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DRUGS Flashcards

1
Q
A
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2
Q

what medicines are typically used to induce mydriasis?

A

tropicamide
phenylephrine

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3
Q

what is the mechanism of action of tropicamide?

A
  • muscarinic (M3) antagonist
  • stops ACh binding to M3 receptors
  • stops circular muscle contraction
  • stops pupil constriction
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4
Q

what is the mechanism of action of phenylephrine?

A
  • alpha-adrenoceptor agonist
  • binds to receptors and causes radial muscles of iris to contract
  • increases pupil size
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5
Q

what % of tropicamide is standard?

A

0.5%

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6
Q

what % of phenylephrine is standard?

A

2.5%

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7
Q

what % is the standard does of pilocarpine?

A

2%

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8
Q

what medicines can be used to induce myopia?

A

pilocarpine

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9
Q

list 3 tricyclic ADs

A

desipramine
amitriptyline
clomipramine

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10
Q

desipramine, amitryptyline, clomipramine are all what type of antidepressant?

A

tricyclic

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11
Q

list 3 SSRIs

A

fluoxetine
paroxetine
flucoxamine
sertraline
citalopram

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12
Q

fluoxetine, paroxetine, flucoxamine, sertraline, citalopram - what type of antidepressant are these?

A

SSRIs

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13
Q

list 2 SNRIs

A

venlafaxine
duloxetine

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14
Q

venlafaxine and duloxetine are examples of what type of antidepressant?

A

SNRIs

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15
Q

what does each antidepressant block?

A

tricyclics and SNRIs - SERT and NAT
SSRIs block only SERT

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16
Q

what is the mechanism of action of propofol?

A

GABA agonist - increases inhibitory effect

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17
Q

what is the volume of distribution of propofol?

A
  • 60L/kg
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18
Q

what is the MOA of isoflurane?

A
  • reduces gap junction channel opening times
  • alters tissue excitability
  • induces muscle relaxation
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19
Q

what is the MOA of fentanyl?

A
  • agonist of mu opioid receptor
  • inhibits adenylate cyclase
  • = downregulation
  • hyperpolarises cell and inhibits nerve activity
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20
Q

what is a typical dose of fentanyl?

A

0.05mg/mL IV

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21
Q

what is the MOA of suxamethonium?

A
  • depolarising neuromuscular blocker
  • mimics ACh but not rapidly hydrolysed
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22
Q

wh

what is the MOA of atracurium?

A
  • non-depolarising neuromuscular blocker
  • antagonist of ACh sp. at nicotinic receptors
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23
Q

what is the MOA of neostigmine?

A
  • inhibits AChE
  • prolongs action of ACh
  • increases muscular contraction and reverses muscle relaxants
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24
Q

what is hte MOA of atropine/glycopyrrate

A
  • antagonise muscarinic receptors
  • inhibit cholinergic transmission
  • decreases bradycardia risk from neostigmine
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25
Q

what is the MOA of mannitol?

A
  • increases blood plasma osmolarity
  • increases flow of water from tissues
  • decreases ICP
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26
Q

what is the MOA of depakote?

A
  • folate antagonist
  • blocks reuptake of GABA into glia cells
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27
Q

what is the MOA of paracetamol?

A
  • selective COX2 inhibitor
  • Inhibits production of prostaglandins (anti-inflammatory) and thromboxanes (anti-platelet)
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28
Q

what is the typical dosage of paracetamol

A

0.5-1g every 4-6 hours to max of 4g daily

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29
Q

what is the MOA of ibuprofen?

A

Weak COX 1 inhibitor

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30
Q

what is the typical dosage of ibuprofen

A

300-400g 3-4 times daily to max of 2.4g

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31
Q

what is the MOA of co-codamol

A
  • opiod prodrug
  • Mainly binds to Mu receptors
  • Inhibits adenylyl cyclase
  • Reduces intracellular cAMP
  • Opens K channels
  • Causes hyperolarisation
  • Inhibits Ca2 opening
  • Reduces NT release
32
Q

what is the MOA of morphine?

A
  • opioid prodrug
  • Mainly binds to Mu receptors
  • Inhibits adenylyl cyclase
  • Reduces intracellular cAMP
  • Opens K channels
  • Causes hyperolarisation
  • Inhibits Ca2 opening
  • Reduces NT release
33
Q

what is the MOA of gabapentin?

A
  • anticonvulsant
  • Increases GABA concentration by modifying Ca channels
34
Q

what is gabapentin used to treat

A

neuropathic pain

35
Q

what is the typical dosage of gabapentin

A

300mg OD on day 1
300mg BD on day 2
300mg x3 on day 3

36
Q

what is the MOA of lidocaine?

A
  • local anaesthetic
  • Blocks Na channels
  • Prevents generation of AP in pain fibres
37
Q

what is the MOA of tricyclics

A
  • Blocks reuptake of NAdr and 5HT
  • Increases conc in synaptic clefts
38
Q

what are the MOA of thrombolytics, like TPA

A

Inactivates thrombin and ADP
Cleaves plasminogen to form plasmin
Plasmin cleaves fibrin to degrade thrombi

39
Q

what is the MOA of warfarin

A

Vit K antagonist
Vit K is a cofactor in the formation of coagulation factors VII, IX, X and thrombin

40
Q

what is the MOA of aspirin

A

Inhibits the function of platelets in clot formation

41
Q

what is the MOA of statins

A

Inhibit HMG-CoA reductase, the rate limiting enzyme in cholesterol synthesis

42
Q

what is the MOA of SSRIs like sertraline

A

Selectively block serotonin reuptake transporter proteins
Increases concentration of 5HT in synapse

43
Q

what is the MOA of pregabalin

A
  • anticonvulsant that increases GABA synaptic conc
44
Q

what is the MOA of benzodiazapine

A
  • anticonvulsant
  • Binds to alpha subunit of GABA-A receptor = ion channels open
  • Causes influx of Cl- ions = hyperpolarisation
  • Reduces anxiety
45
Q

what is the MOA of SNRIs like venlafaxine

A

Blocks 5HT and Nadr reuptake transporter proteins
Increases conc in synaptic cleft

46
Q

what is the MOA of MAOIs

A

Prevents reuptake of Nadr 5HT and DA

47
Q

what is the MOA of L-dopa

A

Precursor or DA
Decarboxylated into DA after crossing BBB
Stimulates dopaminergic receptors

48
Q

what is the MOA of benserazide

A

Peripherally-acting DOPA decarboxylase inhibitor
Reduces peripheral side effects of L-Dopa
Doesn’t cross BBB so doesn’t prevent the effects of L-dopa in brain

49
Q

what is the MOA of carbidopa

A

dopa decarboxylase inhibitor used in combination with levodopa

51
Q

what is the MOA of selegiline

A

Irreversible MAOB inhibitor
Increases DA in pre-synaptic neurone after reuptake
Allows more DA to be repackaged into vesicles via VMAT

52
Q

what is the MOA of rasagiline

A

Irreversible inhibitor of MAO

53
Q

what is the dosage of rasagiline

54
Q

what is the MOA of entacapone

A

selective COMT inhibitor used in treatment of PD

55
Q

what is the MOA of entacapone

A

200mg given with each dose of L-dopa

56
Q

what is the MOA of risperidone

A

antipsychotic
Blocks D2 receptors in ventral striatum, alleviating =+ve symptoms of SZ
Blocks 5HT2 receptors in mesocortical tract - causing excess of DA

57
Q

what is hte MOA of olanzipine

A

D1, D2, D4, 5HT and muscarinic receptor antagonist

2nd generation antipsychotic

58
Q

what is the MOA of quetiapine

A

D1, D2, 5HT antagonist

59
Q

what is the typical dosing of olanzipine

A

10mg daily and adjusted accord to response

60
Q

what is the typical dosage of quetiapine

A

25mg BD for day 1
50mg BD for day 2
100mg BD for day 3
150mg BD for day 4

61
Q

what is the MOA of aripiprazole

A

D2 partial agonist with weak 5HT agonism

62
Q

what is the typical dosage of aripiprazole

A

10-15mg OD

63
Q

what is the MOA of amisulpride

A

Selectivee dopamine receptor antagonist with high affinity for mesolimbic D2 and D3 receptors

64
Q

what is the MOA of clozapine

A

D1, D2, 5HT muscarinic receptor antagonist

65
Q

what is hte MOA of propofol

A

Strong agonist at mu opioid receptor
Inhibits adenylate cyclase
Inhibits release of nociceptive substances

66
Q

what is the MOA of suxamethonium

A

Mimics ACh but isn’t broken down by AChE
Desensitises the NMJ
Depolarising

67
Q

what is the MOA of atracurium

A

Blocks ACh receptors in NMJ

68
Q

what is the difference between suxamethonium and atracurium

A

suxamethonium = depolarising
atracurium = non-depolarising

69
Q

what is the MOA of isoflurane

A

MOA unknown
Inhaled volatile anaesthetic agent - maintains anaesthesia

70
Q

what is the MOA of fentanyl

A

Strong agonist at mu opioid receptor
Inhibits adenylate cyclase
Inhibits release of nociceptive substances

71
Q

what is the MOA of neostigmine

A

Blocks AChE
Increases conc. Of Ach in NMJ
Increases muscle contraction

72
Q

what is the MOA of glycopyrolate

A

Muscle receptor antagonist
Limits parasympathetic effects caused by neostigmine eg. bradycardia

73
Q

what is the difference between glycopyrolate and atropine?

A

atropine can cross the BBB wheres glycopyrolate cannot

74
Q

what is the MOA of mannitol

A

osmotic diuretic
Increases solute content in proximal tubule of kidneys
Decreases fluid in body and increases plasma osmolarity
Reduces ICP

Med School Yr 2 (96 decks)

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