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Drugs! Flashcards

1
Q

When performing an X-ray with iodine containing contrast, such as intravenous urography, which drug is a contraindication?

A

Metformin

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2
Q

What is Metformin?

A

An antidiabetic drug and is first choice in overweight patients where strict dieting has failed.

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3
Q

Which two antibiotics should be used for a septic urinary stone?

A

1g IV ampicillin and IV gentamicin.

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4
Q

What class is ampicillin and what is it’s mode of action?

A

Beta-lactam. It is able to penetrate both gram-negative and gram-positive bacteria. It inhibits the action of transpeptidase, which bacteria need to make their cell wall, this causes cell lysis.

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5
Q

What class is gentamicin and what is its mechanism of action?

A

Aminoglycoside. It is a bactericidal antibiotic, it binds to the 30s subunit of the bacterial ribosome interupting protein synthesis.

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6
Q

Which two drugs does Jay Khastigir say are used in medical expulsion therapy for kidney stones?

A

Alpha blockers and Nifedipine.

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7
Q

Which drug is a synthetic replacement for vasopressin? And what does it do?

A

Desmopressin, encourages water retention by reducing urine output, useful for obstructed ureters.

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8
Q

What is Heparin and what is its use?

A

It is a glycosaminoglycan, and is used as an anti-coagulant. It binds to antithrombin III which activates AT and allows it to deactivate thrombin and other proteases involved in clotting.

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9
Q

What is Atropine?

A

It is a muscarinic antagonist, used to dilate the pupils.

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10
Q

What is Doxazosin and what is its function?

A

It is an Alpha-1 antagonist used to treat hypertension.

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11
Q

What is Salbutamol and what is its function?

A

It is a Beta-2 agonist used in the treatment of asthma.

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12
Q

What is Timolol and what is its use?

A

It is a non specific Beta antagonist and is used in the treatment of glaucoma.

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13
Q

What is Bisoprolol and what is its use?

A

Bisoprolol is a Beta-1 antagonist and is used used to treat hypertension and cardiac ischaemia.

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14
Q

What drug is used to dilate the pupil and what is its mechanism of action?

A

Atropine, muscarinic antagonist so decreases the input of the parasympathetic system.

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15
Q

What drug is an Alpha-1 antagonist that is used in the treatment of hypertension?

A

Doxazosin

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16
Q

Which drug is a Beta-2 agonist used in the treatment of asthma?

A

Salbutamol.

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17
Q

Which non-specific Beta-antagonist is used in the treatment of glaucoma?

A

Timolol

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18
Q

Which Beta-1 antagonist is used in the treatment of hypertension and cardiac ischaemia?

A

Bisoprolol

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19
Q

What is orlistat?

A

Orlistat is a weight loss drug, it inhibits the production of lipase, so fats are less absorbed.

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20
Q

What is the name of the weight-management drug that can cause malabsorption and steatarrhoea?

A

Orlistat.

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21
Q

What is syntocinon used for?

A

Synthetic Oxytocin - Used to create more regular and efficient contractions during labour.

22
Q

Why does oxytocin need to be given I.V.?

A

It is destroyed in the gastrointestinal tract.

23
Q

What is ergometrine?

A

It is used in obstetrics to facilitate the delivery of the placenta and to reduce bleeding, as such it is used to reduce post-partum haemorrhage.

24
Q

What is Prostin?

A

It is the trade name for Prostaglandin E2, and is used to help soften the cervix.

25
Q

What is syntometrine and what is its use?

A
  • Oxytocin and Ergometrine
  • Used in the active management of the third stage of labour, to help deliver the placenta and prevent post-partum haemorrhage.
26
Q

What class is Benzylpenicillin, what are it’s uses and mechanism of action?

A
  • Known as penicillin G and is the gold standard penicillin.
  • It is given parenterally.
  • It is a penicillin antibiotic.
  • Bacteriacidal, it disrupts the wall of the bacteria eventually causes lysis.
27
Q

What class of antibiotics is Clarithromycin, what are it’s uses and mechanism of action?

A
  • It is a macrolide.
  • It binds to 50s subunit of the bacterial ribosome and thus prevents them from producing proteins.
  • It is predominantly used to treat respiratory tract infections and skin infections.
28
Q

What class of antibiotics is Cefuroxime, what are it’s uses and mechanism of action?

A
  • Cephalosporin
  • It is less susceptible to Beta-lactamase and so is used in the treatment of haemopholus influenza, gonorrhoea and Lyme disease.
  • Work in a similar manner to other Beta-lactams by disrupting the cell wall by disrupting peptioglycan synthesis.
29
Q

What is Coamoxiclav?

A
  • It is a combination of amoxicillin (a beta-lactam) and clavulanic acid (a beta-lactamase inhibitor).
  • This gives it a broader spectrum and has more resistance to beta-lactamase producing bacteria.
  • Used broadly for UTIs, RTIs and skin infections.
30
Q

What class of antibiotics is amoxicillin, what are it’s uses and mechanism of action?

A
  • It is a beta-lactam antibiotic in the aminopenicillin family.
  • It is better absorbed after oral consumption than other beta-lactams.
  • As with other beta-lactams it disrupts the bacterial cell wall and causing lysis.
31
Q

What class of antibiotics is metronidazole, what are it’s uses and mechanism of action?

A
  • It is a nitroimidazole antibiotic.
  • It is used predominantly for anaerobic bacteria and protozoa.
  • It is absorbed by the bacteria where it is then reduced and forms bonds with enzymes within the bacteria thus making them unavailable for use.
32
Q

Which class of antibiotics is Rifampicin, what are it’s uses and mechanism of action?

A
  • It is a rifamycin antibiotic.
  • It is used in the treatment of TB, Mycobacterium infections, MRSA (methicillin-resistant Staphlycoccus aureus) amongst others.
  • It works by inhibiting RNA synthesis by binding to RNA polymerase.
33
Q

Which class of antibiotics is Flucloxacillin, what are it’s uses and mechanism of action?

A
  • It is a beta-lactam of the penicillin class.
  • It has a narrow-spectrum but it beta-lactamase stable so can be used to treat beta-lactamase producing organisms.
  • As with other beta-lactams it disrupts the bacterial cell wall resulting in lysis.
34
Q

Mycobacterium, Legionella, Listeria and Chlamydia are all bacteria that become intracellular. Which four classes of antibiotics can pass into mammalian cells?

A
  • Glycopeptides.
  • Macrolides.
  • Quinolones.
  • Tetracyclines.
35
Q

What is Loperamide? What is its mechanism, indications and side-effects?

A
  • It is an antimotility drug.
  • Used in the symptomatic treatment of acute diarrhoea.
  • It is an opioid receptor agonist, which decreases the activity of the myenteric plexus, leading to decreased tone of the longitudinal and smooth muscle of the intestinal wall.
  • Abdominal cramps, dizziness.
36
Q

Ipratropium: What is it? What’s its mechanism, indications and side-effects?

A
  • Antimuscarinic bronchodilator.
  • Muscarinic receptor antagonist, causing the bronchi to dilate.
  • Indicated for reversible airway obstruction, particularly COPD.
  • Side-effects are minimal but dry-mouth is common.
37
Q

Lorazepam: What is it? What’s its mechanism, indications?

A
  • Benzodiazepine.
  • Used as short-term treatment of anxiety disorders.
  • It has all six intrinsic benzodiazepine effects.
38
Q

What are the six intrinisic benzodiazepine effects?

A

1) Anxiolysis.
2) Anterograde amnesia.
3) Sedation.
4) Anti-emesis/nausea.
5) Muscle-relaxant.
6) Anti-seizure.

39
Q

Tramadol: What is it? What’s its mechanism, indications and side-effects?

A
  • Opioid analgesic used for moderate to severe pain.
  • It produces by two mechanisms: Opioid effect and an enhancement of serotonergic and adrenergic pathways.
  • It has fewer of the typical opioid side-effects, but; nausea, vomiting, constipation, dry mouth, diarrhoea, retching, fatigue, paraesthesia.
40
Q

How does the opioid system work?

A

Opioids are a psychoactive drugs that resemble morphine, they bind to opioid receptors found in the digestive tract and CNS. Binding to these receptors causes their beneficial and adverse effects.

41
Q

Ondansetron: What is it? What’s its mechanism, indications and side-effects?

A
  • It is a serotonin 5-HT3 receptor antagonist used for the treatment of nausea and vomiting caused by cancer chemotherapy, radiotherapy and surgery.
  • Serotonin is released by enterochromaffin cells in the small intestine in response to chemotherapy, and initiate vomiting.
  • Constipation, headache, flushing and injection-site reactions.
42
Q

Metyrapone: What is it? What’s its mechanism, indications and side-effects?

A
  • It is a competitive inhibitor of 11ß-hydroxylation in the adrenal cortex, the resulting inhibition of cortisol leads to an increase in ACTH hormone which leads to the increased release of cortisol precursors.
  • It is therefore used as a test of anterior pituitary function and has also been used in controlling the symptoms of Cushing’s syndrome.
  • It can cause nausea, vomiting, dizziness, headache, hypotension, sedation.
43
Q

Spironolactone: What is it? What’s its mechanism, indications and side-effects?

A
  • It is a potassium sparing-diuretic that acts by antagonising aldosterone.
  • It is used in the treatment of ascites and oedema in cirrhosis of the liver, malignant ascites, nephrotic syndrome, oedema in congestive heart failure and moderate to severe heart failure.
  • It is also used in the treatment of primary hyperaldosteronism (Conn’s syndrome).
  • Side-effects include GI disturbances, hepato-toxicity, malaise, confusion, drowziness, gynaecomastia.
44
Q

Simeticone: What is it? What’s its mechanism, indications and side-effects?

A

• It is an anti-foaming agent that is added to antacids to relieve flatulence.

45
Q

Sucralfate: What is it? What’s its mechanism, indications and side-effects?

A
  • It is a complex of aluminium hydroxide and sulphated sucrose that protects the gut mucosa from acid and pepsin attack.
  • Used for gastric and duodenal ulcers.
  • It can cause diarrhoea, constipation, nausea, indigestion, flatulence, gastric discomfort, back pain, dizziness, headache, drowsiness.
46
Q

Misoprostol: What is it? What’s its mechanism, indications and side-effects?

A
  • It is a synthetic prostaglandin analogue, that promotes the healing of peptic ulcers. It can prevent NSAID-associated ulcers and so is used in the elderly for whom NSAIDS cannot be withdrawn.
  • Side-effects - Diarrhoea, abdo. pain, dyspepsia, flatulence, nausea and vomiting.
47
Q

Domperidone: What is it? What’s its mechanism, indications and side-effects?

A
  • It is a motility stimulant, a dopamine receptor antagonist which stimulate gastric emptying and small intestinal transit, and enhance the strength of the LOS.
  • It is indicated for nausea and vomiting, GORD and dyspepsia.
48
Q

Metclopramide: What is it? What’s its mechanism, indications and side-effects?

A
  • It is a dopamine receptor agonist which stimulates gastric emptying and small intestine transit, and enhance the strength of the LES.
  • It is indicated in adults for nausea and vomiting, GORD and treatment with cytotoxics or radiotherapy.
49
Q

Ranitidine: What is it? What’s its mechanism, indications and side-effects?

A
  • It is a H2-receptor antagonists, which heals gastric and duodenal ulcers by reducing acid output.
  • It indicated in the treatment of PUD and GORD.
  • Side-effects include diarrhoea, headache and dizziness.
50
Q

Omeprazole: What is it? What’s its mechanism, indications and side-effects?

A
  • Omeprazole is a PPI which inhibit gastric acid secretion by blocking the proton pump of the gastric parietal cell.
  • It is indicated for PUD, GORD, Zollinger-Ellison syndrome.
  • Side-effects include GI disturbances and headaches.

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