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UKMLA Prep > Drugs > Flashcards

Drugs Flashcards

1
Q

Gold risk in rheumatology

A
  • myelosupression
  • renal toxicity
  • mouth ulcer
  • photosensitivity
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2
Q

MAO inhibitors side effects

A

Hypertensive reaction to foods high in tyramine (cheese, processed meats…)

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3
Q

Drugs cause delirium

A
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4
Q

Labetalol risks

A
  • hypoglycaemia
  • bradycardia
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5
Q

Mechanism of ACE inhibitors

A

inhibits the conversion angiotensin I to angiotensin II
→ decrease in angiotensin II levels → to vasodilation and reduced blood pressure
→ decrease in angiotensin II levels → reduced stimulation for aldosterone release → decrease in sodium and water retention by the kidneys

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6
Q

renoprotective mechanism ACE inhibitors

A

angiotensin II constricts the efferent glomerular arterioles
ACE inhibitors therefore lead to dilation of the efferent arterioles → reduced glomerular capillary pressure → decreased mechanical stress on the delicate filtration barriers of the glomeruli
this is particularly important in diabetic nephropathy

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7
Q

How are ACE inhibitors are activated

A

phase 1 metabolism in the liver

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8
Q

Side effects of ACE inhibitors

A
  • cough
  • angioedema
  • hyperkalmeia
  • first dose hypotension
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9
Q

ACE inhibitors cautions and contradictions

A

pregnancy and breastfeeding - avoid
renovascular disease - may result in renal impairment
aortic stenosis - may result in hypotension
hereditary of idiopathic angioedema
specialist advice should be sought before starting ACE inhibitors in patients with a potassium >= 5.0 mmol/L

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10
Q

Interactions of ACE inhibitors

A

patients receiving high-dose diuretic therapy (more than 80 mg of furosemide a day)
significantly increases the risk of hypotension

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11
Q

Mechanism of Adenosine

A

causes transient heart block in the AV node

agonist of the A1 receptor in the atrioventricular node, which inhibits adenylyl cyclase thus reducing cAMP and causing hyperpolarization by increasing outward potassium flux

adenosine has a very short half-life of about 8-10 seconds

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12
Q

Adverse effects adenosine

A

chest pain
bronchospasm
transient flushing
can enhance conduction down accessory pathways, resulting in increased ventricular rate (e.g. WPW syndrome)

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13
Q

Contradictions of Adenosine

A

Asthmatics
Causes bronchospasm

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14
Q

Adenosine should ideally be infused

A

large-calibre cannula due to it’s short half-life,

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15
Q

Interactions of adenosine

A

dipyridamole (antiplatelet agent) and blocked by theophyllines.

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16
Q

Noticible adverse effects ADP receptor inhibitors

A

ticagrelor may cause dyspnoea
due to the impaired clearance of adenosine

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17
Q

Clopidogrel drug contradictions

A

clopidogrel and proton pump inhibitors, particularly omeprazole and esomeprazole, leading to reducing antiplatelet effects.

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18
Q

contraindications to prasugrel use.

A

prior stroke or transient ischaemic attack, high risk of bleeding, and prasugrel hypersensitivity are absolute contraindication

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19
Q

Salbutamol

A
  • beta receptor agonist
  • short-acting bronchodilator
  • Relaxes bronchial smooth muscles through beta 2 receptors
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20
Q

Corticosteroids

A
  • Anti-inflammatory
  • used as maintenance therapy
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21
Q

Ipratropium

A
  • Blocks the muscarinic acetylcholine receptors
  • Short-acting inhaled bronchodilator. Relaxes bronchial smooth muscle
    • Used primarily in COPD
    • Tiotropium has similar effects but is long-acting
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22
Q

Methylxanthines (e.g. theophylline)

A
  • Non-specific inhibitor of phosphodiesterase resulting in an increase in cAMP
  • Given orally or intravenously
    • Has a narrow therapeutic index
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23
Q

Monteleukast, zafirlukast

A
  • Blocks leukotriene receptors
  • Usually taken orally
    • Useful in aspirin-induced asthma
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24
Q

Oxygen saturation targets
acutely ill patients

A

94-98%

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25
Q

Oxygen saturation targets patients at risk of hypercapnia (e.g. COPD patients)

A

88-92%

26
Q

COPD management O2

A

prior to availability of blood gases, use a 28% Venturi mask at 4 l/min and aim for an oxygen saturation of 88-92% for patients with risk factors for hypercapnia but no prior history of respiratory acidosis
adjust target range to 94-98% if the pCO2 is normal

27
Q

When not to use O2 therapy (no hypoxia present, but conditions diagnoses)

A

myocardial infarction and acute coronary syndromes
stroke
obstetric emergencies
anxiety-related hyperventilation

28
Q

Theophylline poisoning

A

acidosis, hypokalaemia
vomiting
tachycardia, arrhythmias
seizures

29
Q

Management of theophylline poisoning

A
  • consider gastric lavage if <1 hour prior to ingestion
    activated charcoal
  • whole-bowel irrigation can be performed if theophylline is sustained release form
    charcoal haemoperfusion is preferable to haemodialysis
30
Q

Potential mechanism of theophylline

A

theophyllines may be a non-specific inhibitor of phosphodiesterase resulting in an increase in cAMP. Other proposed mechanisms include antagonism of adenosine and prostaglandin inhibition

31
Q

canakinumab

A
  • monoclonal antibody targeted at IL-1 beta
  • used systemic juvenile idiopathic arthritis and adult-onset Still’s disease
32
Q

anakinra

A
  • IL-1 receptor antagonist
  • used in the management of rheumatoid arthritis
33
Q

What are antipsychotics used for?

A

Management of schizophrenia, psychosis, mania, and agitation

34
Q

How are antipsychotics categorized?

A

Typical and atypical antipsychotics

35
Q

What is a key reason for the development of atypical antipsychotics?

A

To reduce extrapyramidal side effects associated with typical antipsychotics

36
Q

What is the mechanism of action of typical antipsychotics?

A

Dopamine D2 receptor antagonists, blocking dopaminergic transmission

37
Q

List common adverse effects of typical antipsychotics.

A
  • Extrapyramidal side effects
  • Hyperprolactinaemia
38
Q

What are common examples of typical antipsychotics?

A
  • Haloperidol
  • Chlorpromazine
39
Q

What are the common extrapyramidal side effects (EPSEs)?

A
  • Parkinsonism
  • Acute dystonia
  • Akathisia
  • Tardive dyskinesia
40
Q

What is tardive dyskinesia?

A

Late onset of choreoathetoid movements, may occur in 40% of patients

41
Q

What are the specific warnings for antipsychotics in elderly patients?

A
  • Increased risk of stroke
  • Increased risk of venous thromboembolism
42
Q

What are common side effects of atypical antipsychotics?

A
  • Weight gain
  • Hyperprolactinaemia
  • Agranulocytosis (in clozapine)
43
Q

What is the first-line treatment for schizophrenia according to 2005 NICE guidelines?

A

Atypical antipsychotics

44
Q

What is the primary action of benzodiazepines?

A

Enhance the effect of GABA by increasing the frequency of chloride channels

45
Q

List the uses of benzodiazepines.

A
  • Sedation
  • Hypnotic
  • Anxiolytic
  • Anticonvulsant
  • Muscle relaxant
46
Q

What is the recommended duration for prescribing benzodiazepines?

A

Short period of time (2-4 weeks)

47
Q

What is benzodiazepine withdrawal syndrome?

A

Condition similar to alcohol withdrawal syndrome with symptoms like insomnia and anxiety

48
Q

What are common adverse effects of clozapine?

A
  • Agranulocytosis
  • Neutropaenia
  • Seizures
  • Constipation
  • Myocarditis
49
Q

What is the therapeutic range for lithium?

A

0.4-1.0 mmol/L

50
Q

What are common adverse effects of lithium?

A
  • Nausea/vomiting
  • Fine tremor
  • Nephrotoxicity
  • Thyroid enlargement
  • Weight gain
51
Q

What should be monitored in patients on lithium therapy?

A
  • Lithium levels
  • Thyroid function
  • Renal function
52
Q

What are SSRIs primarily used for?

A

First-line treatment for depression

53
Q

Name two preferred SSRIs.

A
  • Citalopram
  • Fluoxetine
54
Q

What are common adverse effects of SSRIs?

A
  • Gastrointestinal symptoms
  • Increased risk of gastrointestinal bleeding
55
Q

What are the risks associated with citalopram?

A

Dose-dependent QT interval prolongation

56
Q

What is the mechanism of action for SNRIs?

A

Inhibit the reuptake of serotonin and noradrenaline

57
Q

What are tricyclic antidepressants (TCAs) primarily used for?

A

Depression and neuropathic pain

58
Q

What is a common low-dose TCA used for neuropathic pain?

A

Amitriptyline

59
Q

What are Z drugs?

A

Drugs that have similar effects to benzodiazepines but act on the α2-subunit of the GABA receptor

60
Q

List the groups of Z drugs.

A
  • Imidazopyridines (e.g., zolpidem)
  • Cyclopyrrolones (e.g., zopiclone)
  • Pyrazolopyrimidines (e.g., zaleplon)
61
Q

What are common adverse effects of Z drugs?

A
  • Similar to benzodiazepines
  • Increased risk of falls in the elderly

UKMLA Prep (46 decks)

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