Used to facilitate mechanical ventilation in ICU.

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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.
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22
Q

What are the side effects of atracurium?

A
  • Flushing/hypotension
  • Bronchospasm
  • Tachycardia and cardiac arrest (rare).
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23
Q

What are the contraindications of atracurium?

A
  • No direct contraindications.

- Be careful prescribing to patients with neuromuscular disorders.

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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.
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25
Q

What class of drug is bendroflumethiazide?

A

Thiazide diuretic.

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26
Q

What diseases are treated with bendroflumethiazide?

A
  • Oedema

- Hypertension

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27
Q

What is the mechanism of action for bendroflumethiazide?

A
  • 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.
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28
Q

What are the side effects of bendroflumethiazide?

A
  • Metabolic alkalosis (due to disruption to electrolyte levels)
  • Constipation or diarrhoea
  • Dry mouth
  • Electrolyte imbalances
  • Erectile dysfunction
  • Electrolyte imbalance
  • Hyperglycaemia/uricaemia/calcaemia.
  • Hypokalaemia.
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29
Q

What are the contraindications of bendroflumethiazides?

A
  • 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).
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30
Q

What does bendroflumethiazide interact with?

A
  • Lots of things. Highly interactive - prescribe with caution.
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31
Q

What class of drug is cefuroxime?

A

A cephalosporin (broad spectrum antibiotic)

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32
Q

What diseases is cefuroxime used to treat?

A
  • Infections of: soft tissues, respiratory tract, urinary tract, genital tract and the CNS.
  • Can also be used anaphylactically.
  • Second line for pneumonia.
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33
Q

What is the mechanism of action of cefuroxime?

A
  • Broad spectrum antimicrobial.
  • Inhibits cell wall synthesis.
  • Antimicrobial activity against many types of bacteria.
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34
Q

What are the side effects of cefuroxime?

A
  • No serious ones.

- Typical ones some people may have to any medication (abdominal pain, diarrhoea, headache etc.).

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35
Q

What are the contraindications of cefuroxime?

A
  • None. Very safe drug.
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36
Q

What does cefuroxime interact with?

A
  • No interactions severe enough to be noted.
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37
Q

What class of drug is celecoxib?

A
  • COX-2 inhibitor.
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38
Q

What is celecoxib used to treat?

A
  • Ankylosing spondylitis

- Sometimes osteo/rheumatoid arthritis (less common).

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39
Q

What is the mechanism of action of celecoxib?

A
  • 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.
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40
Q

How is celecoxib NOT as likely to cause peptic ulcers as aspirin or ibuprofen are?

A
  • 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.
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41
Q

What are the side effects of celecoxib?

A
  • 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
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42
Q

What are the contraindications of celecoxib?

A
  • 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).
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43
Q

What does celecoxib interact with?

A

When prescribed with other NSAIDS, may increase risk of peptic ulceration and subsequent perforation/bleeding.

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44
Q

What class of drug is chloramphenicol?

A

Broad-spectrum antibiotic.

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45
Q

What diseases can chloramphenicol be used to treat?

A
  • Otitis externa (ear infection).
  • Superficial eye infection
  • Life-threatening infections (esp. if caused by Haemophilus influenza).
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46
Q

What is the mechanism of action of chloramphenicol?

A
  • Inhibits proteins from forming within bacteria.

- This kills bacteria (antibiotic).

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47
Q

What are the side effects of chloramphenicol?

A
  • Allergy (this is very rare)
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48
Q

What are the contraindications for chloramphenicol?

A
  • Acute porphyrias (this is a rare genetic disorder).
49
Q

What does chloramphenicol interact with?

A
  • Some diabetic medications.

- Not much else.

50
Q

What class of drug is ciclosporin?

A

Immunosuppressant

51
Q

What is ciclosporin used for?

A
  • Severe ulcerative colitis (2nd line after corticosteroids)
  • Severe psoriasis/atopic dermatitis
  • Organ transplantation.
52
Q

What is the mechanism of action for ciclosporin?

A
  • Inhibits the production and release of lymphokines.

- Results in the suppression of cell-mediated immune response.

53
Q

What are the potential side effects of ciclosporin?

A
  • Appetite decrease/ diarrhoea/ GI discomfort.
  • Electrolyte imbalances
  • Peptic ulcer
  • Fatigue/fever/vomiting
54
Q

What are the contraindications for ciclosporin?

A
  • Malignancy
  • Uncontrolled hypertension
  • Uncontrolled infections
  • Active ocular/peri-ocular infection (when administered by eye).
55
Q

What does ciclosporin interact with?

A
  • Many other drugs due to immunosuppressive nature.

- PRESCRIBE WITH CAUTION.

56
Q

What class of drug is ciprofloxacin?

A

Broad-spectrum antibiotic.

57
Q

What diseases can be treated with ciprofloxacin?

A

Wide range of infections. For example:

  • Crohn’s disease
  • Diverticulitis
  • Eye infection
  • Gonorrhoea (if bacteria causing it are sensitive)
58
Q

What is the mechanism of action for ciprofloxacin?

A
  • Inhibits DNA replication of bacteria.

- Prevents bacterial growth/replication.

59
Q

What are the potential side effects of ciprofloxacin?

A
  • Various allergic responses
  • QT prolongation (a longer interval between heart beats).
  • GI symptoms (sickness, pain etc.)
60
Q

What are the contraindications for ciprofloxacin?

A
  • History of tendon disorders related to use of quinolone antibiotics.

(ciprofloxacin is a type of quinolone antibiotic).

61
Q

What does ciprofloxacin interact with?

A
  • NSAIDS. These will increase the risk of seizure.
62
Q

What class of drug is co-amoxiclav?

A
  • A combination antibiotic (Amoxicillin + clavulanic acid)
63
Q

What is co-amoxiclav used to treat?

A
  • Acute diverticulitis.

- Infections due to beta-lactamase-producing bacterial strains.

64
Q

What is the mechanism of action for co-amoxiclav?

A
  • 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
Q

What are the side affects of co-amoxiclav?

A
  • 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
Q

What are the contraindications to co-amoxiclav?

A
  • 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
Q

What does co-amoxiclav interact with?

A
  • Warfarin. Increases the risk of bleeding.

- Methotrexate (an immunosuppressant). Co-amoxiclav will make methotrexate even more toxic.

68
Q

What class of drug is diamorphine?

A

An opioid (analgesics)

69
Q

What is diamorphine used to treat?

A
  • Acute pain
  • Chronic uncontrolled pain
  • MI
70
Q

What is the mechanism of action of diamorphine?

A
  • A narcotic analgesic that acts on the CNS and smooth muscles. It depresses the CNS, which is what results in the analgesic effect.
71
Q

What are the side effects of diamorphine?

A
  • Arrhythmia and palpitations
  • Confusion and hallucinations
  • Dizziness/nausea
  • Potential development of opioid dependancy/addiction.
72
Q

What are the contraindications for diamorphine?

A
  • 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
Q

What drugs interact with diamorphine?

A
  • Not many

- Be cautious when prescribing alongside other neurological drugs.

74
Q

What class of drug is dalteparin?

A
  • It is a type of heparin (anticoagulant).
75
Q

What is dalteparin used for?

A
  • Unstable coronary artery disease
  • Prophylactically for DVT prior to surgery.
  • DVT
  • Pulmonary embolism
  • Thromboembolism
76
Q

What is the mechanism of action for dalteparin?

A
  • 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
Q

What are the potential side effects of taking dalteparin?

A
  • Haemorrhage
  • Thrombin-induced thrombocytopaenia (platelet deficiency).
  • Hyperkalaemia (due to aldosterone secretion being inhibited).
78
Q

What are the contraindications for heparin?

A
  • 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
Q

Which drugs interact with dalteparin?

A
  • 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
Q

What class of drug is dobutamine?

A

B1 adrenergic receptor stimulant (“cardiac stimulant”)

81
Q

What is dobutamine used for?

A
  • MI
  • Perioperatively to cardiac surgery (often CABG). It will provide temporary support to the myocardium.
  • Cardiomyopathy
  • Septic/cardiogenic shock.
82
Q

What is the mechanism of action of dobutamine?

A
  • 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
Q

What are the side effects of dobutamine?

A
  • Arrhythmia, palpations and chest pain
  • Vasoconstriction
  • Bronchospasm/dyspnoea
84
Q

What are the contraindications for dobutamine?

A
  • Very few direct contraindications.

- Manufacturer says breastfeeding.

85
Q

What other drugs interact with dobutamine?

A
  • 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
Q

What class of drug is Doxazosin?

A

Alpha blocker (antihypertensive)

87
Q

What is doxazosin used to treat?

A
  • Hypertension
  • BPH

(a-blocker)

88
Q

What is the mechanism of action for doxazosin?

A
  • 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
Q

What are the potential side effects of doxazosin?

A
  • Arrhythmia, chest pain
  • Confusion, vertigo, nausea
  • Hypotension, headache, nausea and stroke.
  • GI discomfort
90
Q

What are the contraindications for doxazosin?

A
  • Micturition syncope

- Postural hypotension

91
Q

What other drugs does doxazosin interact with?

A
  • 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
Q

What class of drug is ephedrine?

A

An alpha/beta receptor agonist.

93
Q

What is ephedrine used to treat?

A
  • Reversal of hypotension caused by spinal or epidural anaesthesia.
  • Airway obstruction
  • Neuropathic oedema
  • Nasal congestion
94
Q

What is the mechanism of action of ephedrine?

A
  • 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
Q

What are the potential side effects of ephedrine?

A
  • Anxiety, headache, insomnia, nausea, hyperhidrosis.
  • Arrhythmia, palpations
  • Confusion, irritability, asthenia.
  • Vomiting
96
Q

What are the contraindications for ephedrine?

A
  • No direct contraindications

- Be careful if the patient has other hyper-sympathetic conditions (DM, hypertension, hyperthyroidism etc.)

97
Q

What drugs interact with ephedrine?

A
  • Antidepressants/ anxiety drugs.

- Some Parkinson’s drugs (such as safinamide, a monoxide-oxidase-B inhibitor).

98
Q

What class of drug is erythromycin?

A
  • Macrolide antibiotic (an alternative to penicillin).
99
Q

What is erythromycin used to treat?

A
  • Many infections, especially if the patient is allergic to penicillin.
  • Gastroenteritis (Effective against campylobacter, which is the most common cause of gastroenteritis).
100
Q

What is the mechanism of action for erythromycin?

A
  • Inhibits protein synthesis within the bacteria by binding to the rRNA polynucleotides.
101
Q

What are the side effects of erythromycin?

A
  • Diarrhoea, decreased appetite, GI discomfort.

- Headache, nausea, vomiting.

102
Q

What are the contraindications for erythromycin?

A
  • No direct contraindications except for acute porphyrias.
103
Q

What does erythromycin interact with?

A
  • Lots of drugs, including chemotherapy ones. Prescribe with caution.
104
Q

What class of drug is ethinylestradiol?

A
  • Synthetic oestrogen (HRT)
105
Q

What is ethinylestradiol used to treat?

A
  • Oestrogen deficiency
  • Female hypogonadism
  • Osteoporosis anaphylaxis
  • Palliative treatment of prostate cancer.
106
Q

What is the mechanism of action for ethinylestradiol?

A
  • Has the effects that would be expected by increasing oestrogen levels in the body.
  • For example, reducing bone resorption (osteoporosis treatment).
107
Q

What are the potential side effects of ethinylestradiol?

A
  • Breast abnormalities, feminisation
  • Electrolyte imbalances
  • Cholelithiasis
  • Fluid retention
  • Mood changes, depression.
108
Q

What are the contraindications for ethinylestradiol?

A
  • Thromboembolic disease.
  • History of breast cancer
  • Liver disease
  • Vaginal bleeding
109
Q

What does ethinylestradiol interact with?

A
  • Some drugs, but no specific drug classes.

- One example is raloxifene (used to treat osteoporosis if biphosphonates are not feasible.)

110
Q

What class of drug is furosemide?

A

Loop diuretic

111
Q

What diseases is furosemide used to treat?

A
  • Oedema
  • Resistant hypertension
  • Heart failure (hypervolaemic).
112
Q

What is the mechanism of action of furosemide?

A
  • 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
Q

What are the potential side effects of furosemide?

A
  • Dizziness, fatigue, headache, nausea.
  • Electrolyte imbalances, muscle spasms
  • Metabolic alkalosis (due to loss of fluids, leading to increased concentration of HCO3-).
114
Q

What are the contraindications to furosemide?

A
  • Anuria (failure of kidneys to produce urine).
  • Coma (Associated with liver cirrhosis).
  • Renal failure due to nephrotoxic/hepatotoxic drugs.
  • Hypokalaemia
  • Severe hyponatraemia
115
Q

What other drugs does furosemide interact with?

A
  • A huge number of drugs are completely contraindicated.

- Prescribe with caution.

116
Q

What class of drug mesalazine? What is it used to treat?

A
  • 5-Aminosalicyclic acid

- 1st line treatment for ulcerative collitis

117
Q

What is a potential side effect of rifampicin?

A
  • Haematuria.

- “Red urine = Rifampicin”

118
Q

What is rifampicin commonly used to treat?

A
  • TB. Used for 3 months together with pyridoxine.

Phase 2a diseases (18 decks)

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