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Semester 4 (NME) > Drugs > Flashcards

Drugs Flashcards

1
Q

How do NSAIDS have an analgesic effect?

A

Decreased prostaglandin synthesis (e.g. bradykinin)

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2
Q

How do NSAIDS have an anti-inflammatory effect?

A

Decrease in prostaglandin E2 and prostacyclin (PGI2)

- Via COX2 inhibition

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3
Q

How do NSAIDS have an anti-pyretic effect?

A

Prevent IL-1 releasing prostaglandins in the CNS

Normally these prostaglandins elevate the hypothalamic temp set point

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4
Q

Name 4 SE’s of alpha-adrenoreceptor antagonists?

A

Dizziness, postural hypotension, dry mouth, depression

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5
Q

Furosemide (I,M,SE)

A

I: Diuretic (AntihyperT + oedema)
M: Blocks Na/K/2Cl reabsorbtion in ascending loop of Henle
SE: Dehydration, electrolyte imbalance, meta alkalosis

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6
Q

Which types of diuretic are best used in patients with:

a) Impaired renal function
b) Preserved renal function

A

a) Loop (Furosemide, butnetanide, torasemide)

b) Thiazide (Chlorthalidone, bendrofulamethiazide, indapamide)

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7
Q

Name two potassium sparing diuretics?

A

Amiloride and Eplerenone

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8
Q

Bendrofluamethiazide (I,M,SE)

X-thiazide

A

I: Thiazide diuretic (HyperT and odema)
M: Blocks Na/Cl symporter in DCT (increased Na secretion)
SE: Hypokalaemia, postural hypotension, gout

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9
Q

Asprin (I,M,SE)

A

I: Antiplatlet, antipyrexic, antiinflam, analgesic
M: Blocks thromboxane A2, cox-1 (irreversable) and cox-2
SE: GI ulcers, bleeds

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10
Q

Name 4 NSAIDS and 3 NSAID SE’s

A

Ibuprofen, naproxen, diclofenac, asprin

SE: GI ulcers, bleeds, impaired clotting, affects renal blood flow

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11
Q

Against which type of bacteria would penicillin be most effective, what is it’s MoA?

A

Gram +ve

Inhibits peptidoglycan so bacteria can’t make a cell wall

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12
Q

Name 3 side effects of steroids?

A

Inhibtion of bone formation, decreased Ca absorbtion and decreased wound healing

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13
Q

Prazosin (I,M,SE)

A

I: Anti-hypertensive + for BPH
M: Alpha1-adrenoceptor antagonist
SE: Dizziness, postural hyperT,

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14
Q

Doxazosin (I,M,SE)

A

I: Anti-hypertensive + for BPH
M: Alpha1-adrenoceptor antagonist
SE: Dizziness, postural hyperT,

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15
Q

Atropine (I,M)

A

I: Depress PNS (Bradycardia, Pupil dilation, hyperhidrosis)
M: Muscarinic acetylcholine receptor antagonist

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16
Q

Loperamide (I, M)

A

I: Control and relief of diarrhea (Gastroenteritis + IBD)
M: Acts on opoid receptors to slow peristalsis (but does not cross brain so no analgesic)

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17
Q

Ipatropium (I,M)

A

I: Bronchodilator
M: Blocks acetylcholine receptor action (blocks muscarinic receptors)
= Bronchodilation and less mucus secretion

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18
Q

Omeprazole (I,M,SE)

A

I: Ulcers, reflux, heartburn etc
M: PPI (inhibits gastric acid secretion by inhibiting H+/K= ATPase enzyme on parietal cells
SE: Stomach pain, gas

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19
Q

Cimetidine (I,M,SE)

A

I: Ulcers, reflux, indigestion, heartburn
M: Histamine H2 receptor competitive antagonist- On basolateral parietal cell, reducing stim to secrete gastric acid
SE: Tiredness, gynecomastia

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20
Q

Gaviscon (I,M,SE)

OTC

A

I: Heartburn and GERD
M:Uses aluminum hydroxide and magnesium carbonate as antacids
SE: Constipation or diarrhea

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21
Q

Pepto-bismol (I,M,SE)

OTC

A

I: Heartburn, indigestion, nausea, diarrhea
M: Contains bismuth subsalicylate (it’s antacid and bactericidal)
SE: Black tongue/ stools

22
Q

Pancreatin (contents)

A

Enzyme mixed from porcine/bovince pancreas
Contains amylase, lipase and a protease (trypsin)
SE: Diarrhea, skin rash, nausea, stomach pain

23
Q

Which opposing side effects are seen in aluminium and magnesium hydroxides?

A

AlOH: Constipation
MgOH: Diarrhea

24
Q

Fluorouracil (5-FU) - I,M

A

I: Chemotherapy treatmennt
M: Masquerades as a pyrimidine, stopping the cell getting through S phase of cell division so blocks conversion of cytosine and stops incorporation of thymidine into the DNA strand

25
Q

Leucovorin (I,M)

A

I: Antidote to folic acid antagonist chemotherapy (i.e methotrexate)
M: Is a folic acid derivative so provides the needed folate
It also enhances the effect of fluorouracil

26
Q

Peginterferon alfa-2a (I,M)

A

I: Chemotherapy treatment
M: Bind to interferon receptors which upregulate MHC proteins on the cell surface allowing them to be targeted by CD8+ cells

27
Q

Methotrexate (I,M)

A

I: Chemotherapy agent
M: Inhibits folic acid reductase (so inhibits DNA synthesis)

28
Q

Name 7 side effects of methotrexate chemo:

A

Low blood counts, mouth sores, N+V, poor appetite, kidney toxicity, skin rash, diarrhoea, hair loss

29
Q

Propylthiouracil (I, M, SE)

A

I: Hyperthyroidism (incl graves)
M: (central) Inhibits thyroperoxidase enzyme (iodide to iodine) and (peripheral) inhibits 5’ diodinase (converts T4 to T3)
SE: Skin rash/ hair loss/ itch
Rare: Agranulocytosis/ liver failure

30
Q

What is carbimazole and how does it act?

A

It’s a pro-drug

Converted to methimazole

31
Q

Methimazole (I,M,SE)

And its pro-drug carbimazole

A

I: Hyperthyroidism
M: Inhibits thyroperoxidase (Iodide to iodine)
SE: Skin rash/ itch/ hair loss
Rare: Agranulocytosis

32
Q

Propanolol (I.M,SE)

A

I: Antihypertensive/ Angina/ Thyrotoxicosis
M: Bind to B1-adrenoreceptors in the heart, inhibiting sympathetic action (reduce rate/ force)
SE: Fatigue/ cold hands and feet/ disturbed sleep

33
Q

Name a drug which primary acts on the heart which can be used to treat thyrotoxicosis:

A

Propanolol
Reduces tachycardia symptoms but also:
Inhibits 5’-monodeiodinase which converts T4 to T3
(So also lowers active T3 levels)

34
Q

Levothyroxine (I, M, SE)

A

I: Hypothyroidism
M: Levothyroxine acts like the endogenous thyroid hormone thyroxine (T4)
SE: Many but rare

35
Q

What are common SE’s of NSAIDS?

A

Gastric irritation, skin rashes, lowers renal blood flow, prolonged bleeding, and increased risk of thrombotic events (MI/Stroke)

36
Q

What is the MOA of NSAIDS?

A

Inhibition of arachidonic acid oxidation by COX enzymes

37
Q

Most antacids are salts of magnesium or aluminium. Which SE’s relating to motility are caused by each of these?

A

Magnesium hydroxides: Diarrhoea

Aluminum hydroxides: Constipation

38
Q

A single dose of omeprazole will affect gastric acid for roughly how long?

A

2-3 days as it accumulates in the canaliculi and inhibits H+/K+ ATPase irreversibly

39
Q

What are alginates used for?

A

Alginates are added to help protect the lining of the gullet (oesophagus) from stomach acid. Alginates include sodium alginate and alginic acid.

40
Q

When is radioactive iodine used?

A

Thyroid is the only part of the body to uptake large amounts of Iodide (apart from the kidneys). Sodium Iodide (I131) can be used to target the cells of the thyroid gland and reduce it’s size without severely affecting other organs.

41
Q

Metformin (I,M,SE)

A

I: T2DM (lowers blood glucose)
M: Activates AMP-activated protein kinase (AMPK), a liver and muscle enzyme. AMPK causes GLUT-4 translocation to the cell membrane
SE: Lactic acidosis

42
Q

Sitagliptin (I, M, SE)

and all X-gliptin

A

I: T2DM (increase insulin secretion)
M: Inhibits DPP-4 enzyme which degrades incretins such as GLP-1
SE: Hypoglycemia in OD

43
Q

Exenatide (I,M)

and all X-tide

A

I: T2DM (increase insulin secretion)
M: Acts as functional analog of GLP-1 so increases insulin levels

44
Q

Dapagliflozin (I,M, SE)

and all X-gliflozin

A

I: T2DM
M: Inhibits SGLT2 so blocks Na/glu cotransporter re-absorption in prox tubule
SE: UTI risk

45
Q

Gliclazide (I,M,SE)

and all X-azide/ X-amide

A

I: T2DM
M: Binds to ATP dependent K+ channel on pancreatic Bcells to inhibit depolarization and thus insulin granule secretion
SE: Hypoglycaemia/ weight gain

46
Q

Alfa-interferon (I, M, SE)

A

I: Anti-viral (hep C, leukaemia)
M: Interferon alpha binds to T1 interferon receptors which upregulates MHC1 proteins so increased likelihood of immune destruction
SE: Flu like symptx/ fatigue

47
Q

Mannitol (I, M)

A

I: Hypertension/ oedema
M: Increases osmolarity of filtrate in kidney, preventing water re-absorption, sucks fluid from tissue as raises blood osmolarity

48
Q

Spironolactone (I,M)

A

I: Low renin hypertension and hypokalaemia
M: Antagonises aldosterone so increases water/ Na+secretion and decreases K+ secretion

49
Q

Bevacizumab, ranbizumab (I, M)

A

I: Inhibits VEGF-A (treat cancers)
M: Binds with VEGF to prevent interaction with it’s receptors, prevents growth of new BV’s

50
Q

How can thiazide diuretics cause gout?

A

Cause increased urea retension and therefore increased levels of uric acid (can lead to gout)

51
Q

What is cholestyramine used for?

A

Binding bile salts to prevent reabsorption in terminal ileum

Used for itching in obstructive jaundice

Semester 4 (NME) (24 decks)

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